эпидемия вакцинации - 2

[eugenegp]

Tom Jefferson выступил в British Medical Journal с призывом придти в себя и привести политику вакцинации от гриппа в соответствие с имеющимися научными данными. Джефферсон - один из руководителей секции Cochrane по изучению вакцин. Изображать, что он - городской сумасшедший, будет тяжеловато. Смысл заявления простыми словами - например, в Гардиан.

"There is little clinical evidence that the vaccines have an effect on things like hospital stay, time off work, death in healthy adults or even those with conditions like asthma and cystic fibrosis, he said.
Vaccines given to children under the age of two have the same effect as if they were given a dummy drug, he added."

("Практически отсутствуют клинические доказательства того, что вакцины влияют на такие вещи, как продолжительность пребывания в больнице, больничные, смертность - что у здоровых взрослых, что у тех, кто страдает астмой или кистозным фиброзом. Для детей в возрасте до двух лет эффективность вакцин такая же, как у плацебо")

Тем временем в Барнауле:
http://www.altinformburo.ru/index.php?option=com_content&task=view&id=416&Itemid=51
На вскрытии - обширный инфаркт. Что они ищут на вскрытии? Перефразируя theoretik - записку "В моей смерти прививку прошу не винить"? :(

В самой статье в BMJ Джефферсон делает такие небезынтересные для медика замечания:


The large gap between policy and what the data tell us (when rigorously assembled and evaluated) is surprising. The reasons for this situation are not clear and may be complex...

Another reason may be "availability creep." In their efforts to deal with, or be seen to deal with, policy makers favour intervention with what is available—registered influenza vaccines. A similar philosophy is the "we have to make decisions and cannot wait to have perfect data" approach. This attitude may have an altruistic basis but has two important consequences. Firstly, it uses up resources that could be invested in a proper evaluation of influenza vaccines or on other health interventions of proven effectiveness. Secondly, the inception of a vaccination campaign seems to preclude the assessment of a vaccine through placebo controlled randomised trials on ethical grounds. Far from being unethical, however, such trials are desperately needed and we should invest in them without delay. A further consequence is reliance on non-randomised studies once the campaign is under way. It is debatable whether these can contribute to our understanding of the effectiveness of vaccines. Ultimately non-randomised designs cannot answer questions on the effects of influenza vaccines

The optimistic and confident tone of some predictions of viral circulation and of the impact of inactivated vaccines, which are at odds with the evidence, is striking. The reasons are probably complex and may involve "a messy blend of truth conflicts and conflicts of interest making it difficult to separate factual disputes from value disputes" or a manifestation of optimism bias (an unwarranted belief in the efficacy of interventions).

"Availability creep" - это хорошо сказано...

Comments

[antanian.livejournal.com]

"Пятимесячная девочка в Лидском районе погибла от прививки?"
http://www.lida.info/modules.php?name=News&file=view&news_id=541

[eugenegp.livejournal.com]

Vaccines expert queries value of flu jabs

Staff and agencies
theguardian.com, Friday 27 October 2006 15.12 BST

An expert today cast doubt on the clinical effectiveness of seasonal flu jabs, questioning whether they were worth the millions of pounds the government is spending on them this year.

The Department of Health has ordered 15.2m doses for across the UK, some 1m more than last year. The cost of the vaccinations in England alone will be more than £150m, plus £1.5m spent on advertising.

However, Tom Jefferson, coordinator of the vaccines field at the Cochrane Collaboration, which independently reviews healthcare provision, called for an urgent re-evaluation of such campaigns.

Writing in the British Medical Journal (BMJ), he said the effectiveness of vaccines was compromised by the fact that influenza viruses mutated and varied from year to year.

Dr Jefferson said there was little clinical evidence that the vaccines had any effect on length of hospital stay, time taken off work or the likelihood of death in adults, regardless of whether people were otherwise healthy or already had conditions such as asthma and cystic fibrosis.

Vaccines given to children under the age of two had the same effect as a placebo, he said.

However, the Department of Health questioned his judgments. The department's director of immunisation, Dr David Salisbury, told the Daily Telegraph: "We know that flu vaccines can give up to 70% to 80% protection against infection."

Dr Salisbury said flu vaccines were the best way to protect against influenza, and that this was why countries around the world used them to protect vulnerable communities.

Dr Jefferson urged scientists to study the precise effects of vaccines, and described most studies as being of poor quality. There was little comparative evidence on the safety of the vaccines, he said.

Policy makers, "in their efforts to deal with, or be seen to deal with" a situation, favoured action with what was available: flu vaccines.

The difficulty in distinguishing between flu and flu-like illness added to the confusion, with some illnesses listed as flu that were not, he said.

He wrote: "The large gap between policy and what the data tell us (when rigorously assembled and evaluated) is surprising.

"The reasons for this situation are not clear, and may be complex. The starting point is the potential confusion between influenza and influenza-like illness, when any case of illness resembling influenza is seen as real influenza, especially during peak periods of activity.

"Some surveillance systems report cases of influenza-like illness as influenza without further explanation.

"This confusion leads to a gross overestimation of the impact of influenza, unrealistic expectations of the performance of vaccines and spurious certainty of our ability to predict viral circulation and impact."

But the flu vaccination provider Doctorcall responded to Dr Jefferson's arguments by pointing to studies that found flu vaccination to be effective. It warned people thinking of getting an injection not to jump to "hasty decisions".

Doctorcall's medical director, Dr Charles Levinson, said: "It is essential that those who require a flu vaccination do not panic as a result of this announcement and ask their GP or medical adviser for advice rather than jumping to any hasty decisions."

Earlier this month, there were fears that vulnerable people in the UK may have to wait for flu jabs after the government confirmed that stocks would arrive late.

The injection is given to high-risk groups first, including the over-65s, people with respiratory conditions, such as asthma, and those with chronic conditions including diabetes.