Intended for healthcare professionals

Letters Covid vaccine efficacy

Money, market, media, and vaccine nationalism in the pandemic era

BMJ 2021; 372 doi: (Published 05 March 2021) Cite this as: BMJ 2021;372:n630
  1. Padmanabhan Badrinath, consultant in public health medicine and associate clinical lecturer12
  1. 1Directorate of Public Health, Endeavour House, Suffolk County Council, Ipswich IP1 2BX, UK
  2. 2University of Cambridge, Cambridge, UK
  1. p.badrinath{at}

The BMJ reports preliminary efficacy data from the phase III trial of the Novavax vaccine.1 In this pandemic era, the rules of scientific publication and peer review have been rewritten, and important studies are reported not through peer reviewed publications but through press releases to the market. This is true for both Novavax2 and Johnson & Johnson3 vaccines, which have the potential to make money for shareholders or increase investment. Novavax proclaimed: “NVX-CoV2373 is the first vaccine to demonstrate not only high clinical efficacy against covid-19 but also significant clinical efficacy against both the rapidly emerging UK and South Africa variants.” Words such as “spectacular” and “extremely encouraging” also feature in the release. Johnson & Johnson declared “protection against severe disease across geographies, ages, and multiple virus variants, including the SARS-CoV-2 variant from the B.1.351 lineage observed in South Africa.” Given the grave concerns about the emergence of new variants, it is unsurprising that these releases attracted media attention.4

In the early stages of the pandemic, I cautioned against abandoning the “Ingelfinger rule,”5 which originally stipulated that the New England Journal of Medicine would not publish findings that had been published elsewhere, in other media or in other journals. The rule upholds high standards of scientific publication and integrity. The difficulties in interpreting and understanding covid-19 research and publications have been discussed in detail.6

The pandemic has also given rise to the phenomenon of vaccine nationalism with countries clamouring for vaccines for their population and threatening export bans.7 I would like to draw the attention of authors and editors to the importance of adhering to high standards in their research and publishing the findings,8 which will help us disseminate good quality peer-reviewed research benefiting the population and communities we are here to serve and protect.


  • Competing interests: PB works in a local authority public health department and leads the local specialist COVID response team. The views expressed here are his personal view and in no way represent the views of his employer, Suffolk County Council.

  • Full response at:

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