During the 2009-10 flu season, public health officials across the world were concerned about a flu pandemic caused by the H1N1 influenza virus. In response to the dangerous new flu, these same public health officials made certain to protect their citizens with new a new H1N1 flu vaccine that would protect individuals from the pandemic H1N1 flu virus.
There have been two H1N1 flu pandemics in recent history. The first, the 1918 pandemic, also called the Spanish Flu, infected over 500 million people worldwide (when the planet only had about 2.5 billion humans) and killed between 50-100 million. And no, it didn’t target babies and the elderly, it killed everyone targeting healthy young adults.
In the USA alone, the US Centers for Disease Control and Prevention estimated that the 2009 pandemic resulted in over 43-89 million cases, 195-403 thousand hospitalizations and between 8,870 and 18,300 deaths. The CDC also estimated that over 300,000 people died worldwide from the 2009 H1N1 flu.
No wonder the world’s public health authorities made sure the H1N1 flu vaccine was widely available. I cannot imagine what those numbers would have been without it – possibly millions of deaths worldwide.
Recently, anti-vaccine hawker, Peter Doshi, continues with his perverse, pseudoscientific assaults on flu vaccines by now using a ridiculously amateurish conspiracy to invent safety concerns about the 2009 H1N1 flu vaccine. I’m not one to let this nonsense pass, so here goes.
All about Peter Doshi
Unless you enjoy debunking the vast lies of the anti-vaccine religion, you may not know much about Peter Doshi. But it’s my goal to make sure you know about him and his anti-vaccine proselytizing.
Doshi is not a scientist, he has no background in anything even remotely related to vaccines. Doshi received his BA in anthropology from Brown University, an MA in East Asian studies from Harvard University, and a Ph.D. in history, anthropology, and science, technology and society from the Massachusetts Institute of Technology.
Those would be fine credentials for someone who is going to teach history or anthropology. They are laughably inadequate for someone who promotes himself as a vaccine “expert.”
For those of us who respect science and scientific knowledge, an authority in vaccines should have actual study and experience in those biomedical science fields related to vaccines like virology, microbiology, epidemiology, immunology, cell biology, and a few others.
On the other hand, I keep trying to make a critical consideration – credentials actually don’t matter, what does matter is evidence. And we want quantity and quality of said evidence. Doshi lacks credentials or evidence.
However, there are times when credentials can matter. They imply many things – a broad education in the science of the subject matter, hard work in the minutiae of that field of science, and approval by one’s peers. Getting a Ph.D. in epidemiology is not simply taking classes, but it’s actually doing research in the laboratory and field with a published thesis that is reviewed by numerous scientists, some of whom may not be in the specific field (to give some unbiased eyes to the research).
Clearly, Doshi lacks a broad research and publication record in any of those areas, save for his critique of the flu vaccines, which included a statement that claims that “influenza” (disease caused by influenza viruses) is different than “flu” (a syndrome with many causes, of which influenza viruses appear to be a minor contributor).” That makes me conclude that Doshi actually fails to understand the basic principles of diseases.
Peter Doshi is currently an assistant professor (non-tenured) of pharmaceutical health services research in the School of Pharmacy at the University of Maryland. This field of study is not basic pharmacological and clinical research of pharmaceuticals – it is an economic-based study for drug utilization and other areas. These fields might be interesting if I was writing about pharmaceutical economics, but is nearly irrelevant to understanding vaccines.
Doshi is also an editor at BMJ, a leading medical journal. Why he is at that journal, which published Brian Deer’s investigations of Andrew Wakefield’s fraud, is not clear to me. And, as you will see, he uses BMJ to promote his anti-vaccine nonsense.
One more thing. The anti-vaccine religion depends on false authorities, like Doshi. Because no serious scientist is anti-vaccine, they need to dig up a failed anthropologist to do their bidding. It’s kind of sad.
And if you think I just have some chip on my shoulder about Doshi, let’s turn to our favorite cantankerous blogger, the tenacious Orac:
…Peter Doshi, who’s well known in the provaccine community as someone who’s parroted more than a few antivaccine talking points himself and try to portray himself as an authority on influenza and the flu vaccine. He’s also given a talk to at least one antivaccine crank conference. So it’s not at all surprising that Doshi would play the victim card and whine about being called “antivaccine.” It’s also hilarious that RFK Jr. seems to think that Doshi speaks for the editors of the BMJ when in fact they probably published his opinion piece to be a bit provocative.
I’m not happy that Doshi is at BMJ, so I hope the whiny Doshi is there to be “provocative.”
Doshi attacks H1N1 flu vaccine
This is not a paper that presented original scientific research, because Doshi is not a scientific researcher. This paper did not include data from a case-control or cohort study with solid controls. I am not sure that the paper was even peer-reviewed since it’s just an opinion piece.
Before I get to Doshi’s anti-vaccine nonsense, let’s talk a bit about Pandemrix. This vaccine, given mostly to Europeans, was linked to narcolepsy, a neurological autoimmune disorder which leads to extreme sleepiness and daytime sleep, in children who received the vaccine. However, this is based on a tiny number of cases, less than 20, and no one has established a causal link. Several researchers have proposed that the H1N1 pandemic flu virus contains a protein that causes the immune system to cross-react with a protein, hypocretin, that keeps people awake.
Thus, it is possible that those who contract the H1N1 flu virus may be at risk for narcolepsy at a level equivalent to or higher than those who receive the vaccine. However, one can die from the H1N1 pandemic virus while not dying from the pandemic flu vaccine.
So what is Doshi going on about in his opinion piece?
First, Doshi claims that the 2009 flu pandemic turned “out to be a far milder pandemic than officials had predicted.” In other words, Doshi thinks that 300,000 deaths worldwide is mild. It’s hard to take these anti-vaxxers seriously when they dismiss so many deaths, but what do you expect from someone who hasn’t got a clue about anything but his own beliefs.
Next, Doshi goes after Pandemrix with a bunch of numbers and a cute infographic. He claims that super-secret documents (not super-secret) uncovered in pre-trial discover during lawsuits against GSK show that the adverse events reported after receiving GSK’s H1N1 flu vaccine are higher than in other GSK vaccines.
Since Doshi has no science background, he relied upon an analysis from another clueless anti-vaccine pseudoscientist, Tom Jefferson. What did they find? Pandemrix showed a substantially higher adverse event risk than GSK’s other flu vaccine, Arepanrix.
Now, this may be interesting except for one major thing – these are reports to GSK, not from a well-controlled, well-designed, published, peer-reviewed study. Doshi has a perverse love with data from the US-based Vaccine Adverse Event Reporting System (VAERS), a system where individuals can report supposed adverse events post-vaccination, to “prove” certain adverse events.
Like VAERS, these reports to GSK can be made online, by fax or by mail. However, without an active investigation, the data derived from VAERS is just barely above the level of totally meaningless – at best, it’s observational data which cannot show correlation or causation. Importantly, most epidemiologists know it is valueless. Even the VAERS system itself says that the data cannot be used to ascertain the difference between coincidence and true causality.
Vaccine deniers, like Doshi, use the passive data from the VAERS and GSK’s reporting system as “evidence” to show that vaccines are dangerous.
This observational data from VAERS or another reporting system could be used to form a testable hypothesis, the hallmark of real science. Using any reporting system, from GSK, Merck or VAERS, as evidence to support a hypothesis, say “Pandemrix causes narcolepsy”, is pseudoscience, pure and simple.
If we were to take the GSK data at face value, and I don’t, the numbers seem to show that there were 3807 adverse events out of about 30 million vaccines given. That’s about a 0.013% risk, far below the risk of catching the H1N1 flu, getting hospitalized from it, or dying from it. But Doshi, because he’s so in love with being a hero of the anti-vaccine religion, that he overlooks the benefits of the vaccine as opposed to the risks.
Then there’s the huge point that Doshi (and I presume his co-false authority, Jefferson) try to establish that 47 people died because of Pandemrix. This again. Do these science deniers understand anything about the post hoc fallacy?
People die after receiving vaccines, but not as a result of vaccines. If there were so many deaths post-vaccination, you’d think that someone would have written about it. Yet, when I searched for mortality or death after Pandemrix vaccination, I could only find articles that showed that maternal vaccination with the H1N1 flu vaccine did not have an effect on maternal or fetal outcomes. Ironically, it was published in BMJ, which publishes most of whiny Doshi’s fake science.
To be fair to Doshi, maybe a skilled attorney might be able to convince a jury that one or more of those deaths is linked to the H1N1 flu vaccine. Except, most of us with more than a few neurons firing in our brain understand that legal, basketball, or tennis courts do not get to decide science. There is simply no evidence that supports the claim that Pandemrix is linked to any death, despite the post hoc claims of a few reports to GSK.
Now, I have reviewed the data regarding a link between the Pandemrix H1N1 flu vaccine and narcolepsy. I’m not convinced of a causal link, mainly because the numbers are so small, it’s difficult to see statistical significance. Of course, Doshi wants to use low-quality complaints as definitive. It is not.
Peter Doshi has continued his flu vaccine denial by going after the Pandemrix H1N1 flu vaccine using weak evidence from VAERS-like reports. Using outlandish verbiage and shocking graphics, he’s trying to convince the world, in an opinion piece, that a flu vaccine is dangerous.
There might be some evidence that the GSK H1N1 flu vaccine has some issues with narcolepsy. But the evidence is rather weak.
Nevertheless, not-a-scientist Doshi keeps publishing these opinion pieces that the anti-vaccine rabble use as “proof” of their nonsense. If only we could make him stop.
Does any real scientist actually believe this guy?
- Ahmed SS, Volkmuth W, Duca J, Corti L, Pallaoro M, Pezzicoli A, Karle A, Rigat F, Rappuoli R, Narasimhan V, Julkunen I, Vuorela A, Vaarala O, Nohynek H, Pasini FL, Montomoli E, Trombetta C, Adams CM, Rothbard J, Steinman L. Antibodies to influenza nucleoprotein cross-react with human hypocretin receptor 2. Sci Transl Med. 2015 Jul 1;7(294):294ra105. doi: 10.1126/scitranslmed.aab2354. PubMed PMID: 26136476.
- Dawood FS, Iuliano AD, Reed C, Meltzer MI, Shay DK, Cheng PY, Bandaranayake D, Breiman RF, Brooks WA, Buchy P, Feikin DR, Fowler KB, Gordon A, Hien NT, Horby P, Huang QS, Katz MA, Krishnan A, Lal R, Montgomery JM, Mølbak K, Pebody R, Presanis AM, Razuri H, Steens A, Tinoco YO, Wallinga J, Yu H, Vong S, Bresee J, Widdowson MA. Estimated global mortality associated with the first 12 months of 2009 pandemic influenza A H1N1 virus circulation: a modelling study. Lancet Infect Dis. 2012 Sep;12(9):687-95. doi: 10.1016/S1473-3099(12)70121-4. Epub 2012 Jun 26. Erratum in: Lancet Infect Dis. 2012 Sep;12(9):655. PubMed PMID: 22738893.
- Doshi P. Pandemrix vaccine: why was the public not told of early warning signs? BMJ. 2018 Sep 20;362:k3948. doi: 10.1136/bmj.k3948. PubMed PMID: 30237282.
- Ludvigsson JF, Ström P, Lundholm C, Cnattingius S, Ekbom A, Örtqvist Å, Feltelius N, Granath F, Stephansson O. Maternal vaccination against H1N1 influenza and offspring mortality: population based cohort study and sibling design. BMJ. 2015 Nov 16;351:h5585. doi: 10.1136/bmj.h5585. PubMed PMID: 26572546; PubMed Central PMCID: PMC4644812.
- Shrestha SS, Swerdlow DL, Borse RH, Prabhu VS, Finelli L, Atkins CY, Owusu-Edusei K, Bell B, Mead PS, Biggerstaff M, Brammer L, Davidson H, Jernigan D, Jhung MA, Kamimoto LA, Merlin TL, Nowell M, Redd SC, Reed C, Schuchat A, Meltzer MI. Estimating the burden of 2009 pandemic influenza A (H1N1) in the United States (April 2009-April 2010). Clin Infect Dis. 2011 Jan 1;52 Suppl 1:S75-82. doi: 10.1093/cid/ciq012. PubMed PMID: 21342903.
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