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Postscript
Letters
The non-specific effects of vaccines in low income countries
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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 …