Reply to R.I.P. American children

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[quote=Anonymous]This is a delicate discussion that deserves a much greater degree of sensitivity than people give it credit for.

There are good reasons for giving the hep B vaccine at birth: hepatitis B can readily be passed from mother to child; the vaccine can likely prevent the overwhelming majority of occasions where a child catches hep B from his or her mother; chronic hep B infections can lead to liver cirrhosis or cancer.

There are also good reasons for not mandating the hep B vaccine at birth across the board: mothers are screened for hep B; some portion of children will have serious side effects from the vaccine; it is widely regarded as medically unethical to administer a medical intervention that is unnecessary, not least because it is a fact of life that most medical interventions have a financial upside to someone somewhere.

The choice ultimately comes down to a subjective value judgment: is it the value of inoculating children whose mothers are hep B positive but received a false negative on the screener greater than the cost of known and unknown vaccine side effects?

What complicates this issue is the asymmetry in harms: if “don’t mandate it” crowd is wrong, you know exactly what harm results—a baby gets hep B. If, however, the “let’s mandate it” crowd is wrong, and some appreciable degree of harm results to some meaningful number of babies from the shot, it’d be really hard to know; you just can’t run a years-long double-blind placebo-controlled study to see how health outcomes differ between people vaccinated at birth against hep B and those who were not. So, if the “let’s mandate it” crowd is wrong, we probably wouldn’t notice it.

On balance, I’m comfortable with the decision not to mandate it. If you’re in a stable, loving marriage with no history of hep B risk factors and if you test negative on the hep B screener, there’s probably a good chance that you’d pass the option up if you weren’t so distracted watching the miracle of life. But I understand why people see it differently.

For those of you whose passions run hot on this issue, I’d urge compassion and kindness.[/quote]

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