May 14 2006
According to two U.S. medical ethicists, because stocks of bird flu vaccine are likely to be in short supply, in the event of a bird flu pandemic, the young should have priority over the elderly, ill and disabled.
A pandemic would currently present society with an ethical dilemma over who should be vaccinated first.
As a rule medical staff and the old are priority groups but a new report says the young have a right to live through all life's stages and should be a priority.
The researchers Ezekiel Emanuel and Alan Wertheimer, from the National Institutes of Health, say an alternative ethical framework should be considered as any vaccines offering protection against a new form of the H5N1 strain of bird flu which can pass easily between humans will be limited in supply.
They predict that it is likely that no more than 10% of the U.S. population will be inoculated against the disease in the first year.
Past experience of the three previous major flu pandemics have given mixed messages about who is most likely to be at risk, with differing experiences in each.
The researchers believe that a range of principles have guided rationing of medicines or vaccines in the past with which they disagree.
They argue that the policy of giving vaccines to those at highest risk before the well and young is unethical as each person should have the opportunity to live through all stages of life.
They suggest that death seems more tragic when a child or young adult dies than an elderly person because the younger person has not had the opportunity to live and develop through all stages of life.
The researchers say that a global pandemic would make all the issues about sharing vaccines and working with other countries even more pertinent.
A vaccine remains the best defense but a perfect vaccine could not be formulated until after the strain actually appeared and current methods mean it could take months to manufacture a flu vaccine.
Even working at full capacity, all the influenza vaccine plants in the world can only produce 900 million doses a year and it is suggested that an H5N1 vaccine would take a higher dose than than the annual flu vaccine to work, meaning even fewer would be available.
Countries who have not as yet drawn up priorities for vaccination will be relying on emerging evidence and guided by World Health Organization principles aimed at protecting healthcare workers most at risk and those needed to keep essential services running.
As yet the H5N1 avian influenza virus remains a disease predominantly in birds and does not easily infect people.
It has swept across much of Europe and Asia in birds, and has infected more than 200 people and killed 115 of them.
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