US - Guidelines to detail who would get flu vaccinations

[Guest guest]

I guess this is to sort out the ones they haven't killed off or driven to

suicide through fear....? Do these *eminent* people really believe this?

Have they also been brainwashed....?

Out of curiosity, when does Mr B get his?

http://www.suburbanchicagonews.com/couriernews/top/3_1_EL12_A1FLUETHICS_S1.h

tm

Guidelines to detail who would get flu vaccinations

• In pandemic: Gov't, bioethicists don't agree on hierarchy

By n Neergaard

the associated press

WASHINGTON — Who should get the first flu vaccine during a worldwide

outbreak — the 60-year-old grandmother with a weak heart and lungs or the

healthy 4-year-old with decades ahead of her?

Government guidelines put the ill grandmother at the head of that line, for

now.

Younger, healthier people should be moved ahead, argue bioethicists at the

National Institutes of Health, raising new issues to consider as federal

officials review the nation's pandemic guidelines.

" Death seems more tragic when a child or young adult dies than an elderly

person — not because the lives of older people are less valuable, but

because the younger person has not had the opportunity to live and develop

through all stages of life, " Drs. Ezekiel Emanuel and Alan Wertheimer wrote

for today's edition of the journal Science.

It's a different way of weighing the agonizing decision of how to ration

scarce vaccine if a super-strain of influenza sparks a worldwide epidemic.

If that flu arises, it will take manufacturers months to brew inoculations

for everyone.

First doses will go to workers in vaccine factories and to people caring for

the ill, a Bush administration decision widely shared by health specialists,

including the two bioethicists.

The question is whom to inoculate next.

Federal health advisers have recommended that people up to age 64 who have

at least two high-risk health conditions — such as asthma, heart disease,

emphysema — be first in that line.

Next would come pregnant women and people who come in contact with people

who have poor immune systems, such as HIV or chemotherapy patients. They're

followed by key government leaders and healthy people older than age 65.

At the end of the list, after funeral directors, come healthy people ages 2

to 64.

Long-used principle

The list is part of the government's evolving pandemic plan. It is under

discussion and not final.

It rests on a long-used public health principle, that the people most

vulnerable to dying from a disease should be vaccinated first. In an average

winter, flu mostly kills the elderly. No one knows if that will hold true

during a pandemic. In 1918, for instance, history's worst pandemic, young

adults were the chief victims.

To the average person, protect-the-young is an equally powerful principle,

argues Emanuel, who also treats cancer and notes that the 65-year-old who

succumbs often is mourned with the " but he had a good life " comfort that's

missing when a child dies.

But youngest-first is too simple, Emanuel concluded. So he also considered

how much has been invested in a young person's future, plus a " public order "

principle that gives priorities to providers of necessities like food and

fuel.

Combining those ideas, he wants healthy 13- through 40-year-olds to get

scarce flu inoculations right after the vaccine makers and health workers —

especially those who are police officers, utility workers or in other

professions important to societal order. They would be followed by younger

children and the middle-aged, with the sick elderly last in line.

" We need principles people share (such as) this protective instinct for

young people to allow them to lead a full life, " said Emanuel, whose paper

doesn't reflect NIH policy but his own opinion.

Debating alternatives

Other alternatives already are being debated, such as whether preschoolers

and schoolchildren should be among the first vaccinated during a pandemic

because they are the main spreaders of influenza.

And the government advisers who recommended the current guidelines first

strongly considered putting police officers and truck drivers at the head of

the line. Then, " not only can the truck driver keep delivering goods, he or

she will be protected and cannot give it to others, " said Dr.

Schaffner, a Vanderbilt University flu specialist who was part of those

debates.

" There is no single right answer, " said Schaffner, who praised the new

article's call for wide public discussion about the hard choices that would

have to be made. " These are prioritizations that should be transparent. "

The government wants public input, said Dr. Bruce Gellin, who heads the

federal vaccine policy office.

" There should be vigorous public discussion about this, " Gellin said. " It's

important that people know what's in the plan and begin to think what it may

mean for them. "

05/12/06