Flu Vaccines: Who, Where, and How Much?

In the Globe and Mail, Francoise Baylis asks the tough questions about how much swine flu vaccine to produce and who should receive it.

In the US, our government has just decided that pregnant women should be among those to be included in the H1N1 flu vaccine trials (presumably because they will be among those who would receive it), but that group of persons is just one among many who are vulnerable and who will be eager to be first in line to secure protection from H1N1.

According to Baylis, "In Canada, the federal government has said unequivocally that "the current plan is to produce sufficient quantities of vaccine for Canadians who need or want to receive it."" This is easier said than done.

Baylis even goes so far as to argue that this prioritization of Canadians over those in other countries is "wrong-headed" and that because Canada has the capacity to produce vaccine beyond that of so many other countries they have a moral obligation to give it to countries that do not. Personally, I agree. Share the wealth.

But only once a clear prioritization scheme is in place for whom in Canada should first receive the vaccine, which will have to be a select few of....whom? The most vulnerable? The most essential personnel?

Baylis also makes the important distinction between those who will "need and want" the vaccine and those who may either need OR want the vaccine. Those who NEED it certainly should get in, in my view--those being the most vulnerable and essential personal such as healthcare workers, political leaders and others key to the functioning of society. Then, what vaccine remains for those who want it must be distributed in a way that is equitable--perhaps evenly geographically distributed on a first, come first serve basis?

But in any case, Baylis claim is that Canadian citizens need to give back to the world as well as take care of their own. This seems like a reasonable claim in theory, but the question is how can it be accomplished in practice.

Will the United States have the same goal? Time will tell. The general aim seems reasonable enough, but as always, the devil is in the details.

Summer Johnson, PhD

comments

I am extremely surprised that on a bioethics blog, you would suggest that "political leaders and others key to the functioning of society" should be vaccinated first. Since when does social status make one more deserving of a vaccine? Would it not be more prudent to determine the most vulnerable age groups and areas, then proceed as needed? Most political leaders are actually older than the age group likely to take a big hit from swine flu this winter--those between 18 and 45 (an estimate). I understand your intentions, but every human life has value--whether 'key to the functioning of society' or not. We should aim to vaccinate those whose cases are most likely to be severe or lead to death. I do agree that it is important to vaccinate health workers as they are vital to further distributing the vaccine.

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