Conflicts of interest in vaccine safety research

7 Mar

When this abstract came out I had hopes, vain hopes, that it wouldn’t get discussed much online. It’s perfectly reasonable to discuss issues surrounding conflicts of interest in vaccine safety research, but the author has a track record of less-than-excellent publications. Prof. DeLong wrote A positive association found between autism prevalence and childhood vaccination uptake across the U.S. population, which was discussed here at Left Brain/Right Brain, Neuroskeptic and The Biology Files (to name a few). Again, not an excellent study.

Here is the abstract of the new paper:

Conflicts of interest (COIs) cloud vaccine safety research. Sponsors of research have competing interests that may impede the objective study of vaccine side effects. Vaccine manufacturers, health officials, and medical journals may have financial and bureaucratic reasons for not wanting to acknowledge the risks of vaccines. Conversely, some advocacy groups may have legislative and financial reasons to sponsor research that finds risks in vaccines. Using the vaccine-autism debate as an illustration, this article details the conflicts of interest each of these groups faces, outlines the current state of vaccine safety research, and suggests remedies to address COIs. Minimizing COIs in vaccine safety research could reduce research bias and restore greater trust in the vaccine program.

The introduction to the paper starts with “How safe are vaccines?” This for a paper whose purported subject is “Conflicts of interest in vaccine safety research”.

I was going to put off reading the paper until I found this line in Orac’s article on it. Prof. DeLong, former board member of SafeMinds, wrote about “advocacy groups” (which includes SafeMinds, NVIC and the Autism Research Institute) thus:

While these organizations are not as well-staffed or well-funded as government agencies or vaccine manufacturers, their main task is to generate information to refute agency or industry claims.

We hear over and over how these groups have the focus to provide accurate information, to allow for “informed consent”. But here we find that they are focused on generating “..information to refute [government] agency or industry claims.”

Which begs the question: what if/when the information from the government or industry is correct? Prof. DeLong appears to be assuming that the information is always in need of refutation. Not exactly what I want for in an “advocacy group”.

Which brings us to another point: why are “advocacy groups” only those who are in the business of “refuting” government and industry information? What about advocacy groups such as the Sabin Vaccine Institute, the Bill and Melinda Gates Foundation, CHOP’s Vaccine Education Center, Every Child by Two, to name a few. I know many vaccine skeptics dismiss these groups as “front groups” for the government or industry, which is a particularly hard argument to make for the Gates Foundation.

Prof. DeLong makes a passing attempt to include conflicts of interest for the advocacy groups she does include. I say “passing attempt” because while much of the paper is devoted to methods whereby public health decisions should be made without influence of COI’s, she only makes these suggestions for people from industry or government. For example, she says that we should “manage the influence of vaccine manufacturers on medical journals”. No mention of, say, Andrew Wakefield serving on the editorial board of “Autism Insights” when a paper supporting him was published by one of his employees. Or for less severe questionable activities such as people funded by “advocacy groups” serving as referees or editors of journals. She also has a section on how we should “prohibit agencies that promote vaccines from overseeing vaccine safety”. But no prohibition for members of “advocacy groups” which often include, as in her case, people who have filed claims in the vaccine court and are, thus, facing a significant financial COI.

Much of the paper is basically a Trojan Horse. Under the title of “Conflicts of interest in vaccine safety research”, the paper spends considerable space discussing vaccine safety (remember that first sentence of the paper?). We are left with the premise that “trust in vaccine safety is low”. Those two paragraphs are a good example of selective quoting of statistics. For example, we are told that 77% of people surveyed have at least one concern about vaccine safety. Count me in. Am I an example of “low trust” in vaccine safety? “Low” is a relative word. A counter example to those given in the paper: vaccine uptake is still about 90% (and more) for most childhood vaccines. People watching these numbers are concerned with fractions of a percent drop. “Low” is “low enough to potentially endanger public health by allowing for outbreaks”. That’s my definition of low. Not the implied, most people have low trust.

The paper is about 25 pages long, in published format. That’s a big effort. It is, in the end, largely a very long blog post. If you’ve been reading the online discussions for the past few years, you’ve likely encountered much of what she has to say. It ends up more of an opinion piece than a scientific paper.

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4 Responses to “Conflicts of interest in vaccine safety research”

  1. RAJ March 7, 2012 at 23:03 #

    Gee Sullivan you are as obsessed about vaccines as Age of Autism. Read this for a little context:

    http://www.guardian.co.uk/science/the-lay-scientist/2012/mar/06/2?CMP=twt_gu

    The same happened in Britain with the MMR scare; public confidence in the vaccine suffered because newspapers failed to report Andrew Wakefield’s research in context. One small study simply shouldn’t have mattered against the broader weight of scientific evidence, fraud or otherwise; but many in the press were either too ignorant to grasp this, or more interested in juicy sensationalism than clear context.

    Brian Deer’s subsequent investigations were great journalism, but largely irrelevant to any scientific question about MMR; yet he seems to see himself as the hero of the story, once declaring in a bad-tempered Guardian piece that, “13 years passed before I slayed the MMR monster.” The monster was long since dead of course, its twitching corpse dutifully held aloft by a legion of crappy hacks for St. Brian to stick his sword into.

    The irony of Deer’s pursuit of the MMR dragon is that it reinforced the mistaken belief that Wakefield and his study ever mattered in the first place. A debate that should have been about the weight of scientific evidence became instead a personality contest. Deer’s investigation of Wakefield was informed by the same flawed world-view that led to the scare in the first place; the belief that personalities, bold statements and single studies matter more than evidence, context and consensus.

    Stories based on single studies or experts are not unlikely to be wrong, and over-reliance on stock phrases like ‘scientists say’ suggests the writer hasn’t grasped the wider picture. In the world of science, context is king – we need more of it.

  2. Liz Ditz March 8, 2012 at 19:38 #

    Ivan Oransky (Retraction Watch, Embargo Watch) twitter summary of the paper:

    Paper decries conflicts of interest in vaccine research, praises Wakefield, neglects to mentions his COIs

  3. Prometheus March 9, 2012 at 23:09 #

    Whenever I read (or hear) one of the “vaccines-cause-autism” crowd parroting on about “conflicts of interest” I can’t help remembering that biblical line: “You blind guides, who strain out a gnat and swallow a camel!”.

    There are many types of conflict of interest, but even if we limit our discussion to financial conflicts, who is more conflicted – the scientists who receives a grant from a drug company for one study out of the hundreds they will do in their career or the “alternative” practitioner whose entire livelihood depends on convincing parents that autism is caused by “vaccine injury” (and that they can “cure” it)?

    I cannot fathom why people would distrust scientists because part of their funding comes from industry or “the government” yet willingly believe someone who claims to have cures that “they” don’t want you to know and is entirely funded by the sales of that “cure”.

    Clearly, there is money to be made by assuming people are incredibly gullible.

    Prometheus

  4. lilady March 10, 2012 at 09:40 #

    RAJ…I don’t know if you worked in public health both before and after Wakefield issued his press release…I did, during those periods. Long before the study was published in Lancet…other “researchers” were making audacious claims about the ingredients, excipients and preservatives in vaccines that “somehow” caused M.S. in children and adults, were (vaguely and unscientifically) studied and were “causing autism” and other developmental disabilities and were totally ineffective (according to the anecdata) that was touted by the press. These activities did cause us in public health great concern due to the credulousness of parents who, uneducated in the complicated science of immunology…took the easy road…by listening to self-promoting doctors and “talking head” newscasters and tabloid reporters.

    Please do not try to convince us that Wakefield did not embark on a self-promoting ego trip. We have the original Press Release that his co-authors disavowed, transcripts of interviews and the video tapes of what Wakefield stated at the time that the study was published in Lancet. We also have video tapes and the interviews that he gave within weeks and months after the Lancet article.

    The Lancet messed up big time, by not scrutinizing the study and Wakefield doctored the charts…possibly with parental complicity to more closely associate onset of autistic symptoms with the dates that the children received vaccine.

    Deer was and is, a respected science journalist who had already earned that respect by superb and intensive investigative skill and reporting of other “irregularities” in the marketing of certain drugs. Why shouldn’t he have give this “landmark” study his complete attention?

    While his other co-authors shied away from the publicity (perhaps they were aware of the gross irregularities in the study design and execution)…Wakefield gave interview after interview and he outright associated the triple jab with the onset of autism and “autistic regressive enterocolitis”.

    The ramifications of the results of the study and the many articles written had a profound effect on vaccine uptake in the U.K. and in the USA. The virulent notorious anti-vax groups now with slick websites, promoted the vaccine-autism “link”…long after that pseudoscience theory was studied repeatedly and no plausible link was found, Wakefield and those same anti-vax groups, continued to promote that same small study.

    Brian Deer only followed the money and the schemes that were in place long before Wakefield ever enlisted any of his study subjects.

    If you want to blame someone for the unwarranted publicity that the pseudoscientific “insignificant” study produced and its impact on vaccine uptake…you are attaching blame to the wrong man and the wrong group. You should be blaming Wakefield and his anti-vax groupies.

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