Vaccine is distributed: Who is " most important person "

Vaccine is distributed: Who is " most important person "
Vaccine is distributed: Who is " most important person "
The square bamboo shoot has swept across more than 100 countries like tornado in first type H1N1 influenza epidemic situation up till now, have infected more than 250,000 people in the world, has initiated global concern and worry. Preventing influenza from taking place and transmitting the most effective means is to inoculate vaccine of influenza. At present, the intersection of influenza and vaccine that use adopt the intersection of chicken and the intersection of embryo and law go on on a large scale producing mostly on being clinical. However, limited source, strict screening standard and requirement for the production technology of chicken's embryo, lead to the fact vaccine is with very high costs, production capacity is limited by suring too. The scientist is optimizing the vaccine large-scale production method constantly too, but still remain technically to be further ripe. The global main influenza vaccine manufacturer includes being comparable to Philippine Pasteur, Glenn plain SmithKline and American triumphant dragon of the promise, the maximum production capacity of vaccine is about No. 680 million Branch / every year, it is estimated that can reach No. 1,400 million Branch / every year by 2014. Take U.S.A. as examples, under present vaccine supply, once the epidemic situation of influenza appears to break out on a large scale, the American close to 90% has not injected the chance of vaccine in the first year when influenza break out. From confirm one pathogenic the intersection of virus and list, take time for 5- 6 months at least on a large scale to corresponding vaccine, especially prevail in period big at influenza, the surge of the vaccine demand will further expand the gap that vaccine will be supplied. When vaccine can't be satisfied with the demand, put to vaccine in front of us the assigned question. Saving the most important person in distribution of medical resources, people always regard morals as code of conduct and bottom line. For example, syphilis wreaks havoc during World War II, penicillin is offered to those soldiers most hopeful to recover preferably. In the emergency medical dept. or ICU of the hospital, when the quantity or medical resource of the sick bed is insufficient, even if latecomer and patient on the sick bed suffer from likewise serious disease, " to have first first " It is still one of the principles treated and cured in the course. Are these principles suitable for vaccine to assign too? In fact, each more easily infected group with big and prevailing influenza have a difference at various degrees: When influenza was great to prevail in 1918, the ones that lost the life were mostly 20 years old - 40 -year-old young people. But in the influenza epidemic situation of 1957 and 1968, children and the elderly became the biggest risk crowd. So, American national vaccine is recommended the committee (NVAC) Propose the committee (ACIP) with the regulation of immunity inoculation Have jointly proposed proposing, has proposed vaccine should follow " save the most important person " to distribute Principle,last producer, medical personnel, government official and the elderly over 64. 2 years old - 64 -year-old healthy person is arranged to the end, even is inferior to corpse handler and funeral parlor staff member. They say, this kind of method of salary distribution is not for reflecting the life of the people is more valuable than the others' one, can't explain them and have higher social value than others either, but only guarantee vaccine a producer and the medical personnel's health, they can produce more vaccine, offer better medical treatment service for patient. They emphasized, if successively carried on vaccine and inoculated in proper order according to this kind, would contribute to lowering morbidity and mortality of influenza, reduce the influence on causing in society and economy of the epidemic situation. But a lot of scholar show to the intersection of U.S.A. and NVAC and proposal that ACIP get out of that query, think " saves the most important person " Principle should set up at state of emergency, difficult individual according to having priority in degrees of foundation that be classified. They put forward different distribution principle, the intersection of lifespan and the principle and investment repayment principle also. The lifespan principle points out, everybody should enjoy and live the rights of different stages in all one's life, the intersection of children and issue, the intersection of teenagers and one, the manhood and senescence phase. Compared with the elderly, if a young person or children die in an accident unfortunately, people will often respond with more sympathy and sorry, because they have not grown up enough yet, has not gone through remakable success and brilliant period while growing yet. According to this principle, young people should enjoy more medical resources if. The investment repayment principle emphasizes the grade order, according to individual's overall devotion after born in and ratio of time of surviving of the surplus, to weigh its one that got vaccine preferably. Reach middle age as to adolescence ' 13 years old - 40 years old) Person,throw by a lot of already into in life, be had ideal, aspiration they they, but a lot of people have not found time to realize yet. So, compared with baby a year old, the personal value of the person of this age bracket is higher, there should be priority of vaccine inoculation. The public order is influencing the assigned priority of vaccine too to a certain extent. The public order principle is with a view to guaranteeing the public security and necessary for life, such as the supply of the food and fuel. In fact, in controlling influenza virus to propagate, except that vaccine inoculates, if other means isolate a patient, close the school and reduce the public activity etc. to play a very important role. If combine investment repayment principle and public order principle together, will contribute to the implementation of the means of above-mentioned comprehensive prevention and control. This is that the most meaningful control means prevails in period in an epidemic situation too. The one that prevented the society from being inequitable and is similar to proposal of U.S.A. NVAC and ACIP is, this kind of combination type principle places vaccine manufacturer and medical personnel on inoculating the first place of the crowd too, but emphasize the priority of crowd's vaccine inoculation between 13 years old - 40 years old even more, and influenza was great similar that the risk crowd in period prevails in 1918. In addition, some mathematical model results that studies set up according to the fashion trend of influenza reveal, can save more more easily infected group while following the combining principle. Though this kind of combination type principle has advantage in theory, there are certain drawbacks too. Because in different societies, the individual's life expects to have very great differences with the prospect. For example in U.S.A., one 16 -year-old white boy live, get 65 -year-old chance have 77%, and at the same age the intersection of black person and boy might have only 37% of the chances. If define according to the combining principle strictly, the black boy has no right of vaccine inoculation, this increase fairness and racial discrimination of society undoubtedly. In addition, some seemingly fair ways, for example determine the distribution of vaccine by way of drawing lots, replace science and ethics with luck, it is sheerly the cannot help but act. We still need to look for an equalization point between morals and income. People will influence existing method of salary distribution and ethical principle too if people must carry on the political pressure that the governments of various countries of the choice exert. The manufacturer of global vaccine mainly centres in developed countries such as U.S.A., Britain and France,etc. at present, and China, India, Mexico and Brazil,etc. Developing countries. There is not vaccine production base in a lot of countries, such as Sweden and Spain. If the epidemic situation breaks out in the world, the serious shortage of vaccine, do those countries producing vaccine know?  unexpectedly  sisters-in-law peaceful in Song by diligent without being teased bluff  rue to last Yi fan [chew clever to break one Zhui rime 5 sheaths lucky Gun of Pu 1 Guo assuare  harmony buttocks Zhyuan Φ nurse whether there aren't  entangling Wave  Ji Φ's tomb  of Guo's thin white silk of good fortune and cure τ's rime basketry and manage Jian  barium Nao of shallow lake overgrown with wild plants and sting ? In 2009, the " lancet " magazine publishes the article to point out, tight distribution which is short of medical resource such as organ and vaccine should follow the following principles: Equal medical treatment, inclined to serious disease patient, total benefit maximizing and social payback. But in reality, no principle can give consideration to morals and interests standard of every aspect. People must carry on the choice, adopt the relatively fair principle, in order to guarantee the stability and mankind's ethnic continuity of the society. Though first type H1N1 influenza virus has already been sown prevailingly scatteredly in the whole world, the one that is worth happying is, to the trend that influenza has been great and popular for many years, a lot of countries have made the scheme of meeting an urgent need, have played an important role in controlling the epidemic situation to propagate. We believe, with the development of medical science, the global production capacity against virus medicine and vaccine will be improved greatly. Though the variation of the virus is unpredictable, have one day to overcome epidemic situation eventually through human untiring efforts. (author is " The blog station hand in hand " Medical editor)


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