Since the COI thread went downhill in the debate forum...

teacozy · Oct 28, 2013

The COI thread went downhill pretty fast in the debate forum and as others stated in that thread, it was pretty clear the intentions were just to attack anyone who posted. 
 
So I was wondering if anyone wanted to discuss the topic here? In our safe space? We asked for this forum so I am just trying to put it to good use! 
 
What are your opinions on the topic of COI and vaccine data/research? How are you personally able to trust that vaccines are safe even though the companies that produce them can do some pretty terrible underhanded things?

Dakotacakes · Oct 28, 2013

For me, I just don't find the conflict of interest argument very compelling. Largely, because both sides have huge conflicts of interest, however, the conflict of interest problems on the vaccine-skeptic side are usually forgotten or brushed aside. That tells me that it isn't conflict of interest that is really the concern, it is still just vaccines that are the concern and looking for a reason to discredit the schedule and those who promote it.
 
The other thing that helps me is having gone through the peer review process. Even if a conflict of interest existed going through the scientific process is grueling. They really don't just publish anything. And I trust the process of checks and balances on that side of things. Also the girth of the research showing vaccine safety it isn't just one study it is a plethora of them.
 
I also find that the arguments against vaccines are making me trust them more because of the research manipulation I see trying to tie vaccines to everything from diabetes to ADHD and even SIDS.. The fact that it has been attempted to link it to almost every negative health condition in our country makes me think it must not link to anything .

erigeron · Oct 28, 2013

I thought that the comment from Dakotacakes and the comment quoting Skeptical Raptor were pretty much on point and I didn't have much to add. And I sure as heck didn't feel like getting sucked into that trainwreck of a thread (as opposed to all of the other threads on that forum that are reasoned and logical <img alt=":wink" src="http://files.mothering.com/images/smilies/winky.gif" style=""> ).
 
My husband teaches writing and when he runs into students who have these sorts of beliefs about conflicts of interest or coverups, he asks them to name all of the people who would have to be involved for the coverup to be for real. Usually they eventually see that a LOT of people would have to be involved and it's pretty unlikely.

teacozy · Oct 28, 2013

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<div class="quote-block">Originally Posted by Dakotacakes <a href="/community/t/1392097/since-the-coi-thread-went-downhill-in-the-debate-forum#post_17495000"><img alt="View Post" src="/community/img/forum/go_quote.gif" style=""></a> 

For me, I just don't find the conflict of interest argument very compelling. Largely, because both sides have huge conflicts of interest, however, the conflict of interest problems on the vaccine-skeptic side are usually forgotten or brushed aside. That tells me that it isn't conflict of interest that is really the concern, it is still just vaccines that are the concern and looking for a reason to discredit the schedule and those who promote it.
 
The other thing that helps me is having gone through the peer review process. Even if a conflict of interest existed going through the scientific process is grueling. They really don't just publish anything. And I trust the process of checks and balances on that side of things. Also the girth of the research showing vaccine safety it isn't just one study it is a plethora of them.
 
I also find that the arguments against vaccines are making me trust them more because of the research manipulation I see trying to tie vaccines to everything from diabetes to ADHD and even SIDS.. The fact that it has been attempted to link it to almost every negative health condition in our country makes me think it must not link to anything .
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This. I also thought your answer on the thread was excellent. You made some excellent points. 
 
"Also the girth of the research showing vaccine safety it isn't just one study it is a plethora of them."
 
I have tried to make this point multiple times and it just never sinks in. Either that or they just choose to ignore it. I had a bridge vs boat analogy in a different thread (not sure if anyone read it) and I almost made a reply to the COI thread pointing out that *even if* 50% of the engineers were tied to big pharma that would still mean that 5,000 people with no ties at all to big pharma are saying/showing that vaccines are safe and effective vs 1 who thinks they are dangerous. Additionally, there's a good chance that that one is trying to sell supplements, or a book about the dangers of vaccines. Just replace engineers with studies or papers and the point is the same. There is just SO much literature that has absolutely no COI with big pharma that it really is a non issue for me as far as if the data really does show that vaccines are safe and effective.

JohannaInDairyland · Oct 28, 2013

After reading "Autism's False Prophets," I became convinced that the COI is more on the side of the anti-vax/autism biomed industries. (But I'm already a Paul Offit/Children's Hospital of Philadelphia fangirl.) One time, low cost, highly-researched and relatively low risk (vaccines) versus expensive, unproven "treatments" which one must purchase essentially for life? 
 
Long story short, not at all concerned about the so-called "conflict of interests" that may or may not be involved in getting preventative health care. More concerned about charlatans preying on well-intentioned parents.

cwill · Oct 28, 2013

Thanks for bringing this here. It's a good idea because I would like to discuss it and have been going back and forth on whether I should post or not! Apologies in advance for rambling. I will try to actually get my main points across.
 
I actually think COIs can be problematic. We know, through research, that something as simple as a free pen or pad of paper can cause someone (I think the study I'm thinking of looked at medical doctors) to view a business more favorably. We also know that this can influence people without them realizing it. So I do worry about loss of objectivity and think we need checks and balances to counteract that. 
 
And we have checks and balances. We have informal peer-review through colleagues (which is often the most brutal!). We have formal peer-review. We have editorial boards. We have the published results available for interpretation. We have replication (or lack of replication) of results. We have real-life results. Now I don't think the scientific method or peer-review process is flawless, but I do think it works well most of the time.
 
I think the study kathymuggle posted is somewhat important to address. <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2758529/#APP1" target="_blank">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2758529/#APP1</a> There's unfortunately not enough information in it to really do a good job and it is not specific to vaccine research, but it stood out to me that some of the things the authors considered a compromise of presenting results are not things I would consider a compromise (such as delaying publication - could be, but more often isn't). And the authors aggregated their compromises to make things look worse than they are. Having said that, I do think 15% of participants being asked to more favorably present data is potentially a huge deal. And the study she posted is not the only one highlighting the potential effects of COIs. 
 
As for other things often pointed out as COIs, many of them I think are actually good things that require additional oversight, but are not in and of themselves bad things. Industry funding research? Yes, vaccine makers should fund the research pertaining to their products. Revolving doors? Yes, I want people who know the science, know the industry, and the know the people involved to be in regulatory positions. They know what's going on and can most efficiently and intelligently make the system work.
 
But I suppose the question still stands ... we do know that pharmaceutical companies and researchers and journal editors have behaved badly in the past. How often do all of those things come together and result in harm?

cwill · Oct 28, 2013

Oh, but I should specifically address vaccines! haha! I think COIs have had little influence on vaccine data publication. I agree that there is a huge body of literature showing their safety. There is also a huge real world population demonstrating the reliability of the available data.

teacozy · Oct 28, 2013

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<div class="quote-block">Originally Posted by cwill <a href="/community/t/1392097/since-the-coi-thread-went-downhill-in-the-debate-forum#post_17495088"><img alt="View Post" src="/community/img/forum/go_quote.gif" style=""></a> 

Oh, but I should specifically address vaccines! haha! I think COIs have had little influence on vaccine data publication. I agree that there is a huge body of literature showing their safety. There is also a huge real world population demonstrating the reliability of the available data. 
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Yeah, the original thread in the debate forum was specifically asking about vaccines, and I agree with you that COI have had little influence of vaccine data. There is no denying that some products have turned out to be more dangerous than they were originally claimed to be, and COI played a huge part in that. But I don't believe vaccines are one of those products.

cwill · Oct 28, 2013

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<div class="quote-block">Originally Posted by teacozy <a href="/community/t/1392097/since-the-coi-thread-went-downhill-in-the-debate-forum/0_50#post_17495105"><img alt="View Post" src="/community/img/forum/go_quote.gif" style=""></a> 

 
The original thread in the debate forum was specifically asking about vaccines, and I agree with you that COI have had little influence of vaccine data. There is no denying that some products have turned out to be more dangerous than they were originally claimed to be, and COI played a huge part in that. But I don't believe vaccines are one of those products. 
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I think given the history of some pharmaceutical companies, I would be potentially skeptical when new vaccines are released or new recommendations are made. And I think we've seen that even on the vaccinating on schedule board that some parents would like to see a product on the market for a while before giving it to their child. Things like Gardasil or the chicken pox vaccine (which really isn't new anymore, but maybe still feels new to a lot of people?) or vaccinations during pregnancy...
 
I'm not arguing with you, just thinking more about how COIs can potentially influence vaccination decisions among pro-vaxx parents, even without the COIs directly affecting vaccine research.

teacozy · Oct 28, 2013

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<div class="quote-block">Originally Posted by cwill <a href="/community/t/1392097/since-the-coi-thread-went-downhill-in-the-debate-forum#post_17495137"><img alt="View Post" src="/community/img/forum/go_quote.gif" style=""></a> 

 
I think given the history of some pharmaceutical companies, I would be potentially skeptical when new vaccines are released or new recommendations are made. And I think we've seen that even on the vaccinating on schedule board that some parents would like to see a product on the market for a while before giving it to their child. Things like Gardasil or the chicken pox vaccine (which really isn't new anymore, but maybe still feels new to a lot of people?) or vaccinations during pregnancy...
 
I'm not arguing with you, just thinking more about how COIs can potentially influence vaccination decisions among pro-vaxx parents, even without the COIs directly affecting vaccine research.
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No, I get what you are saying. I know I have stated that I'm glad that the Gardasil vaccine will have been out for a while by the time my son would need it. For me personally, that has nothing to do with me thinking that the pharmaceutical companies are faking data or hiding side effects or anything else related to COI type of concerns. It has more to do with wanting to see if there are any long term effects that haven't shown up yet. I seriously seriously doubt there are and there have been numerous studies that have shown it to be extremely safe ( I posted one recently that had close to a million girls). If I had a girl instead of a boy, it would be a no brainer. Even if she was 11 years old right now. The risk of getting cervical cancer is so much higher than the risks of the vaccine in my opinion but the cancers caused by HPV that effect men are a lot more rare.

chickabiddy · Oct 28, 2013

I recognize there may be occasional conflicts of interest, or at least the perception of them. But the sheer number of studies that show vaccines are largely safe can't ALL be attributed to Big Pharma's evilness. The magnitude of data is overwhelming.
 
I am more concerned about a "doctor" who directly benefits from selling supplements and getting website hits than a postdoc several steps removed from the actual funding of a study.
 
I'm a certified child passenger safety technician. Did you know that carseat manufacturers conduct their own safety testing and self-report the results? Talk about a conflict of interest! It's everywhere. I wish it wasn't. I still feel that the preponderance of the evidence concludes that vaccines are generally safe.

EineMutti · Oct 28, 2013

Do all the debates disintegrate into personal attacks? And so quickly as well... 
 
Conflict of Interest is a great topic. I think, no I know, that the pharmaceutical companies shouldn't be the ones making the studies as they have a personal interest in the outcome. But then, not all studies are financed by them anyway.
 
The manipulation aspect was a very good point. Suddenly blaming vaccinations for everything just because of personal belief is something that can't be trusted. The "belief" that an alien in the sky is responsible for breast cancer holds as much value as the "belief" that vaccinations cause ADHD. I am sure you can find "evidence" of both claims online. Throw a meme in and you have a debate.
 
Back back to topic, if the COI is so large, then what about antibiotics for bacterial meningitis? I seriously doubt that a non-vaxxer would let her baby die due to COI with the company. What about all the products we consume that are produced from large corporations? Our computers, our medication, the material our house is made of? 
 
I am sure that every mum who debates vaccinations online and states COI as a reason not to vaccinate has given Microsoft and Glaxo Smith more money than a vaccination would.

chickabiddy · Oct 28, 2013

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<div class="quote-block">Originally Posted by EineMutti <a href="/community/t/1392097/since-the-coi-thread-went-downhill-in-the-debate-forum#post_17495317"><img alt="View Post" src="/community/img/forum/go_quote.gif" style=""></a> 

Do all the debates disintegrate into personal attacks? And so quickly as well...
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Unfortunately, usually so.

erigeron · Oct 29, 2013

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<div class="quote-block">Originally Posted by EineMutti <a href="/community/t/1392097/since-the-coi-thread-went-downhill-in-the-debate-forum#post_17495317"><img alt="View Post" src="/community/img/forum/go_quote.gif" style=""></a> 

 
Back back to topic, if the COI is so large, then what about antibiotics for bacterial meningitis? I seriously doubt that a non-vaxxer would let her baby die due to COI with the company. 
 
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Well, I don't think that's a really great analogy because the risk of not getting the antibiotic is a whole lot greater than the risk of not getting a vaccine for a healthy child. So that increased risk is enough to overcome the COI in that case. As for the other stuff, you're right--there are a lot of ethical issues with pretty much every company ever. :/

sciencemum · Oct 30, 2013

Ben Goldacre, who is a UK science writer with a medical degree, has some good writings on "Big Pharma" and why it's reasonable to think they're a bit evil (!), but still think vaccination on balance are better than no vaccination. I've posted from him elsewhere on these boards (people can try a search). He also has some sensible discussion of COI - where it can affect things, and where not. 
 
It's a great point that the huge body of work on vaccination efficacy and safety is just not something which COI can explain away. It's just too large, and would involve too many competing COIs and (shock horror) researchers with moral codes which don't let them get affected by their potential COI.... (nice to be able to write that and hopefully not be told I'm too naive).

Since the COI thread went downhill in the debate forum...

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