kent nickell
Well-known member
This thread title was the title of a book review in the 10/19/07 issue of Science by Paul S. Keim, Dpt of Biological Sciences, Northern Arizona University....
The book is Are We Ready? Public Health Since 9/11 by David Rosner and Gerald Markowitz 2006
""The failed smallpox vaccination program initiated in December 2002 was driven by federal priorities yet had to be implemented at the state and local levels. To state officials, the true nature of the threat was not obvious. As a result, many of them did not fully engage in a program that was funded at less than its true implementation cost. In addition, the public did not fully recognize the threat, and an already-existing, organized anti-immunization community was fighting all vaccination programs. Lastly, in a healthcare environment severly affected by malpractice litigation, the risk of downstream liablilty and the potentially high costs of compensation to vaccination victims posed a threat to caregivers and healthcare administrators. As Gene Matthews (Georgia State University) summarized, "there were three concerns: liability, compensation, and risk assessment... these issues got mixed up with each other." This smallpox vaccination program was not coupled to overall public health development. Georges Benjamin (American Public Health Association) noted that single-minded attention to smallpox "sacrificed core public health activities.' Rosner and Markowitz point to this progam as an example of how federal dictates to the states were ill-fated, mismanaged, and detrimental to long-term infrastructure goals. ""
""Rosner and Markowitz weave commentary and analysis throughout the book but conclude with some basic lessons learned. First, in a crisis the available public health infrastructure makes all the difference in the quality of the local and federal response. Although timely leadership was important, it was effective only within the constraints of what the previous years' efforts had provided. Because of the unpredictability of the next crisis, public health infrastructure is the single most important way of preparing the nation. Second, the authors argue for a redefinition of public health to be more comprehensive and to include the mental health of the population. In addition to the traditional concern with the physical well-being of the population, social and economic health need to be included in the response to crises. Third, they observed that the failure to communicate honestly to the public, even if officials have good intentions to calm a chaotic situation, will lead to the subsequent mistrust of all communication. Lastly, the authors recommend that clear lines of authority need to be established in a crisis. Local authority need not be usurped, but decisive leadership, perhaps from the federal level, is critical. ""
Also just came across another interesting looking book on Amazon.com..
Editorial Reviews
Book Description
This first comprehensive history of the social and political aspects of vaccination in the United States tells the story of how vaccination became a widely accepted public health measure over the course of the twentieth century. One hundred years ago, just a handful of vaccines existed, and only one, for smallpox, was widely used. Today more than two dozen vaccines are in use, fourteen of which are universally recommended for children. State of Immunity examines the strategies that health officials have used--ranging from advertising and public relations campaigns to laws requiring children to be immunized before they can attend school--to gain public acceptance of vaccines. Like any medical intervention, vaccination carries a small risk of adverse reactions. But unlike other procedures, it is performed on healthy people, most commonly children, and has been mandated by law. Vaccination thus poses unique ethical, political, and legal questions.
James Colgrove considers how individual liberty should be balanced against the need to protect the common welfare, how experts should act in the face of incomplete or inconsistent scientific information, and how the public should be involved in these decisions. A well-researched, intelligent, and balanced look at a timely topic, this book explores these issues through a vivid historical narrative that offers new insights into the past, present, and future of vaccination.
About the Author
James Colgrove is Associate Research Scientist at the Mailman School of Public Health, Columbia University.
--------------------------------------------------------------------------------
Product Details
Hardcover: 349 pages
Publisher: University of California Press; 1 edition (October 5, 2006)
State of Immunity: The Politics of Vaccination in Twentieth-Century America (California/Milbank Books on Health and the Public) (Hardcover)
by James Colgrove (Author)
The book is Are We Ready? Public Health Since 9/11 by David Rosner and Gerald Markowitz 2006
""The failed smallpox vaccination program initiated in December 2002 was driven by federal priorities yet had to be implemented at the state and local levels. To state officials, the true nature of the threat was not obvious. As a result, many of them did not fully engage in a program that was funded at less than its true implementation cost. In addition, the public did not fully recognize the threat, and an already-existing, organized anti-immunization community was fighting all vaccination programs. Lastly, in a healthcare environment severly affected by malpractice litigation, the risk of downstream liablilty and the potentially high costs of compensation to vaccination victims posed a threat to caregivers and healthcare administrators. As Gene Matthews (Georgia State University) summarized, "there were three concerns: liability, compensation, and risk assessment... these issues got mixed up with each other." This smallpox vaccination program was not coupled to overall public health development. Georges Benjamin (American Public Health Association) noted that single-minded attention to smallpox "sacrificed core public health activities.' Rosner and Markowitz point to this progam as an example of how federal dictates to the states were ill-fated, mismanaged, and detrimental to long-term infrastructure goals. ""
""Rosner and Markowitz weave commentary and analysis throughout the book but conclude with some basic lessons learned. First, in a crisis the available public health infrastructure makes all the difference in the quality of the local and federal response. Although timely leadership was important, it was effective only within the constraints of what the previous years' efforts had provided. Because of the unpredictability of the next crisis, public health infrastructure is the single most important way of preparing the nation. Second, the authors argue for a redefinition of public health to be more comprehensive and to include the mental health of the population. In addition to the traditional concern with the physical well-being of the population, social and economic health need to be included in the response to crises. Third, they observed that the failure to communicate honestly to the public, even if officials have good intentions to calm a chaotic situation, will lead to the subsequent mistrust of all communication. Lastly, the authors recommend that clear lines of authority need to be established in a crisis. Local authority need not be usurped, but decisive leadership, perhaps from the federal level, is critical. ""
Also just came across another interesting looking book on Amazon.com..
Editorial Reviews
Book Description
This first comprehensive history of the social and political aspects of vaccination in the United States tells the story of how vaccination became a widely accepted public health measure over the course of the twentieth century. One hundred years ago, just a handful of vaccines existed, and only one, for smallpox, was widely used. Today more than two dozen vaccines are in use, fourteen of which are universally recommended for children. State of Immunity examines the strategies that health officials have used--ranging from advertising and public relations campaigns to laws requiring children to be immunized before they can attend school--to gain public acceptance of vaccines. Like any medical intervention, vaccination carries a small risk of adverse reactions. But unlike other procedures, it is performed on healthy people, most commonly children, and has been mandated by law. Vaccination thus poses unique ethical, political, and legal questions.
James Colgrove considers how individual liberty should be balanced against the need to protect the common welfare, how experts should act in the face of incomplete or inconsistent scientific information, and how the public should be involved in these decisions. A well-researched, intelligent, and balanced look at a timely topic, this book explores these issues through a vivid historical narrative that offers new insights into the past, present, and future of vaccination.
About the Author
James Colgrove is Associate Research Scientist at the Mailman School of Public Health, Columbia University.
--------------------------------------------------------------------------------
Product Details
Hardcover: 349 pages
Publisher: University of California Press; 1 edition (October 5, 2006)
State of Immunity: The Politics of Vaccination in Twentieth-Century America (California/Milbank Books on Health and the Public) (Hardcover)
by James Colgrove (Author)