I believe that one particular bias is overlooked by Cochrane when appraising mass interventions like vaccinations. Chronic NCDs (Non Communicable Diseases) have become endemic in the Western world since the introduction of vaccines to prevent acute infectious episodes.

To me it seems that the burden of disease due to these chronic (life long) NCDs are overtaking the prevented morbidity and mortality from acute (short term) infectious diseases (particularly in view of improved hygiene and nutrition). This is not consistently studied, also no consistent research is done to investigate NCD in non- or late vaccinated groups of people.

The Cochrane collaboration does not take into account long term cohorts that check for harm from vaccines. The only way to check on harm from vaccines are long term cohorts on harm and comparing with less, or non-vaccinated groups. Am I right to understand that this bias is missing from THE COCHRANE RISK OF BIAS TOOL and does it need urgent attention?

Best regards,

Wouter Havinga, GP
GMC 3578256