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Old 06-09-2006, 07:40 AM   #1
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Flu Vaccine for Teens not Tots

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When it came to the Titanic, it was women and children first. In the event of a pandemic, however, Canadian children are at the bottom of the heap.

That’s right. If the dreaded bird flu hits, kids will be the very last to receive vaccines.

According to the Public Health Agency of Canada, health-care workers (including paramedics and ambulance drivers) would be the first to receive a vaccine in the event of a pandemic. That’s fine. Front-line health-care workers deserve to be inoculated first. After all, if you’re willing to put your life on the line to try to save others, you deserve all the help and protection you can get.

Next on the list are essential service providers (police, fire, army, etc.). Again, that seems more than fair. If the pandemic is as grim as some are speculating, then chaos and anarchy are sure to follow. We need personnel in place to restore and maintain order.

The next group slated to receive a vaccine can be termed “vulnerable” or “high-risk.” Pregnant women, infants and the elderly are more susceptible to illness and would therefore be given priority.

Healthy adults are fourth on the list.

And at the very bottom? Kids.

That’s right. Children aged two to 18 would be the last to receive a potentially life-saving vaccine.

So a mother would be immunized before her six-year-old son. A grandfather would be vaccinated before his three-year-old granddaughter.

Doesn’t seem fair, does it?

According to two American bioethicists, Canada has it all wrong. Ezekiel Emanuel and Alan Wertheimer argue that the elderly — not babies — should be at the bottom of the list because they’ve already enjoyed long lives. They also have the least amount of years to look forward to in the event that they survive a pandemic.

Emanuel and Wertheimer’s position, outlined in the journal Science, maintains young people (20 to 40) should be bumped up the list. Babies, while ranking higher than the eternal Dick Clark, would still be relegated below the Paris Hiltons of the world.
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Ah the dillemas of supply and demand.
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Old 06-09-2006, 07:48 AM   #2
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Ah, the scale of worthiness of life. It is so much easier to treat all as equal. Pity so few see it like this.
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Old 06-09-2006, 07:55 AM   #3
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A 16 year old is much more valuable after a pandemic than a 76 year old, the life cycle order is logical in it's way.
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Old 06-09-2006, 08:00 AM   #4
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I dont really give a toss about the life cycle order any more than I do about some evangelical position on it. It's all the same.
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Old 06-09-2006, 08:05 AM   #5
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I fail to see how it is, you could have tens of thousands even millions of deaths (of course dependent on population size and a number of other factors), given a restricted ammount of vaccine why should the old be given priority?

Would a lottery be a better way for a government to allocate vaccine to the general public (since health workers, those involved in production, morgue workers etc. take priority)?
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Old 06-09-2006, 08:16 AM   #6
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If you misread what I'm saying, be it on yours, dude. You are as any religious fanatic, clinical decision maker, government official; you run lives through a scale of importance. You did that. You do it. I did not say an elderly person was more vital than another. You placed importance over a survival of the fittest mold.
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Old 06-09-2006, 08:25 AM   #7
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Very valid arguments are made at the benefits of saving those most at risk but a factor in all of these risk-benefit analysis is the magnitude, e.g. a disease that kills 0.5% versus one that kills 5% or the relative risk of infection among different groups.

Importance is a big factor when a government is trying to deal with a potential crisis, if you don't protect your health workers then it would be very dificult indeed to deal with such a pandemic.
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Old 06-09-2006, 08:30 AM   #8
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Agreed that the elderly should be at the bottom of the vaccine list. It may not seem fair if you have an elderly family member, but it makes the most sense. Most likely, the vaccine would have a lower efficacy in the elderly than it would for children due to their weaker immune systems. They get the vaccine and die anyways, defeating the purpose of the vaccine and make less doses available.
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Old 06-09-2006, 08:33 AM   #9
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I do appreciate that aspect, what bothers me about the complaints raised is the tendancy for many people to simply say "we can't do this based on X,Y, Z". As for reasons, science is about as good as it can get. In general, it really gets up my nose that humankind can be graded and herded through some natural selection process without regard to the value of all life - and it being equal. With things that are in our control, we continue to do what nature does, and we do it under the guise of scientific reasoning, or religious belief, or man-made law. The reasons we do it are endless.
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Old 06-09-2006, 08:49 AM   #10
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Natural selection would be letting disease kill off populations that can't deal with them, it would be allowing AIDS to run its course like the black death.

Mankind does not have infinite resources, if you have people who want their governments to take measures to protect them from a possible disaster then those officials have to allocate resources in the way that they think does the most good.

Religion can be fatalistic, even nihilistic, in that an afterlife or redemption excuses suffering. Science and the scientific method has no place putting an order on life, that would be the domain of ethicists - who may consider the evidence and the facts; be they scientific, political, social or economic.

It would be interesting to qualify what makes every life equal? is it a question of potential, achievement or a metaphysical aspect. Even if lives were not equal that still doesn't rob the fact that people have domain over their own; unless they are brain dead or in a coma. When disasters come about power is entrusted to the state and decision makers must to a degree decide priorities play God - is this sort of situation less bad than the alternatives?
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Old 06-09-2006, 09:02 AM   #11
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We're taking over natural selection by imposing our own man-made criteria on a threat. That's what I was getting to. Man-made selection, if you will.

With the last part you wrote, that is exactly what it seems some do in order to remove equality from all life. It is based on a potential or achievement system. Does it actually life's existance or right to? or does it just change what we do with that life. All humans are born pretty much identically. We are born not knowing what colour we are, what social class we are in, what our potential and limitations are. It is when we are all equal. It is when we grow and adopt much lived by rules and so on that we fall into these scales that our scientific or religious or whatever reasoning imposes. Yet, we're all still human beings. All potentially born to achieve as little or as much as we choose. It is the human condition which changes, surely, and even then only circumstance?
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Old 06-09-2006, 09:08 AM   #12
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Angela, under imminent threat, if you had one vaccine syringe in your hand and you had to make the choice of who gets it - a child or an elderly person - how would you categorize the reasons for your decision? Natural selection? Science? Religion? Man-made law?
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Old 06-09-2006, 09:16 AM   #13
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We are not born identically, humanity encompasses a whole lot of diversity and people have different inherent potential; in terms of physical attributes and more debated mental attributes (intelligence is a combination of traits that are in good part genetic).

We "imposed" upon natural selection when we first started using tools, wearing hides, stocking a lader, building wells, growing crops, domesticating animals, treating illness and eventually understanding disease and developing innoculation and ultimately vaccination. All these things involve us modifying our environment and augmenting peoples chances of survival, I do not think it is fair to point to distribution of limited vaccine as where we overstep some sort of line between man and nature.
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Old 06-09-2006, 09:17 AM   #14
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In an absolutely hypothetical situation, I'd pick none. Or I'd toss a coin (given that in a hypothetical I'd be strong enough in my convictions to follow through with 'I cant choose one over the other'). However, we dont live in a hypothetical world. Given that, I still dont subscribe to religion, science, or whatever being the almighty decider. Science, to me, is about the strongest 'law' I can agree with, and do in many situations. I lean away from categorising.
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Old 06-09-2006, 09:37 AM   #15
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Quote:
Originally posted by Angela Harlem In an absolutely hypothetical situation, I'd pick none.
Then your rationale for your choice I'm guessing is natural selection.

Should that determine public policy in a health crisis?

How do you apply that as public policy... first come first served? Would that be the fairest and safest way to handle vaccinations?
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