Let me start by getting this out of the way: Vaccines are one of humankind’s greatest health care achievements, along with antibiotics, clean water, and good sanitation. There should be no argument about this at all.

Vaccines save millions of lives each year — children and adults — and prevent tremendous personal misery caused by infectious diseases. Some vaccines, such as the one against human papillomavirus (HPV), even prevent some types of cancer from developing in adult women and men.

Despite these enormous successes, vaccines are being aggressively attacked by a number of groups, many of which are well-organized and financed. Some of them have suggested that vaccines are more harmful than the diseases they prevent, which is nonsense.

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Why do people oppose vaccinations? There are lots of reasons. The most frequently given one, the raison d’etre of the misinformation campaigns, is that childhood vaccines are dangerous, though I’m still waiting to see a single piece of creditable evidence to support this. One other theme featured prominently in their messaging is that pharmaceutical companies can’t be trusted.

That’s a sad truth: The awful reputation of the pharmaceutical industry is now inhibiting the use of some of its most lifesaving products. Tuesday’s spectacle of seven pharma executives being grilled by the Senate Finance Committee on high drug prices is just the latest example of the industry’s black eye.

Why are so many people suspicious of pharma in general and vaccines in particular? It’s pretty easy to figure it out. The industry has been engaging in bad behavior for several decades, and these self-inflicted wounds have turned much of the public against it.

It wasn’t always this way. In the early 1950s, parents across America feared that the frequent polio epidemics sweeping the nation might leave their sons or daughters crippled, or even worse, confined to an iron lung. The first polio vaccine, developed by Dr. Jonas Salk, eased those fears. Salk was rightly considered a national hero, and was especially lauded for refusing to patent the vaccine.

Pharma companies became among the most admired (as well as the most profitable) businesses in America. In the last half of the 20th century, they brought to market a cornucopia of medicines that combatted previously untreatable diseases. Drugs were developed for heart disease, rheumatoid arthritis, high blood pressure, anxiety, pain, bacterial infections, asthma, contraceptives, cancer. The 1990s brought the first drugs based on recombinant DNA technology, adding a large number of new treatments to fight disease. Pharma companies also developed vaccines.

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Then came the scandals. They haven’t involved just one company. Over the past two decades, we’ve seen scores of pharma and biotech companies hauled into court for a variety of serious, and in some cases deadly, infractions. What kinds of high crimes and misdemeanors have poisoned the well of public opinion? Here’s a sample from just the last few years:

More widely reported are the stories about drugs pulled off the market due to safety concerns (multiple companies), or ones that reveal how pharma payments influence doctors’ prescribing habits for brand-name drugs (multiple companies).

Finally, let’s look at criminal and civil penalties (both state and federal) racked up by the industry over the last couple of decades. According to a Public Citizen analysis, the industry settled 373 cases between 1991 and 2012, paying $35.7 billion for numerous violations. These cases included illegal off-label marketing, overcharging Medicare and Medicaid, kickbacks, concealing data, and poor manufacturing practices. The largest penalties weren’t levied on obscure companies nobody’s ever heard of. They fell squarely on the shoulders of Big Pharma: GlaxoSmithKline, Pfizer, Johnson & Johnson, Merck, Abbott, Eli Lilly, Novartis, AstraZeneca, Bristol-Myers Squibb, and others. These various offenses have, not surprisingly, led to pharma being portrayed as the villain in numerous movies and TV shows.

The pharma industry has established a solid history of shooting itself in both feet via the number and size of these scandals. I’ve suggested over the years that the industry adopt a set of well-defined ethics policies. The response? Rather than try to repair the damage, the industry has simply decided that its monopoly pricing power provides the ultimate insulation from criticism.

Unlike other companies that have trashed their reputations and then struggled mightily to repair them (Wells Fargo is a good example), drug makers know that people will buy their products no matter how much the public dislikes their companies. You generally can’t purchase medicines from a competing company. You can (sometimes) go elsewhere to buy them, like drug tourism trips to Mexico and Canada, if you’re willing to deal with the hassle and expense. Drug companies don’t have to treat their customers well when they have that kind of leverage.

Though the public can’t do much about it, they have clearly noticed the continuous wave of scandals that has enveloped the industry.

All of this has contributed to the prominent anti-pharma themes voiced by the anti-vaxx crowd. At a recent rally in Washington state to defeat legislation aimed at eliminating personal vaccine exemptions, many in the crowd held “Separate pharma and state” signs. Bernadette Pajer, head of the anti-vaccination group Informed Choice Washington, recently said, “I know vaccines are designed to protect children from infection, but they are pharmaceutical products made by the same companies that make opioids.”

Many people, such as those with diabetes who struggle to pay for their lifesaving medicines, share this antipathy towards pharma. Most people don’t realize that vaccines are the least profitable division of the companies that make them. They’re so unprofitable that many drug makers walked away from producing vaccines years ago.

We’re fortunate that demand from many developing countries has sparked a renewed interest in making vaccines. It’s unclear how many companies would stay in the vaccine business without that large market. And who else has the capacity and technical expertise to make hundreds of millions of doses of complex vaccines every year? Amazon may be thinking about entering the drug-delivery market, but don’t look for it to start manufacturing vaccines anytime soon.

At the end of the day, we’re stuck in a twilight zone of cognitive dissonance: We’d like to stand up against the pharmaceutical industry’s continuing bad behavior, but at the same time we’re forced to acknowledge we can’t live without its products. This isn’t a time when we can “just say no.” The industry knows and relies on this. As long as it maintains profitability, it will continue to view the scandalous headlines, fines, and settlements as simply a cost of doing business.

And so we are left to deal with one of the “externalities” associated with this negative industry messaging: It helps drive vaccine hesitancy. Improving the reputation of the pharma industry might help turn the tide against the anti-vaccine forces, but we can’t count on that happening. Vaccine advocates must focus their messaging on the value that vaccines create. If vaccine supporters fail, we’ll continue to see waves of vaccine-preventable outbreaks of measles and other contagious diseases.

Whatever your personal feelings are about the pharmaceutical industry, the benefits of vaccines are undeniable, despite what the anti-vaccine folks would have you believe.

Stewart Lyman, Ph.D., is a biotechnology consultant and vaccine advocate who lives in Seattle.

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  • There are no proper safety studies on vaccines using a placebo, and even if there were, I’d suspect they were falsified. I see not only horrific stories of vaccine victims on Facebook but also around me in the real world including miscarriage after the flu shot and lots of food allergies and autism. How can anyone trust a doctor who receives kickbacks or risks losing their job for sharing an alternative opinion? How can anyone trust the CDC when they own drug patents? No thank you. My body is my temple. I will never give ownership of my body to an agency or organization. I am a human not a cattle.

  • Stewart you say the VAERS is not a reliable source – why isn’t the government instituting a better system? I can tell you it is because they don’t want to know.
    The problem with VAERS is it is a passive reporting system and it is estimated by former FDA commissioner David Kessler than few than 1% of adverse events are reported. A better system was sought but trashed by CDC as obviously it did not suit their agenda to keep the public in the blind about vaccine damage.

    “The idea of automating adverse event reporting to VAERS is not new or even difficult to achieve.32 The Agency for Healthcare Research and Quality, an agency within HHS, sought to do exactly that in 2007 when it provided an approximately $1 million grant to automate VAERS reporting at Harvard Pilgrim Health Care.33 The result was the successful automation of adverse event reports at Harvard Pilgrim:
    Preliminary data were collected from June 2006 through October 2009 on 715,000 patients, and 1.4 million doses (of 45 different vaccines) were given to 376,452 individuals. Of these doses, 35,570 possible reactions … were identified.34

    These results should have been startling to HHS since they show that over only a three-year period, there were 35,570 reportable reactions in just 376,452 vaccine recipients. Given HHS’s statutory mandate to assure safer vaccines, it should have rushed forward with automating VAERS reporting. However, this is not what happened.

    After automating adverse event reports at Harvard Pilgrim, the developers of this system asked the CDC to take the final step of linking VAERS with the Harvard Pilgrim system so that these reports could be automatically transmitted into VAERS. Instead, the CDC refused to cooperate. As the Harvard grant recipients explained:

    Unfortunately, there was never an opportunity to perform system performance assessments because the necessary CDC contacts were no longer available and the CDC consultants responsible for receiving data were no longer responsive to our multiple requests to proceed with testing and evaluation.35

    After three years and spending $1 million of taxpayers’ money, the CDC refused to even communicate with the HHS’ Harvard Medical School grant recipients.

    http://www.icandecide.com/white-papers/VaccineSafety-Version-1.0-October-2-2017.pdf

  • So, since you have a PhD, can you send me some of your studies done on herd immunity and vaccines? I haven’t found one so far. They’ve all been on actual diseases.

  • Thank you so much for pinpointing one of the very big reasons people question vaccinations. Pharma companies have no liability and despite being very difficult to access – the courts have paid out over $4 billion in vaccine damages. Vaccines are extremely profitable fuelled by punitive measures taken by govt.
    A new report published by Future Market Insights titled “Paediatric Vaccine Market: Global Industry Analysis & Opportunity Assessment, 2016 – 2026”, in terms of revenue, the global paediatric vaccine market is expected to increase at 12.2% CAGR during the forecast period 2016-2026. The global paediatric vaccine market is expected to reach US$ 27.97 Bn in 2016.

    The strong growth in institutional health centres can be attributed to increasing government interventions in immunisation programs in order to improve vaccine coverage.

    • It’s unfortunate that you completely misunderstand how the VAERS database works. The Vaccine Adverse Event Reporting System (VAERS) is a reporting process that has been put in place for patients or doctors to record information about problems observed after people have been vaccinated. Its purpose is widely misunderstood. It does NOT exist to track specific and proven adverse reactions caused by vaccines; it is simply there to record information. The purpose of the system is clearly denoted on the VAERS website as follows:

      “When evaluating data from VAERS, IT IS IMPORTANT TO NOTE THAT FOR ANY REPORTED EVENT, NO CAUSE-AND-EFFECT RELATIONSHIP HAS BEEN ESTABLISHED. Reports of all possible associations between vaccines and adverse events (possible side effects) are filed in VAERS. Therefore, VAERS COLLECTS DATA ON ANY ADVERSE EVENT FOLLOWING VACCINATION, BE IT COINCIDENTAL OR TRULY CAUSED BY A VACCINE. THE REPORT OF AN ADVERSE EVENT TO VAERS IS NOT DOCUMENTATION THAT A VACCINE CAUSED THE EVENT.”

      So the reporting of any event after receiving a vaccination is simply a record. It does NOT prove the vaccine caused that issue. Let me put this in a different context to see if that helps. Imagine if there was a similar system that was in place for people to report problems for some period of time after they have shopped at Target or taken a taxi. That database might note that you began to feel sick four days after your shopping trip, or the taxi ride. But does that mean that your sickness was CAUSED by the shopping excursion or the taxi ride? No. It could be related, but maybe not. Coincidences happen all the time. Keep this in mind as you look at data from VAERS.

  • I am not antivax – but I do want better testing of vaccines. The Institute of Medicine acknowledges that there has never been a vaccinated/unvaccinated study which could easily be done by using the VSD which has records of all children…including health and vaccination status.
    In summary, few studies have comprehensively assessed the association between the entire immunization schedule or variations in the overall schedule and categories of health outcomes, and no study has directly examined health outcomes and stakeholder concerns in precisely the way that the committee was charged to address in its statement of task. No studies have compared the differences in health outcomes that some stakeholders questioned between entirely unimmunized populations of children and fully immunized children. Experts who addressed the committee pointed not to a body of evidence that had been overlooked but rather to the fact that existing research has not been designed to test the entire immunization schedule.
    https://www.ncbi.nlm.nih.gov/books/NBK206938/

    • The Anti Vaxx Trollo have been dogpiling anyone that discusses vaccinces online. No one is looking at how they sue sites like this to peddle anti vaxx ideas, and other profitable psuedo science. WAith the help of the tech giants, and online content marketers , this stuff spreads like a multi leve marketing scheme. Since these sites are mostly advertising, corporate public relations, and content marketing, no one recognizes the problem. This is weoponized Market Healthcare, extended to its logical conclusion. They don’t care if peple die, as long as there is a buck in it!

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