In a recent letter, Doug Huntley wrote, “The gold standard for testing [drugs] is the randomized, placebo-controlled clinical trial. Vaccines are drugs so the same standard should apply.”
Trials need controls, but the kind of control depends on the question asked. For most drugs, trials are complicated because people sometimes get better (or worse) when treated, whether the “treatment” is an effective drug or a piece of candy (a placebo). Therefore the question to ask isn’t, “Does the drug work?” but, “Does the drug work better than a placebo?” The appropriate control is the placebo.
In some cases, there is an accepted treatment for the condition, but it has problems. Therefore, the question is “Does the new drug work better than the existing treatment?” The appropriate control is the accepted treatment, not a placebo.
In the case of vaccines, the question is, “Are vaccinated people healthier than unvaccinated people?” Therefore, the appropriate control group for learning about both effectiveness and safety is people who are not vaccinated. Initial tests for safety are performed on adult volunteers. Then the vaccine is given to children, if appropriate.
The familiar vaccines (measles, mumps, diphtheria, tetnus etc.) have been tested in adults and given to millions of children. Effectiveness and safety have been studied repeatedly by comparing the health of vaccinated to unvaccinated children. Some of the studies follow the children for years. Doctors know with certainty that vaccinations are much, much safer than getting these diseases.
Corvallis (March 1)