MD, PhD, FMedSci, FSB, FRCP, FRCPEd

A remarkable article about homeopathy and immunisation entitled THE IMMUNISATION DILEMMA came to my attention recently. Its abstract promised: “evidence quantifying the effectiveness of vaccination and HP (homeoprophylaxis) will be examined. New international research describing and analysing HP interventions will be reported. An evidence-based conclusion will be reached.”

Sounds interesting? Let’s see what the article really offers. Here is the relevant text:

…evidence does exist to support claims regarding the effectiveness of homeopathic immunisation is undeniable.

I was first invited to visit Cuba in December 2008 to present at an international conference hosted by the Finlay Institute, which is a W. H. O.-accredited vaccine manufacturer. The Cubans described their use of HP to control an outbreak of leptospirosis (Weilʼs syndrome – a potentially fatal, water-born bacterial disease) in 2007 among the residents of the three eastern provinces which were most severely damaged by a severe hurricane – over 2.2 million people [7]. 2008 was an even worse year involving three hurricanes, and the countryʼs food production was only just recovering at the time of the conference. The HP program had been repeated in 2008, but data was not available at the conference regarding that intervention.

I revisited Cuba in 2010 and 2012, each time to work with the leader of the HP interventions, Dr. Bracho, to analyse the data available. Dr. Bracho is not a homeopath; he is a published and internationally recognised expert in the manufacture of vaccine adjuvants. He worked in Australia at Flinders University during 2004 with a team trying to develop an antimalarial vaccine.

In 2012 we accessed the raw leptospirosis surveillance data, comprising weekly reports from 15 provinces over 9 years (2000 to 2008) reporting 21 variables. This yielded a matrix with 147 420 possible entries. This included data concerning possible confounders, such as vaccination and chemoprophylaxis, which allowed a careful examination of possible distorting effects. With the permission of the Cubans, I brought this data back to Australia and it is being examined by mathematicians at an Australian university to see what other information can be extracted. Clearly, there is objective data supporting claims regarding the effectiveness of HP.

The 2008 result was remarkable, and could only be explained by the effectiveness of the HP intervention. Whilst the three hurricanes caused immense damage throughout the country it was again worse in the east, yet the three homeopathically immunised provinces experienced a negligible increase in cases whilst the rest of the country showed significant increases until the dry season in January 2009 [8].

This is but one example – there are many more. It is cited to show that there is significant data available, and that orthodox scientists and doctors have driven the HP interventions, in the Cuban case. Many people internationally now know this, so once again claims by orthodox authorities that there is no evidence merely serves to show that either the authorities are making uninformed/unscientific statements, or that they are aware but are intentionally withholding information. Either way, confidence is destroyed and leads to groups of people questioning what they are told…

Final Conclusions

The attacks against homeopathy in general and HP in particular will almost certainly continue. If we can achieve a significant level of agreement then we would be able to answer challenges to HP with a single, cohesive, evidence-based, and generally united response. This would be a significant improvement to the existing situation.

 

Reference 7 is the following article: Bracho G, Varela E, Fernández R et al. Large-scale application of highly-diluted bacteria for Leptospirosis epidemic control. Homeopathy 2010; 99: 156-166. The crucial bit if this paper are as follows:

A homeoprophylactic formulation was prepared from dilutions of four circulating strains of Leptospirosis. This formulation was administered orally to 2.3 million persons at high risk in an epidemic in a region affected by natural disasters. The data from surveillance were used to measure the impact of the intervention by comparing with historical trends and non-intervention regions.

After the homeoprophylactic intervention a significant decrease of the disease incidence was observed in the intervention regions. No such modifications were observed in non-intervention regions. In the intervention region the incidence of Leptospirosis fell below the historic median. This observation was independent of rainfall.

The homeoprophylactic approach was associated with a large reduction of disease incidence and control of the epidemic. The results suggest the use of HP as a feasible tool for epidemic control, further research is warranted.

The paper thus describes little more than an observational study. It shows that one region was less affected than another. I think it is quite clear that this could have many reasons which are unrelated to the homeopathic immunisation. Even the authors are cautious and speak in their conclusions not of a causal effect but of an “association”.

The 2012 data cited in the text remains unpublished; until it is available for public scrutiny, it is impossible to confirm that it is sound and meaningful.

Reference 8 refers to this article: Golden I, Bracho G. Adaptability of homœoprophylaxis in endemic, epidemic and stable background conditions. Homœopathic Links 2009; 22: 211-213. I have no access to this paper (if someone does, please fill us in) but, judging from both its title and the way it is described in the text, it does not seem to show reliable data about the efficacy of homeopathic immunisation.

So, is it true that “evidence does exist to support claims regarding the effectiveness of homeopathic immunisation”?

I do not think so!

Immunisation is by no means a trivial matter; wrong decisions in this area have the potential to cost the lives of millions. Therefore proofs of efficacy need to be published in peer-reviewed journals of high standing. These findings need then be criticised, replicated and re-criticised and re-replicated. Only when there is a wide consensus about the efficacy/safety or lack of efficacy/safety of a new form of immunisation, can it be generally accepted and implemented into clinical practice.

The current consensus about homeopathic immunisation is that it is nothing less than dangerous phantasy. Those who promote this quackery should be publicly exposed as charlatans of the worst kind.

6 Responses to Homeopathic immunisation is dangerous, unethical madness

  • Bracho’s study is oft-cited by homeopaths as proof of homeopathy for just about everything!

    However, his study was a dreadful and has been roundly criticised. Other than the issues you cite, other problems were that it judged its success by comparing incidence of leptospirosis with forecast models:

    Forecast models: Although no model can predict exactly the future incidence of Leptospirosis, adjusted models are useful to forecast probable incidence trends and epidemics. 42 Five available forecast models were tested for best fit to temporal series of Leptospirosis cases (dependent) and rainfall (independent variable). To select the best fitting model, all were tested to determine how well they predicted the real temporal series of 2000-2004. The differences between forecast and real values (residual error) were analysed for statistical significance. All models gave similar forecast curves, but simple exponential smoothing was selected as no significant differences were observed when the residual errors were analysed in five out of five different tests with a 95% confidence level while the other five models all failed in one or more tests. Adjusted forecast curves, lower and upper confidence limits were validated with real data sets from different years.

    Unfortunately, no further details of those models, nor their accuracy nor details of any validation were given. All that is presented is a line on a chart (Figure 2A), with rather wide 95% CL.

    The other gem the paper reveals is that the proven conventional vaccination, vaxSpiral, also developed by the Finlay Institute was also used in high-risk groups during the study period:

    The intervention in 2007
    Considering the epidemic situation in the IR, the unfavourable prognosis and the emergency caused by natural disasters, a massive HP application of nosoLEP 200C was started at week 45, 2007. vaxSpiral vaccination and chemoprophylaxis in high-risk groups were continued but because of the limited availability of vaccines, vaccination coverage among newly exposed population was limited to 15,000 individuals in the IR (0.6% coverage).

    I asked Isaac Golden about these criticisms in a discussion about the Australian NHMRC draft report on homeopathy when he turned up in the comments. He contradicted the figure for coverage by vaxSpiral given in the paper, stating that the coverage was 2%, not 0.6%, but he seemed a bit hazy about the details of who had been given it. This seems to me to be a rather important issue, but detailed explanations and answers were not forthcoming before the article was closed for comments.

    He asserted:

    The Cubans are using homeopathic immunisation for 6 diseases now with great success.

    I asked for evidence for this remarkable assertion, but none was forthcoming.

    In fact, I have spent some time looking into this, but that was some 18 months ago and have not got round to publishing it on my blog. However, after an extensive search at that time, I could find no evidence that any further homeoprophylaxis had taken place. In my correspondence with Bracho, he stated:

    After the trial, homeoprophylaxis on Leptospirosis have been extended resulting in a further decrease on the incidence all across the island and a significant reduction on the needs for conventional vaccines (Trivalent Leptospirosis vaccine produced at Finlay Institute) as preventive tool.

    However, he was unable to give any further details and I am not aware that any further results have been published.

    I also corresponded with the President of Vacunas Finlay S.A, Dr Francisco Domínguez Álvarez. He stated

    Today, homeopathic prophylaxis for Leptospirosis is not used in Cuba.

    Given the apparent miraculous success claimed by this trial and the claims made by others, this is indeed remarkable.

    • Wow, talking in circles to try to make a wonderful, harmless and effective medical treatment sound dangerous! Who Are You?!

      • Julie K Schooley said:

        Wow, talking in circles

        What circles?

        to try to make a wonderful, harmless and effective medical treatment sound dangerous!

        Please provide evidence to substantiate your claims.

        Who Are You?!

        Why do you believe that would matter? Can you answer any of the criticisms and questions raised above?

  • Funny that so-called HP would be considered to work prophylactically for a disease on a mass scale, when homeopathy is meant to be individualised by specimen. How could you possibly know which symptoms the person was not going to get?

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