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Re: A Vaccine to Save =?iso-8859-1?b?V29tZW6Scw==?= LivesFrom: Dean Huffman . (dean@thehuffpeople.net)Wed Feb 7 09:56:54 2007
.. Clearly there are a number of issues with vaccination in general and this vaccination in particular. Some people feel that the vaccine is not yet “proven safe and effective” even though it has been released by the FDA. I suppose I can accept that arguement. Some say that the vaccine is not 100% effective. I will give them that. Probably no vaccine is 100% effective. But even partial effectiveness is partial protection. There is an issue of risk from a vaccine. Say 1 in 1000 persons dies from a disease, if not vaccinated and 1 in 1000000 die if they ARE vaccinated (some from the disease and some from the effects of the vaccine). Should the vaccine be given? Probably. Unfortunately, the 1 in 1000000 makes the lawyers drool. (Hence the federal legislation about childhood vaccinations.) This is an important issue in the debate about whether to give the Salk or Sabin polio vaccine. The Salk is very safe, but protection is less effective. Salk is given in the United States in order to protect the vaccinee. In other areas or the word, where polio is endemic, however, the Sabin (oral vaccine) is used because it offers better protection (at the risk of occasional vaccine induced polio) and the vaccine also protects those who are not vaccinated by secondary infection with the virus used in the vaccine. Another point is that vaccinations often are as protective for those who do not receive them as well for those who do. The oral polio vaccine is an example. For another example, if the people who had religious exemptions from the rubeola (measles) vaccine in Indiana had been vaccinated, the recent measles epidemic probably would not have occurred. First, the measles would not have been imported into Indiana from overseas because the index case would have been protected from contracting measles. Even if measles had been imported into the United States, there probably would not have been any secondary cases. Probably the best example of a vaccine intended to protect those other than the person receiving it is the rubella vaccine. It is intended solely to protect the unborn fetus. If it were not for congenital rubella syndrome, the rubella vaccine probably would not have been developed. Maybe a vaccine should be developed for parvovirus. Along those lines, the HPV vaccine probably should be given to boys, too, not so much to protect them (although there is evidence that it is protective in people receiving anal intercourse), but to protect the girls that they ultimately will have sexual intercourse with. An interesting concept would be to create liability for those who pass on a disease for which there is protection offered through vaccination, but who did not receive, or refused, the vaccination for other than medical reasons. (More lawyer drool.) Hence, maybe the families in Indiana who chose not to vaccinate their children should be liable for damages to anybody who contracted a secondary case of measles. Some feel that in Texas, at least, there may be a conflict of interest on the part of the governor in as much as he is apparently a stockholder in the vaccine producer (? Merck ?). I can understand that. I do take issue, however, with statements such as “ [my] … 9-yr-old daughter … is not at risk for [HPV], and not at risk for spreading same to ANYONE.” She might not be at risk TODAY, but if one thinks that one can control her daughter forever, that is vary naive thinking. Many, if not most, daughters will have sexual intercourse some time, either during high school, during college, or at some other time. The act of sexual intercourse will put her at risk. Even if she has sexual intercourse only in marriage, and only with her husband, she is still at risk for HPV. And it may well be too late at that time. In many respects, the vaccine will protect the girl against herself. She will almost never be as “pure” as her parents think. Waiting until the later teenage years or early adulthood might be too late to give protection to the young lady. The reason for suggesting that the vaccine should be given in the 9 – 11 year old age group is that this is the time when there is a very high probability that they have not yet been exposed to HPV and, hence, are able to be protected. Once they are exposed, it is too late. Thus, if the only reason one has to withhold the vaccination is that “my daughter will never be infected because she leads a moral life, and I will make sure that she continues to do so, and therefore does not need the vaccination”, then I submit that the parent is very naïve and is putting the child at unnecessary risk. I must admit that I have some problems with the governor of Texas making the vaccination mandatory. However, if the decision is left to parents whether or not to vaccinate (MMR, polio, tetanus, hepatitis B, etc., etc.) then far too many people will fail to be vaccinated and not only will they be at risk, but the benefits of herd immunity will also be lost. Much as I hate to say it, some people must be protected against themselves. The same argument can be made for other dangerous activities, such as not wearing seat belts, not using a helmet on a motorcycle, etc. Just my thoughts. As they say, I might be wrong (but I doubt it). - - - - From: "Meenan, Anna" <annam@uic.edu> Subject: Re: A Vaccine to Save Women’s Lives Date: Feb 7, 2007 10:07 AM I think the discussion of behavior choices and their protective effects was more directed at the 9-year-olds. I would object to anyone mandating that i have a 9-yr-old daughter immunized with a new vaccine against something she is not at risk for, and not at risk for spreading same to ANYONE. I certainly agree with voluntarily having daughters immunized at any age you choose. I would have waited a bit more to have my daughter immunized except that she is going off our insurance this summer. Anna Meenan, MD
>A "behavior choice" does not really offer protection. I have taken
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