Sisyphus and the Conjugate Vaccines III
Part III of a three part series. Parts one and two can be found here and here.
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The big question with these conjugate vaccines is “What is the overall effect?”
How many fewer cases of invasive bacterial disease are happening after replacement is accounted for?
The more narrowly you look, the better these conjugate vaccines look. The more broadly you look, the more the apparent effects melt away to nothing. With Hib and “replacement disease”, if you just compare h influenza serotype B to serotype A, it would appear that killing off Hib via mass vaccination was extremely successful in the grand scheme of things. When you look at nontypeable (also known as “non capsulated”) h influenzae plus Hia and Hif, that’s when you start seeing that we’re not really any better off now than we were before the Hib conjugate vaccine. Read more