Is ‘conflict of interest’ a Misnomer? Managing interests in immunization research and evaluation

Figures & data

Table 1. Examples of actions which may have contributed to the eroding of public trust

Responsible Party	Description
Academia and academic publishers	Data fraud pertaining to effects of MMR vaccination in children by AJ Wakefield et al., 1998 published in The Lancet.^Citation10
Industry	Press release of premature, not peer-reviewed data from eight study subjects in a COVID-19 vaccine trial, with perceived corporate rather than scientific benefit.^Citation11
Patient advisory groups	Lobbying by meningitis charities in the UK for inclusion of the meningococcal B vaccine in the routine immunization schedule for older children despite a lack of evidence to support the cost-effectiveness of inclusion.^Citation12
Government	Press release from NIAID describing early trial results of remdesivir as a treatment for COVID-19 prior to the publication of peer-reviewed data.^Citation13

Table

Source	Definition
Faculty of Medicine, University of Ottawa (http://www.med.uottawa.ca/Organisation/ProfessionalAffairs/eng/policies_procedures_fom_industry_relations_policy.html – s2)	“Conflict of Interest may be actual, potential or perceived. A conflict of interest occurs when an individual has a significant financial, professional or other personal consideration with Industry that may compromise, or have the potential to compromise or the appearance of compromising, their professional judgment or integrity in clinical responsibilities, teaching, conducting or reporting research, or performing other obligations.”
College of Physicians and Surgeons of British Columbia (Practice Standard: Conflict of Interest. 2019.)	“A conflict of interest arises when a physician’s duty to act in the patient’s best interests may be affected or influenced by other competing interests. Conflicts of interest can be real, potential or perceived. Conflicts of interest may arise in a variety of circumstances including financial, non-financial, direct, and indirect transactions with patients and others. Financial gain by a physician is not necessary to establish a conflict of interest. Additionally, a physician does not need to directly profit from the relationship. A conflict of interest may arise where the benefit is, or could be, accrued by a physician’s family, close friends, corporation or other businesses, and business partners.”
Treasury Board Secretariat, Public Health Agency of Canada (Policy on People Management. 2020.)	“A situation, whether real, apparent or potential, in which the person employed has private interests that could influence the performance of their official duties and responsibilities or in which the person employed uses their office for personal gain.”
World Health Organization (https://www.who.int/about/ethics/declarations-of-interest)	“Generally speaking, a conflict of interest arises when a secondary interest interferes with the primary interest of WHO and its staff. The scope of conflict of interest goes beyond financial interest.”
ICES (Conflict of Interest Policy and Declaration Form. 2020.)	“Refers to any situation where there is a potential divergence between an individual’s interests and his or her obligations to ICES. A conflict of interest may be actual, perceived or potential.”
Pfizer (The Blue Book: Summary of Pfizer Policies on Business Conduct. 2019.)	“A conflict of interest arises when you place your personal, social, financial or political interests before the interests of the Company.”

The Editors of The Lancet. Retraction—Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet. 2010;375(9713):445–445. doi:10.1016/S0140-6736(10)60175-4.

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Moderna Announces Positive Interim Phase 1 Data for its mRNA Vaccine (mRNA-1273) Against Novel Coronavirus [press release]; 2020. 18 May 2020.

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Petition: Give the Meningitis B vaccine to ALL children, not just newborn babies.

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NIH Clinical Trial. Shows Remdesivir Accelerates Recovery from Advanced COVID-19 [press release]; 2020. 29 April 2020.

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