"When many cures are offered for a disease, it means the disease is not curable" -Anton Chekhov
''Once you tell people there's a cure for something, the more likely they are to pressure doctors to prescribe it.'' -Robert Ehrlich, drug advertising executive.
"Opinions are like sphincters, everyone has one." - Chris Rangel
Commending vs. Condemning: Ross at The Bloviator fired back at my smallpox post from yesterday. There seems to be a perception on the part of the CDC’s Advisory Panel and some others in public health that their only choice is to recommend or condemn the smallpox vaccine. They have another choice - they can leave the decision ultimately up to the individual requesting the vaccine. This is a unique situation. The magnitude of the risk of exposure to smallpox is unknown, but it’s a real present and threat. The risks of the vaccine are known (The newer vaccines can be expected to have similar side effects and risks. They are still live cowpox virus vaccines, it isn’t as if they’re new and innovative vaccines.) It isn’t unusual for advisory panels to make a statement that they can “neither recommend for or against” an intervention, but it is unusual for the ACIP to issue such a statement. They seem to be caught up in the paternalistic attitudes of days gone by, when vaccination campaigns began, and paternalism was required to stem rampant communicable diseases. No one is asking them to make smallpox vaccine a part of the standard immunization schedule, or to encourage its use, only to allow its use if requested.
Choice is everything. It’s when we strongly recommend treatments without giving people a choice that we take the greatest risk. Leave the choice to have the vaccine up to the individual, bar advertising for the vaccine, both by physicians and by the companies who make it, (advertising always glosses over the risks and touts the benefits), educate the public about the risks of the vaccine, and the risk of lawsuits would be substantially reduced. Pass tort reform and the damages from those lawsuits would be substantially curtailed, too.
