To the Editor.—
Adequate studies to determine the benefits of smallpox vaccination for selected otherwise healthy patients disabled by herpes simplex, have never been reported. Presumptions about missing data may be convenient, but are not logical. The study by Kern and Schiff did not select patients so as to set major measurable objectives, for example, the improvement in a visual disability.
Although present knowledge holds that the two viruses are "unrelated," it is presumptuous to suppose that no other mechanism of action or benefit could account for the clinical results which have been reported, and are discussed so often.
As in the case of many treatments, some major counterindications exist to the use of vaccination. Dr. Neff's case reports confirm again that it is dangerous to ignore these counterindications but fail to evaluate the treatment when indications are correct.
Such terms as "mistaken impression," "should be discontinued," "has no benefit,"
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