Philippines halts dengue immunisation campaign owing to safety risk
BMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j5759 (Published 12 December 2017) Cite this as: BMJ 2017;359:j5759
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Doctor Anand's note is a cri de coeur....I agree with him, and remind him of the Tar Baby in the Uncle Remus story: conscientious critics of vaccine authorities are like Br'er Rabbit; the authorities are like the Tar Baby, mute and unresponsive to any criticism of vaccines, however well supported ethically or scientifically....All we can do is keep plugging away at the truth, courtesy of the good offices of the BMJ, and hope that no one throws us into the Briar Patch....Happy Holidays!
Competing interests: No competing interests
Dr Cunningham's rapid response does raise the question: Is Dr Cunningham mistaken? Or, is he right?
Will the distinguished public health experts drawing a salary from the tax-payer funded NHS come out of hiding and argue with Dr Cunningham, prove him wrong?
Dr Cunningham has thrown down the gauntlet. If you don't pick it up, the readers must conclude that our vaccination advocates are lacking in knowledge.
Competing interests: No competing interests
The Phillipine Dengvaxia scandal continues to unfold (NYT, WSJ, CIDRAP 12/18/17).....Meanwhile it reminds us that influenza vaccines also increase the risk of illness via "antibody-dependent enhancement" of infection: some vaccines evoke antibodies that are poorly matched to circulating viruses; instead of neutralizing the viruses these antibodies enhance uptake of the viruses via Fc receptors on mononuclear phagocytes, which then manufacture large numbers of virus, leading to severe illness. This seems counterintuitive, but the phenomenon is quite real. In the third year of a randomized trial the risk of hospitalization from a dengue infection was 5-fold in young vaccine recipients. (Hadinegoro, NEJM 2015;373:1195. Halstead, Am J Trop Med 6/8/16).....ADE helps account for the fact that the 2008-9 flu shot doubled the risk of illness from the 2009 H1N1 pandemic flu (Skowronski, PLoS Medicine 2010); the increased H1N1 illness risk in US children associated with the 2015-16 nasal flu vaccine (Jackson, NEJM 2017) ; and the 68% increase in H3N2 illness risk among UK elderly after the 2016-17 flu shot (Pub Health England 8/31/17).
Recent announcements that the 2016-17 flu shot was "only 10% effective " against H3N2 in Australia concealed the possibility that it increased the risk in the elderly by as much as 160%!! (VE minus 20%; minus 160 to 42). (Paules, NEJM 11/29/17. Sullivan, Euro Surveill 10/2617)
Influenza deaths do occur in vaccinated individuals, and some are likely the result of antibodies that enhance infections instead of neutralizing them. This is particularly worrisome as we wait for the next pandemic, possibly from the H7N9 virus that has emerged in China. (Skowronski, Euro Surveill 4/25/13)....Finally, one of the obstacles to the development of a universal influenza vaccine is the very real possibility of provoking ADE. (Jang, Viruses 2014;6;3159. Dutry, BMC Proceedings 2011; 5:suppl 1:P62)
Competing interests: No competing interests
Re: Philippines halts dengue immunisation campaign owing to safety risk
Anand challenges our UK Public Health experts to respond to Cunningham’s observations about Dengue vaccine, which in turn give rise to further concerns about flu vaccination.
I admire their perseverance, but I fear that they are unlikely to be rewarded, soon, with any meaningful response.
It has been impossible to have an open, informed discussion about the safety and effectiveness of vaccinations in recent years.
Journalists and commentators in the public media know that to mention vaccines in anything but a positive light may lose them their jobs, such is the financial power of the vaccine industry, exercised through the placing, or not, of pharma advertising in media outlets.
In professional journals like the BMJ, polite scepticism of the vaccine industry is allowed on Rapid Responses, but the contagion is kept away from your print issue.
After Anand’s recent call for a debate about the possibility of mandatory vaccination being enforced on the UK (1), the interesting responses that followed did not include a single attempt to support the way our current vaccination programme is presented to the public, and certainly no voice was raised in support of mandatory vaccination. (2)
The vaccine industry accords it’s critics as much respect as a mosquito enjoys on a rhino’s hide. The birds on a rhino’s back eat mosquitos, just as media owners would dismiss any out spoken journalist.
When any vaccination procedure is contemplated, the interests and well being of the person to be vaccinated should be paramount.
He or she, or a child’s parents, must be given sufficient information about safety and effectiveness to enable them to give, or decline to give, their informed consent, be it to Dengue, flu or any other vaccine.
Does this happen ?
If it does not happen, as many observers of the vaccine scene believe, perhaps it is time that the BMJ, staffed with editors to promote and protect patients’ interests, provides space for an informed debate in it’s print edition.
What better example could there be, in 2018, of the BMJ’s concern for the well being of people, everywhere ?
1 http://www.bmj.com/content/358/bmj.j4100/rr-1
2 http://www.bmj.com/content/358/bmj.j4100/rapid-responses
Competing interests: No competing interests