What will it be like if/when we have our next influenza pandemic and the public at large discovers the limited initial supply of pre-pandemic vaccine and the first batches to roll off the production line are for specific segments of critical infrastructure? What will we, as individuals, be thinking knowing that the vast majority are not going to receive a vaccine in any timely fashion?
Will it come as a shock to most people that they will have to wait for several months – or more?
Today from Reuters:
Wed Jul 23, 2008 1:17pm EDT
By Maggie Fox, Health and Science Editor
WASHINGTON, July 23 (Reuters) - Essential health care workers would be immunized first if a flu pandemic broke out in the United States, the government said on Wednesday.
The Department of Health and Human Services released long-awaited details on who would get vaccinated and when if a serious global influenza epidemic emerged.
The plan put a million health care workers, such as emergency room staff and nurses skilled in vaccinating others, at the top. Next were military and "mission critical" personnel, public health workers and hospital and nursing home staff.
All of these play a "critical role in providing care for the sickest persons; highest risk of exposure and occupational infection," the plan read.
Since it would take many months to produce enough vaccine to protect everyone, experts agree a plan is needed to determine who gets the first doses.
The HHS plan designates 700,000 "deployed and mission critical personnel" to follow the key health care workers. After that, 300,000 public health workers, 3.2 million inpatient health care providers, 2.5 million outpatient doctors, nurses and other professionals, and 1.6 million long-term care workers would be next to get the vaccine.
Emergency services, law enforcement, makers of pandemic vaccines and drugs, pregnant women and babies and toddlers are also in the first designated groups.
Healthy adults not in any other priority group come last.
Most people will fall in the later tiered groups, and that is only fair. Those who risk the most, and provide the most benefit to the community as a whole, deserve to be afforded whatever level of protection we can offer them.
Human nature being what it is, many will not see the wisdom and fairness of this distribution but hey, sometimes life just isn't "fair". Or, I should say, our operative definition of "fair" given the specific time-place circumstances we are saying "Not Fair!" about. And if we are honest with ourselves we know this to be true.
Our officials should be doing themselves [and everyone else in the process] a favor by making every effort to educate the public on the scarcity of vaccine issue(s) before the time comes for the public's shocked and indignant awakening at the dawn of a pandemic.
A part of honest and open communication is that all-important COMMUNICATION component. Publishing plans on the internet followed by the odd newspaper article do not constitute "communication"; it constitutes CYA and doing just enough so as not to be guilty of hiding information. I don't believe that is what is consciously being done, but it's also a part of general human nature that in difficult or distasteful situations we tend to do no more than we are minimally required. It's just easier.
It's not that I think officials don't know this – quite the opposite in fact – they are well aware. That's what makes their communications failure all the more frustrating, they know what they should be doing, they know the how of it, and they even know the why of it, yet still they fail [see Community Reaction to Bioterrorism: Prospective Study of Simulated Outbreak, here, for just one example of all that in-place knowledge].
It's only fair to inform as clearly and as concisely as possible that should a pandemic happen before major innovations in vaccine manufacturing most people will have to manage without a vaccine. It's only fair, not because it will alleviate allegations of unfair practice(s) being leveled by the public, but simply because one should always attempt to be as fair as possible, regardless of our own human natures to want to take the easy way out.
Openly admitting, frequently, and via multiple venues, there are no easy fixes or handy stashes of vaccine will produce the greatest potential for educating the public that their wellbeing will be dependent upon their own actions. Focusing on all the wonderful advances on the vaccine front that may not be available in time gives a false impression of supply. Silence in the face of a potentially life endangering belief is akin to validating that dangerous belief.
The public must know before they can act, and they must act before there is a pandemic.