Oh, To Be A Fly On the Wall
Jul 13, 2011

How many times have you heard of a new rule, law or recommendation and thought, “I wish someone had asked me what I thought about that before it became standard practice.”
Well for about 100 people with opinions regarding vaccine recommendations, yesterday was one of those days.
That’s because yesterday, the CDC hosted a public meeting in Seattle that was intended to engage the public in a discussion about vaccine recommendations, with specific emphasis on a vaccine for meningococcal disease in infants. This meeting was promoted to the public with the intent of getting input on the factors that should be considered when deciding if, and how,  vaccines should be added to the childhood vaccine series. While it’s extremely important for policy makers to understand and appreciate the public’s concerns, my suspicions regarding the productivity of this meeting began when I heard the rally call go out on well-known anti-vaccine sites. I suspected that the 100 individuals gathered in Seattle yesterday may not have been an appropriate representation of the country as a whole. It would be a shame to see this entire forum derailed by conversations of vaccine safety and efficacy from attendees who were simply trying to force their own agenda.
Prior to the event, Ed Marcuse, professor of pediatrics at Seattle Children’s Hospital, optimistically expressed his opinions regarding the meeting to KPLU Seattle by saying

 “It’s terribly important that you get other people engaged in the discussions of values, not just the experts. Because experts have knowledge, but the experts’ values don’t trump the values of the general public.”

While this is an admirable point of view, and I appreciate that the experts are concerned about the publics’ values, I am left wondering what I might have witnessed had I been a fly on the wall.
According to the coverage of the event from The Seattle Times, the attendees “wrestled with questions of safety, cost and effectiveness of a vaccine for meningococcal meningitis, one of several types of the disease, which can cause inflammation of the membranes covering the brain and spinal cord”.
The Seattle Times article goes on to explain the intricacies of this specific vaccine decision. Some key points to be considered are:

• The vaccine has just recently been approved for infants as young as 9 months
• It will likely be as expensive as the version used for teens: about $100.
• Other formulations of meningitis vaccine are now in the approval pipeline.
• Unless the CDC and the federal Advisory Committee on Immunization Practices (ACIP) officially recommend it for infants, insurers likely won’t cover it, nor will programs that provide free vaccines for low-income children.
• While bacterial meningitis is considered relatively rare, it is often deadly.
• Children under age 5 account for nearly a quarter of the 1,000 cases of meningitis in the United States each year. (According to the CDC, about 30 of those children die and about 35 will have a lifelong disability.)
• It’s anticipated that the current vaccine, which covers about a third of the causes of bacterial meningitis in infants, would protect against about 75 of the 250 cases in children.

It’s encouraging to hear that the CDC had presented this type of critical information to the attendees – all pertinent in evaluating the possible recommendation.  However, I’m left to wonder how constructive it was for the CDC to hear from people who do not possess the expert knowledge on this subject.  Ultimately, will the opinions of the public play into the decision or is this simply a way to gauge public response once a decision is made?
Oh, believe me…If would welcome the chance to share my thoughts and concerns with immunization policy makers. Unfortunately, like many other mothers who have an interest in vaccine advocacy, traveling to Seattle just wasn’t feasible.  Certainly there are others who also wish they had the opportunity to express their opinions on this particular subject. Therefore, if you care to include your views in a comments below, I will then forward them along to those at the CDC who are listed as the facilitators of this meeting.
And just so you are aware of what they have heard so far, upon the conclusion of yesterday’s meeting in Seattle, it has been reported by The Seattle Times that 53 percent of the participants indicated that they would like to add the vaccine to the schedule for all children, 31 percent were against recommending routine use but were for adding it to the government’s Vaccine for Children Program, and 16 percent suggested that the vaccine should not be recommending, nor paid for.
So, what are your thoughts? We want to know.

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