Intended for healthcare professionals

Rapid response to:


Misconceptions about the new combination vaccine

BMJ 2004; 329 doi: (Published 19 August 2004) Cite this as: BMJ 2004;329:411

Rapid Response:

Misconceptions about misconceptions

According to vaccine experts, doubts about vaccination programmes
cannot be based on more than “misconceptions” (BMJ 21 Aug, 411). Let’s try
to demonstrate that in this field the distribution between “myth” and
“reality” is not so univocal.

On the side of myths, there is a growing awareness that guidelines
are governed by more than scientific evidence [1], whereas experience
gives no reason to believe that vaccine experts, who make recommendations
on vaccine programmes, are above conflicts of interests (BMJ 21 Aug, 417).
On the other hand, when published papers on vaccine safety contain such
gross inconsistencies [2] that even a body not suspect of any hostility
against vaccination (French Agency, Feb. 2000 report) is forced to admit
that they should be “discarded”, one would appreciate more than a
“personal communication” to be reassured about the success of a vaccine.

On the side of reality, it is not only “ignorance” [3] that inclines
scientists to worry about vaccination as “an additional player in the
mosaic of autoimmunity” [4] and to put this risk in perspective with the
appalling quality of most safety trials on vaccines… This is another
reality that a combination vaccine largely marketed in Europe was rejected
by the FDA due to efficacy and safety concerns (SCRIP 2001; No 2625: 22).
Another reality, again, that, as a manufacturer, Aventis has a regrettable
tendency to repeated production problems, esp. with its vaccines [5].
Editorial limitations on Letters make it impossible to give references on
other very sad realities: e.g. that WHO’s records on infections may be
more consistent with manufacturers interests than with epidemiological
evidence, or that it is despairingly difficult to publish even in major
journals to correct with all due documentation inaccurate reports from
vaccine experts.

1. Raine R, Sanderson C, Hutchings A, Carter S, Larkin K, Black N. An
experimental study of determinants of group judgments in clinical
guidelines development. Lancet 2004; 364: 429-437

2. Zipp F, Weil JG, Einhaupl KM. No increase in demyelinating diseases
after hepatitis B vaccination. Nature Medicine 1999; 5:964-5

3. Begg N, Nicoll A. Myths in medicine – Immunisation. BMJ 1994; 309: 1073

4. Shoenfeld Y, Aharon-Maor A, Sherer Y. Vaccination as an additional
player in the mosaic of autoimmunity. Clin Exp Rheumatol 2000; 18: 181-184

5. Girard M. Vraies terreurs et fausses pénuries. Moniteur des Pharmacies
2004 ; No 2544 : 24

Competing interests:
Dr Girard is an independent consultant working for pharmaceutical firms (including vaccines manufacturers) as well as a medical expert witness in charge of reports in the setting of civil or criminal inquiries on vaccines.

Competing interests: No competing interests

31 August 2004
Marc Girard
1 bd de la République 78000-Versailles (France)