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Hilary's Desk

When Indian doctors open their mouths...

Hilary Butler - Friday, July 09, 2010

What happens when paediatricians take a look at the disease incidence in their own country and decide that certain vaccines are not justified on epidemiological grounds?  Nothing, So long as they keep their mouths shut.  What happens when they look into the use of certain vaccines, and find that reactions are being covered up?  Nothing.  So long as they keep their mouths shut. But when they tell the world about both... , no matter that good science is on their side, there is only one possible result. To start with, they will be branded ANTI VACCINE. What better slur is there?  Anti vaccine people are idiots, don't you know?  Truth won't be discussed.  Truth is inconvenient to the vaccine industry, especially to organisations who owe their existence and income to the vaccine industry. Simple as that. Here's the story.

Dr Jacob Puliyel (Hospital head of Paediatrics) in India, had a few things to say about the proposed introduction of a pentavalent vaccine in India.  For some really weird reason, an Indian provaccine reporter called Ganapati Mudur, had a go at him in the BMJ. "Woe to us in India, that these ornery stupid medical people are getting in the way of ever altruistic GAVI... " (see upload)  Why Ganapati Mudur didn't fire his blank bullets in the relevant Indian medical journal is mystifying, but what is even stranger, is that the BMJ published his drivel without thinking.

A question like, "Are the objections of these medical specialists grounded in good science?" comes to mind. Had the BMJ looked perhaps they might have asked the question, "Exactly WHY is this vaccine being considered at all, in India?" The answer could have been a really potent Feature Article with riveting parallels to the BMJ's expose of the Swine Flu Scam.  Somehow, that escaped their notice.

This little stoush just might open up a HUGE pandora's box, because the group of doctors fired a loaded salvo straight back, via BMJ e-responses.  (Not long after BMJ put up the e-response, Puliyel's website became unavailable.  However, I had uploaded the WHO document concerned, just before that happened, so it is embedded in the e-response below.  Puliyel's site crashed as I was downloading the original document.  Funny that.).  Part of the BMJ e-response tells us:

If a vaccine results in death it is a very serious concern. A vaccine may have been used successfully in millions and with no adverse effects, yet in the next patient it may cause a fatal anaphylaxis reaction. The adverse effect following immunization (AEFI) investigation is set up to study if the reaction in the given child was related to the vaccine or is unrelated. The AEFI report does not comment on the likelihood of reaction if the vaccine is given to other children in the future. If the same reaction occurs twice it is defined as a cluster.

Pentavalent vaccine was introduced in the national immunization programme in Sri Lanka in January 2008 but after several thousand doses were administered, it was withdrawn in April 2008 because of 25 serious adverse reactions that included 5 deaths. A WHO expert panel investigated the adverse effects and deaths and in its report classified 3 deaths (identified as cases D1, D3, and D6) as ‘Unlikely’ (to have been caused by the vaccine). Pentavalent vaccine was then introduced in national immunization programme of Bhutan in July 2009. Within 2 months, after 8 deaths, the vaccine was withdrawn in that country (6). At the behest of the WHO, the vaccination programme was restarted in Sri Lanka some 4 months ago and it is claimed that there is no change in the death rate in Sri Lanka – as if deaths in 3 infants from AEFI will alter the countries mortality statistics.

In response to our petition in the High Court in Delhi, the detailed AEFI report on the deaths in Sri Lanka was made available to the Court and thereby, in the public domain. As only a summary of this report is available on the internet (7), we have scanned the report and 
put it on the net and it can be accessed freely (8). The report quotes an aide- memoire on the standard WHO classification on AEFI (9).

The standard WHO classification of AEFI is best understood in the form of an algorithm. The first question is whether the adverse events have a plausible time relationship to vaccine administration. All such reactions are classified in one of three categories: ‘Very likely/Certain’, ‘Probable’ or ‘Possible’.

If the time of the adverse event and the time of vaccine administration make a causal connection improbable, it is classified as ‘Unlikely to be related’. If the time of the event and the time of vaccine administration make a causal connection incompatible, it is to be classified as ‘Unrelated’

For adverse events that have a plausible time relationship to vaccine administration, the next level of the algorithm is used to distinguish Probable from Possible. If the death cannot conclusively be attributable to another cause, it is classified as ‘Probable related’. If the death can be attributable to another cause then the association with vaccine is said to be ‘Possible’

The report presented to the Delhi High Court shows that the experts on AEFI in Sri Lanka deleted the categories Probable and Possible from the standard classification. All adverse events which could not be classified as Very likely/Certain were classified as Unlikely. Using this new classification, they declared that 3 of the Sri Lanka reactions were ‘unlikely’ to be related to vaccine ‘although it could not be conclusively attributable to another cause’. It is evident from the discussion above that the three deaths (D1, D3, D6) would have been classified as ‘Very likely/certain AEFI’ or ‘Probable AEFI’ using the standard WHO classification.

When the news of this change in classification caught the attention of the press, a WHO spokesperson defended the change saying that the WHO used ‘independent experts’ and they were free to make up their own classification. Furthermore the WHO spokesperson clarified that even if the standard classification were used; the three deaths would not be classed as probable or possible as there was ‘non-conclusive evidence of other potentially attributable causes for the adverse events’. The potentially attributable conditions unearthed by the experts were the following: one had malnutrition (a condition which defines a large proportion of the population in rural areas), the second case had autopsy findings of milk aspiration (often seen as a terminal event in many cases of sudden death from any cause) and the third case had ‘autopsy findings suggestive of Reye’s syndrome’. The expert body did not suggest that these findings qualified as plausible explanations for the deaths and the temporal relation of the deaths to vaccination has not been disputed. Interestingly the experts say that they discussed the possibility that the vaccine may have unmasked an underlying condition. One is left wondering whether they considered malnutrition, milk in the trachea, or Reye ’s syndrome as conditions that would have remained ‘masked’ had it not been for the vaccine.

For a document produced to a court of law, the document is not even complete. The names of the experts and their declaration of conflict of interests were left out. We have learnt that at least one of experts has previously been accused of not declaring his conflict of interest arising from research funded by pharmaceutical companies including GlaxoSmithKline.

Classification of AEFI as ‘Certain/ Very likely’, often needs de- challenge or re-challenge evidence. This is not possible when the initial reaction results in death. The question the larger public (outside of India and Asia) needs to answer is whether they will permit this new classification to replace the standard WHO classification of AEFI. If this is allowed, deaths which occur as reaction to vaccine will nearly always be classified as ‘unlikely’ because de-challenge and re-challenge will not be possible post-mortem.

The Indian doctors are rightly outraged at all this. 

But us old timers have long since got passed "outraged", realising that this is "business as usual". CARM, IMAC, WHO and everyone else freely make up their own classifications, and always have. They are all called "independent experts" and therefore, "she'll be right, mate".  Except for parents and children constantly shafted by this culture of denial.

Having been labelled "anti-vaccine", the next step against these Indian doctors is predictable.  A step-wise campaign will be orchestrated until they, and any other of their ilk in whatever country..., until they are deregistered and utterly "discredited".

Sometime. 

Nothing less will do. 

Medical Heretics who question the actions of the WHO/Bill Gates jabbem-fairy alliance will be silenced.  

Welcome to the real world. 

 

 

 

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