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Department of Health's claims of 75-80% efficacy branded a 'fantasy'

New study sparks flu vaccine controversy

Vaccination against influenza has little or no effect on rates of the disease and may be a waste of time and money, concludes a major new review of worldwide data.

The author, a leading reviewer at the Cochrane Collaboration and former GP, warned there was insufficient evidence to justify the UK's large-scale vaccination campaign.

Writing in a commentary and analysis published in last week's BMJ, Dr Tom Jefferson argued flu vaccination did not reduce the number of working days lost, hospital admissions, transmission rates or deaths from flu – particularly not in the elderly.

A meta-analysis of flu vaccines in the elderly found the effect on all-cause mortality varied from none to a greater effect than all deaths attributable to flu, findings described as 'coun-ter-intuitive and implausible'.

Dr Jefferson, co-ordinator of the Cochrane Vaccines Field, added: 'It is impossible for a vaccine that does not prevent flu to prevent its complications.'

Following his analysis of systematic reviews included in the Cochrane Library, Dr Jefferson said: 'In general there is a very wide gap between what policy makers claim and public health policy.

'For example, what David Salisbury [the Department of Health's director of immunisation] claims, that vaccines are 75-80 per cent effective in the elderly, is just a fantasy.'

GPs and flu virus experts roundly dismissed the claims.

Dr Douglas Fleming, director of the RCGP Birmingham research unit and a Government adviser on influenza, said: 'There is good evidence that the flu vaccine is effective at reducing hospital admissions, deaths and other serious manifestations of flu.'

But Dr Fleming did admit: 'The impact of vaccination on winter respiratory illnesses is not as strong as one would hope. He is right to challenge some of the economic analyses, which rather overstate the benefits.'

Professor John Oxford, professor of virology at Queen Mary, University of London, strongly disagreed with the conclusions. 'One has to be careful about these things. What if he persuades a lot of people not to have the vaccine and they die? It's easy to sound off, but what about the consequences?'

But Dr Jefferson argued there should be more concern about the 'very serious consequences from giving people a vaccine that has not been adequately tested'.

The review and its findings

Search strategy

• Systematic reviews identified from Cochrane Library, MEDLINE, EMBASE, NHS, HTA and NICE

• Study designs included RCT, cluster and cohort studies, and placebo-controlled RCTs

Problems with clinical evidence

• Heavy reliance on non-randomised studies

• Absence of convincing evidence on most campaign objectives

• Most studies of poor methodological quality

• Small and heterogeneous dataset on safety of vaccines

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