Winnipeg Free Press - PRINT EDITION

FYI: A shot in the arm to all those who got a shot in the arm

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I got my H1N1 shot this week. I went to the clinic on College Avenue, where I was told the lines were short. When I got there, however, there must have been 20 cars in the lot and a bus was parked at the door. Nuts.

I went in anyway and discovered that I was the only -- the lonely -- person in line. The cars in the lot belonged to the dozen or so bored nurses, and the clutch of security guards, greeters and handlers. The bus? Who knows.

A security guy told me there is never any waiting at the College Avenue clinic. "You should always come here," he said.

Well, actually, once is enough, but I took his meaning.

I got the shot mostly because I'm a new grandad (Ryan Charles, the perfect son of Megan and Perry Allard, thank you for asking).

But I would have done it anyway for the simple reason that once inoculated you are not a danger to yourself -- or anyone else.

That makes it a duty, or it should.

But given that, maybe, 15 per cent of Canadians have taken the plunge to the shoulder, that would appear to be a conviction that few share.

Why is that? I talked to Dr. Ethan Rubinstein, head of the infectious diseases section, University of Manitoba school of medicine.

He said that even in the planning stages it was not expected that more than 40 per cent of Manitobans would get a shot. But given that 15 per cent to 20 per cent had been "naturally" immunized by getting sick in the first wave of H1N1 in the spring, and that 15 per cent to 20 per cent of people older than 65 likely were naturally immunized by past swine flu outbreaks (including my 95-year-old father Leo who likely has been safe since the 1918 outbreak) it meant that something like 70 per cent of the population would be immune by, say, Christmas.

And when that large a proportion is immune, a "herd immunity" comes into play so that the holdouts get the benefit of living amongst a population that mostly poses no threat to them.

But that, of course, has not happened because, on the evidence to date, a greater proportion of people than expected are betting that this strain will remain "mild" as will the "third wave" next spring.

But what if they bet wrong? Earlier this fall, when two young people died suddenly, there was the beginnings of a panic and conjecture along apocalyptic lines. Suddenly, so-called queue-jumpers were pariahs shamefully throwing women and children from metaphoric lifeboats. And then when it became clear that the coincidence of the two sad deaths was simply that -- a tragic coincidence -- well, there was no longer a queue to jump.

Dr. Rubinstein said the phenomenon of "chronic optimism" in the face of a pandemic threat -- or more darkly, the refusal to act in interests of the greater good -- is something that will need to be studied after this cloud has passed.

But he noted that in 1903, the state of Massachusetts passed a law requiring all citizens to be immunized against a prevalence of small pox. The fine for not doing so was $5.

The law was challenged twice, finally going to the U.S. Supreme Court in 1905 in a case called Jacobson vs Commonwealth of Massachusetts. Jacobson argued that every freeman has the right "to care for his own body and health in such a way as seems to him best."

The court, however, found for the state, saying, in essence, that in a civilized society everyone accepts the bargain that individuals give up some liberty in exchange for the benefits of the civilization.

"Jacobson sought to enjoy the benefits of his neighbours being vaccinated without personally accepting the risks inherent in vaccination," according to the Louisiana State University Medical and Public Health Law Site.

Fast forward to 2009, and what do we find? We find, Dr. Rubinstein said, the recent ruling of the New York Supreme Court.

When the state decided that all health workers should be vaccinated to protect themselves and people they would be treating, some health workers balked, arguing essentially the same thing as Jacobson had argued a century earlier. But this time, the state lost and the court found in favour of the individual rights of the complainants.

Is that progress? And if it is so deemed, will it still be a progressive decision if "wave three" catches most all of us freely unprepared in a civilized society?



Republished from the Winnipeg Free Press print edition November 28, 2009 H11

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