Wednesday, December 04, 2002

White House Looks at Smallpox Vaccine -- Will the Bishops?

WASHINGTON (AP) - The Bush administration plans to make the smallpox vaccine available to all Americans eventually, but officials will recommend that only those who are at greatest risk of encountering a patient get the shots.

The Bishops have spoken a lot about a prospective war, admitting as they do that their opinions are formed by incomplete information. And whatever their opinions, they are principally meant to guide the leaders of the country--who are not, by and large, Roman Catholic, and who are therefore unlikely to feel bound by those opinions. This is all well and good, and part of the natural order of things.

But I would like to hear from the Bishops on smallpox (and other bioweapon) vaccinations. There are significant ethical and moral considerations to examine before a "voluntary" program is undertaken, and well in advance of any mandatory mass vaccination.

In 1 million vaccinations, the statistical probability is that two or three people will die. Several dozen others may get seriously ill. All this assumes 1 million people of reasonable health, with normal immune systems. If all 270 million of us get a shot, that amounts to hundreds of dead citizens, and thousands of seriously ill people, without a terrorist raising a finger. On the other hand, even 20 or 30 million new vaccinations will have the effect of slowing the spread of smallpox among the uninoculated. This could save tens of thousands of lives in an attack.

Does this then place a moral obligation on those of us who are otherwise in good health to get a voluntary shot? In addition to building up what epidemiologists call "community immunity" (cutting down on the number of possible transmitters of an infection), several 10s of millions of already-immunized people could relieve what is sure to be a very significant strain on an already-taxed healthcare system. Finally, a pre-immunized population would be able to keep essential economic and political infrastructure operating (beyond just the "emergency responders" in police and fire departments), offsetting and somewhat mitigating the devastating economic consequences of what would otherwise be a national quarantine.

There are therefore compelling reasons to think that a "voluntary" inoculation is not far from an imperative, but there are countervailing imperatives as well, particularly for parents with small children. This is something that is unquestionably within the competency of the bishops' authority, and most if not all the relevant factors of risk and benefit are well known and in the public domain.

Please, your eminences, speak now while discussion can still be fruitful.

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