Recently, British Medical Journal has been signalling an ambitious intent to rid public health of commericial influence 'COMMERCIAL INFLUENCE IN HEALTH: FROM TRANSPARENCY TO INDEPENDENCE', but how serious is it? In this regard I wrote first to its on-line correspondence column, Rapid Responses, and then when my letter was not published to the lead author of the pilot paper Roy Moynihan and journal's editor in chief, Fiona Godlee, which in turn was not replied to. I was drawing their attention to the story familiar in the pages of Age of Autism of Prof Andrew Pollard.
Prof Pollard is the lead developer among other things with Oxford Vaccine Group (OVG) of the Meningitis B vaccine, Bexsero. OVG, which is also part of Oxford University, develops vaccines in partnership with the pharmaceutical industry. Back in 2013 Oxford Vaccine Group became affiliated to the newly created agency Public Health England (PHE), a mysterious agglomerate body working within the United Kingdom National Health Service which seems to have been created with the intention of escaping normal governmental accountability.
Shortly after its creation the then Secretary of State for Health, Jeremy Hunt, wrote to the Joint Committee on Vaccination and Immunisation (JCVI), the committee which recommends vaccines to the NHS schedule (and is also affiliated to PHE), to urgently consider the case for Bexsero. The JCVI passed over this unusual request in June 2013 but Prof Pollard was himself appointed to head the JCVI for the very next meeting in October 2013, and under his chairship the vaccine was recommended to the infant schedule at his second meeting in February 2014. Soon after this event negotiations began for GSK to take over the vaccine division of Novartis which manufactured Bexsero, and these were completed early in 2015. This was by chance just in time for Hunt to come to an agreement with GSK over the provision of Bexsero and for him to announce the deal before the May 2015 general election. The commercial prospects of the product took off.
This is just part of the picture. Prof Pollard is adviser to the British and European licensing agencies, he sits on the board of the Jenner Vaccine Foundation until earlier this year with Dr Norman Begg Vice-President and Chief Medical Officer of GSK Biologicals: he has connections with many products which are recommended by the JCVI. If BMJ did not think the instance was relevant Moynihan could have written to explain their position. Instead there is silence, while they back off discussing facts which are well inside the public domain, if largely hidden.
BMJ need to show they mean business.
The correspondence to - but not with BMJ - is below.
Dear Prof. Moynihan,
I do not know whether there could be legal reasons why...has not posted on-line my letter of 5 December (see below) but there could not be a network of influence more germane or central to the issues you and BMJ are raising. This is certainly not a personal issue about Prof Pollard, but the ubiquitousness of his name poses extremely serious questions. The director of Oxford Vaccine Group (an agency of Public Health England) which develops vaccines with the industry is also the Chair of the Joint Committee on Vaccination and Immunisation (another agency of PHE) which recommend products to the UK schedule. He also acts as an advisor to the MHRA and EMA, which was extensively discussed in the Nordic Cochrane complaints about HPV vaccines. OVG took part as well in trials of the controversial Pandemrix vaccine in 2009 prior to marketing. I am just sketching in a few issues which could extend over many products.
It is not my view that Prof Pollard is individually to blame for this opaque situation since all these institutions are presumably aware of the potential conflicts and allow them to continue. I personally raised the problem of the OVG/JCVI conflict with the DH, PHE and in the Scottish Parliament to no effect. But I do believe there is an obligation for those who know about these problems to bring them into the light of day, and this could not be an area of greater legitimate public concern. I hope BMJ will see fit to act.
I also attach for information the GSK document 'Evening of Evidence' 30 September 2015.
With all good wishes,
John Stone (UK Editor, Age of Autism)
cc Fiona Godlee, ...
Re: Pathways to independence: towards producing and using trustworthy evidence - the case of vaccines
I express concern about the prestige and doctrine of quasi-infallibility accorded to vaccines, which even put them in a different category from other medical products . The assumption that all medicines are double blind placebo safety tested was called into question in these columns in relation to vaccines earlier this year and unfortunately not satisfactorily answered . It often seems that the imperative to ward against infectious disease has itself become reckless.
As an example, the following facts are recorded in an Oxford University submission to Ref2014 :
"Oxford University research has also led to the planned use of vaccines against serogroup B meningococcal disease, which have been licensed and recommended for the prevention of disease in high-risk individuals, and broader use is under
consideration...The first global clinical trials in infants of a quadrivalent meningococcal vaccine (MenACYW, Menveo, Novartis vaccines)..., a combination Haemophilus influenzae type b-serogroup C meningococcal vaccine (Menitorix, GSK vaccines)...and the first trials of the leading serogroup B meningococcal candidate vaccine (MenB, Bexsero, Novartis
vaccines)...were undertaken in Oxford and Professor Pollard was the chief investigator for the panEuropean phase 3 study of the MenB vaccine (1,885 infants enrolled)... These studies showed that the vaccines were safe and highly immunogenic in infants and toddlers..."
But also of note was when Joint Committee on Vaccination and Immunisation met to discuss Bexsero in February 2014 and it was agreed to recommend the vaccine for infant use in the UK (para.72) Prof Pollard himself was in the chair . I note that Secretary of State for Health, the Rt Hon Jeremy Hunt, was himself involved over the preferment of this product .
The Oxford submission states that the products were "safe" but there seems even under current testing with Bexsero to be numerous and sometimes serious provisos .
I submit that the same transparency and safety standards should be required for the marketing and recommendation of vaccines as for other medical products, not least because of the blanket way in which they are administered to entire populations. Statements that products are safe when they have hazards should not be allowed.
 Moynihan et al, 'Analysis Commercial Influence in Health: from Transparency to Independence: Pathways to independence: towards producing and using trustworthy evidence', BMJ 2019; 367 doi: https://doi.org/10.1136/bmj.l6576 (Published 03 December 2019)
 John Stone, 'Re: Response to John Stone (2019 Jul 24)', 29 July 2019, https://www.bmj.com/content/365/bmj.l4291/rr-37
 REF2014: EFFECTIVE DESIGN, DEVELOPMENT AND EVALUATION OF MENINGITIS VACCINES http://impact.ref.ac.uk/casestudies2/refservice.svc/GetCaseStudyPDF/15529
 JCVI minute of meeting Tuesday 11 and Wednesday 12 February 2014, https://app.box.com/s/iddfb4ppwkmtjusir2tc/1/2199012147/229171703722/1
 Letter of Jeremy Hunt to acting JCVI Chair Andrew Riordan c.June 2013, https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/239394/SoS_letter_to_JCVI_Men_B_Vaccination_logo.pdf
 John Stone, 'Re: Child vaccination rates in England fall across the board, figures show', 4 October 2019, https://www.bmj.com/content/366/bmj.l5773/rr-12