Healthy Skepticism Library item: 16779

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Publication type: Journal Article

Gérvas J, Wright J
Please may we have an RCT now?
BMJ 2009 Nov 10; 339:
http://www.bmj.com/cgi/content/extract/339/nov10_1/b4651?papetoc

Abstract:

Mass vaccination against A/H1N11 is based on several false assumptions:

That the H1N1 pandemic will mimic the Spanish flu pandemic of 1919, although the world in 1919 was very poor without public health systems, tap water, or antibiotics
That H1N1 flu is severe and deadly, although the death rates are much lower than for seasonal flu2 3
That the vaccine will work, although randomised controlled trials of effectiveness are lacking for both H1N1and seasonal flu vaccines
That the H1N1 vaccine will provide similar immunity to the natural infection, in which the first flu virus we are exposed to generates the strongest immune response and lasts for over 50 years,4 although flu vaccines have to be given as one (or two) shots annually to achieve lesser immunity.
H1N1 vaccines need to be tested in a placebo controlled randomised controlled trial.5 Without such an approach, we will still not know whom to vaccinate . . .