For healthcare professionals only

News

MEPs devise strategy to tackle vaccine hesitancy among public

BMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k1378 (Published 23 March 2018) Cite this as: BMJ 2018;360:k1378

Re: MEPs devise strategy to tackle vaccine hesitancy among public

The US Supreme Court described vaccines as “ unavoidably unsafe products “ in 2011 (1), Seven years on, many of your readers may need reminding of that judgement, although the responses from John Stone and Vinu Arumugham point to the need for even greater alarm, especially when we read that the European parliament’s recent resolution states that “ Licensed vaccines ... are safe “.

The European parliament, we are also told “..urges governments and the European Commission to combat this misinformation by developing awareness and information campaigns to increase vaccination coverage. In particular these should target physicians, “underlining their obligations, including providing patients (or patients’ legal guardians) with sufficient information about recommended vaccines so that they can make an informed decision.”

A fully informed decision before vaccination is all important, to allow what is an invasive procedure. When I suggested six months ago, that “GPs are often not fully aware of the safety concerns around vaccination, and that GPs are often unaware that they may have serious gaps in their knowledge, which prevent them fulfilling their duty to obtain valid informed consent, prior to vaccination,” (2) no one dissented from, nor qualified, my statement.
Published advice from the Medical Defence Union makes it clear that doctors should explain in detail all the safety concerns around treatments and procedures, particularly so since the Montgomery judgement. (3)

If the UK presently has such a dysfunctional consent process, relating to vaccination, as I have suggested, why is it so ?
GPs depend on advice from the Joint Committee on Vaccination and Immunisation, (JCVI ) re the NHS vaccination schedule, and receive a financial bonus if they meet high child vaccination targets.
Is this situation conducive to a disinterested, comprehensive exchange of information between all parties, ensuring fully informed consent, or dissent, to vaccination ?
Is such an exchange possible when one party has a financial incentive to see the vaccination proceed ? A financial incentive that the other party to the discussion may not be made aware of.

What of the concerned parent, who may seek out information prior to their child or teenager’s vaccination ?
The Oxford Vaccine Group, based at the University of Oxford’s Dept of Paediatrics, has on it’s website details of it’s Vaccine Knowledge Project, which “ is designed to help people make informed decisions about vaccine issues. “ (4)
Parents’ uncertainty about the HPV vaccine, for instance, may be reduced when they read, on that website, that “ In clinical trials, the vaccine was over 99% effective at preventing cancer caused by HPV types 16 or 18 in young women, and it is expected that vaccination will reduced the number of cases of the most common kind of cervical cancer by at least 70%.“
Where is the clinical trial evidence for this remarkable assertion ? The trials would need to have lasted for decades.

Their final paragraph about the HPV vaccine, “ Is the vaccine safe” makes light of the risk of serious side effects, and links readers to an MHRA 2012 report, which concluded of Gardasil “ ..it’s safety profile is well established .”
Concerned parents might draw a very different conclusion, if they read the details of serious side effects and deaths, following HPV vaccination, recorded on the up to date WHO website, as well as Hinks’ significant comments on the MHRA. (5,6)
It is interesting that Professor Andrew Pollard is the leader of the Oxford Vaccine Group, as well as being Chairperson of the JCVI.
If the process of gaining fully informed consent to vaccination is as essential as the European parliament, and many of us, believe, and if that process involves a comprehensive account of possible side effects and risks, is Professor Pollard not in an ambivalent position ?
Particularly when the minutes of recent JCVI meetings show that he is involved with, amongst others, the Gates Foundation, GAVI, and the European Medicines Agency ?
A discussion about fully informed consent for vaccination in the UK, is essential, now.

1 https://www.supremecourt.gov/opinions/10pdf/09-152.pdf
2 https://www.bmj.com/content/358/bmj.j4100/rr-8
3 https://mdujournal.themdu.com/issue-archive/issue-4/informed-consent-a-y...
4 https://www.ovg.ox.ac.uk/research/vaccine-knowledge-project
5 https://www.bmj.com/content/358/bmj.j3414/rr-22
6 https://www.bmj.com/content/358/bmj.j3414/rr-13
7 https://www.jostrust.org.uk/sites/default/files/minute_2017_10_draft.pdf

Competing interests: No competing interests

29 March 2018
Noel Thomas
retd/ part time GP
BronyGarn, Maesteg, Wales CF34 9AL