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Re: Further to Peter Flegg and the TB ref.

http://bmj.bmjjournals.com/cgi/eletters/330/7483/112-d

Dear Sir,

Further to Peter Flegg's reply. From the first reference he gave us, which is indeed the study published in the Lancet (although other reports of this study include other information of relevance), I would draw Peter Flegg's attention to the following:

Page 64:

"the overall protection by BCG, for all ages was seen to be nil."

....for children 1 month to 9 yrs, was 27% for either strain, 25% for Danish strain and 17% for French strain, the levels of protection in all four instances being statistically not significant.

Again, the discussion on page 63 (and 65) is interesting, as they considered the protective level for 5 - 12.5 years to be 69 percent. Then, in discussing the discrepancy levels between that, and the two other groups, they consider it statistically insignificant as well. Perhaps that's because the confidence levels were so wide, and lie on either side of zero, if they looked too hard, they might come up with a different interpretation.

So they opted for the politically correct language, and said that the numbers should be interpretted "with caution".

In other words, "we don't really have a clue what we are looking at, because actually it looks pretty bad."

There was also noticed, in children, in a detailed discussion on page 63, excess cases of tuberculosis in the vaccinated children in the first five years of life, and again, between 12.5 - 15 years of age, a pattern also seen in another trial at Madanapalle, in South India, where more cases were seen among the vaccinated during the first three years, and after 9 years of age...

It is also noted that much of the article was spent trying to find reasons to explain away the results, and none were found.

The most telling remarks were on Pgs 67-68:

"Thus even if BCG offered protection in those initially uninfected (which it does not) the public health value of BCG can be only in preventing childhood mortality caused by disease resulting from haematogenous spread. The impact on infectious cases can at best be only marginal...

In conclusion.... has shown that BCG offer no protection against adult type bacillary tuberculosis. Consequently BCG cannot be expected to reduce the transmission due to tuberculosis. This observation of failure to protect could not be attributed to defects in methodology, inadequate sample size, prior exposure to environment mycobacteria or to most of the disease being a result of exogenous reinfection. These unexpected results have led to several studies which would eventually increase our understanding of the host responses and immune mechanisms in tuberculosis."

This last part in particular, underscores the little "can of worms" above, which Peter Flegg and others have studiously chosen to ignore.

Which is the fact that not only does Mr Flegg have little idea about neonatal immunity and the "differences" between neonates, adolescents and adults,, or how vaccines actually "work" inside the body apart from supposed final antibody response but...., as this study points out...., Mr Flegg also has little understanding about "host responses and immune mechanisms."

The problem is that this professional ignorance doesn't just stop with Tuberculosis.

Sincerely,

Hilary Butler.

Competing interests: None declared