Comments on: Victoria, Australia government wants to stop free pertussis vaccines

By: Greg

Greg — Fri, 29 Jun 2012 15:09:47 +0000

@flip(65)
I considered telling you the answer, but I’ve decided not to. It’s irrelevant. Using my pro- or anti-vaccine stance as a factor in this discussion is either an appeal to authority or an ad hominem argument (depending on your stance); both are logically invalid. You don’t get to discuss me, only the substance of my arguments (see 64).

By: Todd W.

Todd W. — Fri, 22 Jun 2012 14:25:06 +0000

Looks like NSW government is not going to up and cut the program completely. Starting July 1, pertussis vaccines will be provided free to new mothers within the first two weeks after giving birth. Dads will, it seems, have to pay out of pocket. This program will "continue until more definitive evidence becomes available about the effectiveness of vaccinating adults to protect new babies".

By: Nigel Depledge

Nigel Depledge — Wed, 06 Jun 2012 12:56:49 +0000

@ Greg (53) -
Well, that seems to answer most of my objections. Thanks for setting things straight.

By: flip

flip — Sun, 03 Jun 2012 12:27:46 +0000

Still confused. Given that my questions were really ‘yes/no’ answers required, I’m going to stop participating in this discussion. You’re a little too vague for my liking. All you had to do was say “I support vaccines in general, because the evidence shows they have efficacy and are cost-effective, but in this particular case, the program isn’t working and needs to be stopped”. I still have no idea whether you have an overall problem with vaccines, or if you’re just arguing about this specific program.

Considering you could have easily answered my questions in clear terms, I’m going to move on to other discussions.

By: Greg

Greg — Sun, 03 Jun 2012 08:32:40 +0000

It doesn’t matter what I think; it matters what can be shown through evidence. And in this case, PBAC found and I accept that the submitter did not show that giving free boosters to parents was either i) effective at preventing infections in infants; nor ii) cost effective in doing so. As such, I believe i) PBAC was justified in not recommending inclusion of that regime; ii) that the NSW Health Minister was justified in following that finding and discontinuing the program.

If this is still insufficient, let me know.

By: flip

flip — Sun, 03 Jun 2012 07:11:15 +0000

Actually Greg I’m more interested in you answering my questions directly. None of what you wrote specifically addresses my point:

Are you arguing about this because you think vaccines have not been proven to be efficacious (and therefore the program needs to be stopped)?

Or are you arguing about this because you think that while vaccines have evidence of efficacy, in this particular case, the program is not doing enough to show efficacy?

By: Greg

Greg — Sun, 03 Jun 2012 01:18:14 +0000

@flip
I’m less interested in the funding question because i) I think it’s a policy question rather than a strict scientific one; and ii) a reasoned approach to health budget allocations requires far more information than is available to us thread bloggers. There’s a reason NSW has an entire ministry dedicated to figuring out such things.

However, if you’re actually interested in my opinion about the defunding, I think that the PBAC and the NSW Health Ministry have demonstrated a consistent and science-based approach to their decision making, and that we should be more trusting of their process. That is, I see no evidence of a Meryl Dorey plot here; at worst some prioritization disputes.

By: Paul in Sweden

Paul in Sweden — Sat, 02 Jun 2012 15:41:24 +0000

@58. Greg Says:

Good advice. I rarely send Phil email because I don’t want to disturb him and in this case I thought my question sort of fit in the tread. I really don’t know on this one. In Sweden/Finland they are really talking this narcolepsy Pandremrix vaccine issue. I tend not to believe. tc -Paul

By: flip

flip — Sat, 02 Jun 2012 10:14:19 +0000

I’m confused: is Greg arguing that the program should be gotten rid of based on lack of efficacy within this *specific* instance, or is he arguing that vaccines themselves haven’t shown any efficacy, therefore this program is based on assumption only? Is he arguing only over cost effectiveness, or medical effectiveness? Is he arguing that herd immunity is only an assumption?

I will leave the report he provided for others who are better equipped at understanding them; ie Todd and Nigel. Who as always say things better than I could.

By: Greg

Greg — Sat, 02 Jun 2012 07:32:48 +0000

@Todd
I would like to tweak two points from your analysis of the PBAC finding.

1. You say that this finding was only about Adacel, and other vaccines are available. While technically true, the finding also says that Boostrix was rejected in July 2011.

2. You say, “It was not a finding that providing the vaccine free to parents of newborns was cost ineffective.” Also technically true, but what they did find was that according to the submitter’s provided evidence, Adacel had a (highly uncertain) ICER of $45K-$75K, and that this would likely increase (get worse for the submitter) as better evidence was provided. The claim was rejected partially because of this highly uncertain ICER.