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David Oliver: Vaccination sceptics are immune to debate

BMJ 2019; 365 doi: (Published 22 May 2019) Cite this as: BMJ 2019;365:l2244

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Re: David Oliver: Vaccination sceptics are immune to debate

Whether or not I qualify for David Oliver’s “vaccine sceptic” label, I can assure him that “ vaccine positivists “ (to extend his terminology to embrace those who seem happy with the status quo) may be no better at communicating in debate, than are those “sceptics” he finds fault with.
Oliver may be aware that in the past eighteen months about 100 copies of three well referenced books on vaccination science and controversies were sent to senior doctors, legislators, and other vaccine cognoscenti, in an attempt to stimulate debate. Four or five were acknowledged. (1)

The questions posed by Oliver in his follow up response (2) seem to require answers “ ... from those campaigning against vaccination...“. Oliver’s choice of words rules out most contributors to this on line discussion, who are concerned to encourage an informed debate on the safety and effectiveness of vaccines, not to eliminate their use.
Oliver raised some similar points last year, (3) and I attempted straightforward replies, (4).
He did not comment.
He and like minded colleagues have regular access to the BMJ print edition. Others, who raise uncertainties about vaccination, are sometimes labelled as ‘anti vaxx’ in those pages, where we are not granted space to justify our unease. We remain grateful to the BMJ for on line access.

The essential medic-legal issue is surely the need for every patient or parent in the UK to be provided with sufficient information on the effectiveness, safety and possible side effects of vaccines, so that they can give fully informed consent.

I make no excuse for repeating, yet again, this necessary professional duty, which is part of UK law. (5)

Has Oliver, or have any of his like minded colleagues, acknowledged that they are aware of the necessity of gaining fully informed consent, in these post Montgomery times, and of the consequences of not doing so ?

The Patient information Leaflets (PILs) for vaccines describe possible rare, serious side effects. eg. The Guillain-Barre syndrome. (6) If these are not discussed, and the child is affected by such an alleged adverse event, the courts have demonstrated that neglecting the Montgomery decision in clinical situations will be punished - to the tune of £4.4million damages - in a case last year. (7)

I am not aware of any comment on this case, from the JCVI, the RCGP, nor PHE, whose ‘Green Book’ on immunisation in primary care continues to quote the Bolam case, and not the Montgomery decision, in its chapter on liability. (6)
It is four years out of date.
Similarly, I am not aware of comments on the seeming conflicting interests of the chairperson of the JCVI I raised in a rapid response. (8)
Are such conflicting interests consistent with the impartial role of the JCVI ?

In view of Oliver’s professed trust in such expert bodies, he may wish to comment ?

How many parents are given the PILs to read carefully, as the PIL heading requests ? How many doctors are cognisant of the rare but real risks of adverse effects, and how many are knowledgeable enough to put the risks in context ?
How many doctors explain to parents, the practice’s financial interest in achieving high vaccination rates ?

If we cannot give confident positive answers on these points, the tendency of Oliver, his colleagues, and the WHO to concentrate attention on “vaccine hesitancy" seems very strange, when such central concerns go unaddressed.

My concern is to make our profession more aware of the need for informed consent, post -Montgomery, and of the need for us to be well informed on all aspects of vaccine use.
At the BMJ, informed consent for vaccination seems to arouse little interest.
The BMJ recently left unreported the 30 year failure by the USA HHS, to perform its statutory governance role regarding the vaccine industry. (9)
Very relevant to the UK, is it not ?
Attempting to debate the role of vaccination in the northern hemisphere is more difficult because many serious students of vaccination seem unaware of the research of Thomas McKeown, later confirmed by others, showing that the morbidity and mortality from common infectious diseases had fallen almost to zero before the widespread use of antibiotics and vaccines. (10)










10 Thomas McKeown. The Role of Medicine. Nuffield Provincial Hospitals Trust. 1976.

Competing interests: No competing interests

28 May 2019
Noel Thomas
retired / part time GP
Bronygarn, Maesteg, Wales CF34 9AL