Jewish World Review July 8, 2002 /28 Tamuz, 5762

Drs. Michael A. Glueck & Robert J. Cihak

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Consumer Reports

Don't procrastinate, vaccinate! | In a column last year, we wrote: "If there were enough vaccine to go around, we would leave the choice and decision up to individuals and families, in consultation with their own physicians and local medical officials."

There is now more than "enough vaccine" to go around. On top of the known 10 million available doses last year, a pharmaceutical company found what had apparently been lost, namely over 70 million more doses. (Yes, it still works!) In addition, 200 million doses of smallpox vaccine ordered by the US government should be available by the end of this year.

As Peggy Noonan asked in a recent Wall St. Journal column, "If people want to be vaccinated, and they are told of the dangers -- vaccinations can make some people sick, -- and they agree to sign a waiver saying they will not sue if the outcome's unfortunate, then why not make it available?"

We agree. The time has come to allow Americans to get the vaccine IF THEY WANT IT. In 1957 we had "Sabin Oral Sundays" to beat polio terror. In 2002 we need "Smallpox Injectable Sundays" to defeat smallpox terrorism.

Unfortunately, a government committee doesn't see it this way.

Recently, a 15 member Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention recommended that Tommy Thompson, Secretary of Health and Human Services, allow smallpox vaccination of only 10,000-20,000 doctors, nurses and other high-risk emergency personnel.

Their rationale: wider vaccination is too dangerous. If the general population were to be vaccinated, the committee estimates 300 deaths coast-to-coast. But that's based on old, head-in-the-box data and thinking, and on a modern misinterpretation of the "First do no harm" maxim that confuses intentional harm with acceptable risk. And it's also based, at least in part, on the standard bureaucratic desire to minimize exposure in the never-ending Beltway Blame Game. Oh, imagination where art thou?

But the truth is, with newer and better supportive care for those suffering vaccination complications, the toll would likely be less. The alternative to not vaccinating is that millions could perish if a smallpox attack occurred. Today, the safest approach may be the most risky: risky for a few individuals, but safer for all America.

Could millions perish? Conceivably, simultaneous bioterrorism attacks in several high-density urban areas - New York City, Dallas, Los Angeles, for example - could produce such a result. For sure, far more would sicken and die from such attacks than would die from vaccination.

In a June 19 editorial "The Public Health Priesthood" The Wall Street Journal got it right. "The smallpox choice comes down to this: The government can continue with the current policy, which is to wait until an outbreak occurs and then hope federal agencies do a better job than their floundering with anthrax. Or it can offer citizens the choice to get vaccinated now, dramatically decreasing the chances of a mass outbreak."

In an exclusive interview, Frederick C. Robbins, M.D., Case Western Reserve University Medical Professor Emeritus and Nobel Laureate for his work on the polio virus says it might work "to vaccinate the first line people and make vaccine available to those who wish it through their physician" although he personally tends "to favor the position adopted by the CDC" committee. He acknowledges, "A reasonable case can be made for universal vaccination."

Just as we're against government-forced non-vaccination, we're also against government-forced vaccination. Certainly, patients with eczema, HIV/AIDS, immuno-suppression, children with weak immune systems and those with other contraindications should be warned about possible complications. Those with personal beliefs against vaccines would be free not to vaccinate. There still would be significant herd immunity left.

So why not vaccinate today under calmer and cooler conditions rather than wait for a crisis and cave-like chaos? We suspect a prepared people might even dissuade Osama from a smallpox attack. Personally and professionally we would feel a whole lot better if everyone were allowed the freedom to make an informed decision.

So let's light a colossal firecracker under Secretary Thompson, the CDC and its advisory committee to get it done now! This is not a time to waffle, shuffle, stutter or put off diagnosis and treatment of a known disease with a vector from hell.

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Michael Arnold Glueck, M.D., of Newport Beach, Calif., writes on medical, legal, disability and mental health reform. Robert J. Cihak, M.D., of Aberdeen, Wash., is president of the Association of American Physicians and Surgeons. Both JWR contributors are Harvard trained diagnostic radiologists who write numerous commentaries and articles for newspapers, newsletters, magazines and journals nationally and internationally. Comment by clicking here.


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02/15/02: Why the recent moaning about cloning?
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01/15/02: Score one for the value of human life
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12/28/01: Who's afraid of a 'dirty bomb'?
12/21/01: End of medicine?
12/14/01: More heroes: Docs deserve a little credit after 9/11
11/16/01: Do we need 'Super Smallpox Saturdays'?
11/09/01: Why the post-9-11 health care debate will never be the same
11/01/01: Common sense good for our mental health
10/26/01: Your right to medical privacy --- even in terror time
10/12/01: Failed immigration policy ultimately bad for nation's mental health: Enemy within leads to epidemic of jumpy nerves
09/28/01: Can legal leopards change their spots: A treat instead of a trick
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08/30/01: Shut down this government CAFE
08/23/01: School Bells or Jail Cells?
08/15/01: Time to take coaches to the woodshed
08/10/01: Blood, Guts & Glory: The Stem of the Stem Cell controversy

© 2002