Re: How to spin a vaccine study?
"bigvince" <Vince.Miraglia@gmail . com > wrote in message
news:1193956946.480434.169240@k79g2000hse.googlegroups . com ...
> Tuesday, July 17, 2007
> Research on Hib vaccine 'dubious'
> This amazing letter documents the skewed and often bogus data vaccine
> researchers generate to get a vaccine approved for use.
The vaccine was approved for use in most countries long before the present
study was published (it also suggests a 90% reduction in cases of
Haemophilus meningitis, but that doesn't get a mention). The approval was
properly based on well-designed randomised controlled trials, which this
trial is not.
Case control studies like this are less reliable in determining vaccine
efficacy, but presumably intended to give some idea how cost-effective the
"real world" use of such vaccines will be in underdeveloped countries where
there is otherwise not much information about the incidence and morbidity
of the conditions that the vaccine prevents.
There will always be some subjectivity in judging when a vaccine is
worthwhile and where scarce resources will be best spent. I don't think
anyone here including myself can make that judgment on this information.
PM
> Congratulations to Dr. Puliyel for having the courage to correct the
> journalist's mistake and kudos to the Editor for printing his letter.
>
> Dr. Sherri
> +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
> Letter to the Editor:
>
> I was quoted in the Hib vaccine news story from 4 July (see Hib
> vaccine could save thousands in Asia), but perhaps due to constraints
> of column space, I feel justice was not done to what I said.
>
> My main argument against the research findings from Bangladesh is not
> that it does not make economic sense, but that the study is seriously
> flawed. The visible enthusiasm of the sponsors of the study must not
> be allowed to cloud scientific objectivity.
>
> In the study, cases of pneumonia were compared with a control group
> without pneumonia. Because more children in the control group received
> the Hib vaccine, the researchers considered the vaccine to prevent
> pneumonia. But closer reading of the paper suggests that the Hib
> vaccination status in the control children was only coincidental.
>
> The control children were significantly richer, lived in better houses
> and their mothers were better educated. With their greater affluence,
> more children in the control group probably wore branded T-shirts, but
> we would not expect Nike or Reebok to suggest that wearing their
> apparel is protective against pneumonia.
>
> Where starvation and cholera kill thousands of children each year,
> international agencies such as the GAVI Alliance, USAID and the WHO
> are busy spending millions on dubious research to emphasise the harm
> from a disease that local doctors hardly ever come across. All this so
> that vaccine manufacturers can fill their coffers. This situation can
> only be described as scandalous. It is unfortunate that five resource
> poor countries -- Afghanistan, Bangladesh, Bhutan, Pakistan and Sri
> Lanka -- have been persuaded to undertake the expensive intervention on
> the basis of flawed research.
>
> Jacob M Puliyel, M.D.
> Head of Paediatrics
> St Stephens Hospital
>
> * sayingnotovaccines.blogspot . com /2007/07/research-on-hib-vaccine-dubious.html
>