DPT vaccine
DTP is one of the most common vaccines used in the world. In 2012, SAGE requested that the WHO review the evidence concerning the possible effects of DTP vaccines on mortality1. In a new expert report, Peter C. Gøtzsche, Professor, DrMedSci, MSc analyzed the WHO systematic review as well as any studies published after the WHO report that assessed the effect of DTP vaccine on total mortality. This new expert report concludes that the "evidence tells us that it is likely that the DTP vaccine increases total mortality in low-income countries." 2

This echoes the conclusion by Peter Aaby - a highly acclaimed scientist renowned for studying and promoting vaccines in Africa - that "all currently available evidence suggests that DTP vaccine may kill more children from other causes than it saves from diphtheria, tetanus or pertussis. Though a vaccine protects children against the target disease it may simultaneously increase susceptibility to unrelated infections." 3 Dr. Aaby's recent study, the first ever naturally randomized comparison of mortality between children receiving DTP and those that are unvaccinated, found that children vaccinated with DTP were 10 times more likely to die in the first 6 months of life than the unvaccinated.3

One of the five goals of the WHO's Global Vaccine Action Plan (GVAP) is to exceed the UN Millennium Development Goal 4 target of reducing child mortality.4 A strategy for achieving this goal is to reach 90% national vaccination coverage on DTP containing vaccines worldwide.4 According to Gøtzsche's conclusions, this strategy would be counterproductive toward the goal of reducing child mortality.

Gøtzsche offers several suggestions for potential next steps. As stated by UNICEF, "the percentage of children receiving the diphtheria, tetanus and pertussis vaccine (DTP) is often used as an indicator of how well countries are providing routine immunization services" 5. Gøtzsche recommends that the indicator be changed to something that is "known to be positively associated with better child survival."2 Gøtzsche then explains that "it is the duty of a manufacturer of a drug or vaccine to demonstrate in randomized trials that it works and has a positive benefit to harm balance. This has not been done for the DTP vaccine." 2 As such, he advocates for the initiation of randomized trials and considers the need for them "an urgent ethical imperative."2

Gøtzsche concludes with a call for the re-evaluation of current DTP vaccination practices. "No one should be offered this vaccine without full informed consent that includes information that the vaccine is likely to increase total mortality. I also believe that the vaccine should not be recommended and that, if anyone wants to use it, it must be as part of a large randomized trial."2

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References:
1. https://www.who.int/immunization/sage/sage_wg_non_specific_effects_vaccines_march2013/en/ 2. https://vaccinescience.org/expert-report-effect-of-dtp-vaccines-on-mortality-in-children-in-low-income-countries/
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5360569/
4. https://www.who.int/immunization/global_vaccine_action_plan/GVAP_doc_2011_2020/en/
5. https://data.unicef.org/topic/child-health/immunization/