Showing posts with label Editorial. Show all posts
Showing posts with label Editorial. Show all posts

Friday, October 10, 2014

A Blogger’s Dilemma – What To Do About `Suspect’ Ebola Cases

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# 9173

 

Over the past 48 hours I’m aware of perhaps a dozen suspected Ebola `scares’ around the world (outside of Western Africa) where one or more persons has displayed symptoms consistent with the disease – resulting in hospitalization and/or testing.

 

Recent locations have included Paris, Macedonia, Texas,  Brazil, and  Prague.

 

I’ve not blogged any of these cases because:

  • Most, I believe, will turn out to be false alarms
  • They are already well covered  by the media and Flublogia (Crofsblog, FluTrackers, the Flu Wiki)
  • And realistically, there is little of value I can add beyond saying `We’ll have to wait to see’.

 

As I written before, whenever surveillance (whether for Ebola, Avian Flu, or MERS) works – we tend to see a lot of `suspect cases’ – although the vast majority will turn out to have something far less concerning – like seasonal flu, rhinovirus, or malaria.  

 

This fall and winter  – we’ve not only Ebola to screen for, it’s a fair bet we’ll see the return of MERS and avian flu – meaning that the number of `suspect cases’  in the news only likely to rise even further. 

 

If I tried to blog on each one of these reports, soon I’d have time for little else. None of this is a pledge that I won’t cover suspect cases – only that I feel I need more of a reason than `it has been reported somewhere in the world that . . . – before I’ll  write about it. 

 

If it is an extraordinarily unusual or potentially high-impact report, then yes, I may blog it.  And If I can add context, or additional value – then once again, I’ll probably include it. 

 

It’s a personal choice, but I’ll leave the reporting of individual suspect cases to those who do that sort of thing much better than I, and try to concentrate on more macro infectious disease and preparedness issues, to which I can hopefully add some value.

Monday, August 04, 2014

mBio: The Risks & Benefits Of `GOF’ Experimentation On Pathogens With Pandemic Potential

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Credit CDC PHIL

 


# 8911

 

 

Somehow, between the Ebola news, and the fact that it was published on Wednesday (instead of mBio’s normal Tuesday publication date), I missed the following editorial by Arturo Casadevall  and Michael J. Imperiale in the open-access journal mBio.

 

It is a long, thoughtful look at the complex issues at hand.   Follow the link to read it in its entirety.

 

1 August 2014

Risks and Benefits of Gain-of-Function Experiments with Pathogens of Pandemic Potential, Such as Influenza Virus: a Call for a Science-Based Discussion

Arturo Casadevall and Michael J. Imperiale

doi:10.1128/mBio.01730-14

Editorial

Influenza virus is one of a handful of infectious disease agents that can cause devastating pandemics with high mortality and morbidity in human populations. The human species is vulnerable to zoonotic infection with new influenza viruses, with the last occurring as recently as 2009. Influenza kills thousands of people each year, and the world is continuously confronting new epidemics. Today the complexity and interconnectivity of our society create vulnerabilities, such that pandemics with even low mortality have the potential to cause widespread suffering and economic disruption. Epidemics can have catastrophic effects on the social order and result in the disruption of benefits that we associate with current society, such as law and order and reliable food distribution (for a vivid and dramatic representation of the effect of epidemics on society, readers are invited to see the movie Contagion, where an outbreak with a new fictional virus leads to the breakdown of the social order). Hence, epidemics pose existential threats to civil society even when morbidity and mortality occur in a fraction of those infected. Given the biological characteristics of the influenza virus that ensure the continuous generation of antigenic variability, this virus poses a continuous extant threat, with the likelihood of new pandemics being determined by variables that remain poorly understood. In this environment, the influenza virus research community is humanity’s best defense against influenza virus. Consequently, anything that impacts influenza virus research is of utmost importance to societal well-being.

(Continue . . . )

 

For more on this controversial debate, you may wish to revisit:

 

Scientists For Science: GOF Research `Essential’ & Can be Done `Safely’

Updating The Cambridge Working Group

ECDC Comment On Gain Of Function Research

The Debate Over Gain Of Function Studies Continues

Lipsitch & Galvani: GOF Research Concerns

The Call For Urgent Talks On `GOF’ Research Projects

Sunday, January 30, 2011

AFD Editorial Policies

 

Note: My apologies for this lengthy post in advance.

 

In response to several queries over the past few months as to why I do or don’t do specific things on this blog, I’ve decided to post my rationale for how I manage this blog.

 

Over five years, this blog (and blogger) have undergone a number of changes. Hopefully for the better - but that is for you, the reader - to judge. I’ve learned a great deal about infectious diseases of course, but perhaps even more about science blogging in general.

 

So today, if you’ll indulge me, an outline of the editorial policies I use when writing this blog, including  the sticky issue of`fair use’ of other people’s work.

 

These policies are specific to me, and and geared to address my personal strengths, sensitivities and foibles, and are not intended to be a guide for any other blogger but myself.

 

We each have our own style, strengths, and weaknesses. It would be a boring Internet indeed if we all wrote by the same rules.

 

# 5269

 

 

I have, admittedly, some fairly stringent self-imposed rules for writing this blog.  Since I serve as both author, and editor of AFD, they are the only safeguards I have to keep this 5-year endeavor from `jumping the shark’ (1).

 

Primarily, I try not to speculate, rant, or make this blog all about me. I also avoid, as much as possible, lifting more than a paragraph or two (with a link back) from any newspaper article.

 

Of course, from time-to-time, bits of these elements do sneak in. So it isn’t a complete ban.

 

But it is a goal.

 

And then there’s the tricky minefield of what to do with conflicting science, pseudoscience, politics and individual belief systems. 

 

 

A day doesn’t pass when I don’t find some idiotic news item, blog post, or nutty idea worthy of an acidic rant. The internet is, as they say, a target rich environment. And the strong, sometimes overwhelming temptation is to go after these nutbars with devilish delight.


But I’m pretty sure my small but erudite band of loyal readers don’t need me to tell them when some idea, or policy, is inane.

 

I’d be preaching to the choir. In the end, a rant would only serve to vent my own spleen.  So while I sometimes write them (it’s therapeutic!), I rarely post them.

 

Besides, if I succumbed to the temptation often, this blog would start to sound like a broken record. So I try to resist.

 

 

As far as personal speculation or bias goes, I work constantly to remove it from my writing.

 

Why?

 

Because no one should give a flip what cockamamie ideas this aging ex-paramedic might have on avian flu, virology, or any other subject for that matter.

 

When on rare occasions I do speculate, I try to clearly label it as such.  And I must feel I have at least some credible evidence to back it up.

 

Otherwise, it’s nothing more than biased dreck, and I know it.

 

My goal is to provide context and scientific evidence, not my opinion. I figure my readers are smart enough make up their own minds, without me insultingly trying to do it for them.

 

 

I also try to avoid assuming facts which are not yet in evidence.  Even if they seem `reasonable’, I side with caution.

 

Which is why, when we see suspected cases of H5N1 in Indonesia or Egypt, I don’t automatically assume them to be positive.

 

Or assume that negative results are always`false-negatives’.

 

When we see more than one infection in the same vicinity, and at the same time, I don’t instantly assume them to be the result of human-to-human transmission.

 

Yes, I know.

 

Someone else will likely be the first to declare that an outbreak has begun somewhere in the world. But since I know of no prize for being first to shout `Pandemic’ on the internet, I can live with that.

 

I’d rather be a day late and sure of the facts, than a day sooner and dead wrong.

 

Yes . . .you can always print a retraction, but Google never forgets. 

 

 

You’ve probably noticed I use colored text to segregate what I’m writing from excerpts or quotes by others (always in blue text).

 

Just another way to clarify who is saying what.

 

The subject of `fair use’ has come up a lot over the last year, and while I’ve always limited the amount of text I would lift from a news item (usually a linked headline, and a few paragraphs, followed by a second link), I’m taking even less today.

 

Over the past year I’ve tried to go with just the linked headline and no more than 1 or 2 paragraphs, along with my own summary of the news report.

 

Exceptions are generally press releases, state or official news releases, and of course, open access journal articles.

 

For other journal articles, I’ll give the citation, and some excerpts from the abstract, and then my own summary. 

 

Everything gets linked back to the source, of course.

 

My reasons are simple.

 

It’s no secret that newspapers, and journalists, are in financial trouble. And at least part of the problem is the wholesale `borrowing’ of their work, and reposting it all over the web.

 

I believe I can help them by enticing people to follow the link I provide and to read the original article with a well placed snippet or two, but I would be hurting them if I took much more than that.

 

I’ve too much respect for the talent and hard work of Maggie Fox, Helen Branswell, David Brown, Jason Gale, Lisa Schnirring, Robert Roos, David Dobbs, Maryn McKenna, and many others to ever want to scuttle their ships in order to pad my blog.

 

You’ll find that I use the very same standards when referring to another blogger’s work. And whenever I use a news item dug up by a newshound, I try to give them credit (note: I don’t use items unless linked to the original source), as well.

 

Now, I must confess that I have a personal bias when it comes to this blog.

 

I believe in promoting evidence based public health policies.

 

Unfortunately, sometimes scientific evidence is weak, anecdotal, or conflicting.  And as we all know, today’s `accepted truth’ has a bad habit of becoming tomorrow’s rejected fallacy.

 

Which is why you’ll sometimes find I write blogs like The Temporary Immunity Hypothesis and When Studies Collide (Revisited), that look at conflicting reputable scientific studies.  

 

When I do, I try not to take sides (at least not in print).

 

But when scientific evidence favoring one side is strong enough (notice I used the word `evidence’, not `proof), I’ll side with the preponderance of evidence. Even though I know there is a chance it may be proven wrong later.

 

Why?  

 

Because the best we can do on any given day is to base our decisions on what the best evidence indicates right now, even if absolute proof is lacking.

 

As I’ve said before, if you want a guarantee. . . buy a Craftsman.

 

Which explains why I am pro-vaccination, even though I’m aware of the (minor) risks involved and the fact that they aren’t 100% effective.  And why I don’t use this blog to actively push unproven protective regimens, like Vitamin D (a frequent question, btw), even though there is some evidence that it may be effective.

 

(Personal admission: Being a `belt and suspenders’ type of guy, every flu season I use both).

 

 

Beyond that, I try not to attack anyone personally, even if I vehemently disagree with them (their ideas are always fair game, however). I also avoid dragging politics or religion into this blog like the plague, simply because I believe they polarize the audience, and distract from the science. 

 

I’ll leave that to others, better equipped and better suited, to joust with those windmills.

 

But most importantly, I try my very best not to sensationalize, or use unnecessary hyperbole when reporting on emerging threats. I believe that to do so is both irresponsible, and unprofessional.

 

And that, I think, harkens back to my years as a paramedic (yes, I’m violating the `about me’ rule here, but this whole blog post teeters on that precipice), where maintaining calm while in the midst of chaos was ingrained into us.

 

It’s why we walked (albeit briskly) at the scene of an emergency, never ran. And its how we `handled’ dealing with a dozen horrible events every day.

 

So if you detect the hint of a detached or dispassionate voice when I report on what are admittedly terrible events around the world, you now know why.  

 

There you have it.  The basic rationale I use when writing this blog.  These are my rules, for my blog, and are not meant to apply to anyone else.

 

I’ll post this on my sidebar, so that it remains available on the front page.

 

Hopefully it will have answered any questions you may have had, and now that I’ve written it down, will make it easier for me to stick to.

 

          *             *           *           *            *

 

(1)  `Jumping the Shark’ is an American idiom that goes back to the late 1970s.  It refers to an episode of the sitcom Happy Days, where Fonzie on water skis, jumps over a shark.  It was seen as a low point in the series, and a sign that the show was running out of good ideas, and on the decline.


To `jump the shark’ now means that something that was once great, has lost its way, and is on the downhill path.

Wednesday, October 06, 2010

PLoS Essay: Reflections On The International Pandemic Response

 

 


# 4962

 

 

A long and very informative opinion piece appeared yesterday in PloS Medicine  on what went right, and what went wrong, with the international response to the 2009 pandemic.

 

A brief summary follows, but follow the link to read the report in its entirety.

 

 

Reflections on Pandemic (H1N1) 2009 and the International Response

Gabriel M. Leung1*, Angus Nicoll2

1 Food and Health Bureau, Government of the Hong Kong SAR, People's Republic of China, 2 European Centre for Disease Prevention and Control, Stockholm, Sweden

Summary Points

  • Many of the initial responses to the 2009 H1N1 pandemic went well but there are many lessons to learn for future pandemic planning.
  • Clear communication of public health messages is crucial, and should not confuse what could happen (and should be prepared for) with what is most likely to happen.
  • Decisions regarding pandemic response during the exigencies of a public health emergency must be judged according to the best evidence available at the time.
  • Revising pandemic plans—to be more flexible and more detailed—should wait for WHO leadership if national plans are not to diverge. Surveillance beyond influenza should be stepped up, and contingencies drawn up for the emergence or re-emergence of other novel and known pathogens.
  • Data collection and sharing are paramount, and include epidemiological and immunological data. Clinical management of severe influenza disease should not be limited to the current antiviral regimen, and include the development of other therapeutics (e.g., novel antivirals and immunotherapy).
  • Greater and more timely access to antivirals and influenza vaccines worldwide remains an ongoing challenge.

 

 

While this contains much worth reading, the second point of the summary struck me as being one of the most important and most difficult to address:

 

Clear communication of public health messages is crucial, and should not confuse what could happen (and should be prepared for) with what is most likely to happen.

 

 

The problem, of course, is getting the media to treat `worst-case’ estimates and scenarios for what they are – possible but not probable outcomes.

 

Many times I heard public health officials cautiously speak of `possibilities’ only to see them reported in some media venues as either fact, or at least likely to happen.

 

Caveats, or other nuances, were often omitted or minimize in order not to water down a `good story’.

 

And the public – who generally get their news filtered through the lens of the mass media – ends up with skewed perception of the threat.

 

How you get the media (new and old) to report responsibly, when ratings and ad revenue are often enhanced by hyperbole and sensationalism, is a major challenge. 

 

The authors point out, in a list of `firsts’ for this pandemic, that:

 

  • The first pandemic with instant communication so that early impressions (such as the experience and response in Mexico and the Ukraine) could be shared ahead of proper scientific analysis.
  • The first pandemic in which web-based platforms of traditional journals expedited dissemination, complemented by other innovative online resources (e.g. PLoS Currents: Influenza, http://knol.google.com/k/plos-currents-i​nfluenza#, based on Google's knol technology).
  • The first pandemic with a “blogosphere” and other rapid social media messaging tools that challenged conventional public health communication.

 

A good deal of the pandemic rumor mongering, including wild unsubstantiated conspiracy theories, continue online and in the media even after the end of the pandemic.

 

Each day I weed through hundreds of dubious news stories, blog posts, and twitter tweets that are either recycled old news (some intentionally presented as new), are pseudo-news items filled with improbable conspiracy theories or unbridled speculation, or are simply wild tales made up out of whole cloth (see Ukraine And The Internet Rumor Mill).

 

 

This PLoS Medicine  essay goes into far more than just communications issues, including surveillance, antivirals, vaccines, and the use of NPIs (Non-Pharmaceutical Interventions).

 

It provides abundant food for thought and discussion as the post mortem on this pandemic continues.

 


Highly recommended.

Wednesday, August 18, 2010

Nature Editorial: After The Pandemic

 

 

# 4819

 

 

The respected Journal Nature has published a brief editorial on the WHO’s (World Health Organization’s) handling of the pandemic.

 

 

After the pandemic

Date published: (19 August 2010)
DOI:10.1038/466903b

Despite some mistakes, the World Health Organization handled the flu outbreak well.

 

A hat tip to Ironorehopper on FluTrackers for posting this link.

 

In early June Nature published a detailed rebuttal of many of the outrageous conflict-of-interest allegations that have been cast in the WHO’s direction, so it isn’t terribly surprising to see this editorial stance.

 

(See Experts Weigh In On Allegations Against The WHO)

 

After months of the media reporting on unsubstantiated accusations of impropriety on the part of the WHO, I’m heartened to hear some reasonable and respected voices speaking out.

 

A few of my essays on this `blame game’ directed at the WHO, the CDC, and vaccine manufacturers includes:

 

WHO To Review Their Pandemic Response

Hubris And The Flu

Before We Ride Down And Shoot The Survivors.

Tuesday, April 13, 2010

Referral: NYT’s Editorial On H1N1

 


# 4494

 

 

Overnight the New York Times published an editorial by Richard P. Wenzel, a professor of internal medicine and an infectious disease specialist at Virginia Commonwealth University.

 

If the name is familiar, it is probably because in May of 2009, Dr. Wenzel was the first to report on a large number of afebrile flu cases upon his return from Mexico (see H1N1: Apparently Not Your Father’s Influenza).

 

Since the entire editorial is worthy of your time and consideration, I’ll simply provide the link and suggest you read it in its entirety.

 

What We Learned From H1N1’s First Year

  • By RICHARD P. WENZEL  Published: April 12, 2010

Friday, November 20, 2009

Alan Sipress: The Great Flu Cover-up

 

# 4050

 

 

No . . . this isn’t some wild conspiracy theory.

 

Last spring the British government dragged their feet in testing, and reporting H1H1 cases so as not to establish `community transmission’ in a second WHO region. 

 

From this blog way back on May 29th of this year (New Scientist: The Invisible Pandemic)

 

The `useful fiction’ that community transmission of the H1N1 virus has yet to occur in Europe (or Asia, or Africa . . . .) has been bolstered by the relatively small number of positive H1N1 tests coming out of those regions.

 

Of course, by failing to demonstrate community transmission in another WHO region, the politically dicey decision to raise the pandemic alert level again can be postponed.

 

 

Much of what we knew at the time came from excellent reporting by the New Scientist  magazine (Europe may be blind to swine flu cases and New swine flu cases point to invisible pandemic).

 

Alan Sipress, the Washington Post’s economics editor and the author of the book "The Fatal Strain: On the Trail of Avian Flu and the Coming Pandemic." has a detailed analysis of this cover-up in the current issue of  Foreign Policy Magazine

 

You’ll find another recent blog regarding Alan Sipress at Alan Sipress: Playing chicken with a nightmare flu.

 

A hat tip to DemFromCt, editor of The Flu Wiki, for this link.

 

 

 

The Great Flu Cover-up

How governments concealed the extent of the H1N1 pandemic and risking the outbreak of a virus that's even more deadly.

BY ALAN I. SIPRESS | NOVEMBER 17, 2009

As swine flu was spreading around the globe this spring, a senior disease specialist from the World Health Organization (WHO) held an urgent conference call with top British health officials. In the conversation this May, later described as "aggressive" by sources familiar with the discussion, the WHO official accused the British of concealing the extent of their country's swine-flu outbreak. Among those with swine-flu symptoms, Britain was only counting people who had traveled to places that, like Mexico, had already confirmed an outbreak of the virus, known to scientists as H1N1. Their method left much to be desired in a country where the virus was already spreading fast. Countless Britons fell sick and were intentionally left uncounted.

 

Governments, of course, have a long history of concealing outbreaks, and this year's flu pandemic, while the first of this particular century, was certainly not the first to be brushed under the rug. The consequences of cloaking swine flu weren't disastrous on this occasion, but the result will not always be so benign. In fact, at this very moment, another virus -- with the potential to be far more devastating -- is continuing to seed infections, frustrating efforts to root it out. That virus, H5N1, or avian flu, is a far more lethal strain. And you guessed it: front-line countries' records in candidly reporting the disease's spread don't bode well.

(Continue . . . )

 

Tuesday, November 17, 2009

A Pair Of Vaccine Editorials

 

# 4026

 

 

First, an editorial in the prestigious British medical journal The Lancet  which speaks to the avalanche of inaccurate information about vaccines being promulgated on the web, in the media, and across our societies.


The full text is available to those who have registered (which is free).

 

 

Vaccine safety: informing the misinformed

The Lancet Infectious Diseases, Volume 9, Issue 12, Page 719, December 2009

doi:10.1016/S1473-3099(09)70307-X

Preview |Full Text | PDF

 

At the time of going to press, the first major vaccination campaigns to prevent pandemic H1N1 are getting underway. The vaccine might not have been ready in quite the volume hoped; nonetheless, for the production of vaccine in any substantial quantity in such a short time while still providing seasonal vaccine, those involved—the scientist, the pharmaceutical companies, and the chickens that laid the millions of eggs used—should be applauded.

 

Towards the end, the author states:

 

Concerned parents will continue to attend the University of Google; researchers, medical professionals, journalists, and bloggers need to ensure that they get the right tutors.

 

 

Next an editorial in The National Post, by Joe Schwarcz, on the ridiculous idea that Hollywood celebrities are our best source of information about vaccine safety.

 

Joe Schwarcz: An injection of H1N1 reason

Posted: November 17, 2009, 9:00 AM by NP Editor

Joe Schwarcz

I think the time has come to panic. But not about catching the H1N1 “swine flu.” And not about the alleged risks of the vaccine that can protect against it. For the vast majority of people, the flu will mean no more than a week or so of misery, not different from previous versions. As far as the risk of the vaccine goes, it’s minimal. However, there is something to panic about: the stunning amount of misinformation being bandied about.

 

(Continue . . . )

 

 

The amount of bad information out there, in the media and particularly on the internet, is nothing less than astounding. 

 

Just as tabloid newspapers use titillation, public fears, or scandal to drive readers to their rag, many bloggers and website owners use similar tactics to attract visitors.  

 

I’m fully aware that wild tales of `chipping’ people with vaccines, or of UN global depopulation plans, or that the H1N1 virus was `engineered’ are more `marketable’ than reporting solid, evidence based, and sometimes `dry’ science.   

 

People love tall tales and intrigue. And playing to people’s fears has always been effective marketing.

 

But the damage these stories do is significant.   Lives may well be lost because someone was swayed by the anti-vaccine propaganda, and decides not to take the vaccine or to get it for their child.

 

Vaccines have an excellent safety profile, but no vaccine is 100% safe.   And I don’t know of any reputable scientist or doctor who would suggest that they are.

 


But the risks of going unvaccinated far outweigh the risks of vaccination.   Thousands have already died from the H1N1 virus, and no doubt thousands more will succumb over this winter. Taking the vaccine would likely prevent a lot of those deaths.

 

The vaccine isn’t perfect, of course.  But it is our best, and safest weapon against an influenza  pandemic.    And that is the message bloggers, reporters, and medical professionals need to be spreading.

 

Even if the public thinks the truth about it is kind of boring.

Thursday, November 12, 2009

Arthur Caplan On `Flunking The Swine Flu Test’

 

 

# 3998

 

 

Arthur Caplan, Ph.D., who is director of the Center for Bioethics at the University of Pennsylvania, has written a scathing assessment of our nation’s response to the H1N1 pandemic in a commentary appearing on the MSNBC website. 

 

In it he takes politicians, health care workers, and dispensers of conspiratorial Internet malarkey to task.   He believes the nation is `Flunking the Swine Flu Test’, and isn’t reticent to say so. 

 

 

Opinion: U.S. swine flu response dismal at best

Vaccine delays, priority breakdowns raise fears about a worse crisis ahead

Commentary By Arthur Caplan, Ph.D.

updated 5:48 p.m. ET, Mon., Nov . 9, 2009


Few seem to want to say so, but this nation has mounted a dismal response to the swine flu epidemic.

 

By dismal I mean this: There’s not nearly enough swine vaccine to go around, there are conflicted messages about when the doses and antiviral supplies will arrive and half of all Americans are reporting they are too afraid to get the vaccine even if they are able to find it.

 

Health care workers are throwing fits when directed to take the vaccine, even if they work around high-risk patients, and there’s a breakdown of a strict distribution system to make sure the vaccine we do have is used to protect and save the most lives.

 

We have had the better part of a year to get ready for swine flu.  And yet, the response to the pandemic H1N1 outbreak has been lousy. What would happen if a hostile power launched a large-scale bioterrorism attack against us with no warning?

 

The Obama administration bears much of the blame for the fear the public and health care workers have of the swine flu vaccine. The facts do not square with the fear.

 

(Continue . . . )

Tuesday, October 06, 2009

NYT’s OP-ED: America Takes On Swine Flu

 

# 3806

 

 

Crof at Crofsblog calls this the `must-read of the day’, and I quite agree.   You’ll find some very familiar names among the contributors to this editorial.

 

 

October 5, 2009, 6:34 pm

America Takes On Swine Flu

By The Editors

swine flu

Nati Harnik/Associated Press Five doses of swine flu vaccine, part of the first shipment of vaccine sent to Methodist Hospital in Omaha, Neb., Oct. 5, 2009.

 

The roll-out of the swine flu vaccination program, one of the largest such drives in U.S. history, started Monday. The federal government has ordered 250 million doses of vaccine, which will be distributed by state health officials this fall.

 

Yet surveys have found that a large portion of the public is uncertain about getting the vaccine, either because of concerns about potential side effects or because they sense the health warnings about the H1N1 virus are overblown. At the same time, many doctors worry that they are ill-prepared to handle the nationwide drive to immunize everyone.

 

We asked some doctors and public health experts, will such an ambitious immunization program work? What worries you most?

(Continue . . .)