Reporting Guided by Competing Interests
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The entire research article as well as two of the three authors were funded by the vaccine manufacturers. Furthermore, the first author, Ms Theidel, is employed by a contract research organization that, according to its own website, provides “strategic consulting” to 48 pharmaceutical companies. Such conflicts of interest raise the probability that the authors will select positive study findings (1).
In this context the irrational focus on the vaccine Prevenar seems striking, for example. It is highly praised in the article, because “the success of conjugate vaccines is obvious in children,” although this is not the subject of the article (2). Another example for positive bias (too positive, in our opinion): “The restricted recommendation from the STIKO regarding the use of the pneumococcal conjugate vaccine in adults is viewed critically by experts […].” The authors give preference to experts most of whom have received fees from Pfizer (http://erj.ersjournals.com/site/misc/statements39.xhtml; http://data.aerzteblatt.de/pdf/103/24/a1690.pdf) over a consensus-based STIKO recommendation (3), which, by contrast, takes a critical view of Prevenar.
The message of the results in the abstract, “According to an optimistic estimate, the percentage of pneumococcal vaccination in the overall population is 3.75% […]” was chosen in error, as vaccination of the overall population is not the objective—in this context, however, this suggests underprovision.
We think that the undeclared objective of this article is to speed up market entry for Pfizer’s conjugate vaccine Prevenar.
We further think that as a consequence, persons with serious conflicts of interest should be excluded as authors in future. The Lancet already does this, at least in partial areas, in order to improve the scientific quality of the publication.
Dr. Niklas Schurig, Bietigheim, Vorstandsmitglied MEZIS e.V.
Coauthors in alphabetical order:
Anton J. Beck, Rottenburg
Dr. Hannes Blankenfeld, München
Manja Dannenberg, Neubukow, Vorstandsmitglied MEZIS e.V.
Dr. Michael Freitag, Weimar
Dr. Martin Hirte, München
Dr. Vanadis Kamm-Kohl, Nürnberg
as well as 9 further signatories
|1.||Lieb K, Klemperer D, Koch K, Baethge C, Ollenschläger G, Wolf-Dieter Ludwig: Interessenkonflikte in der Medizin: Mit Transparenz Vertrauen stärken. Dtsch Arztebl 2011; 108(6): A 256–60 VOLLTEXT|
|2.||Theidel U, Kuhlmann A, Braem A: Pneumocccal vaccination rates in adults in Germany—an analysis of statutory health insurance data on more than 850 000 individuals. Dtsch Arztebl Int 2013; 110(44): 743–50 VOLLTEXT|
|3.||Epidemiologisches Bulletin 7/2012: Stellungnahme zur Impfung Erwachsener gegen Pneumokokken; RKI; www.rki.de/DE/Content/Infekt/EpidBull/Archiv/2012/07/Art_01.html?nn=2375548 (Last updated on 20 Februray 2012; last accessed on 20 February 2014).|