by Phil Harper
Sometimes, all you need is a single thread to pull. Before long, you reveal a large network of interests that sheds light on how our ideas about healthcare are shaped. A single article, posted to The Guardian on Wednesday the 3rd of April, is one such thread. In the end, I found enough eye-catching stuff that I’ll be splitting this into a series of articles. From this jump off point, we can start to map out the network of interests that sit behind your news headlines.
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The NHS, for all their faults, now only recommend the mRNA vaccines if you “are aged 75 years old or over, live in a care home for older adults, [or] are aged 6 months old or over and have a weakened immune system”
Put simply, the NHS have stopped recommending the vaccine for healthy people under the age of 75. We can infer from this that the NHS no longer believe the benefits for covid vaccination outweigh the risks for healthy people, otherwise the policy would be different. It’s something Dr Clare Craig and I spoke about in our recent podcast.
It’s somewhat of an inconvenience to the industry pushing the mRNA vaccines because their UK market was drastically reduced from everyone, to the immunocompromised people and the elderly. Their profit outlook took a sizable haircut. Perhaps some lobbying is in order?
Knowingly or not, Linda Geddes, Science correspondent for The Guardian published an article which at least had the appearance of some special interest lobbying. You couldn’t have missed the headline, front page news a few days back, “Covid boosters are a gamechanger – if they are free for everyone”
The broad argument of the article is that yes, you can get a Covid booster, but if you want one, you have to go and pay for it, and since this is dampening demand, it would be much better if these shots were free for everyone. That means the taxpayer should buy more vaccines. The article casts shade on the NHS policy which reserves free access to these shots for the groups we mentioned: immunocompromised or older people. The data to support this position comes from “a modelling study published in Annals of Internal Medicine in March”. The data apparently showed that a strategy of vaccinating annually, then boosting toddlers and those over 50 “could result in 123, 869 fewer hospitalisations, 5,524 fewer deaths and save $3.63bn (£2.9bn) in direct healthcare costs each year”.
Rather tellingly, there’s a collection of quotes from various UK academics included in the article, and their insights block out the end of the piece. It’s a pattern familiar to many journalists, because it closely resembles a press release. It was the combination of a bullish ‘vaccinate more’ headline and the press release ‘feel’ that prompted me to look into it. I asked Linda Geddes if the quotes in her article were taken from a press release but I didn’t get an answer. If they are, that very seriously changes the credibility of the article, but for now, let’s assume that they are not. Related or (hopefully) not, Geddes stepped down as Science Correspondent the very next day.
So what are the quotes, and who are they from?
Answering that question throws you into a complex web of influences that yank and shape our understanding of healthcare. Before we get into it, I want to emphasise that I do not believe the people I’m about to discuss have done anything wrong at all.
It’s very important that I make this clear because unravelling these networks is a tricky business that always creates the impression there’s some bad person somewhere in the middle. There isn’t. Instead, what you discover is a complex network of organisations, money, companies, intellectual property and research institutes, and operating inside that network are ordinary ambitious people trying to do good work and progress their careers.
Perhaps, sometimes, there’s a difference between private and public beliefs. But that’s only my personal suspicion….
What I hope to achieve in my writing is to give you that same sense that I get about how this all really works. It’s a sense I pick up as I research all of this, and it’s not always easy to convey in an engaging way. All I can hope for is that my skill as a writer can make this as interesting as possible, whilst being fair.
So, with that genuinely important disclaimer out of the way…Firstly, to the study itself.
The study, which underpinned The Guardian’s ‘gamechanging’ headline is actually a model, or perhaps it would be better understood as a simulation. To use the authors words, they “simulated 5 annual vaccination strategies.” The idea behind the study was to simulate an FDA proposal to adopt a ‘vaccinate everyone yearly’ strategy, in which children under 2 and adults over 50 would also receive a booster.
When there’s good real data which can be used to draw conclusions, modeling studies are an odd choice for generating insights. All kinds of assumptions and guessworks are baked in, then a simulation happens, and an answer comes out. Really good models are calibrated against ‘real data’ afterwards. For example, could you accurately simulate the pandemic and test it against the real world data we have afterwards? Was the model accurate? Did it arrive at a similar place to the real world? We find no such calibrations here, instead there’s one rather large assumption baked into the model: “The model results assumed that no individual has prior vaccine-acquired immunity.” Why bake that into the model!? Why start from a Covid-19 ‘year zero’, when we know this is absolutely not true.
No surprises for guessing that the model found: “the FDA-proposed campaign …produced the largest reduction in direct health care costs compared with the annual campaign.” Ta daaaa! Vaccinate and boost every year!
To add to the assumption that no one in the model had any vaccine-acquired immunity, the study also assumed that people would actually follow this new FDA vaccination guideline, despite acknowledging that “as of 9 December 2023, SARS-CoV-2 vaccine uptake was 16%.” But that doesn’t matter, pay no attention to the real world data, we have the conclusion we need: annual shots are better, double shots for toddlers and over 50s is better.
Could the sponsors have anything to do with these conclusions? We wouldn’t be able to tell from The Guardian article…
The main funder of the study was “Natural Sciences and Engineering Research Council of Canada”, which has an extensive conflict of interest policy for any members who sit on the council. I haven’t yet found any signed declaration forms for the current council, but I did find this interesting paper by Professor Joel Lexchin at The University of Toronto, about the lack of transparency over conflicts of interest in Canadian healthcare, including the Covid-19 Taskforce. “Minimal disclosure of information about a COI is typical of declarations of people serving on Health Canada advisory committees and panels.” he concluded. Canadian readers – what can you tell me about this?
Moving on, one author of the study who was tasked with final approval, revisions, interpretation of data, statistical expertise and gathering funding was Seyed M. Moghadas. On the declaration of interests form, buried three layers deep on the study, we see that Seyed M. Moghadas is a consultant for Janssen Canada and Sanofi.
Does that change things?! Let’s start with Sanofi…
Sanofi signed an agreement with the Government of Canada to supply ‘72 million doses of adjuvanted COVID-19 vaccine.’ Throwing in their exports to the USA and plans to supply the UK government, these deals could be worth more than $2.1 billion. So… conducting a study that verifies and promotes a proposal to double dose the public with COVID-19 vaccines, whilst being a consultant at a company making and supplying COVID-19 vaccines is about as relevant as conflicts of interest get. There was absolutely no mention of this fact in the article which the public read in The Guardian, only a bullish headline on the merits of vaccinating more people.
Sanofi and The Government of Canada are currently in business together over the construction of a $925 million vaccine facility in Toronto with plans to manufacture and sell vaccines in Canada and export them to the United States and Europe. How quickly do they plan to get up and running on new vaccines? “Within about six months of the World Health Organization identifying a pandemic flu strain” reports have said. According to the same report, “company and government representatives” have spoken at press conferences singing from the same hymn sheet highlighting “the need for Canada to be better prepared for any future pandemic.” It’s always nice to see when massive transnational corporations and governments make huge investments together then issue the same talking points! Finally, as you can see from the COI declaration, Moghadas is also a consultant for Janssen Canada, who also had a COVID-19 vaccination licensed for use in Canada.
What about the other authors? Well, Meagan Fitzpatrick also declared that she receives consulting fees from… Sanofi. She was responsible for the original conception and design of the study, the analysis of the data and a final approval of the article. Isn’t it relevant to tell the public these facts when reporting the recommendations of the modelling study in the UK national press?
