I have read the correspondence on ‘Is Hib vaccination required at all in India’(1) with interest. In their reply, Dr Cherian and colleagues protest "the Cynical attitude towards research that involves participation of industry"(2). They say their trials are available for audit 15-20 years after the completion of the study and are in no way influenced by the manufacturers.

It is unbelievable that members of any standing in the Academy of Pediatrics, will fudge data at the behest of commercial sponsors. This is not the reason why the declaration of commercial interest is in place. The data is always pure. It is how the data is interpreted that may be influenced, consciously or unconsciously, by the sponsor. Such influence can be seen even in the reply given by Dr Cherian and colleagues.

Drs Beri and Ojha(1) have referred to an article published in ‘Vaccine’ showing that children in India seem to develop natural immunity to Hib in infancy(3). The understanding used to be, that children under 2 years have a poor immune response to capsular polysaccharide of Hib. Overseas, even children who develop invasive Hib infection such as meningitis, often do not develop a substantial concentration of serum antibodies, if they are under 18 months of age(4). The presence of natural immunity in infancy in India, was therefore of sufficient interest as to be published in ‘Vaccine’. Natural immunity can make use of the vaccine redundant in India, if the report in Vaccine is true. It is remarkable that in their reply(2) Cherian et al. fail to note this finding, even after it is pointed out to them, and they write, "children everywhere develop natural immunity by 5 years and this does not negate the need for the vaccine in India".

While I am not against the sponsorship of research by industry, I commend the policy of ‘Indian Pediatrics’ to publish this declaration of commercial interest, which allows the reader to look for such subtle, often unintentional, bias in published articles. This policy and the policy letters by readers critical of biased papers ensure that sponsored research is worthy of the science.

Vikas Taneja,
Department of Pediatrics,
Sir Ganga Ram Hospital,
New Delhi - 110 060.