Voting on Vaccinations: Thumbs Up, Thumbs Down. It’s Your Life

CBS’s 60 Minutes did a segment on H1N1 flu and the vaccine. The segment extended the coverage they had done previously, and was one of their traditional follow-up stories providing an update on the Arkansas boy (Luke Duvall) who had come down with the flu. In their story, CBS brings up the issue that about 40% of the population has indicated that they won’t get the vaccine even if it is available to them. Public Health officials, of course, express their concerns that these people are placing themselves at risk by not availing themselves of the protection the H1N1 vaccine will offer them.

What is being overlooked here is a great scientific and medical research opportunity; and I would suggest an intelligence test as well. Consider the following: we are at a point where the Government could institute a program to enable each citizen to opt-in or opt-out of the vaccine program. It would be similar to programs that many school systems have begun to employ with regard to vaccination efforts. Children are being required to obtain their parents’ consent before the school allows them to be vaccinated at school. Some local school efforts have been mentioned on the news in my area and the news reporters seem a little surprised that a large proportion of the parents have refused to give their permission.

I am not going to spend a lot of time pointing out that the reporters have not looked into a very interesting possibility with respect to these schools’ approach to their vaccination programs. After all, how many of the children, who did not return a signed parent’s permission slip did so because the child did not ask the parent to even decide. Not that any child might not have wanted to get a shot or that they just forgot.

But the schools’ have illuminated a process that any of the various Government agencies could leverage as a means to create a grand experiment. We could set up an Opt-In or Opt-Out H1N1 vaccination program. Given the current limitations with supplies this would even help in focusing the need for the vaccine into areas that are seeking it and to avoid distributing the vaccine to locations where the need is not as great. The program would be very simple; if you want the Vaccine for H1N1 you can register for eligibility – Opting-In. A web-site could be set up to make this registration easy and readily accessible. And for anyone who doesn’t have access to a computer, registration at doctor’s offices, pharmacies, public health office and other public centers could be offered. Not only could individuals register to be eligible to be vaccinated, they could register to not be eligible – Opting-Out. Parents could obviously register their children according to their preferences.

Now come the tricky part. If you register to Opt-Out and then later change you mind, you have to wait until the people who Opted-In to receive their vaccines before you would be able to get vaccinated when supplies are no longer limited. It is not clear that the Government would be able to not allow you to not change your mind and prevent you from getting vaccinated. This would be ideal from an experimental perspective, but it would be difficult to keep the lawyers from trying to sue everyone they could think of when an Opting-Out individual dies or is seriously impaired from the flu. Some family member will then insist that it was the Government’s responsibility to give them access to the vaccine.

With such a self-directed Vaccination choice program, the Government would be able to collect an enormous amount of data about the consequences to the different groups from their decisions. This experiment would help the Government assess the efficacy of their H1N1 flu information dissemination efforts. It would provide an insight to different social groups with regard to their decision making on matters from health care to other social issues. It would even allow the public to determine the impact their personal choices can have and in the significance that the religious, political, and social leaders that they are placing their trust in.

It could be a grand experiment. How many more people from what groups lived or died because of their choices. It would even provide proof for how efficiently diseases are spread in populations that are composed of mixed vaccinated and un-vaccinated groups. It would be a great waste of data and understanding to be gained from a situation that is going to be taking place anyway. Why not use this opportunity to learn and help our society in the future. It will also be a more definitive teaching lesson if we have the data to show people that there are real consequences to such decisions. And isn’t it the obligation of the Government, the health care system and the public itself to help insure that we are provided with the best information possible in matters of life and death?