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The non-specific effects of vaccines in low income countries
  1. Frank Shann
  1. Intensive Care Unit, Royal Children's Hospital, Melbourne, Australia
  1. Correspondence to  Prof Frank Shann, Intensive Care Unit, Royal Children's Hospital, Melbourne, Parkville, VIC 3052, Australia; frank.shann{at}

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In their commentary on my article about the non-specific effects of vaccines, Paul Fine and David Elliman state that we are dealing with ‘unproven non-specific effects’ and imply that these effects may not be of widespread importance because ‘much of the evidence’ comes from Guinea-Bissau.1 First, proof is never possible in medicine. Second, Fine and Elliman completely ignore the extensive laboratory evidence of the importance of non-specific (heterologous) immunity.2 Third, attenuated Mycobacterium bovis (BCG vaccine) has unequivocal effects on M tuberculosis, M leprae and bladder cancer. Fourth, I presented evidence from 11 randomised trials suggesting that BCG and measles vaccines …

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