Thursday, November 1, 2007

Pandemic, Vaccine, and Kids

Given the potential for an Avian Influenza pandemic, the allocation of "scarce" resources becomes a major ethical issue for the medical community.

Simply put: if/when a vaccine is available to give effective protection against H5N1 flu, who should get it first? And who last?

I've encountered a couple of schools of thought on one aspect of this.

One is that key personnel (like "front-line" medical staff) should get the vaccine first, and children should be among the last (if at all). That is based on the concepts of both non-maleficence/public safety, in terms of limiting the spread of the disease, and reciprocity, in terms of supporting medical personnel who take significant risks to treat flu victims. The argument about children seems to be a matter of beneficence of some sort; is an adult better able to care for a two year old child, or a two year old child care for an adult? (Plus, if you vaccinate a child before the parents, you could end up with a lot of orphans in a pandemic.)

But, more recently, another thought from the world of annual 'flus. If you vaccinate the children, they are less likely to bring the flu home from school (school kids being a primary "spreaders" of most/all communicable diseases). One could then argue, on the bases of public safety and non-maleficence, that you should inoculate children early in the process, rather than later.

Put yourself in the position of someone who has to decide about avian 'flu shots? Do you recommend that children be vaccinated earlier or later? Why?