08 March 2019

Health Research

‘PhD thesis opposing immunisation: Failure of academic rigour with real-world consequences’ by Kerrie Wiley, Julie Leask, Margaret Burgess and Peter McIntyre in (2019) 37(12) Vaccine 1541 offers an elegant, important and alas necessary appraisal of the University of Wollongong doctorate by an anti-vaccination advocate.

The authors conclude
It might be argued that a thesis on immunisation policy conferred through a Faculty of Law, Humanities and the Arts is not expected to present a detailed and systematic literature review or undertake primary research. We argue that a thesis which explicitly sets out to examine “Government vaccination policies, including an assessment of the underpinning scientific evidence and the stakeholders who have influence in the decision-making process” (pp2), irrespective of the faculty or discipline in which it is conducted, should use methods for identifying and assessing scientific evidence of comparable rigour to those used by the academic and scientific bodies which inform policy makers. 
This thesis is notable for its lack of evidence of systematic literature review. Despite its extensive claims, there is no primary research, but there is abundant evidence of strong bias in selecting the literature cited and sometimes outright misrepresentation of facts. We agree that critique of immunisation policy is a valid academic exercise that goes beyond technical knowledge, but equally it cannot be based on incomplete, flawed technical assertions. 
The thesis legitimately highlights the importance of transparency and accessibility in the processes by which vaccines are assessed for inclusion on any national immunisation schedule. It also raises the importance of perceptions about conflicts of interest among contributors to immunisation policy development, and the need for open conversation about policy decisions among all immunisation stakeholders, including the public. These considerations are important for countries seeking to improve established National Immunisation Technical Advisory Groups (NITAGs), as noted by the Supporting Independent Vaccine Advisory Committee (SIVAC) initiative. Areas of public health importance such as immunisation are legitimate topics for scrutiny. It is important to question long-embedded policies and practices, however such scrutiny must be rigorous, disciplined, and draw on the full range of appropriate expertise. 
Almost three years after the event, the award of PhD by a reputable University has validated the thesis’ claims and allowed the author to add weight to her subsequent prolific writings, including open letters to politicians, and seminars to parents, with consequences on a national and international scale. Tangible evidence of real-world consequences come from two sources. First, two of us (KW and JL), in our research with non-vaccinating Australian parents, find some who state that material in this PhD and its endorsement by a recognised university supports their decision not to vaccinate their children. Second, the author of the thesis has put herself forward as an expert witness in legal proceedings where parents are in dispute over the need for their children’s immunisation by positioning her status as a PhD graduate to assert expert status. 
Those looking for balanced information about immunisation deserve a balanced critique of this thesis to aid them in their decision-making. We believe that our critique serves as an accessible, objective and fair appraisal of the thesis, allowing valid assessment of the quality of the information it presents and the credentials of its author, within the limitations and framework of a journal article.