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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

There can be no defence for any party spreading or contributing to “unreliable, misleading and unscientific information on vaccination.” But nor can there be a defence for any party over simplifying the situation and categorically stating that licensed vaccines “are safe”, as the resolution does.

Dr John Clements, a vaccine safety expert at the World Health Organisation was quoted by Lord Clement Jones as has having said that “there is no perfectly safe or completely effective vaccine but we all benefit from them”. (1) The WHO website states realistically that “there is no such thing as a "perfect" vaccine which protects everyone who receives it AND is entirely safe for everyone”.(2)

The Parliamentary Office for Science and Technology (POST, June 2004, Number 219) publication states that, “as with any other medical intervention, vaccination is not entirely free from risk. All vaccines may have some adverse effects.”(3)

Against that backdrop one has to wonder how the MEP’s could evidence the fact that licensed vaccines “are safe”.

The rigorous testing and “multiple phase trials” they refer to are not infallible either, as evidenced by the serious adverse reactions uncovered following the marketing of the Urabe mumps containing brands of MMR vaccine in the 1980’s and more recently the Pandemrix vaccine.

In both circumstances the serious adverse events which resulted in their removal from use were not detected in the clinical trials prior to them entering the market. In the case of Urabe, subsequent post marketing surveillance failed to detect the scale of the problem with POST later stating in 1995 that the Urabe problem was “exacerbated by the failure of the Yellow Card surveillance system to detect the scale of the problem” (4)

More recently, a number of individuals suffered cataplexy and narcolepsy following administration of the Pandemrix vaccine with neither condition being detected in the pre marketing clinical trials or reported on in the subsequent studies to evaluate the safety and tolerability of the vaccine in children 6 months to 12 years of age in the UK population. (5)

In the case of Pandemrix, a number of claims alleging a link between the vaccine and narcolepsy have recently been awarded a payment by the Vaccine Damage Payment Scheme in the UK. (6)
These payments would not have been made had the assessors not been satisfied that on the balance of probability, the claimants had established that the vaccine was the cause of the condition.

MEP’s in tackling what they see as “the worrying phenomenon of vaccine hesitancy” would do well to learn from experience and abandon the age old approach of categorically asserting as fact, that all vaccines are safe. Referenced and reliably sourced material in the public domain evidences the fact that this is not always the case.

They would be of greater service to the communities they serve if, whilst promoting vaccination in a positive light, they were to adopt a more realistic, open and transparent approach to the subject. They would do well to legislate for safer vaccines, more extensive clinical trials and studies prior to licensing with a robust and very sensitive heightened post marketing surveillance system to instantly detect any adverse reactions (which might not have been detected in the trials due to the size of the cohort) and respond immediately with the removal of the product from the market for further investigation. All too often reports of adverse events are dismissed as being in line with what was statistically expected and not indicative of a serious problem or denied altogether on the argument that there is no evidence of causation. Acknowledgements of adverse events in hindsight (sometimes many years later) are of no consolation to the victims.

The implementation of compensatory schemes to provide payments to all vaccine damaged recipients, irrespective of level of disablement, where a link is established, would provide a reassurance that in the event that something does go wrong, financial help and support is available to the victims and their families. Such payments cannot turn the clock back or restore to the individual what they have lost through vaccination but are essential to meet the needs of the disabled person and their families in coping with the difficulties they now encounter in their daily lives. The current practice which exists in the UK whereby assessors can concede that the individual is vaccine damaged but not to the extent required so as to qualify for a payment, has no place in a caring society and is unlikely to encourage people to view vaccination favourably.

MEP’s cannot be ignorant of the reasons why vaccine hesitancy exists in their communities and they cannot realistically place all the responsibility for it on unreliable and misleading information being relayed by the media.

They, more than any other group are excellently placed to initiate change and restore confidence in vaccination but it will require a lot more than a blanket assurance of vaccine safety to achieve it.

In view of the quotes from the vaccine safety expert, Dr Clements, the WHO, POST and others, is there not a case for questioning whether or not the resolution is guilty of spreading “unreliable, misleading and unscientific information on vaccination” if it states absolutely that licensed vaccines are safe?.

(1) https://publications.parliament.uk/pa/ld199900/ldhansrd/vo000628/text/00... Column 982

(2) http://www.who.int/vaccine_safety/initiative/detection/AEFI/en/

(3) POST June 2004 Number 219

(4) POST 66 July 1995

(5) http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?ID=32010001172

(6) https://www.narcolepsy.org.uk/resources/pandemrix-narcolepsy

Competing interests: No competing interests

01 April 2018
WENDY E STEPHEN
Retired Nurse
Stonehaven, Scotland