Thank you for dedicating some time and thought to these complex questions.
1. Based on the above definition, are there conflicts of interest in vaccine research and policy-making?
"Yes, there are conflicts of interests based on that definition in absolutely everything that involves research and/or policy. By that definition I honestly think pretty much everyone has a conflict of interest."
I won't argue here.
"I know this is fishing for Paul Offit has a ROTA vaccine patent. and scientists go from the CDC to private industry and vice versa, so we must ignore everything because COI COI COI. I get that. Yes, I see that by this definition he has a conflict of interest. But I will also point out some other specific conflict of interests."
I'm really not trying to entrap anybody. What I'd like to see is a candid admission that this is going on instead of the rampant denialism of which I see entirely too much. I appreciate that you concur. I disagree, however, with your statement, " . . . so we must ignore everything because COI COI COI." That is not at all my argument. We just know, as cited in the "Debate This Meme" thread, that studies based on COIs are more likely to show results favorable to a product, so it is more than fair to lift a skeptical eyebrow when drug companies are involved in research.
"Pharmaceutical companies and medical establishments would make a lot more money treating VPD than they do for vaccines. For example, paying full price for a polio vaccine is listed at $82 at CVS the profit is likely less than the total charge. However, an Iron lung to treat polio I am sure is much more than $82 (though I truly have no idea). The Daptacel DTAP vaccine costs $25.98 according to the CDC. Hospitalization for Whooping Cough cost is around $3000/day. So this could be a clear conflict of interest that those profiting from treating vaccine preventable diseases could in fact by the definition provided have a COI because it would benefit them for more people to contract VPD."
I am talking specifically about vaccine-related research and policy-making. The tu-quoque approach doesn't really work here because, (as just one example), despite Wakefield's clear COI, his intent was arguably to advance his personal interests in a lawsuit and not to impose a pharmaceutical product from which he profits on an entire population. If people refuse the MMR vaccine, Wakefield makes no money. Neither does Mercola, McCarthy, etc. And none of these parties have lobbied for exemption restrictions and other just-shut-up-and-do-as-you're-told policies.
The other problem with the tu-quoque tactic is that it's shifting the subject a wee bit. :-) Yes, I acknowledge that they exist, but the ramification are much, much different. (More on that momentarily).
Also, everybody from Offit to Sears to the Dalai Lama gets a profit from producing a book. When I review the BMJ definition linked above, I don't consider a book publication in and of itself a COI.
Still, I see your point, and it does sound compelling...at least initially. Treating a smattering of the population for a disease, in aggregate dollars, may actually amount to less than vaccinating millions and millions. From our neighbors across the pond, we see this: http://www.cnbc.com/id/101123545
"Several pharmaceutical companies made a conscious decision to chase and develop the vaccines market towards the end of the last decade, as it became clear that the traditional blockbuster drug treatment model for the industry was changing. Vaccines were seen as promising from a business perspective because they could be applied to huge swathes of the population, and because the economic case for payment could be made to governments. AstraZeneca, the U.K. pharmaceuticals giant, paid $15.6 billion for MedImmune, the U.S vaccines specialist, in 2007 to get a foothold in the vaccines market.
Chris Viehbacher, chief executive of Sanofi, explained part of the appeal of vaccines earlier this year. 'The nature of vaccines is such that generally you have a better feeling for the success of a vaccine than you do for a new drug,' he said."
"I don’t view most them as problematic for me personally."
What about on a more global level? I know I'm not the only parent who doesn't obey orders to vaccinate on schedule out of concern for COIs. I would think that the pro-compliance camp would be at least somewhat concern that COIs erode away at trust in public health programs.
"I value the scientific method and I am familiar with the manner in which research is disseminated. I have been through the peer-review process myself and I understand that it is grueling. I do not believe that the conflict of interests will impact the research that policy is based on, nor do I accept research that has not been tested through peer review impact my health decisions . I think that if someone truly was trying to present fraudulent research for personal gain it would be discovered during the peer review process. Since I do not research using blogs or websites without scientific rigor personally those Conflicts of interest do not impact me."
I have a little bedtime reading on the topic.
"I don’t think anything can be done to address COIS as we are defining it in this discussion. We have a first amendment right to free speech."
Do you see any potential ethical issues in vaccine-related research--specifically, that which shows favorable results for vaccine safety and/or efficacy? Again, we can tu-quoque in another thread. Right now, I am concerned that medical recommendations and mandates that directly affect me and my children are based at least in part on COI, rendering them at least suspect.
My last question was mostly to gauge how seriously people take these COIs.
My pipe dream is to have a pro-vaxxer address these COIs candidly and unflinchingly without feeling that these COIs somehow pose a threat to their stance. They actually don't necessarily.
It's fair to admit that COIs are behind vaccine research, recommendations, and mandates. It's OK to acknowledge that these COIs are ethically questionable, at best, and downright unethical, at worst. It's reasonable to call for an end to COIs to ensure that the science is sound and the public's trust in public health programs is rock solid. You can do ALL of this and still fully vaccinate yourself and your children with the unwavering confidence that you've made the right decision. But instead, (and this isn't addressed at you, just in general), I've heard pro-vaxxers bristle in defense at this topic and respond with sophist pageantry instead of honest answers.
(Rrrrrachel, back when she posted here, may have been the exception. I may be thinking of the wrong poster, but it seems that she openly and honestly acknowledged the systemic flaws).
The questions that started this thread aren't going away. The more they get ignored, dismissed , mocked ("you conspiracy theorist!"), and explained away, the louder these questions will be asked by an increasingly skeptical public.