|
medpundit |
||
 |
 |
|
Monday, July 01, 2002The CDC has three main arguments for not offering the vaccine. The first is that the risk of a smallpox attack is small, or at least unknown. This is shortsighted. The Soviet Union experimented with smallpox as a weapon in the 1970's, and there is a good chance that the Iraqis have weaponized it , too. If the Iraqis have it, you can bet the terrorists have it or will have it, too. It is an inexcusable failure of imagination not to take this into account when considering whether or not to offer smallpox vaccine to the public, as Peggy Noonan pointed out in her column. The second argument is that the vaccine can have serious complications, including death in those who receive it. (See my previous post on the smallpox vaccine for details.) This is certainly true, but people should be given the information about both the disease (much more fatal) and the vaccine and then allowed to decide for themselves whether or not to risk having the vaccine. The third argument is more valid, and that is the fact that the cowpox virus used in the vaccine can be transmitted from the recently vaccinated to those with compromised immune systems or with eczema. The transmission, however, comes from direct contact with the scab or the site of the vaccination. Once the scab heals, there is no longer any danger of transmission. This can be prevented, or at least minimized, by advising people to take precautions until their scab is gone. That means keeping it covered, and avoiding such activities as swimming. When I received my vaccination as a child, my mother made me wear a plastic shield over the vaccination site until it was completely healed. Surely such measures are not beyond our present technology or know-how. The AMA supports the CDC panel's position (via The Bloviator), as does the American Academy of Pediatrics,and the American Academy of Family Physicians. (The American College of Emergency Room Physicians doesn't have any comments on the decision on their website.) I doubt that most of the membership of these organizations, however, support the decision. It will be the practicing physicians, after all, who will have to deal with the consequences of a smallpox epidemic. It will be practicing physicians who have to try to explain to the survivors why people are dying from a vaccine preventable disease. So far, our professional organizations have let us down by failing to force more of a discussion within the medical community on the issue. Instead, they have followed the CDC's lead as if this were any other routine immunization issue. It isn't. The Press Wakes Up: Now that the CDC has made their decision, the mainstream media have finally picked up the issue. It has even made some strange bedfellows. Both the Wall Street Journal, and the New York Times have advocated offering the vaccine to the public. Other good editorials on the subject can be found here and here. Too bad they didn't address it more ardently before the CDC held their public forums. Perhaps the voice of the people would have been better heard. It may not be too late, however. The Bush Administration and the Department of Health and Human Services is going to consider the advice given by the CDC. Hopefully, they have their own set of advisers, like smallpox expert D.A. Henderson, and other bioterror experts to help them objectively evaluate the advice of the CDC. Hopefully, they won't fail us. Hopefully, they will recognize that the American public is much smarter than the CDC is giving them credit for being, and they will let us decide whether or not we want to risk having the vaccine. ADDENDUM: Howard Fienberg (of Kesher Talk) had an excellent Tech Central Station column about the smallpox vaccine, too. UPDATE: A reader who attended two of the CDC public forums sent this observation: "I attended two of the CDC community meetings on the vaccine and found them pretty predictable. Ironically, while there was a small turnout from the medical community, the public turnout was negligible...not enough publicity is my guess. So it is safe to say that you could not use those meetings as a successful barometer of the publics opinion one way or the other. The perfectly timed release of the Robert Wood Johnson/Harvard School of Public Health study on the topic gives insight to the publics wishes. 59% said they would want to be vaccinated, if it became available." In Other News: The National Academy of Sciences advocates a broader anti-bioterror program and hints that perhaps the CDC shouldn't be the ones responsible for the smallpox vaccine program: The report's authors also urged greater coordination between government agencies with expertise in researching or responding to biological weapons attacks and public health threats. Several vaccine development and disease tracking functions currently centered at the Centers for Disease Control and Prevention and other agencies could be transferred to the cabinet-level Department of Homeland Security proposed by President Bush last week. (emphasis mine) The administration is considering at least two candidates for the director's job at the CDC. One is an agency insider, the other an outsider. The Pentagon is going to resume anthrax vaccinations and they plan to share them with civilians in event of a civilian attack, too. The New York Times says that anti-depressants aren't miracle drugs. (link requires registration) Silly me. I never realized they were miracle drugs in the first place. Still, the newer anti-depressants like Prozac do have far fewer side effects than the older anti-depressants. And for some people, but by no means all, they are miracle drugs. Neither birth control pills, nor vasectomies cause cancer. President Bush had an uneventful colonscopy. The House passed a plan for senior citizen drug subsidies. (Will prove to be very expensive. They should proceed with caution) An examination of media reports finds that the media is less critical of mammograms than breast cancer drugs: Woloshin and Schwartz base their findings on a review of 85 news stories about three recent events related to tamoxifen and mammography. In January of 1997, the National Institutes of Health recommended that women in their 40s not receive regular mammograms, an opinion reversed by the National Cancer Institute only months later. The investigators also analyzed print and broadcast stories about a study released in April 1998, which showed that tamoxifen can prevent breast cancer. The investigators found that 65% of news stories highlighted the debate over tamoxifen, suggesting that women had a choice in whether or not to take the drug, and none recommended that women take the drug. In contrast, only four of the analyzed stories about mammography implied that women should feel they have a choice in whether or not to be screened, and 96% suggested that women schedule regular mammograms. And cranberry juice really does help fight bladder infections! posted by Sydney on 7/01/2002 05:48:00 AM 0 comments 0 Comments: |
|
