The US Centers for Disease Control and Prevention, or CDC, recommends that everyone aged six months and up should get an annual flu shot, and public health officials and the media routinely relay the CDC’s recommendation to us by characterizing this policy as being firmly grounded in science. However, what the government and mainstream media say science says about the influenza vaccine and what science actually tells us are two completely different things.
A useful case study of the divergence between the science and the public message is the New York Times article “Why It’s Still Worth Getting a Flu Shot”. Its author, Aaron E. Carroll, characterizes the science as though it fully vindicates the CDC’s recommendation. To support this characterization, he cites systematic reviews of the medical literature conducted by the prestigious Cochrane Collaboration. However, as demonstrated in part one of this series, Carroll’s own sources in fact arrived at the opposite conclusion.
To briefly review, Carroll claims that science tells us that the flu vaccine—even in years such as this one, when it is admittedly “particularly ineffective”—confers “a big payoff in public health”. Yet the very Cochrane review he cites to support this claim in fact concluded that the available scientific evidence rather seems “to discourage the utilization of vaccination against influenza in healthy adults as a routine public health measure.”
Carroll claims that harms from the influenza vaccine are “almost nonexistent”, yet the authors of the very Cochrane review he cites to support this claim in fact concluded that there is an alarming lack of studies demonstrating the vaccine’s safety in children. As they put it, “If immunization in children is to be recommended as a public health policy, large-scale studies assessing important outcomes, and directly comparing vaccine types are urgently required.”
As also seen in part one, the New York Times, in so greatly deceiving its readers, was simply taking its cue from the CDC. In fact, far from vindicating public policy, as the Times would have us believe, the Cochrane researchers actually went so far in their criticism of the CDC as to accuse the agency of deliberately misrepresenting the science in order to support its influenza vaccine recommendation.
The example the review authors cited to illustrate this official dishonesty was a policy document outlining the CDC’s rationale for its flu shot recommendation. As outlined therein, the CDC’s primary justifications for this policy are the assumptions that universal vaccination will (1) reduce transmission of the influenza virus and (2) reduce the risk of potentially deadly complications from influenza.
And yet, in their 2010 systematic review of the literature, the Cochrane researchers found “no evidence that vaccines prevent viral transmission or complications”. In fact, in a remarkable illustration of the institutional myopia that exists within the medical and scientific communities when it comes to vaccines, they noted that none of the studies included in their review even seemed to consider the question of whether the central assumptions underlying the CDC’s policy were actually true.
Furthermore, whereas the CDC recommends the flu vaccine for infants as young as six months, the Cochrane researchers found “only one study of inactivated vaccine in children under two years”—hence the need for safety studies being “urgently required”.
Whereas the CDC tells pregnant women to get the flu shot, the Cochrane researchers observed that the number of randomized controlled trials evaluating the safety for the expectant mother and her developing fetus was zero.
In this second installment, we’ll dive deeper, taking a closer look at the claims the CDC makes to support its policy. You will see how the CDC serves the pharmaceutical industry by using fear and deception to sell more flu vaccines.
This includes scaring people into getting the vaccine by citing numbers of influenza-related hospitalizations and deaths that may be greatly overestimated, as well as relying on thoroughly discredited claims about the effectiveness of the vaccine in preventing deaths among the elderly, for whom there is the greatest risk of potentially deadly complications. And whereas the CDC assumes the vaccine prevents transmission, one recent study that bothered to actually look at that question indicates that it might actually increase the spread of the influenza virus.
Additionally, you’ll come to understand how it can be possible that there is such a shocking disparity between public policy and the scientific evidence. In addition to an institutionalized bias favoring public policy due to the influence of government on the science, the disparity is also in part explained by the endemic corruption that exists at the CDC. Furthermore, and regardless of why this deception exists, public vaccine policy constitutes a gross violation of the individual right to informed consent.
That is to say, government policy represents a serious threat to both our health and our liberty, and this should be concerning to everyone, regardless of one’s own personal choice or individual risk-benefit assessment about whether or not to vaccinate.
- The CDC’s “Problem” of “Growing Health Literacy”
- The Problems with the CDC’s Estimates of Annual Flu Deaths
- The CDC’s Debunked Claims about the Flu Shot’s Effect on Mortality
- How the Flu Shot May Increase Viral Transmission
- The Endemic Corruption at the CDC
- How Public Policy Violates the Right to Informed Consent
- Summary of Part II
To preface our further examination of the CDC’s claims versus what science actually tells us, it’s useful to examine the mindset at the agency with respect to how CDC officials view their role in society. An instructive snapshot of this mindset was provided in a presentation by the CDC’s director of media relations on June 17, 2004, at a workshop for the Institute of Medicine (IOM).
In its presentation, the CDC outlined a “‘Recipe’ for Fostering Public Interest and High Vaccine Demand”. It called for encouraging medical experts and public health authorities to “state concern and alarm” about “and predict dire outcomes” from the flu season. To inspire the necessary fear, the CDC encouraged describing each season as “very severe”, “more severe than last or past years”, and “deadly”.
One problem for the CDC is the accurate view among healthy adults that they are at not at high risk of having serious complications from the flu. As the presentation noted, “achieving consensus by ‘fiat’ is difficult”—meaning that just because the CDC makes the recommendation doesn’t mean that people will actually follow it. Therefore it was necessary to create “concern, anxiety, and worry” among young, healthy adults who don’t regard the flu as something to be terribly afraid of.
The larger conundrum for the CDC is the proliferation of information available to the public on the internet. As the CDC bluntly stated it, “Health literacy is a growing problem”.
In other words, the CDC considers it to be a problem that people are increasingly doing their own research and becoming more adept at educating themselves about health-related issues.
And, as we have already seen, the CDC has very good reason to be concerned about people doing their own research into what the science actually says about vaccines.
One prominent way the CDC inspires fear in the public about influenza is with its estimates of the numbers of people who are hospitalized or die each year from it.
As we learned from Aaron Carroll in the New York Times, the CDC estimates that anywhere from 140,000 to 710,000 people are hospitalized each year due to influenza, and 12,000 to 56,000 people die.
What Carroll doesn’t explain is that these numbers aren’t directly from surveillance data, but are estimates based on mathematical models. The problem with the CDC’s models is that they are only as good as the assumptions built into them.
For context, it’s important to understand why there are no surveillance data directly showing how many people infected with influenza are hospitalized or die as a result. For some clues, we can conveniently turn once again to the 2010 Cochrane review also cited by Carroll.
As the authors of that review explained, only about 7 percent to 15 percent of what are called “influenza-like illnesses” are actually caused by influenza viruses.
In fact, there are over 200 known viruses that cause influenza-like illnesses, and to determine whether an illness was actually caused by the influenza virus requires laboratory testing—which isn’t usually done.
“At best,” the authors added, “vaccines may only be effective against influenza A and B, which represent about 10% of all circulating viruses” that are known to cause influenza-like symptoms.
While the CDC now uses a range of numbers to describe annual deaths attributed to influenza, it used to claim that on average “about 36,000 people per year in the United States die from influenza”. If that number sounds familiar, it’s probably because it was so routinely cited for so many years before the CDC switched to using a range after criticism that the average was misleading since there was great variability from year to year. And while the range addressed that problem, others remain.
The problem with “the much publicized figure of 36,000”, as Peter Doshi observed in a 2005 BMJ article, was that it “is not an estimate of yearly flu deaths, as widely reported in both the lay and scientific press, but an estimate—generated by a model—of flu-associated death.”
Of course, association does not necessarily mean causation. Just because a person dies after an influenza infection does not mean that it was the flu that killed him. And many people diagnosed with “the flu” may not have actually been infected with influenza, but any of the great number of other viruses that cause influenza-like illnesses.
The 36,000 number came from a 2003 CDC study published in JAMA that noted the difficulty of estimating deaths attributable to influenza since most cases are not laboratory confirmed. Additionally, “many influenza-associated deaths occur from secondary complications when influenza viruses are no longer detectable.”
In other words, to look only at the surveillance data on lab-confirmed influenza-associated deaths would likely underestimate the number of people whose deaths may have been flu related. The CDC researchers therefore developed a mathematical model to estimate the number by starting with all “respiratory and circulatory” (R&C) deaths, which are inclusive of all “pneumonia and influenza” (P&I) deaths.
Of course, not all respiratory and circulatory are caused by the influenza virus. In the CDC’s model, this number represents “an upper bound”.
On the other hand, the CDC argues that all pneumonia and influenza deaths “can be considered a lower bound for deaths associated with influenza”. The CDC’s website states that pneumonia and influenza deaths “represent only a fraction of the total number of deaths from influenza”.
But of course, not all pneumonia deaths are caused by influenza, either.
In fact, according to the CDC’s own estimate, 2.1 percent of all respiratory and circulatory deaths and 8.5 percent of all pneumonia and influenza deaths are influenza associated.
So how can the CDC maintain both (a), that the total number of reported pneumonia and influenza deaths represents only a fraction of actual influenza deaths, and (b), that only 8.5 percent of pneumonia and influenza deaths are influenza-associated?
The answer is that the CDC assumes that influenza related deaths are so greatly underreported that they dwarf the combined numbers of reported influenza and pneumonia deaths, and it has built this assumption into its model.
As Peter Doshi put it in his BMJ article, “US data on influenza deaths are a mess.” The CDC “acknowledges a difference between flu death and flu associated death yet uses the terms interchangeably. Additionally, there are significant statistical incompatibilities between official estimates and national vital statistics data. Compounding these problems is a marketing of fear—a CDC communications strategy in which medical experts “predict dire outcomes” during flu seasons.”
To illustrate part of the problem, Doshi observed that for the year 2001, the total number of reported pneumonia and influenza deaths was 62,034. Yet, of those, less than half of one percent were actually attributed to influenza. Furthermore, of the mere 257 cases blamed on the flu, only 7 percent were laboratory confirmed cases of influenza. That’s 18 cases of lab confirmed influenza out of 62,034 “pneumonia and influenza” deaths—or just 0.03 percent, according to the CDC’s own National Center for Health Statistics (NCHS).
Setting aside pneumonia and looking just at influenza-associated deaths, from 1979 to 2002, the average number according to the NCHS data was a mere 1,348.
If the CDC’s mortality estimates were correct, Doshi further observed, it would mean that half of all deaths classed as due to pneumonia in the NCHS data were actually secondary infections, with a primary influenza infection being the underlying cause of death. But the NCHS criteria itself indicated otherwise, stating that “Cause-of-death statistics are based solely on the underlying cause of death … defined by WHO as ‘the disease or injury which initiated the train of events leading directly do death.’”
At the time Doshi was writing, the CDC was publicly claiming that annually “about 36,000 [Americans] die from flu”. Yet the lead author of the CDC study that number came from, William Thompson of the CDC’s National Immunization Program, acknowledged that the number rather represented “a statistical association” that does not necessarily mean causation. In Thompson’s words, “Based on modelling, we think it’s associated. I don’t know that we would say that it’s the underlying cause of death.” (Emphasis added.)
As Doshi noted, Thompson’s acknowledgment is “incompatible” with the CDC’s “misrepresentation”.
Additionally, the 36,000 estimate represented an 80 percent increase from the CDC’s previous estimate of 20,000 influenza-associated deaths per year. True, the population of Americans over age 65 had grown, but only by 12 percent. Another explanation was that a more virulent strain of the virus had dominated during the 1990s. “But flu deaths recorded by the NCHS were on average 30% lower in the 1990s than the 1980s.”
The CDC, Doshi further observed, was “working in manufacturers’ interest by conducting campaigns to increase flu vaccination”, but “by arbitrarily linking flu with pneumonia, current data are statistically biased.”
In summary, to avoid underestimating influenza-associated hospitalizations and deaths, the CDC appears to have gone too far in the other direction and may be greatly overestimating these numbers. The CDC also continues to present its estimates—and the media continue to relay them—as though representing known cases of influenza-related illness or death, as opposed to estimates produced by mathematical models that are highly problematic.
This apparent overestimation of the impact of influenza on societal health, of course, is in line with the CDC’s goal of using fear to generate greater demand for the pharmaceutical industry’s influenza vaccine products.
The CDC has not only cited what may be wildly overinflated numbers of annual “flu deaths”. To support its policy, it has also cited numbers crediting the vaccine with a dramatic reduction in influenza-related deaths among the elderly.
The problem with the CDC’s claims in this regard is that they have been thoroughly discredited by the scientific community.
Researchers from the National Institutes of Health (NIH) expressed concerns about the CDC’s mortality claims in a study published in April 2005 in Archives of Internal Medicine (now JAMA Internal Medicine). Their concern was prompted by the observation that, despite a considerable increase in vaccination coverage among people aged 65 or older—from at most 20 percent before 1980 to 65 percent in 2001—pneumonia and influenza mortality rates actually “rose substantially during this period” (emphasis added).
That is to say, to quote from a review published in Virology Journal in 2008, contrary to the CDC’s claims of a great beneficial effect on mortality, “influenza mortality and hospitalization rates for older Americans significantly increased in the 80’s and 90’s, during the same time that influenza vaccination rates for elderly Americans dramatically increased.” (Emphasis added.)
As the authors of the 2005 NIH study commented, this result was “surprising” since vaccination was supposed to be “highly effective at reducing influenza-related mortality”—an assumption underlying CDC policy that “has never been studied in clinical trials”.
Relying instead on retrospective observational studies, the CDC has claimed that vaccine efficacy in preventing influenza-related deaths is as high as 80 percent. Furthermore, to support its claim of an enormous benefit, the CDC has relied on a meta-analysis of observational studies that concluded that vaccination reduces the number of flu-season deaths from any cause among the elderly “by an astonishing 50%.”
In their own study, however, the NIH researchers found that, over the course of thirty-three flu seasons, influenza-related deaths were on average only about 5 percent and “always less than 10% of the total number of winter deaths among the elderly.”
The obvious question was: How could it be possible for the influenza vaccine to reduce by half deaths during winter from any cause when no more than one-tenth of deaths in any given flu season could be attributed to influenza?
The most obvious answer was that it couldn’t, and so the researchers examined more closely the methodology of the observational studies that the CDC was relying upon. The conclusion they drew from doing so was that the CDC’s implausible numbers were due to a systemic bias in those studies. There was a “disparity among vaccination” in these studies between cohorts that received a flu vaccine and those that didn’t. Specifically, it wasn’t that vaccinated individuals were less likely to die, but that sick elderly people whose frail condition made them more likely to die during the coming flu season were less likely to get a flu shot.
The CDC’s response to the NIH researchers’ study was to question their methodology while reiterating its unshaken faith in the studies it was relying on to promote the flu vaccine.
Notwithstanding the lack of science to support the statement, and no doubt prompted by the need for government agencies to show solidarity on public vaccine policy, the CDC and NIH subsequently published a joint statement claiming that the seasonal flu shot was the best way to protect old people from dying.
Ironically, and tellingly, while commenting on the lack of evidence that the vaccine was preventing deaths among the elderly and the observed increase in mortality, the NIH researchers in their 2005 study had also acknowledged the effectiveness of naturally acquired immunity at reducing mortality (emphasis added):
The sharp decline in influenza-related deaths among people aged 65 to 74 years in the years immediately after A(H3N2) viruses emerged in the 1968 pandemic was most likely due to the acquisition of natural immunity to these viruses. Because of this strong natural immunization effect, by 1980, relatively few deaths in this age group (about 5000 per year) were left to prevent. We found a similar pattern in influenza-related mortality rates among persons aged 45 to 64 years, an age group with substantially lower vaccine coverage. Together with the flat excess mortality rates after 1980, this suggests that influenza vaccination of persons aged 45 to 74 years provided little or no mortality benefit beyond natural immunization acquired during the first decade of emergence of the A(H3N2) virus.
We will return to question of natural versus vaccine conferred immunity in a future installment of this series. The point for now is to illustrate once again the institutionalized cognitive dissonance that exists when it comes to public vaccine policy.
Numerous additional studies have been published highlighting the lack of credibility of the CDC’s claims about the vaccine’s effectiveness. A systematic review published in The Lancet in October 2005 found a “modest” effect of the vaccine on mortality, but its authors—which included lead author Tom Jefferson, a top researcher for the Cochrane Collaboration—cautioned that this finding must be interpreted in light of the apparent systemic bias of the observational studies. They likewise attributed the perceived effect of the vaccine to a difference in vaccination rates among the cohorts “and the resulting selection bias”.
Randomized controlled trials could minimize any such bias, they observed, but the evidence from such studies was “scant and badly reported.” Hence, placebo-controlled trials were needed to “clarify the effects of influenza vaccines in individuals”. The problem was that such studies were considered impossible “on ethical grounds” due to the fact that mass vaccination was already recommended as a matter of public policy.
The lead author of the 2005 NIH study, Lone Simonsen, was also coauthor with W. Paul Glezen of a commentary in the International Journal of Epidemiology in 2006 that reiterated the problems with the CDC’s claims. Although the vaccination rate for elderly people had increased by as much as 67 percent from 1989 to 1997, there was no evidence that vaccination reduced hospitalizations or deaths. On the contrary, “mortality and hospitalization rates continued to increase rather than decline”. The studies the CDC cited to support its claim of a dramatic reduction in mortality suffered from a selection bias that resulted in “substantial overestimation of vaccine benefits.”
A study in the International Journal of Epidemiology also published in 2006 confirmed the systemic selection bias of the observational studies. Its authors concluded that not only had the results of those studies indicated “preferential receipt of vaccine by relatively healthy seniors”, but that the magnitude of this demonstrated bias “was sufficient to account entirely for the associations observed”. (Emphasis added.)
Peter Doshi, the author of the 2005 BMJ commentary asking whether the CDC’s flu death figures were “more PR than science”, also followed up with a letter to the BMJ published in November 2006 under the headline “Influenza vaccination: policy versus evidence”. As he summed up the situation, “Not only is the evidence supporting the safety and effectiveness of influenza vaccination lacking, but there are also reasons to doubt conventional estimates of the mortality burden of influenza.”
Furthermore, “influenza vaccines impose their own particular burden—to the tune of billions of dollars annually.” Indeed, the “very high cost of yearly vaccination for large parts of the population” was among the considerations of the 2014 Cochrane meta-analysis discussed in part one of this series that concluded that the results of a systematic review of existing studies “provide no evidence for the utilization of vaccination against influenza in healthy adults as a routine public health measure.” A randomized controlled trial studying the cost effectiveness of influenza vaccination in healthy adults under aged 65 published in JAMA in 2000 found that this practice “is unlikely to provide societal economic benefit in most years”—when it generated greater costs than to not vaccinate.
Doshi followed up again with a 2013 BMJ commentary. After all those years, the CDC was still sticking to its claims. And yet, if the CDC’s claims were true, it would mean “that influenza vaccines can save more lives than any other single licensed medicine on the planet. Perhaps there is a reason CDC does not shout this from the rooftop: it’s too good to be true. Since at least 2005, non-CDC researchers have pointed out the seeming impossibility that influenza vaccines could be preventing 50% of all deaths from all causes when influenza is estimated to only cause around 5% of all wintertime deaths.”
Despite scientists pointing out the “healthy user bias” inherent in the observational studies that the CDC relied on to support its bold claims, “CDC does not rebut or in any other way respond to these criticisms.”
“If the observational studies cannot be trusted,” Doshi asked, “what evidence is there that influenza vaccines reduce deaths of older people—the reason the policy was originally created? Virtually none…. This means that influenza vaccines are approved for use in older people despite any clinical trials demonstrating a reduction in serious outcomes.” (Emphasis added.)
“Perhaps most perplexing”, Doshi added, “is officials’ lack of interest in the absence of good quality evidence.”
He further observed how government agencies promote the flu shot by claiming it’s been proven safe. He cited the example of a YouTube video produced by the NIH in which the director of the US National Institute of Allergy and Infectious Diseases, Anthony Fauci, declared that it was “very, very, very rare” for a serious adverse event to be associated with the influenza vaccine.
Yet, “Months later, Australia suspended its influenza vaccination program in under five year olds after many (one in every 110 vaccinated) children had febrile convulsions after vaccination. Another serious reaction to influenza vaccines—and also unexpected—occurred in Sweden and Finland, where H1N1 influenza vaccines were associated with a spike in cases of narcolepsy among adolescents (about one in every 55,000 vaccinated). Subsequent investigations by governmental and non-governmental researchers confirmed the vaccine’s role in these serious events.”
The NIH’s presenter in the video, Anthony Fauci, also happened to be among the opponents of conducting randomized, placebo-controlled studies to determine the safety of the influenza vaccine. “The reason? Placebo recipients would be deprived of influenza vaccines—that is, the standard of care, thanks to CDC guidelines.”
“Drug companies”, Doshi continued, “have long known that to sell some products, you would have to first sell people on the disease.” Only, in the case of the influenza vaccine, “the salesmen are public health officials”.
In sum, there is no credible evidence to support the CDC’s claim that the influenza vaccine reduces hospitalizations or deaths among the elderly. The studies the CDC has relied on to support this claim have been discredited due to their systemic “healthy user” selection bias, and, in fact, the mortality rate has observably increased along with the increase in vaccine uptake—which the CDC has encouraged with its marketing strategy of scaring people into getting the flu shot.
Recall also that one of the CDC’s primary justifications for recommending universal influenza vaccination is the unproven assumption that it would prevent transmission of the virus. Well, one very recent study, just published on January 18, 2018, in the journal of the Proceedings of the National Academy of Sciences of the United States of America, PNAS, strongly indicates that this assumption is false.
The researchers set out to answer the question of how the virus becomes airborne. One would think this was already known, but, surprisingly, as they pointed out, it hasn’t been well studied. So, to find out, they screened volunteers with confirmed cases of influenza and took breath samples. And among their findings was “an association between repeated vaccination and increased viral aerosol generation” (emphasis added).
In fact, subjects who had received the influenza vaccine in both the current and the previous season were found to shed over six times more aerosolized virus than those who did not get a flu shot during either season.
They speculated that the reason for this is that “certain types of prior immunity”—in this case, the kind of immunity conferred by the vaccine as opposed to naturally acquired immunity—“promote lung inflammation, airway closure, and aerosol generation.”
Calling for more studies, they rather understatedly concluded that, “If confirmed, this observation, together with recent literature suggesting reduced protection with annual vaccination, would have implications for influenza vaccination recommendations and policies.” (Emphasis added.)
Yes, you read that correctly. In a future installment of this series, we will discuss the literature being referred to in that quote, including studies showing than annual vaccination can actually increase the risk of illness. The point for now is that the CDC’s assumption that the influenza vaccine reduces transmission of the virus appears to be false.
So what can explain the CDC’s behavior? How can one explain the lack of good scientific evidence supporting its flu vaccine recommendation? How can one explain its apparent lack of interest in establishing the safety of the vaccine in infants and pregnant women? How can one explain its willingness to mislead the public about flu hospitalizations and deaths? How can one explain its insistence on citing estimates of the flu vaccine’s effect on mortality that the scientific community has thoroughly discredited?
While the media are fond of dismissing critics of public vaccine policy as “conspiracy theorists”, no conspiracy is required to explain how this situation can exist. On the contrary, the CDC’s intentions can be explained to a considerable degree by good intentions.
It’s useful here to recall from part one of this series Milton Friedman’s pertinent observation that “Concentrated power is not rendered harmless by the good intentions of those who create it.” The road to hell is paved with good intentions, as the saying goes; or, as Izzy Kalman reiterates it at Psychology Today, “If our interventions cause more harm than good, the interventions are not moral regardless of the loftiness of our intentions.”
It is only human psychology to be resistant to ideas that challenge one’s own self-identity. It’s not difficult to understand how public health officials might be unwilling to acknowledge the possibility that they could be wrong. The idea that public officials are susceptible to what is known as “confirmation bias”, or the tendency to accept information supportive of one’s personal belief system while dismissive of information that contradicts it, should hardly be considered far-fetched.
It is also not as though the medical establishment has not been wrong before! As Dave Sackett, “the father of evidence based medicine” once quipped, “Half of what you’ll learn in medical school will be shown to be either dead wrong or out of date within five years of your graduation; the trouble is that nobody can tell you which half—so the most important thing to learn is how to learn on your own.”
This situation isn’t helped by the pharmaceutical industry’s undue influence on the direction of science. As we saw in part one, BMJ editor Richard Horton has commented that “Journals have devolved into information-laundering operations for the pharmaceutical industry.”
Studies into this problem have shown that an alarming proportion of medical literature gets the science wrong. As a 2013 study published in the European Journal of Clinical Investigation concluded, “To serve its interests, the industry masterfully influences evidence base production, evidence synthesis, understanding of harms issues, cost-effectiveness evaluations, clinical practice guidelines and healthcare professional education and also exerts direct influences on professional decisions and health consumers.”
One of the authors of that study was John Ioannidis, who’s been described by The Atlantic as possibly “one of the most influential scientists alive”. In a 2005 essay published in PLoS Medicine, Ioannidis wrote that, “It can be proven that most claimed research findings are false.” And false findings might not just be “the majority”, but could be “the vast majority”. Rather than majority expert opinion representing scientific truths, claimed findings “may often be simply accurate measures of the prevailing bias.”
Among the numerous other problems affecting the quality of research are financial conflicts of interests and institutionalized prejudices. As Ioannidis elaborated,
Conflicts of interest are very common in biomedical research, and typically they are inadequately and sparsely reported. Prejudice may not necessarily have financial roots. Scientists in a given field may be prejudiced purely because of their belief in a scientific theory or commitment to their own findings. Many otherwise seemingly independent, university-based studies may be conducted for no other reason than to give physicians and researchers qualifications for promotion or tenure. Such nonfinancial conflicts may also lead to distorted reported results and interpretations. Prestigious investigators may suppress via the peer review process the appearance and dissemination of findings that refute their findings, thus condemning their field to perpetuate false dogma. Empirical evidence on expert opinion shows that it is extremely unreliable.
As The Atlantic noted, Ioannidis has estimated that “as much as 90 percent of the published medical information that doctors rely on is flawed”, and “he worries that the field of medical research is so pervasively flawed, and so riddled with conflicts of interest, that it might be chronically resistant to change—or even to publicly admitting that there’s a problem.”
That certainly also applies to the CDC, where corruption and conflicts of interest are an endemic problem.
As one prominent example, the head of the CDC from 2002 to 2009, Julie Gerberding, left her government job promoting vaccines to go work as president of Merck’s $5 billion global vaccine division. Merck’s CEO understandably described Gerberding as an “ideal choice”.
She held that position until 2014 and currently holds the Merck job title of “Executive Vice President & Chief Patent Officer, Strategic Communications, Global Public Policy and Population Health”.
That is to say, she is now in charge of Merck’s propaganda efforts. And her relationship with Merck has proved lucrative. Apart from her salary, in 2015, Gerberding sold shares of Merck worth over $2.3 million dollars.
One could say the former CDC director is now doing essentially the same job she did at the CDC, only for more money than she was making at her government job.
Just since the writing of this multi-part exposé began, now ex-CDC Director Brenda Fitzgerald was forced to resign after Politico reported that, after assuming leadership of the CDC on July 7, 2017, she “bought tens of thousands of dollars in new stock holdings in at least a dozen companies”—including Merck.
In August 1999, the House of Representatives Committee on Government Reform initiated an investigation into federal vaccine policy, the findings of which were reported in June 2000. As its report stated, “The Committee’s investigation has determined that conflict of interest rules employed by the FDA and the CDC have been weak, enforcement has been lax, and committee members with substantial ties to pharmaceutical companies have been given waivers to participate in committee proceedings.”
Examples of the corruption included the following:
- “The CDC routinely grants waivers from conflict of interest rules to every member of its advisory committee.”
- “CDC Advisory Committee members who are not allowed to vote on certain recommendations due to financial conflicts of interest are allowed to participate in committee deliberations and advocate specific positions.”
- “The Chairman of the CDC’s advisory committee until very recently owned 600 shares of stock in Merck….”
- “Members of the CDC’s advisory Committee often fill out incomplete financial disclosure statements, and are not required to provide the missing information by CDC ethics officials.”
- “Four out of eight CDC advisory committee members who voted to approve guidelines for the rotavirus vaccine in June 1998 had financial ties to pharmaceutical companies that were developing different versions of the vaccine.”
- “3 out of 5 FDA advisory committee members who voted to approve the rotavirus vaccine in December 1997 had financial ties to pharmaceutical companies that were developing different versions of the vaccine.”
A US Senate report from June 2007 noted how surveys showed that Americans “overwhelmingly” viewed the CDC as doing a good job at keeping them healthy, as well as how the CDC took advantage of that perception by seeking ever increasing levels of funding year after year—and yet the CDC had little to show for its exorbitant spending.
The Senate report cited Julie Gerberding as an example of the problem. Under her leadership, bonuses for the people managing the CDC increased dramatically. The top three CDC financial officers, for example, had “taken in more than a quarter million dollars in bonuses” over the previous several years. A New York Times analysis, the Senate report noted, had found that “The share of premium bonuses given to those within the director’s office has risen at least tenfold under Dr. Gerberding’s leadership.”
Another problem was the “revolving door” of Washington. Citing examples, the Senate report commented that, “While CDC employees’ pay may not be equal to those in the private market, contractors who previously were employed by the CDC appear to have found a lucrative way to make their CDC connections pay off.”
The Senate report was appropriately subtitled, “A review of how an agency tasked with fighting and preventing disease has spent hundreds of millions of tax dollars for failed prevention efforts, international junkets, and lavish facilities, but cannot demonstrate it is controlling disease.”
A 2009 report from the Office of the Inspector General for the Department of Health and Human Services found that “almost all” financial disclosure forms for “special Government employees”—such as the people who sit on the CDC’s vaccine advisory committee—were not properly completed. For 97 percent of them, there was at least one omission, and “Most of the forms had more than one type of omission.” Furthermore, looking at the year 2007, 64 percent of such employees were found to have potential conflicts of interest that the CDC either failed to identify or failed to resolve. The CDC also failed to ensure that 41 percent of such employees received required ethics training, and 15 percent of such employees “did not comply with ethics requirements during committee meetings in 2007.” In sum, the Inspector General’s office found “that CDC had a systemic lack of oversight of the ethics program” for special government employees.
A particularly salient example was the aforementioned June 1998 recommendation of the CDC’s Advisory Committee on Immunization Practices (ACIP) that all infants receive the rotavirus vaccine.
Included among the half of ACIP members who had financial ties to pharmaceutical companies while deliberating what CDC policy should be with respect to the rotavirus vaccine was one Dr. Paul Offit.
Paul Offit is currently director of the Vaccine Education Center at the Children’s Hospital of Philadelphia (CHOP). He also holds the Maurice R. Hilleman Chair in Vaccinology, created in honor of the former senior vice president of Merck, which provided a $1.5 million endowment to the hospital and the University of Pennsylvania to “accelerate the pace of vaccine research”.
Offit joined the ACIP in October 1998 and three times voted in favor on decisions related to the use of the rotavirus vaccine, including a vote to add the vaccine to the CDC’s Vaccines For Children program—while at the same time sharing ownership of a patent for a rotavirus vaccine being developed under a grant from Merck.
A member of the CDC’s advisory committee until June 2003, Offit’s vaccine was approved by the FDA in 2006 under the trademark “RotaTeq”. The Children’s Hospital of Philadelphia was listed alongside Offit as a patent owner on the filing certificate issued by the US Patent and Trademark Office, and the hospital sold its stake in RotaTeq in 2008 under a deal in which Offit profited handsomely; he has acknowledged that the deal made him “several million dollars, a lot of money”.
Offit also happens to be a routinely cited go-to “expert” on vaccines for the mainstream media. He once penned an op-ed for the New York Times accusing parents who choose not to vaccinate their children of child abuse on the grounds that Jesus would advocate forcibly vaccinating children against their parents’ will.
Rather, Jesus would undoubtedly count Paul Offit among the hypocrites who “clean the outside of the cup and dish, but inside they are full of greed and self-indulgence” (Matthew 23:25).
As it so happened, in October 1999, the first rotavirus vaccine licensed for use in the US, Wyeth’s RotaShield, was withdrawn from the market because it was found to be causing intussusception, an often excruciating and potentially fatal condition in which part of the intestine telescopes into itself.
In addition to the conflicts of interest within the CDC, the Food and Drug Administration (FDA) had approved RotaShield as “safe” despite clinical trials having shown an increase in incidence of intussusception in vaccinated infants.
This finding was dismissed as “probably due to chance” by the FDA’s Vaccines and Related Biological Products Advisory Committee (VRBPAC)—the FDA’s equivalent of the ACIP that at the time had similarly included three out of five members having ties to pharmaceutical companies developing rotavirus vaccines.
And while the FDA instructed Wyeth on which specific areas it ought to focus its postmarketing safety studies, the risk of intussusception was not one of them.
Researchers monitoring publicly available postmarketing surveillance data nevertheless did pick up on the incoming reports of intussusception, and studies were conducted that confirmed the association between vaccination and an increased risk of the intestinal disorder.
As the CDC spokesman John Livengood summarized the findings, “We feel there is a strong causal relationship between rotavirus vaccine and intussusception. It’s of high magnitude and it appears to be about one in every five thousand children who are vaccinated with the vaccine.” Estimates ranged from one in five thousand to one in ten thousand. Prior to being pulled from the market, the vaccine was administered to half a million children. Surveillance data showed that during its short time in use, there were 98 confirmed reports of vaccine-related intussusception, over half of which required surgery and one of which resulted in death.
When the CDC voted on October 22, 1999, to withdraw its recommendation for routine use of RotaShield in children, Paul Offit recused himself from the vote on the grounds that it would create a “perception” of a conflict of interest for him to participate in the vote while he was also serving as a consultant for a company developing a vaccine to compete with Wyeth’s RotaShield.
Instructively, he did not consider his rather glaring conflict of interest to have been reason to abstain from the votes to recommend routine use of the rotavirus vaccine in children in the first place.
Now, what would Jesus think about that?
As an additional twist to the story, the virus used in the manufacture of RotaShield was developed by the US government.
With development of a rotavirus vaccine having been considered a priority for researchers since the virus was discovered in the early 1970s, the National Institutes of Health created a “live simian-human reassortant virus” for the purpose. (A reassortant virus is one containing two or more pieces of nucleic acid from different parent viruses, produced by coinfecting a cell with the parent strains. The simian virus in this case was from a rhesus monkey.)
The NIH then licensed Wyeth to use its patented vaccine technology for RotaShield.
Yes, the US government patents vaccine technology and licenses it for a fee to private corporations. As another example, the NIH licensed vaccine technology to Merck for development of its Human Papilloma Virus (HPV) vaccine, Gardasil.
As you can see, the government isn’t so much a “regulator” of the vaccine industry as an integral part of it.
The CDC itself maintains contracts with pharmaceutical companies and, excepting influenza vaccines, purchases more than half of the childhood vaccines distributed in the US. It is essentially a marketing and distribution division of the vaccine industry.
With no lack of irony, the way the government tells the story of RotaShield, it is a shining example of how the bureaucracies charged with ensuring vaccine safety are highly effective at doing so.
But wait, there’s more!
In March 2010, the FDA advised temporarily suspending the use of GlaxoSmithKline’s rotavirus vaccine, Rotarix, because it was found to be contaminated with a pig virus—porcine circovirus type 1 (PCV-1). It was therefore recommended that patients instead receive Merck’s product, RotaTeq.
RotaTeq was soon thereafter also found to be contaminated with both PCV-1 and porcine circovirus type 2 (PCV-2).
The FDA publicized this finding on May 6, 2010. But rather than advising that RotaTeq, too, be suspended from use until this contamination could be resolved and the threat evaluated, on May 14, the FDA recommended that health care professionals resume use of Rotarix alongside the continued use of RotaTeq on the grounds that there was no known risk to humans from these viruses.
Incidentally, one of the scientific contributions of Maurice R. Hilleman—the former Merck vice president in honor of whom the chair held by Paul Offit was created—was his discovery in 1960 that both the live-virus and inactivated polio vaccines in use in the US were contaminated with a monkey virus known as simian virus 40 (SV40). In May the following year, the National Institutes of Health (NIH) convened to discuss the issue, recommending that the vaccines not be withdrawn from use on the grounds that there was no known risk to humans from the virus.
Numerous studies have since found SV40 to be associated with an increased risk of certain types of cancer in humans, including non-Hodgkin lymphoma.
In a 2006 BMJ article, Tom Jefferson (the Cochrane researcher and lead author of the aforementioned 2005 Lancet systematic review) returned to the salient issue of “policy versus evidence” with respect to the influenza vaccine.
As Jefferson explained, to support the claim that the vaccine offers a significant benefit, government agencies like the CDC and WHO cite single studies examining data from only one or two flu seasons.
However, because of the genetic variability in influenza viruses, as well as in the effectiveness of the vaccine from year to year, such studies are “difficult to interpret” and “not reliable sources for generalizing the effects of vaccines”, especially when the data sets are small.
Systematic reviews are useful for helping to get a glimpse at the bigger picture. Jefferson therefore searched for relevant systematic reviews and recognized three immediate problems.
The first problem was the lack of non-randomized studies and the selection bias of the observational studies. The “poor study quality” of the latter was “also seen in the outcome of a review of evidence supporting the vaccination of all children to minimize transmission to family contacts.”
The second problem was “either the absence of evidence or the absence of convincing evidence on most of the effects at the centre of campaign objectives.”
The third problem was “the small and heterogeneous dataset on the safety of inactivated vaccines, which is surprising given their longstanding and widespread use.” The 2006 Cochrane review of vaccines for preventing influenza in healthy children, for example, had found “only one old trial with data from 35 participants aged 12-28 months.”
Furthermore, by design, the kinds of studies the CDC was relying on did not consider the long-term effect of repeated annual vaccination. This great “lack of knowledge” about whether annual revaccination might be harmful, Jefferson commented, “is surprising.” (We will return to the significance of the lack of studies into long-term effects in a future installment of this series.)
In sum, there was a “large gap between policy and what the data tell us”.
Policymakers seemed to be taking the approach that they had to do something and couldn’t wait for the studies to be done. While perhaps well intended, this attitude has “two important consequences”.
First was the opportunity cost: CDC policy resulted in the use of resources that might otherwise be directed toward more effective health interventions.
“Secondly, the inception of a vaccination campaign seems to preclude the assessment of a vaccine through placebo controlled randomized trials on ethical grounds. Far from being unethical, however, such trials are desperately needed and we should invest in them without delay.” (Emphasis added.)
Indeed, as seen with the case of Anthony Fauci, apologists for public vaccine policy do argue that it would be unethical to conduct randomized, placebo-controlled studies of long-term health outcomes in vaccinated versus unvaccinated individuals. The circular reasoning underlying this conclusion is that, since it would necessitate denying people the benefits of the vaccine, therefore it would be unethical to include anyone in a placebo group.
According to this twisted logic, subjecting the entire population to an uncontrolled experiment without their informed consent by injecting them with vaccines for which such safety studies have admittedly never been done is somehow not unethical.
In essence, public vaccine policy constitutes a direct assault on the right of individuals to informed consent.
This includes our right to decide what goes into our own bodies, as well as the right of parents to decide on behalf of their children what goes into their children’s bodies.
In the wake of World War II and revelations about the Nazis’ use of humans for medical experimentation, the international community formally recognized informed consent as a fundamental human right. The Nuremberg Code established medical ethics principles starting with this: “The voluntary consent of the human subject is absolutely essential.” This means, among other things, that the subject must be in a position “to be able to exercise free power of choice, without the intervention of any element of force, fraud, deceit, duress, overreaching, or other ulterior form of constraint or coercion”. Additionally, the subject “should have sufficient knowledge and comprehension of the elements of the subject matter involved as to enable him to make an understanding and enlightened decision.”
The right to informed consent has also been codified in the 1966 United Nations International Covenant on Civil and Political Rights, which states under Article 7 that “no one shall be subjected without his free consent to medical or scientific experimentation.”
The updated 2002 edition of the International Ethical Guidelines for Biomedical Research Involving Human Subjects—guidelines promulgated by the World Health Organization (WHO) and the Council for International Organizations of Medical Sciences—states that, “For all biomedical research involving humans the investigator must obtain the voluntary informed consent of the prospective subject or, in the case of an individual who is not capable of giving informed consent, the permission of a legally authorized representative….”
This right is codified in the Universal Declaration on Bioethics and Human Rights, adopted at the United Nations Educational, Scientific and Cultural Organization (UNESCO) in October 2005: “Any preventive, diagnostic and therapeutic medical intervention is only to be carried out with the prior, free and informed consent of the person concerned, based on adequate information…. Scientific research should only be carried out with the prior, free, express and informed consent of the person concerned. The information should be adequate, provided in a comprehensible form and should include modalities for withdrawal of consent…. In no case should a collective community agreement or the consent of a community leader or other authority substitute for an individual’s informed consent.” (Emphasis added.)
Yet substituting individual informed consent with state authority is precisely what public vaccine policy does—including by treating our children effectively as subjects of one massive uncontrolled experiment.
One obvious violation of the right to informed consent is state governments’ use of mandates to coerce parents into vaccinating their children under threat of penalty for disobedience. (The denial of public education is certainly a penalty for taxpaying parents who wish for their child to receive it.)
It is also manifest in the fact that it is government policymakers determining what qualifies a patient for a medical exemption to vaccination, rather than this being determined by the only parties possessive of the knowledge necessary to reasonably make that determination—namely, the doctor and patient (or the patient’s parents or legal guardians).
But a no less egregious violation of the right to informed consent is how the government—with the help of the compliant establishment media—manufactures consent for vaccine policy by systematically deceiving the public about the science.
The general consequence of this mass deception is that, when consent is given, it is mis-informed, as incontrovertibly demonstrated in the case of the flu vaccine.
The CDC’s own institutionalized prejudice against the right to informed consent is reflected in its view that growing health literacy among the public is an obstacle that must be overcome—including by deliberately deceiving and trying to scare people into getting the flu shot.
As you’ve seen in part one of this series, the government and mainstream media systematically deceive the public about what the science says about the safety and effectiveness of the flu vaccine. In this installment, you’ve witnessed further illustrations of the great extent of this deception.
Rather than encouraging respect for the right to informed consent, the government views people educating themselves and making their own health decisions as a serious challenge to be overcome.
Far from properly informing the public, the government uses fear and deception to incentivize people into getting an annual flu shot.
The mainstream media, rather than performing their duty to investigate and hold government officials accountable, serve only to broadcast the government’s misinformation and fearmongering, as well as to fuel the atmosphere of intimidation that permeates society today—wherein anyone who dares to question public vaccine policy is derogatorily labelled an “anti-vaxxer” and their views dismissed as “anti-science”, no matter how firmly grounded in fact and reason.
In line with its goal of selling more flu vaccines by scaring people into getting an annual shot, the CDC tells the public that hundreds of thousands of people are hospitalized and tens of thousands die each year from the flu. What neither the CDC nor the mainstream media explain to the public is that these numbers are arrived at through theoretical models built on highly problematic assumptions, including the arbitrary lumping together of pneumonia and influenza cases and the failure to account for the fact that most cases of reported “flu” are not actually caused by influenza.
Similarly, the CDC has cited implausible figures to support its claim that vaccination reduces deaths among the elderly. It has stuck by its claim even though the studies it has cited to support its claim have been thoroughly discredited by the scientific community as suffering fatally from an inherent “healthy user” selection bias.
While CDC policy is premised on the assumptions that mass vaccination prevents serious complications and prevents transmission of the virus, systematic reviews of the literature by the prestigious Cochrane Collaboration have found no evidence to support either assumption—and one recent study found that vaccination actually increases transmission, with vaccinated individuals spreading over six times as much aerosolized virus.
Whereas the media frequently dismiss as “conspiracy theory” any suggestion of a disparity between public vaccine policy and the science, in fact this disparity is well recognized by expert scientists writing in the medical literature. Furthermore, no conspiracy is necessary to explain this situation. Rather, good intentions clouded by institutionalized confirmation bias goes a long way toward explaining it, and together with the endemic corruption found at agencies like the CDC and FDA is more than sufficient for us to understand how this can possibly be.
The ultimate consequence of the atmosphere of fear, deception, and intimidation that surrounds the vaccine issue is that individuals’ right to informed consent is being routinely and systematically violated. Indeed, public vaccine policy not only jeopardizes our health but constitutes an all-out assault on our liberty.
There is a discussion to be had about vaccines. It is well past time public health officials and the media started having it.
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Read Other Articles in This Series
This has been the second part of multi-part exposé on how the government and media lie to the public about the safety and effectiveness of the influenza vaccine. To read other installments:
A fifth and final installment is forthcoming.
I would like to gratefully acknowledge my community of readers for the financial contributions that made it possible for me to deliver this information to you. In addition to a number of other donators who either did not reply to my request to publicly acknowledge them or who would prefer to remain anonymous, I would like to thank the following individuals: David P. Lang, “John Marathon”, Brian Murdock, Janet Newman, Eleanor Ommani, “AR”, Bretigne Shaffer, and Dr. Anke Zimmermann.
[Correction Appended, May 12, 2018: As originally published, this article stated that Paul Offit voted in favor of the rotavirus vaccine being included on the CDC’s list of vaccines recommended for routine use in children. That vote occurred before he became a member. He voted in favor of the vaccine on three other votes, including the vote to add the vaccine to the Vaccines For Children program.
Correction Appended, December 10, 2018: As originally published, this article stated that Paul Offit recused himself from the ACIP vote to withdraw the rotavirus vaccine from the schedule because he was “serving as a consultant for a company developing a vaccine to compete with Merck’s RotaShield.” This should have read “Wyeth’s Rotashield”. RotaShield was Wyeth’s rotavirus vaccine, and Offit was developing a competitor vaccine for Merck.]
 Jeremy R. Hammond, “Should You Get the Flu Shot Every Year? Don’t Ask the New York Times.” Jeremy R. Hammond, February 7, 2018, https://www.jeremyrhammond.com/2018/02/07/should-you-get-the-flu-shot-every-year-dont-ask-the-new-york-times/
 Glen Nowak, Ph.D., “Increasing Awareness and Uptake of Influenza Immunization”, Centers for Disease Control and Prevention presentation at the Institute of Medicine Workshop on Pandemic Influenza: Assessing Capabilities for Prevention and Response, Washington, DC, Institute of Medicine Forum on Microbial Threats, June 17, 2004, http://nationalacademies.org/hmd/~/media/Files/Activity%20Files/PublicHealth/MicrobialThreats/Nowak.pdf. For citation information not provided in the slideshow presentation itself, see: Stanley M. Lemon and Adel A. F. Mahmoud, “The Threat of Pandemic Influenza: Are We Ready?” Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science, 2005, http://online.liebertpub.com/doi/abs/10.1089/bsp.2005.3.70?journalCode=bsp.
 Hammond, op. cit.
 Tom Jefferson et al, “Vaccines for preventing influenza in healthy adults”, Cochrane Database of Systematic Reviews, July 7, 2010, https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001269.pub4/full.
 Centers for Disease Control and Prevention, “Influenza: The Disease”, CDC.gov, December 30, 2003; archived on February 5, 2004 at https://web.archive.org/web/20040205120830/www.cdc.gov/flu/about/disease.htm
 Peter Doshi, “Are US flu death figures more PR than science?” BMJ, December 8, 2005, http://www.bmj.com/content/331/7529/1412. The full text is available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1309667/.
 William T. Thompson et al, “Mortality Associated With Influenza and Respiratory Syncytial Virus in the United States”, JAMA, January 8, 2003, https://jamanetwork.com/journals/jama/fullarticle/195750
 Centers for Disease Control and Prevention, “Estimates of Deaths Associated with Seasonal Influenza — united States, 1976—2007”, Morbidity and Mortality Weekly Report (MMWR), August 27, 2010, https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5933a1.htm.
 Centers for Disease Control and Prevention, “Estimated Influenza Illnesses, Medical Visits, Hospitalizations, and Deaths Averted by Vaccination in the United States”, CDC.gov, updated April 19, 2017 and accessed January 29, 2018, https://www.cdc.gov/flu/about/disease/2015-16.htm
 MMWR, August 27, 2010. Centers for Disease Control and Prevention, “Estimating Seasonal Influenza-Associated Deaths in the United States: CDC Study Confirms Variability of Flu”, CDC.gov, updated March 18, 2015, https://www.cdc.gov/flu/about/disease/us_flu-related_deaths.htm. Note that this information has since been removed from this page, but the older version is accessible via the Internet Archive Wayback Machine (archived on May 26, 2016) at https://web.archive.org/web/20160529074133/https:/www.cdc.gov/flu/about/disease/us_flu-related_deaths.htm.
 Doshi, “Are US flu death figures more PR than science?”
 Lone Simonsen et al, “Impact of Influenza Vaccination on Seasonal Mortality in the US Elderly Population”, Archives of Internal Medicine, February 14, 2005, https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/486407
 John J Cannell et al, “On the epidemiology of influenza”, Virology Journal, February 25, 2008, https://virologyj.biomedcentral.com/articles/10.1186/1743-422X-5-29
 Simonsen et al, op. cit.
 Claudia Orellana, “Mortality benefits of influenza vaccine questioned”, The Lancet, April 2005, http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(05)70045-1/abstract
 Lone Simonsen et al
 Tom Jefferson et al, “Efficacy and effectiveness of influenza vaccines in elderly people: a systematic review”, The Lancet, October 2005, http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(05)67339-4/fulltext
 W Paul Glezen and Lone Simonsen, “Commentary: Benefits of influenza vaccine in US elderly—new studies raise questions”, International Journal of Epidemiology, April 1, 2006, https://academic.oup.com/ije/article/35/2/352/694736
 Lisa A Jackson et al, “Evidence of bias in estimates of influenza vaccine effectiveness in seniors”, International Journal of Epidemiology, 2006, http://ije.oxfordjournals.org/content/35/2/337.full.pdf+html
 Peter Doshi, “Influenza vaccination: policy versus evidence”, BMJ, November 11, 2006, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1635629/
 Vittorio Demicheli et al, “Vaccines for preventing influenza in healthy adults”, Cochrane Database of Systematic Reviews, March 13, 2014, http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001269.pub5/full. For further discussion, see Hammond, op. cit. (part one of this series).
 Carolyn Buxton Bridges et al, “Effectiveness and Cost-Benefit of Influenza Vaccination of Healthy Working Adults: A Randomized Controlled Trial”, JAMA, October 4, 2000, https://jamanetwork.com/journals/jama/fullarticle/193139
 Peter Doshi, “Influenza: marketing vaccine by marketing disease”, BMJ, May 16, 2013, http://www.bmj.com/content/346/bmj.f3037. Anthony Fauci, incidentally, was also one of the authors of the NEJM study cited by Aaron Carroll in his New York Times article, discussed in part one of this series. Note that the CDC has persisted in its claims despite acknowledging that “Observational studies that compare less-specific outcomes among vaccinated populations to those among unvaccinated populations are subject to biases that are difficult to control for during analyses. For example, an observational study that determines that influenza vaccination reduces overall mortality might be biased if healthier persons in the study are more likely to be vaccinated.” The CDC adds that “Randomized controlled trials that measure laboratory-confirmed influenza virus infections as the outcome are the most persuasive evidence of vaccine efficacy, but such trials cannot be conducted ethically among groups recommended to receive vaccine annually.” See Anthony E. Fiore et al, Centers for Disease Control and Prevention, “Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2010”, Morbidity and Mortality Weekly Report (MMWR), August 6, 2010, https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5908a1.htm.
 Jing Yan et al, “Infectious virus in exhaled breath of symptomatic seasonal influenza cases from a college community”, PNAS, January 18, 2018, http://www.pnas.org/content/early/2018/01/17/1716561115.full
 Hammond, op. cit.
 Izzy Kalman, “Principle One: Road to Hell is Paved with Good Intentions”, Pyschology Today, August 16, 2010, https://www.psychologytoday.com/blog/resilience-bullying/201008/principle-one-road-hell-is-paved-good-intentions.
 For a useful illustration of how confirmation bias can result in one closing one’s mind to any information that contradicts one’s worldview and self-identity, see Jeremy R. Hammond, “Dr. Mercola Cites My Work on Vaccines: Confirmation Bias of Doctors”, JeremyRHammond.com, March 8, 2017, https://www.jeremyrhammond.com/2017/03/08/dr-mercola-cites-my-work-on-vaccines-confirmation-bias-of-doctors/.
 To offer one example relevant today, see Donald J. McNamara, “Dietary cholesterol, heart disease risk and cognitive dissonance”, Proceedings of the Nutrition Society, May 2014, https://www.cambridge.org/core/journals/proceedings-of-the-nutrition-society/article/dietary-cholesterol-heart-disease-risk-and-cognitive-dissonance/C3A48F8C4614E65E0724F31C2997E7AE. As McNamara observes, “In the 1960s, the thesis that dietary cholesterol contributes to blood cholesterol and heart disease risk was a rational conclusion based on the available science at that time. Fifty years later the research evidence no longer supports this hypothesis yet changing the dietary recommendation to limit dietary cholesterol has been a slow and at times contentious process.”
 Richard Smith, “Thoughts for new medical students at a new medical school”, BMJ, December 20, 2003, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC300793/
 Hammond, op. cit.
 Emmanuel Stamatakis, Richard Weiler, and John P.A. Ioannidis, “Undue industry influences that distort healthcare research, strategy, expenditure and practice: a review”, European Journal of Clinical Investigation, http://onlinelibrary.wiley.com/doi/10.1111/eci.12074/pdf
 David H. Freedman, “Lies, Damned Lies, and Medical Science”, The Atlantic, November 2010, https://www.theatlantic.com/magazine/archive/2010/11/lies-damned-lies-and-medical-science/308269/
 John P. A. Ioannidis, “Why Most Published Research Findings Are False”, PLoS One, August 2005, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1182327/
 Freedman, “Lies, Damned Lies, and Medical Science”.
 “Former CDC head lands vaccine job at Merck”, Reuters, December 21, 2009, https://www.reuters.com/article/us-merck-gerberding/former-cdc-head-lands-vaccine-job-at-merck-idUSTRE5BK2K520091221
 Merck, “Executive Committee”, Merck.com, accessed January 29, 2018, https://www.merck.com/about/leadership/executive-committee/home.html
 United States Securities and Exchange Commission, SEC Form 4, Statement of Changes in Beneficial Ownership for Gerberding Julie L., SEC.gov, May 11, 2015, accessed January 29, 2018, https://www.sec.gov/Archives/edgar/data/310158/000122520815011802/xslF345X01/doc4.xml. Thomas Dobrow, “Merck & Co. EVP Julie L. Gerberding Sells 38,368 Shares (MRK)”, Dakota Financial News, May 11, 2015, https://web.archive.org/web/20150528003538/http:/www.dakotafinancialnews.com/merck-co-evp-julie-l-gerberding-sells-38368-shares-mrk/159207/
 Sarah Karlin-Smith and Brianna Ehley, “Trump’s top health official traded tobacco stock while leading anti-smoking efforts”, Politico, January 30, 2018, https://www.politico.com/story/2018/01/30/cdc-director-tobacco-stocks-after-appointment-316245. Adam Cancryn and Jennifer Haberkorn, “Why the CDC director had to resign”, Politico, January 31, 2018, https://www.politico.com/story/2018/01/31/cdc-director-resigns-fitzgerald-azar-380680.
 US House of Representatives, “Conflicts of Interest in Vaccine Policy Making”, Majority Staff Report of the Committee on Government Reform, June 15, 2000. archived at WorldMercuryProject.org, https://worldmercuryproject.org/wp-content/uploads/conflicts-of-interest-government-reform-2000.pdf
 US Senate, “CDC Off Center”, Minority Office of the Subcommittee on Federal Financial Management, Government Information and International Security, June 2007, https://www.cbsnews.com/htdocs/pdf/cdc_off_center.pdf.
 US Department of Health and Human Services, Office of Inspector General, “CDC’s Ethics Program for Special Government Employees on Federal Advisory”, December 2009, https://oig.hhs.gov/oei/reports/oei-04-07-00260.pdf
 US House of Representatives, op. cit.
 Children’s Hospital of Philadelphia, “Paul A. Offit, MD”, Chop.edu, accessed March 6, 2018, http://www.chop.edu/doctors/offit-paul-a. University of Pennsylvania, Perelman School of Medicine, “The Maurice R. Hilleman Chair of Vaccinology”, accessed February 5, 2018, http://www.med.upenn.edu/endowedprofessorships/maurice-r.-hilleman-chair-of-vaccinology.html. Merck Company Foundation, “The Merck Company Foundation, The Children’s Hospital of Philadelphia and the University of Pennsylvania School of Medicine Announce the Creation of The Maurice R. Hilleman Chair in Vaccinology”, Bussinesswire, March 22, 2005, http://www.businesswire.com/news/home/20050322005469/en/Merck-Company-Foundation-Childrens-Hospital-Philadelphia-University#.VOJb3yvF-So. Archived at https://web.archive.org/web/20170302092654/http://www.businesswire.com/news/home/20050322005469/en/Merck-Company-Foundation-Childrens-Hospital-Philadelphia-University.
 US House of Representatives, op. cit.
 Mark Benjamin, “UPI Investigates: The vaccine conflict”, UPI, July 21, 2003, https://www.upi.com/UPI-Investigates-The-vaccine-conflict/44221058841736/. United States Patent and Trademark Office, Certificate Extenting Patent Term Under 35 U.S.C. § 156, Patent No. 5,626,851, Issued May 6, 1997, http://www.uspto.gov/sites/default/files/patents/resources/terms/5626851.pdf. Amy Wallace, “An Epidemic of Fear: How Panicked Parents Skipping Shots Endanger Us All,” Wired, October 19, 2009, http://www.wired.com/2009/10/ff_waronscience/.
 Paul A. Offit, “What Would Jesus Do About Measles?” New York Times, February 10, 2015, http://www.nytimes.com/2015/02/10/opinion/what-would-jesus-do-about-measles.html
 Centers for Disease Control and Prevention, “Rotavirus Vaccine (RotaShield®) and Intussusception”, CDC.gov, last reviewed April 22, 2011, and accessed February 5, 2018, https://www.cdc.gov/vaccines/vpd-vac/rotavirus/vac-rotashield-historical.htm
 US House of Representatives, op. cit.
 Jason L Schwartz, “The First Rotavirus Vaccine and the Politics of Acceptable Risk”, The Milbank Quarterly, June 2012, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3460207/
 US House of Representatives, op. cit. As Offit stated at the meeting prior to the vote, “I’m not conflicted with Wyeth, but because I consult with Merck on the development of rotavirus vaccine, I would still prefer to abstain because it creates a perception of conflict.”
 Schwartz, op. cit.
 National Institutes of Health, Office of Technology Transfer, “NIH Technology Licensed to Merck for HPV Vaccine”, undated and accessed March 6, 2018, https://www.ott.nih.gov/news/nih-technology-licensed-merck-hpv-vaccine
 Centers for Disease Control and Prevention, Office of the Associate Director For Science (OADS), “For Industry”, CDC.gov, last updated August 17, 2016 and accessed March 15, 2018, https://www.cdc.gov/od/science/technology/techtransfer/industry/licensing/index.htm. Ibid., “Available Technologies for Licensing and Collaboration”, CDC.gov, last updated April 5, 2016 and accessed March 15, 2018, https://www.cdc.gov/od/science/technology/techtransfer/industry/licensing/technologies.htm. Lance E. Rodewald et al, “Vaccine Supply Problems: A Perspective of the Centers for Disease Control and Prevention”, Clinical Infectious Diseases, March 1, 2006, https://academic.oup.com/cid/article/42/Supplement_3/S104/337816#97930722. See also Schwartz, op. cit.
 Schwartz, op. cit.
 Daniel J. DeNoon, “Pig Virus DNA Found in Rotavirus Vaccine”, WebMD.com, March 22, 2010, https://www.webmd.com/children/vaccines/news/20100322/pig-virus-found-in-gsk-rotavirus-vaccine#1. Tom Watkins, “Rotarix rotavirus vaccine contaminated, officials say”, CNN, March 22, 2010, http://www.cnn.com/2010/HEALTH/03/22/rotavirus.vaccine/index.html
 John Petricciani et al, “Adventitious agents in viral vaccines: Lessons learned from 4 case studies”, Biologicals, September 2014, https://www.sciencedirect.com/science/article/pii/S1045105614000748
 F Fisher SG, Weber L, Carbone M, “Cancer risk associated with simian virus 40 contaminated polio vaccine,” Anticancer Research, Vol. 19, No. 3B, May-June 1999, 2173-2180, http://www.ncbi.nlm.nih.gov/pubmed/10472327. Institute of Medicine, “Immunization Safety Review: SV40 Contamination of Polio Vaccine and Cancer”, National Academies Press, 2002, https://www.nap.edu/catalog/10534/immunization-safety-review-sv40-contamination-of-polio-vaccine-and-cancer. Regis A. Vilchez, et al, “Association between simian virus 40 and non-Hodgkin lymphoma,” The Lancet, Vol. 359, No. 9309, 817-823, March 9, 2002, http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(02)07950-3/abstract. Robert L. Garcea and Michael J. Imperiale, “Simian Virus 40 Infection of Humans,” Journal of Virology, Vol. 77, Nol. 9, May 2003, 5039-5045, http://jvi.asm.org/content/77/9/5039.full. There is conflicting evidence, with other studies finding no association between SV40 and human cancer. But the virus has been shown to cause cancers in animals and to change human cells in culture, and the Institute of Medicine in 2002 described studies finding no association “sufficiently flawed” that they were unable to reject the hypothesis it might cause cancer in humans. As the subsequent 2003 Lancet study noted, as more studies have been done, “the case for SV40 infecting humans and contributing to cancer has become more compelling, supported by both experimental and circumstantial evidence”.
 Tom Jefferson, “Influenza vaccination: policy versus evidence”, BMJ, October 28, 2006, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1626345/
 Evelyne Shuster, “Fifty Years Later: The Significance of the Nuremberg Code”, New England Journal of Medicine, November 13, 1997, http://www.nejm.org/doi/full/10.1056/NEJM199711133372006
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