Tag: whooping cough

Bioethics News

Whooping Cough Cases Double in Indiana in a Year, Prompting a Call to Vaccinate

There were 136 confirmed cases of whooping cough in the state, including one that was fatal, in the first half of 2017 — compared with 66 cases, none of them fatal, in the first half of 2016, according to the Indiana State Department of Health

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Cross Post: Italy has introduced mandatory vaccinations – other countries should follow its lead

Written by Alberto Giubilini

This article was originally published on The Conversation 

In the first four months of this year, around 1,500 cases of measles were reported in Italy. As a response to the outbreak, the Italian government introduced a law making 12 vaccinations mandatory for preschool and school-age children.

Parents will have to provide proof of vaccination when they enroll their children in nursery or preschool. In this respect, the Italian policy follows the example of vaccination policies in the US. But there’s one crucial difference: the Italian law doesn’t allow parents to opt out on the grounds of “conscientious objection”.

Unvaccinated school-age children, up to 16 years old, will still be able to enrol in school – but their parents will be fined. The fines range from €500 to €7,500 (£436 to £6,540).

I would argue that these measures are ethically justified, and other countries should follow Italy’s lead.

Undoubtedly, such measures are coercive. Most parents, even if they are opposed to vaccines, will have no choice but to vaccinate their children. But the fact that the new legislation is coercive does not make it ethically impermissible. In fact, it can be argued that many laws are coercive but nonetheless considered ethically acceptable by most people.

To remain in the context of public health, isolation and quarantine are two examples of coercive measures that are sometimes used in public health emergencies. Most people would think that, in many cases, it is acceptable to quarantine or isolate people in order to protect the community from infectious diseases.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Mistrust of Vaccines Is Greatest in France

September 9, 2016

(Scientific America) – Public confidence in immunization varies widely across the world with the French the most skeptical about the safety of vaccines, according to a survey published on Friday. With outbreaks of measles, whooping cough and other infectious diseases occurring in recent years in places where the take-up of vaccinations has been low, the scientists behind the survey said its insights could help policymakers tackle such problems. The study took views from almost 66,000 people across 67 countries about whether they consider vaccines important, safe, effective and compatible with their religious beliefs.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

After the End of Disease: Rethinking the Epidemic Narrative by Dora Vargha

In conversations with people living with polio in Hungary, I often encountered members of the tight-knit community referring to themselves as “dinosaurs”. We are a breed that is about to die out, they said. Nobody gets polio anymore, some added, and they were right – epidemics, even sporadic wild polio cases disappeared from the country in the 1960s. Their words stood in stark contrast with celebrities like Jackie Chan, Desmond Tutu and Bill Gates showing on billboards all over the world that with the Global Polio Eradication Initiative we are ‘this close to ending polio’. Yet the urgency of the eradication campaign and the gradual disappearance of a polio generation over a lifetime both signified the same thing: the end of a disease. But what, exactly, is this end and what comes after?

In the following weeks, a series of posts by historians, anthropologists and sociologists will grapple with these questions as they consider epidemic narratives and the ways in which endings bear on global health issues. This series accompanies the interdisciplinary conference After the End of Disease, held on May 25-27 2016 in London. Bringing together practitioners and academics from various disciplines and fields, this event aims to initiate conversations on when and for whom diseases end, what happens when the end fails to come, who gets to determine the end and who gets left behind, how a focus on endings shape health policies and how we can critically rethink the temporalities of epidemics.

Public and academic discussions on the end of diseases have been abundant in the midst of recent epidemic crises.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Vaccine Injury Compensation and the Common Good

Katharine Browne discusses the Canadian Medical Association’s decision not to implement a vaccine injury compensation program.

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Routine vaccinations are usually administered without incident. However, some individuals can suffer grave adverse effects. For example, Guillain-Barré Syndrome, a rare disorder that sometimes results in paralysis, has been linked to the flu vaccine. Likewise, other common vaccines such as those that protect against measles-mumps-rubella and chickenpox have potential serious risks. Where there are no vaccine injury compensation programs, victims of vaccine injury are left to traditional legal means for receiving compensation for their injuries. In tort law, compensation for injuries is based on negligence, which is hard to establish in the case of vaccines. This is because vaccine injury can happen despite the best practice of both vaccine manufacturer and provider. Consequently, vaccine injury victims have historically not fared well in court.

It is for this reason that many countries have implemented “no fault” vaccine injury compensation programs. Such programs provide individuals who have suffered adverse effects of a vaccine with a means of receiving compensation for their injuries without needing to establish fault on the part of either the vaccine manufacturer or provider. The kind of compensation offered varies depending on the particular program. In Quebec, for example, victims of vaccine injury are eligible for compensation for medical expenses associated with the injury, such as income lost because of injury, expenses related to rehabilitation and personal assistance, and funeral expenses in the case of death.

Statue commemorating the 30th anniversary of the eradication of smallpox by Martin Williams (2010), World Health Organization (WHO) headquarters, Geneva Switzerland.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

When Risk, Doubt, and Difference Converge: A Review Essay by Elizabeth Lewis

On Immunity: An Inoculation
By Eula Biss
Graywolf Press, 2014, 205 pp.

The End of Normal: Identity in a Biocultural Era
By Lennard J. Davis
University of Michigan Press, 2013, 155 pp.

Autism and Gender: From Refrigerator Mothers to Computer Geeks
By Jordynn Jack
University of Illinois Press, 2014, 306 pp.

 

Disability themes have become an increasingly central figure in the media, popular culture, and everyday life. Rates of disability diagnosis have risen sharply among children in the U.S. in the past decade. Disability has exploded in the popular press in such acclaimed recent books as Steve Silberman’s Neurotribes: The Legacy of Autism and the Future of Neurodiversity, Andrew Solomon’s Far From the Tree: Parents, Children, and the Search for Identity, Akhil Sharma’s Family Life, and Lisa Genova’s Still Alice. Similarly, scholarship on disability has gained new momentum. Somatosphere’s Inhabitable Worlds series, edited by Michele Friedner and Emily Cohen, featured cutting-edge writings on the study of disability within the social sciences, and the program for the 2015 American Anthropological Association’s annual meeting included over 50 papers, panels, and posters on disability themes. Without question, disability has emerged from the margins of scholarship and public interest.

Three recent books – Eula Biss’ On Immunity: An Inoculation, Lennard Davis’ The End of Normal: Identity in a Biocultural Era, and Jordynn Jack’s Autism and Gender: From Refrigerator Mothers to Computer Geeks – make important insights regarding the contours and textures of disability in the contemporary U.S. Biss, an essayist and social critic, offers a fascinating analysis of the persistent anxiety surrounding childhood vaccinations, particularly among a vocal minority of parents who oppose vaccines entirely.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

As If We Don’t Have Enough to Think About

My work recently took me to the Multidisciplinary Symposium on Head and Neck Cancer.  Among the proceedings was a discussion of the epidemiology of oropharyngeal cancer—cancer of the throat.  Historically, this tumor typically occurred in people with long histories of smoking and drinking.  Treatment brings the prospect of disfiguring surgery, although the surgeons do great work these days, and/or a 6-7 week slog of radiation treatment, often with chemotherapy as well, and the risk of lifelong dry mouth and aspiration pneumonia, among other things.

But lately, throat cancer has a different cause—human papilloma virus, or HPV, the virus associated with cervical cancer in women, and other, less-common cancers.  HPV-related throat cancer is a sexually transmitted disease.  I don’t want to be indelicate here, but the mode of transmission is—ahem—oral sex.  And as one might expect, men (especially white men) are at greater risk, and the risk goes up directly with the number of (principally female) partners.  There are a number of things not yet fully understood, and HPV-related throat cancer has a better prognosis than smoking-related disease and may not need quite as aggressive treatment, but one still does not want to get it.  And the incidence is increasing sharply.  It’s sort of an epidemic in the U.S. and elsewhere.  Onset of the disease in one’s 40’s or 50’s, sometimes earlier or later.

Of course, one can control and greatly limit, if not eliminate, this risk by choice—specifically, chastity before marriage and monogamy afterward.  And so would and did we, like many fellow religious conservatives, raise our sons, with that council. 

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Resurgence of Measles, Pertussis Fueled by Vaccine Refusals

Credit: Centers for Disease Control and Prevention

I was born in 1950 and was home-schooled until the 6th grade. Thus, I missed exposure to several childhood illnesses that affected most of my generation. I never gave it much thought until, as a medical resident in North Carolina in 1979, I came down with a potentially life-threatening febrile illness that required hospitalization. Only after four days of 105 degree fever did a rash appear, and the diagnosis was made: measles. That was the sickest I have ever been. It turned out that one of my daughter’s school friends had developed measles in a small outbreak of unvaccinated kids in Chapel Hill, and I had been exposed to her. I was born too early to have been vaccinated.

But for most people born in the United States after the 1960s, they have never had to experience the high fever and rash of the measles or the coughing fits of pertussis, commonly known as whooping cough. That’s because these extremely contagious and potentially life-threatening diseases have been controlled with the use of highly effective vaccines and strong vaccination programs. And yet, the number of Americans sickened with measles and pertussis each year has recently crept back up.

Now, an NIH-funded report confirms that many of the recent outbreaks of these vaccine-preventable diseases have been fueled by refusal by some parents to have their children vaccinated [1]. The findings, published recently in JAMA, come as an important reminder that successful eradication of infectious diseases depends not only on the availability of safe and effective vaccines, but also on effective communication about the vaccines and the diseases they prevent.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Immunization Idiocy

I knew that I was going to write this blog post about the
news concerning the resurgence of measles and its relationship to the dangerous
and misguided anti-vaccination movement. The difficulty was with all the lunacy
out there I did not quite know where to start. I grew up in the era prior to
vaccination against childhood diseases. I had measles, mumps, rubella and
chicken pox. I remember the fear people had of these infectious diseases and
even as a child I was aware of how welcome these immunizations were when they
became available. It seems absolutely inconceivable that decades later people
are advocating against vaccines and placing their children and others at risk
of infection with potentially devastating diseases.

There now seems to be a perfect storm of parents making poor
choices for their children, a few vocal physicians giving bad advice, a
staggering number of ill-informed celebrities saying truly stupid things, and
political cowardice and hypocrisy failing to react appropriately. Let’s talk
about the history leading to this unfortunate circumstance. Keep in mind that
in the year 2000 measles was considered to have been vanquished in the US.
There were a few dozen cases all contracted by people who had travelled
overseas. However, these few cases were not transmitted to others because the
rate of immunization was so high, despite the high level of contagiousness.
This circumstance has now changed with people forgoing the vaccinations and
like-minded people creating communities with high levels of the unvaccinated.

This whole mess is largely attributable to the malfeasance
of Dr.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Fear and Loathing in Liberia

by Sean Philpott-Jones, Director of the Center for Bioethics and Clinical Leadership

Two weeks ago, I wrote a commentary decrying the current hysteria in the US over Ebola. It was ironic, I argued, that so many people were demanding the federal government take immediate steps to address the perceived threat of Ebola while simultaneously ignoring the real public health threats that we face.

A seasonal disease like influenza, for example, takes the lives of tens of thousands of Americans every winter. Still, far too many people refuse to get an annual flu shot. Similarly, outbreaks of preventable (and potentially deadly) diseases like measles, mumps and whooping cough are becoming more and more common as childhood vaccination rates plummet.

Moreover, the politicians and pundits calling on the Obama administration to take radical steps to combat Ebola are the same individuals who have repeatedly criticized efforts to combat the main causes of mortality in the US. Plans to tax junk food or limit the size of sugary sodas are seen as unwelcome government intrusions into the private lives of Americans, despite the fact that over 300,000 Americans die of obesity-related illness every year.

This isn’t to say that Ebola shouldn’t be a concern for public health officials in the US. I previously criticized both the US Centers for Disease Control and Prevention (CDC) and US Customs and Border Protection for their initially tepid response to the crisis.

CDC officials, for instance, were slow to update guidelines for treating patients with Ebola, initially recommending a level of training and use of protective gear that was woefully inadequate.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.