More on vaccines

I met with my textbook-writing colleagues at Princeton this past Friday, and of course the topic of the Times article on HPV vaccines came up. See my previous post for details.

Three issues came up in our discussion which are worth noting.

First, articles such as this contribute to the parental fervor against vaccines. This is clearly an emotional topic because parents do not want their children injured. However, most parents do not have the training to interpret the statistics that are involved in determining whether injuries are due to vaccines or not. The outspoken yet uninformed comments of celebrities do not help the cause of vaccines.

Second, the undertone of the article is that the vaccine is not needed in the US but was pushed into the market to improve the profits of the pharmaceutical companies. In my view (see below) any vaccine that saves lives should be offered, but the controversy in this case is further reason why pharmaceuticals should not be made for profit. This is a thorny issue which I have written on previously.

Third, an important question is what determines whether an infectious disease merits a vaccine or not? For diseases such as poliomyelitis and AIDS the answer is simple, because the incidence of both is (was, in the case of polio) huge. But what is the lower limit? In the case of HPV vaccines, is 3,600 deaths from cervical cancer a year worth a vaccine? Is the number lower? In 2007 there were 124 fatalities from West Nile encephalitis, and vaccines against West Nile virus are certainly in development. Will the Times question the value of a West Nile virus vaccine when and if it is released?

I don’t know the answer to this question, but it seems to me that each of us would like to be protected against death from any give pathogen. Therefore it could be that if a vaccine prevents one death a year it is worthwhile.