RAND advises pharmaceutical company on strategies in vaccinating low-income students
The pieces of the pandemic puzzle are coming together as the H1N1 Swine Flu hysteria is reaching new heights. A largely uncovered white paper published by RAND Corporation in March of 2009, sponsored by pharmaceutical giant Sanofi Pasteur, identifies parental consent laws, medical homes, and lack of access to medical records as main barriers “for immunizing low-income adolescents.” The solution proposed to Sanofi Pasteur? Turn schools into a vaccine wonderland.
The triad of barriers to mass-vaccinate adolescents which were identified in RAND Corp’s white paper are:
1. Parental Consent Laws
2. Absence of a reliable Medical Home
3. Access to vaccine registration information
There are many relevant quotes throughout the white-paper to support this claim. Here are just a few…
“It would appear at first blush that vaccinating teens in a school setting would be a practical way to address the barriers posed by the lack of a medical home. Schools are the only place where the vast majority of adolescents are found consistently and predictably ( pg 19) (emphasis mine)
“Many of the barriers we identified “while seemingly distinct”were tied to current consent laws. We found that the requirement that parental consent for vaccination be provided in real time clearly limits the vaccination of adolescents in venues such as schools, where parents and adolescents are not likely to be together.” ( pg 27) (emphasis mine)
“Ambiguity and variability in consent laws also hinder the role of alternative vaccinators and the use of information technology to improve documentation, management, and communication. Current approaches for collecting consent … impede effective and efficient program management that might be possible with modernized parental consent laws.“ ( pg 27) (emphasis mine)
While immunization registries have traditionally focused on younger children, improving their utility for the adolescent population has great potential to facilitate improvement in the management of adolescent vaccination programs. One natural partnership, not yet fully realized, is with local schools.( pg 44) (emphasis mine)
According to the preface of the document, this endeavor started in 2007 as Sanofi Pasteur desired information concerning the current logistical climate for vaccinating the less fortunate. However, the title of the document, ‘Strategies and Models for Promoting Adolescent Vaccination for Low-Income Population’ is misleading. The recommendations that RAND produced for Sanofi Pasteur have ramifications for the entire scholastic population, as shown in the following passage.
“Although our original charge was to focus on low-income adolescents,we found the current policy and practice infrastructure supporting the vaccination of the general population of adolescents to be underdeveloped and thus unlikely to yield substantial increases in vaccination uptake among low-income adolescents in the absence of structural change. For this reason, we addressed the issue of adolescent immunization from a broad perspective, identifying more general approaches that can be tailored to low-income populations, and addressed specific issues and challenges for low-income adolescents where appropriate. ” ( pg 5)(emphasis mine)
It is critical to bring into focus throughout the entirety of this article who is the intended audience of the RAND Corp dossier: Sanofi Pasteur.
UNDERSTANDING OF CONTEXT
We must understand where this report came from. It most certainly did not randomly fall out of the sky and softly land on the lap of an innocent onlooker at Sanofi. Nor is it by chance RAND was engaged for researching this specific topic. Interestingly, the subject of addressing a pandemic influenza has been on RAND Corporation’s radar for some period of time and it would only make sense that a manufacturer of vaccines would have a keen interest in RAND’s insider knowledge.
You may be asking yourself at this point, “Who is RAND Corporation?”
“RAND Corporation(Research ANd Development) is a nonprofit global policy think tank first formed to offer research and analysis to the United States armed forces by Douglas Aircraft Company and currently financed predominantly by the U.S. government, a private endowment, predominantly pharmaceutical corporations,universitiesand private individuals. The organization has long since expanded to working with other governments, private foundations, international organizations, and commercial organizations on a host of non-defense issues.” 
It is well established that members of RAND Corporation are on the dole from entities such as GlaxoSmithKline [3, 4], and Sanofi Pasteur. Other projects concerning health, population control and pandemic issues have been funded by The California Endowment , Robert W Woodruff Foundation [5, 8], William and Flora Hewlett Foundation , David and Lucile Packard Foundation , the Rockefeller Foundation , United Nations Population Fund , the Nuclear Threat Initiative (NTI)[5, 8], The US Department of Health and Human Services [5-7, 10, 11 ] , The Office of the Assistant Secretary for Preparedness and Response [6,11] and the US Army to name a few. Let us not be naive to the fact RAND Corporation has enormous influence in Washington D.C. as evidenced with the recent Gilmore Commission (1999-2003).
The Gilmore Commission was a Congressional Advisory Panel and entered into a contract with the RAND National Defense Research Institute (NDRI), a federally funded research and development center (FFRDC), to establish the Advisory Panel. The Advisory Panel assessed the capabilities for responding to terrorist incidents in the U.S. involving weapons of mass destruction. Response capabilities at the Federal, State, and local levels were examined, with a particular emphasis on the latter two.
“Of the Gilmore Commission’s 164 recommendations, 146 have been adopted in whole or in part by the Congress and the federal government.”  Perhaps you would be comforted if you knew RAND recommended a National Vaccine Authority because private industry bears too much liability and risk? ( Appendix N, ) In a report to the congressional advisory panel, RAND decided to, recommend the establishment of a government-owned, contractor-operated national facility for the research, development, and production of vaccines and therapeutics for specified infectious-especially contagious-diseases.Â ( pg vi, 30)
GlaxoSmithKline (GSK), a ‘competing’ pharmaceutical company, funded RAND in mid-flu-season 2008 to make a determination on how many Americans received their flu shot. Roughly 1/3 of the respondents communicated that the flu jab “wasn’t needed.”Â ( pg 1)
At the end of the 2008/2009 flu season GSK tested the waters again and funded a study to discover 38% of Americans took the annual influenza vaccine. ( pg 1) RAND exposed that roughly 25% of the respondents flat out said they “don’t need it,” ( pg 3) despite the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control (CDC) specifically recommending an annual influenza vaccination.
The data from the GSK-funded study also showed that minorities were also less likely to be vaccinated with the annual influenza vaccine. ( pg 2) Shortly after both of the flu shot coverage studies were completed by RAND, ‘Strategies and Models for Promoting Adolescent Vaccination for Low-Income Population’ was published in 2009.
Remarkably, this data comes on the coattails of hysteria surrounding the H5N1 Bird Flu( pg 1, ), West Nile Virus ( pg 145, ), Monkeypox ( pg 163), SARS ( pg 155), Smallpox ( pg 198) and Anthrax (pg 3, ) scares after 9/11. These aforementioned outbreaks were evaluated by RAND Corporation at some capacity.
Astute students who are “in-the-know” are well aware of the prophetic messages of individuals such as Dr. Sherri Tenpenny as described in her book, “Fowl! It’s Not What You Think”,  in referring to the recent Bird Flu (H5N1). By example, Dr. Tenpenny refers to a patent application for the MF59 adjuvant that was going to be used for the Avian Flu Virus (H5N1). The same MF59 adjuvant is being used in the Swine Flu vaccine (H1N1). Here is an excerpt from US Patent 6299884 and then from a workshop on adjuvants and therapeutic vaccines, respectively.
“Any metabolizable oil, particularly from an animal, fish or vegetable source, may be used. It is essential that the oil be metabolized by the host otherwise the oil component may cause abscesses, granulomas or even carcinomas, or (when used in veterinary practice) may make the meat of vaccinated birds and animals unacceptable for human consumption due to the deleterious effect the unmetabolized oil may have on the consumer.”Â [22-23](emphasis mine)
“Carcinogenicity, we (Dr. Deborah Novicki of Novartis, another pharmaceutical company) have done no testing for the carcinogenicity of MF59 adjuvant or any of our preventive vaccines. We haven’t done it and we don’t plan to.”Â ( pg 391)(emphasis mine)
RAND also recommends funneling the responsibility of determining vaccine stockpile amounts be left to Homeland Security. ( pg vii) Ask yourself, when has your government been successful at anything and had a balanced budget?
When RAND speaks, America’s public servants willingly obey. ‘Lawmakers’ know who calls the shots. This is the history you must know as you need to understand that the recommendations RAND makes are made by seasoned veterans who are not simply giving arbitrary counsel.
FIVE POINTS FOR DISCUSSION
1. Why are parents not identified as stakeholders?
As the story unfolds, the RAND corporation identifies the key stakeholders interviewed for this project for Sanofi Pasteur. The stakeholders are defined as “school nurses and health professionals, researches and legal experts, trade and professional association representatives, immunization coalitions and programs, third-party billers, nontraditional vaccinators.” ( pg 8 ) Parents and adolescents are noticeably absent from the aforementioned list. In other words, the ‘stakeholders’ being interviewed by RAND for Sanofi Pasteur have the ability to identify bottlenecks in the vaccination campaign.
2. How can RAND be confused concerning parental consent rules given the breadth and scope of their past projects in addition to state education departments having strict consent procedures?
RAND frequently refers to there being, “Confusion and lack of clarity surrounding parental consent rules are substantial barriers to broadening teen vaccination,” ( pg 17) and seemingly contradicts themselves “…informants remarked that state education departments’ fear of liability drove strict consent procedures for school-based immunization.” ( pg 19)
Are you aware your child does not have to be vaccinated to attend school? In most states a religious or medical exemption are available. Nineteen states have philosophical exemptions. Simply validate this by viewing the CDC’s website on state immunization laws  or view the National Vaccine Information Center’s (NVIC) website.
3. How do we know RAND Corporation is recommending to Sanofi Pasteur, a private company, to utilize and modify an existing mechanism developed by the CDC to promote ‘health’ instead of their own agenda(s)?
“CDC’s School Health Index (SHI) offers a framework for increasing school accountability for vaccine promotion and administration, either in the absence of or in conjunction with state mandates. The SHI was developed by the CDC in partnership with school staff, school health experts, parents, and other governmental agencies….the lack of a comprehensive focus is a barrier to promoting school accountability and moving toward more comprehensive school-based vaccination programs.” ( pg 37)
“A vaccine-specific module dovetails nicely with existing SHI modules, and would give schools a sense of where they fit on the continuum (from minimal education to vaccination on-site), and where there is room for improvement. As such, an SHI immunization module would help schools increase their involvement and accountability with respect to vaccine promotion and/or administration in ways that are consistent with available resources and levels of interest. In this way, the SHI could be a flexible tool for increasing school accountability for vaccine-related activities in the absence of potentially contentious school mandates, or it could help schools organize and carry out their responsibilities to ensure that students are vaccinated under mandates. “( pg 39)
4. What is RAND Corporation’s intention, specifically, for sharing this information with a company that vaccinates our youth for profit?
“To help providers and other key stakeholders address these issues (vaccinating adolescents), RAND has been developing a set of Geographic Information System (GIS) mapping and decision tools specifically designed for health care decisionmakers.”Â ( pg 41)
“Maps such as these may be used to facilitate the targeting of VFC vaccine, and prioritization of outreach and education based on such factors as the proportion of students receiving free or subsidized school lunches, the availability of primary care providers participating in VFC, and the geographic clustering of Medicaid-eligible children.” ( pg 41)
“Because third-party billers can assess insurance status, submit insurance claims, and process credit card payments, they can engage in broad outreach beyond geographic areas with high concentrations of VFC-eligible(Vaccines for Children) adolescents and make vaccination more convenient for adolescents with and without health insurance.”Â ( pg 43)
5. Given the nature of past projects of RAND Corporation, it is concerning to know what specific recommendations they gave Sanofi Pasteur (and other business entities) regarding a public relations campaign specific to the “art of vaccination”. Is RAND Corporation and Sanofi Pasteur interested in promoting the TRUTH or their version(s) of it?
“..educated adolescents may be able to inform and influence skeptical parents and peers. ( pg 31)
“Tobaccofreekids.org is a potentially useful model for more directly engaging youth and developing adolescent vaccine “champions”. Ardent supporters of a cause, champions can bring about change by educating those around them and spurring others into action through local events, meetings, or publications…The vaccine industry may also provide opportunities for youth to organize local activities related to vaccination.” ( pg 35-36)
In the past, members of the RAND Corporation have been involved in researching how to best shape public behavior in avoidance of discrediting public health authorities in preparation for an influenza pandemic. ( pg 7) Accordingly, their recommendations involve gathering intelligence on community beliefs as well as recommending creating ‘active listening opportunities’ for members of the community. ( pg 8 )
Interesting terms such as “Tipping Point”Â are also used to convey the following message…
(Tipping Point is) meant to identify events, actions, or perceptions that strongly influence psychological reactions or social behaviors at the group or population level…Several individual and community level factors impact these tipping points and will influence the psychological or behavioral responses to pandemic influenza... ( pg 5)
“How a message is packaged and delivered, as well as how trustworthy and knowledgeable the messenger is also impact communications effectiveness in terms of behavioral response.” ( pg 7)
In summary, RAND Corporation has been touted as a preeminent ‘authority’ on questions of public health. Their past influence on the shaping of public policy is undeniable. Serious questions should be raised when RAND makes recommendations to a private company on how to supersede parental rights through the manipulation of local, state and federal law. Parents know what is best for their child, not RAND and certainly not Sanofi Pasteur.
“No problem can be solved from the same level of consciousness that created it.”
1. Harris, K. , Maurer, J. , Lurie, N., “Strategies and Models for Promoting Adolescent Vaccination for Low-Income Population”. March 2009. RAND Corporation.
2. http://en.wikipedia.org/wiki/Rand_corp. Accessed August 24th, 2009.
3. Harris, K. , Maurer, J. , Lurie, N. “Midseason Influenza Vaccine Use by Adults in the U.S. : A Snapshot as of Mid-November 2008“. 2008. RAND Corporation.
4. Harris, K. , Maurer, J. , Lurie, N. “Influenza Vaccine Use by Adults in the U.S. : A Snapshot from the End of the 2008 “2009 Vaccination Season“. 2009. RAND Corporation.
5. Dausey, D., et al. “Designing and conducting tabletop exercises to assess public health preparedness for manmade and naturally occurring biological threats“. 29 May 2007 BMC Public Health 2007, 7:92 doi:10.1186/1471-2458-7-92.
6. Lotstein, D., et al. “Enhancing Public Health Preparedness: Exercises, Exemplary Practices, and Lessons Learned, Phase III. Task B2: Final Report Promoting Emergency Preparedness and Readiness for Pandemic Influenza (PREPARE for PI) Pilot Quality Improvement Learning Collaborative“. June 2007. RAND Corporation.
7. Aledort, J., et al. “Facilitated Look Backs: A New Quality Improvement Tool for Management of Routine Annual
and Pandemic Influenza”.2006. RAND Corporation.
8. Jackson, B., et al. “Bioterrorism with Zoonotic Disease: Public Health Preparedness Lessons from a Multiagency Exercise.” Biosecurity and Bioterrorism: Biodefense Strategy, Practice and Science Volume 4, Number 3, 2006.
9. Bloom D., et al. “The Demographic Dividend: A New Perspective on the Economic Consequences of Population Change. 2003. RAND Corporation.
10. Stoto, M., et al. “Learning from Experience: The Public Health Response to West Nile Virus, SARS, Monkeypox, and Hepatitis A Outbreaks in the United States. 2005. RAND Corporation.
11. Moore, M., et al. “Improving Global Influenza Surveillance: Strategies for the US Government. February 2007. RAND Corporation.
12. Olmsted, S. et al. “Use of an Electronic Monitoring System for Self-Reporting Smallpox Vaccine Reactions. Biosecurity and Bioterrorism:Biodefense Strategy, Practice, and Science Volume 3, Number 3, 2005.
13. Gilmore Commission (1999-2003). http://en.wikipedia.org/wiki/Gilmore_Commission. Accessed 08/19/2009.
14. “Third Annual Report To the President and the Congress of the Advisory Panel to Assess Domestic Response Capabilities for Terrorism Involving Weapons of Mass Destruction. December 15, 2001. http://www.rand.org/nsrd/terrpanel/ – This document is a product of the Advisory Panel and NOT RAND Corporation although the link goes to the document hosted on RAND’s website.
15. Testimony of Michael A. Wermuth Senior Policy Analyst The RAND Corporation and Executive Project Director Advisory Panel to Assess Domestic Response Capabilities for Terrorism Involving Weapons of Mass Destruction Before the Committee on the Judiciary Council of the District of Columbia February 6, 2004.
16. Harris, K. , Maurer, J. , Lurie, N. “Influenza Vaccine Use by Adults in the U.S. : Detailed Survey Data Tables for the 2008 “2009 Vaccination Season“. 2009. RAND Corporation.
17. Reissman, D. , et al., “Pandemic Influenza Preparedness: Adaptive Responses to an Evolving Challenge”. Journal of Homeland Security and Emergency Management: Vol. 3 : Iss. 2, Article 13. 2006.
18. Williams, A.A.,. Parashar, U.D., Stoica, A, et al (2002). “Bioterrorism-Related Anthrax Surveillance, Connecticut, September “December, 2001, Emerging Infectious Diseases, Vol. 8, No. 10, 1078-1082, October 2002. Available from: URL: http://www.cdc.gov/ncidido/EID/vol8no10/02-0399.htm
19. United Nations (2005-09-29). “Press Conference By UN System Senior Coordinator For Avian, Human Influenza”. http://www.un.org/News/briefings/docs/2005/050929_Nabarro.doc.htm. Accessed 08/19/2009.
20. “West Nile virus activity “United States, 2007”. MMWR Morb. Mortal. Wkly. Rep. 57 (26): 720 “3. July 2008. PMID 18600197.
21. Tenpenny, S. “Fowl! Bird Flu: It’s Not What You Think“. http://drtenpenny.com/fowl.aspx.
22. Tenpenny, S. “FOWL! It’s Not What You Think.” PDF Presentation. http://drtenpenny.com/Documents/FOWL-ppt-pdf.pdf. Slide 21. Accessed 08/19/2009.
23. “United States Patent 6299884. Adjuvant formulation comprising a submicron oil droplet emulsion” Patent Storm. 9 October 2001. http://www.patentstorm.us/patents/6299884.html
24. Workshop on Adjuvants and Adjuvanted Preventative and Therapeutic Vaccines. Tuesday, December 2nd, 2008. Center for Biologics Evaluation and Research, National Institutes of Health, National Institute of Allergy and Infectious Disease. http://www.fda.gov/downloads/BiologicsBloodVaccines/NewsEvents/WorkshopsMeetingsConferences/ucm095708.pdf
25. CDC information on State Vaccine Exemptions. http://www2a.cdc.gov/nip/StateVaccApp/statevaccsApp/default.asp. Accessed 08/19/09.
26. State Laws listed on NVIC’s website. http://www.nvic.org/Vaccine-Laws/state-vaccine-requirements.aspx. Accessed August 24th, 2009.