Intended for healthcare professionals

Rapid response to:

Editor's Choice

We can change practice—can we also change culture?

BMJ 2019; 364 doi: (Published 10 January 2019) Cite this as: BMJ 2019;364:l108

Rapid Response:

Re: We can change practice—can we also change culture?

Dear Editor

This has been a most instructive correspondence [1] and doctors may in the near future have to consider what rational advice they can give to members of the pubic regarding a plethora of new products just a few months in development, some involving entirely new technologies. Reuter’s recently reported the words of a Trump administration official [2] :

“The fine line we are walking is getting the American people very excited about vaccines and missing expectations versus having a bunch of vaccines in the warehouse and not as many people want to get it...You may not hear a lot about promoting vaccines over the airwaves in August and September but you’ll be overwhelmed by it come November.”

The danger is, of course, that health policy is being driven for political ends and we may be about to see the first vaccine election. Also, being “excited” is no way to approach Informed Consent (supposing the vaccines are not mandated).

Likewise, in a recent House of Commons answer [5 August], Jo Churchill, Parliamentary Under Secretary for Health and Social Care told Scottish National Party Member Allan Dorans [3]:

"It is vital that a significant proportion of people who are offered take up a COVID-19 vaccine in order to protect themselves as well as other vulnerable individuals. However, there are no plans at present for a COVID-19 vaccine to be mandatory as the Government operates a system of informed consent for vaccinations."

It is interesting that the minister states this without knowing either how the disease will develop or even the limited safety and effectiveness profiles we are likely to have for any of the products if by any chance any are licensed in time to make any difference (which should not be assumed). Meantime, while the assurance about retaining Informed Consent will be hugely welcome to a lot of people it should also be noted that offering a choice to the public is one means by which the British government might escape direct liability for potential harm.

[1] Responses to Fiona Godlee, 'We can change practice—can we also change culture?',

[2] Carl O’Donnell, ‘ U.S. government to launch 'overwhelming' COVID-19 vaccine campaign by November’ Reuter’s 30 July 2020,


Competing interests:, an on-line daily journal, concerns itself with the potential environmental sources for the proliferation of autism, neurological impairment, immune dysfunction and chronic disease. I receive no payment as UK Editor

13 August 2020
John Stone
UK Editor
London N22