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Is the timing of recommended childhood vaccines evidence based?

BMJ 2016; 352 doi: https://doi.org/10.1136/bmj.i867 (Published 23 February 2016) Cite this as: BMJ 2016;352:i867

Rapid Response:

Re: Is the timing of recommended childhood vaccines evidence based?

In the ‘yes’ argument of this article, Edwards, Maldonado and Byington refer to “the introduction of maternal tetanus, diphtheria, and acellular pertussis (Tdap) vaccination to reduce pertussis among infants in the US and many European countries”. The inference is that maternal Tdap vaccination is reducing pertussis in infants, and the ‘evidence’ they provide is a single reference to an observational study published in The Lancet in 2014, currently behind the paywall. I suggest this is a very poor example of ‘evidence’. At this stage we have no idea of the long term consequences of Tdap vaccination of pregnant women.

Edwards et al do not allude to the emerging problems with pertussis vaccination i.e. that the apparently defective acellular pertussis vaccine may actually be causing new strains of the disease to develop[1], and spreading the disease via vaccinated individuals.[2]

The response to the emerging problems with acellular pertussis vaccination has been to recommend ‘boosters’, e.g. A/Professor Ruiting Lan of the University of New South Wales says: “We need to look at changes to the vaccine itself or increase the number of boosters.”[1]

The question is, how does increasing the number of ‘boosters’ of the current acellular pertussis vaccine protect against new strains?

Repeated revaccination with the apparently defective acellular vaccine is now being foisted upon the community. I question whether it is ethical to (a) not properly inform citizens about the uncertainties surrounding pertussis revaccination, and (b) to implement vaccination laws (as in Australia for instance[3]) which coerce parents to have their children repeatedly revaccinated with the questionable diphtheria, tetanus and acellular pertussis vaccine product (DTPa).

In Australia the National Immunisation Program Schedule[4] now stipulates that children be vaccinated six times with the aluminium-adjuvanted combination diphtheria, tetanus and acellular pertussis vaccine product, i.e. primary vaccination at two months, four months and six months, then so-called boosters i.e. revaccination at 18 months, four years, and again between 10-15 years.

And it doesn’t stop there… As well as pregnant women, household contacts of infants and healthcare workers are also being urged to be revaccinated again and again with the diphtheria, tetanus and acellular pertussis vaccine[5], in other words lifelong revaccination with this vaccine product.

What is the point of imposing more and more so called ‘boosters’ with an apparently defective acellular pertussis vaccine product which may be causing new strains of the disease to develop, and spreading the disease via vaccinated individuals? What sort of science is this? The so-called vaccination experts seem to be making this up as they go along, and using the community as guinea pigs, without informed consent.

Certainly repeated revaccinations/’boosters’ must be a very lucrative profit centre for vaccine manufacturers.

References:
[1] See for example: Sharp rise in cases of new strain of whooping cough. UNSW Newsroom. 21 March 2012: http://newsroom.unsw.edu.au/news/health/sharp-rise-cases-new-strain-whoo...
[2] See for example: FDA study helps provide an understanding of rising rates of whooping cough and response to vaccination. FDA News Release, 27 November 2013: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm376937.htm and Jason M Warfel et al. Acellular pertussis vaccines protect against disease but fail to prevent infection and transmission in a nonhuman primate model. PNAS, 22 October 2013: http://www.pnas.org/content/111/2/787.full.pdf
[3] No Jab, No Pay – New Immunisation Requirements for Family Assistance Payments. Australian Government Department of Health. Fact sheet for vaccination providers. November 2015: http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Conte...$File/No-Jab-No-Pay.pdf
[4] Australian National Immunisation Program Schedule (From February 2016): http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Conte...$File/NIP-schedule2016.pdf
[5] 4.12.7 Recommendations. Pertussis. The Australian Immunisation Handbook, 10th edition: http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Conte...

Competing interests: No competing interests

29 February 2016
Elizabeth M Hart
Retired
Adelaide, South Australia