When money and ethics collide

If the NHS does not advise giving a vaccine, how is it ethical to sell them?

Last month, HART wrote an article on the spring booster programme, including linking to an article in Chemist+Druggist on the pending availability of private covid vaccines in pharmacies up and down the land. A company called Pharmadoctor was the first into the ring but has been followed by others including Boots, the oldest of the UK high street chemists, whose strapline on their website is:

We serve your wellbeing for life.

According to the Mail headline: 

Boots to start selling Covid vaccines privately… at almost £100 a pop! Huge shake-up of jab roll-out sees chemists offer top-up doses to all over-12s

The article includes the statement: “Experts say offering Covid vaccines privately — like what happens with the flu every winter — is a no-brainer.” (HART comment: an interesting turn of phrase, which amply sums up the critical thinking involved in the experts’ advice – no-brainer)

They also quote a Boots spokesperson saying:

“We are launching a private Covid vaccination service for people who are not eligible for an NHS vaccination but still want the option to protect themselves from the virus.” 

As we pointed out in February’s HART article, the JCVI spring booster programme only includes over 75s and those under 75 with known immunocompromise. In fact their cost-effectiveness calculations showed that at £25 a shot “vaccination was likely to be cost-effective when offered to the following groups:

  • all adults aged 90 years and over not in a clinical risk group
  • all adults aged 80 years and over in a clinical risk group
  • all adults aged 65 years and over with immunosuppression”

It perhaps has not occurred to Boots or any of the other pharmacies taking part, that there might be another less publicised reason why the JCVI have been steadily dropping most of the groups from the NHS vaccines schedule.  The financial cost-effectiveness balance is one thing, but the health cost-effectiveness balance is quite another.  If vaccines for many groups have been causing more harm than good, then quietly dropping them seems a likely strategy. AstraZeneca was dropped from use in the UK over 2 years ago but remains fully approved and at no point has any public body explained to the British people why this British wonder drug disappeared. 

In order to ensure that they cannot claim ignorance, Dr Ros Jones and Professor Angus Dalgleish on behalf of the Children Covid Vaccines Advisory Council, have sent the following letter to the CEOs of both Boots and Pharmadoctor.

Please feel free to share it with your local chemist.

To: Sebastian James, CEO, Boots UK ; Graham Thoms, CEO, Pharmadoctor , 27th March 2024

Dear Mr James and Mr Thoms,

Re: Private Covid-19 vaccines for healthy children

We are writing to draw your attention urgently to the major breach of ethical principles if your companies proceed to offer covid-19 vaccinations privately to healthy children aged 12 years and above, at a time when the NHS has effectively withdrawn the vaccines for all healthy under 75s.

In last year’s autumn booster there was still an option for healthy 12+ to receive a booster if they had an immunocompromised household member.  This would appear to be a gross infringement of the Universal Declaration on Bioethics and Human Rights (2005), whereby children and others unable to give informed consent should never be given a drug except for their own direct benefit. Article 3 states, “the interests and welfare of the individual should have priority over the sole interest of science or society”.  Article 7, referring to people without the capacity to consent, states, “authorization for research and medical practice should be obtained in accordance with the best interest of the person concerned”.

A large number of senior UK health professionals and academics wrote to the JCVI last September to highlight our concerns over the ethics of using children to protect adults.

By spring 2024, even that indication has been dropped, and the Covid-19 vaccines are now not recommended for any healthy under 75s. It is a cynical move by the JCVI to approve these products for private sale, when they do not think they are beneficial for NHS patients.

I am sure you are both well aware of the huge number of safety concerns over these vaccines, with side effects apparently more common in younger age groups. These include myocarditis with the greatest risk for 16-19-year-olds, thrombotic and cardiovascular events, neurological conditions and most importantly effects on the immune system. You may not be aware that studies have shown that higher numbers of booster doses are associated with a higher risk of catching covid-19, as shown below. Moreover, multiple doses appear to be resulting in a change of the immune response from IgG2 to IgG4.

Figure 1. Cumulative incidence of coronavirus disease 2019 (COVID-19) for study participants stratified by the number of COVID-19 vaccine doses previously received

Concerns have also been raised regarding contamination with DNA during the manufacturing process for both Pfizer BioNTech and Moderna’s mRNA vaccines. I am sure you are also aware of increasing cancers in 15- to 44-year-olds, but perhaps you may be closing your eyes to the possibility that the recently rolled out mRNA vaccines with known effects on the immune system, may be a factor in cancer aetiology. No tests for carcinogenicity were required or performed before emergency approval.

Figure 2. Excess cancer deaths age 15-44 years (ONS data)

Overwhelmingly, children, or for that matter healthy young adults, do not need these vaccines. According to the JCVI’s latest guidance, published 7th February 2024, for 16-19-year-olds, the number needed to vaccinate (NNV) with a booster to prevent one severe hospital admission is 193,500, this number including teenagers with clinical risk factors.  For healthy 20-29s, the same analysis stated a NNV of 706,500 for an autumn booster, thus the number for healthy 16-19s would be expected to be even higher. Furthermore, the vast majority of adolescents have already been repeatedly exposed to SARS-CoV-2 infection and will have good innate and naturally-acquired immunity.

I would implore you both to look beyond short-term company profits, to the potential that your plans will cause real harm to children. Will your staff be obtaining genuinely informed consent? Litigation will surely follow for any vaccine injuries occurring under your watch.

Yours sincerely,

Dr Rosamond Jones, MBBS(Hons), DRCOG, MD, FRCPCH, retired consultant paediatrician

Professor Angus Dalgleish, MD, FRCP, FRACP, FRCPath, FMed Sci, Principal, Institute for Cancer Vaccines & Immunotherapy, Emeritus Professor of Oncology, University of London

On behalf of Children’s Covid Vaccines Advisory Council (www.childrensunion.org/ccvac)  

Cc:  Professor Lim, Chairman, JCVI Covid-19 vaccines committee

Dame Jenny Harries, CEO, UKHSA

Professor Sir Chris Whitty, Chief Medical Officer

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