Last September, when I was reporting about the difficulties some physicians faced in obtaining flu vaccine, for a column in BusinessWeek.com, I focused on the fact that large retail chains like Walgreens and CVS seemed to be getting preference from manufacturers for limited supplies.
But another matter came up during my inquiries with individual physicians, which I didn’t fully explore in the article: their income stream from flu shots. I learned that a practice of three or four physicians might give out 1,500 or 2,000 vaccinations…charging $25 or $30 per inoculation. At a wholesale cost for the physicians of $2 or $3 apiece, you can begin to do the math.
I am reminded of that component of the story by Dave Milano’s comment on my previous post that “there is so much money at stake (even more so when the money-making entities have the ear of government and media). I believe that there is a lot more non-patient-centered motivation in medicine than most people imagine. Far more than most providers and drug companies are likely to admit to.”
The whole vaccine situation bears some resemblance to that of raw milk. With both vaccination and pasteurized milk, we have been so thoroughly propagandized to unquestioningly accept both as essential that we feel terribly at risk if we do without either. I felt quite nervous last winter when for the first time in some years I went without a flu shot…much like I felt the first time I drank raw milk. It’s difficult to buck the conventional wisdom.
There, perhaps, the resemblance ends. The vaccination decision, unlike the raw milk decision, isn’t just one decision, as several readers aptly point out. As such, it’s a complex decision. Do parents who refuse vaccines for their school-age children ride the coattails of other parents who have allowed their children to be vaccinated? How do I know whether I (or my children) have built up enough immunity to fend off measles, which can cause blindness and deafness?
The decisions then become personal, and varied. I may opt out of the flu vaccine, but take the tetanus and hepatitis B vaccines in preparation for traveling to Third World countries (which I did). Parents may opt their children out of some early vaccines, and give them later when the children are more fully developed. And there are consequences; for example, hospitals may (and do) give parents a tough time when an unvaccinated child is brought in with any illness.
The challenge for many of us comes in obtaining reliable information and advice on what to do. The data on such matters as the relationship between autism and vaccination appears to be conflicting. That doesn’t mean we shouldn’t examine it, and make our own final determinations. As Linda Diane Feldt points out, “We shouldn’t turn over our critical decision making to other people.” Especially when these other people have a financial stake in the decisions we make.
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