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BLOG: September 2009

Pneumococcal vaccine for adults useless?

Is it possible that the only one who benefits from the pneumococcal vaccine for adults is - the manufacturer? According to a hot-from-the-oven study, it seems to be very likely.

The goal of this study (Efficacy of pneumococcal vaccination in adults: a meta-analysis, Huss et al. University of Bern, published in the Canadian Medical Association Journal) was to try to resolve all too common situation: conflicting results of different studies on one same subject. In this case, the efficacy of pneumococcal vaccine in adults.

So the researchers went through 22 studies examining this subject, with a total of over 100,000 participants. They were looking at the rates of incidence for pneumonia and rates of death for vaccinated adults and the controls (not vaccinated). But they also paid attention to what they call "methodologic quality" of every trial.

They found out that nearly all trials indicating that the vaccine is efficient were of poor methodologic quality, particularly those that haven't been made double-blind (one of the very basic requirements for an objective, reliable study). The studies that did have higher methodologic quality were consistent in

not showing noteworthy protective effect of the vaccine.

Not even among the elderly and those with chronic illnesses, to whom the vaccine is currently directly recommended.

One has to wonder how efficient is the very system where an apparently useless medical aid is recommended to a large number of people. What was the basis for the official approval of this recommendation? Why is the monitoring of post market effect of pharmaceutical products left to random independent studies, despite their proven potential to adversely affect health of many, or even kill tens of thousands of people?

Not that it comes as much of a surprise, since it is all but well known that the influence of mighty pharmaceutical industry shapes up much of so called official medicine, including medical education system, and even government agencies in charge of overseeing the market.

There's one more unknown with respect to this vaccine, that yet is to be answered: are there any significant adverse effect that it can cause? If the assumption of the efficacy was wrong, so it could be the assumption of "universal safety" of this vaccine (an impudent oxymoron, as anyone familiar with vaccines' ABC knows, but no other rationale could back approving any medication for use by general population).

 The issue of efficacy and safety is not resolved even with the primary users of pneumococcal vaccine, children between 2 and 18 months of age, as detailed in the article about Prevnar from September 2007. According to the manufacturer and the officials, it works just fine, saving lives, and so on. But the post market Prevnar statistics - as incomplete as it is for pharmaceuticals in general - indicates quite the opposite.

And pneumococcal vaccine is barely the tip of the iceberg. No one is really interested, or capable of cleaning up this big mess that has been piling up for decades by letting drugs onto the market while relying on insufficient, often biased pre-market testing by the manufacturers, and with virtually no post-market testing. Pharmaceutical industry loves it just the way it is, while the official medicine and government act as if they don't want to touch this problem with a stick.

There is a good reason for it; chances are, what it would have unearthed is all but pretty, and everyone has their share of responsibility for it. So the whole big mess keeps rolling as it is, with its faulty, loose steering wheel, and many that don't watch out, get hit.

As for the question why would any medical professional or institution even conduct a study that doesn't fulfill basic requirements of reliability, the answer seems to be obvious. It can only take place when obtaining the facts is not a first priority. Apparently, not as infrequent practice as one would like to think.