Note: separate re-issue of part two of one of our myths blogs. We got a complaint that this one was too hard to find and link to. The easiest fix was to split it into a separate article. Thanks for your understanding.
Myth: Vaccines aren’t money makers for drug companies.
Reality: As spoken by Tom Broker about Gardasil and Merck (see page 19 of pdf)
“From a purely business point of view, they’ve been facing some real interesting challenges over the Vioxx issue and they are looking at this as the foundation and the savior of the company. Believe me, they have a huge stake in this, just as we all do.”
How profitable are vaccines? Prevnar did very well for Wyeth:
… Prevnar, which had $2.7 billion in sales last year. Prevnar is Wyeth’s No. 2 product by revenue, behind antidepressant Effexor.
Some business press projections on the potential in the vaccine market:
Gardasil sales totaled $365 million in the first quarter of 2007, helping Merck reach nearly $1 billion in total vaccine sales for the quarter, more than triple vaccine sales from a year earlier. Analyst projections have ranged up to $4 billion in annual sales for Gardasil, assuming the government mandates widespread vaccinations for girls.
Merck launched two other vaccines in 2006 – Zostavax, for the prevention of shingles, and Rotateq, for the prevention of a rotavirus that causes diarrhea in infants. Les Funtleyder, analyst for Miller Tabak, estimates that these vaccines could reach hundreds of millions of dollars in annual sales.
“Merck showed that you can make quite a bit of money with vaccines, and I think that got a lot of people’s attention,” said Funtleyder.
If vaccines have the potential to offer huge profits to pharmaceutical companies–just like other blockbuster drugs–Lipitor or Vioxx are good examples, I think we can reasonably assume that the temptation to publish ghostwritten studies, suppress unwelcome results and use Key Opinion Leaders to subtly sell product is there with vaccines, too. And vaccines offer two additional benefits, available for no other drugs: mandates and immunity from lawsuits (in the US). Who wouldn’t be tempted by a package involving a guaranteed market, and tort immunity?
There was a period, quite a long time ago now, when vaccines were not profitable. But time past is not time present. This myth is long past its sell-by date.
While it’s too soon to be sure, influenza numbers are dropping and the season may be coming to an early close. The CDC has these numbers:
During week 51 (December 20-26, 2009), influenza activity decreased slightly in the U.S.
154 (3.9%) specimens tested by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories and reported to CDC/Influenza Division were positive for influenza.
Translation: of thousands of tested cases of “might be flu”, 154 turned out to really be flu, only 3.9% of the total specimens tested. Lots of sneezing and coughing out there, and not an insubstantial number of hospitalizations and deaths for “influenza-like-illness and pneumonia” , but no influenza viruses are the main cause at this point.
2009 H1N1 virus did turn out to be more dangerous to children than the typical yearly influenza virus: the CDC received 225 reports of deaths this year, 130 last year, 88 in 2007 and 78 in 2006.
The breakdown by age:
Since August 30, 2009, CDC has received 225 reports of influenza-associated pediatric deaths that occurred during the current influenza season (42 deaths in children less than 2 years old, 25 deaths in children 2-4 years old, 83 deaths in children 5-11 years old, and 75 deaths in children 12-17 years old).
How likely was a child under 2 to die from H1N1 based on these numbers?
Live births in 2007: 4,317,000, minus 29,000 infant deaths, gives us a starting number of 4,288,000. The number of births has been going up every year for the last few years, so if we assume the same number in 2008 we are erring on the side of caution. We’ve got a total of roughly 8,576,000 children in the U.S. under the age of two. Forty-two of those children died this year as a result of H1N1, according to the CDC. This means that one child out of every 204,190 died from 2009 H1N1 according to the reported number of cases.
Are the reported number of cases reflective of the true burden of illness? Probably not entirely, but in November, CBS news reported that:
It’s a little counter intuitive,” Frieden said, “but the best way to estimate the total burden of illness is not to count the cases, but to estimate them based on the best available science.”
However, Ashton pointed out, things are very different when reporting pediatric flu deaths. She said states are required to document each case with the CDC, and every week the updated numbers are an accurate reflection of the entire country.
The numbers of pediatric deaths from 2009 H1N1 are based, therefore, on actual case counts in the U.S., during 2009.
Infants and toddlers were one of the groups recommended for the 2009 H1N1 vaccine. However, if saving the maximum number of lives is our goal, then there are several other causes of death in infants and toddlers which we feel should be addressed with a vigor to match the actual death and injury rates for each category.
Among 1- to 4-year-old children, injuries accounted for 42 percent of all deaths, followed by deaths due to congenital malformations (birth defects), malignant neoplasms (cancer), homicide, and diseases of the heart.
Or to give some comparative numbers:
More than 16,500 lives could be saved each year in the United States alone if our under-5 mortality rate was the same as Iceland. If the U.S. rate of under-5 mortality was similar to that of France, Germany and Italy (all 4 per 1,000 live births), over 12,000 child lives could be spared.
The causes of child deaths in the industrialized world differ dramatically from those in developing countries. In the developing world, over half of under-5 deaths are caused by pneumonia, diarrhea or newborn conditions. In the industrialized world, these problems rarely lead to death. Children’s deaths are most likely the result of injury suffered in traffic accidents, intentional harm, drowning, falling, fire and poisoning.
Why else would the CDC supply the parents of America with dumbed down information that contradicts their very own guidelines on how to distinguish trustworthy information from mere opinion? Here are the guidelines from the CDC on evaluating information found on the Internet.
What is the scientific evidence for claims made? The original source of facts and figures should be shown. For example, the Web site should provide citations of medical articles or other sources of information. You should be able to distinguish facts from opinions. Also, facts are more reliable if they come from a published scientific study on humans rather than from unpublished accounts or from reports of a single person or of animal studies.
When it comes to information for parents, the CDC motto is clearly: “Do as I say, not as I do.”