Many lives might be saved if inoculations against cow flu were routinely administered to all people in areas where the disease is detected. However, since there is a small possibility that a person will die as a result of the inoculations, we cannot permi

The author argues that "many lives might be saved in inoculations against cow flu were routinely administered"; however, the argument goes on, claiming that since there is a "small possibility" of death due to the inoculation, they could not permit routine administration of the vaccine at all. Additional, specific evidence is needed to evaluate the soundness of this argument. First, the author would need to provide specific frequency and probabilities of having a fatal reaction to the vaccine. This would allow one to evaluate whether the chance of a fatal adverse reaction is significant enough to justify the decision not to administer the vaccine to anyone. Second, more specific information would be needed on the extent of the problem itself: how many individuals are affected by cow flu? Are particular subsets of individuals or occupations (for example, dairy farmers) at higher risk? How is cow flu transmitted to people (eating contaminated meat, hand-to-hand contact, etc.)? It may be that for certain sub-populations, that there are risk factors for contracting cow flu which may justify (even potentially dangerous) inoculation; however, it may not be the case that the general public has any reason to get routinely inoculated if they are not at risk of contracting the illness. To assess whether such an argument to not permit inoculations is justified, these questions would have to be answered with specific evidence.

The argument is is based on the author's initial claim that "many lives might be saved" if inoculations were routinely administered where cow flu was detected. This claim rests on several assumptions: that the epidemiology of cow flu warrants concern because the illness is harmful or deadly to humans, that there is a connection between detecting the disease in a particular area (in cows? in humans?) and frequency of that illness in that area, and that routine administration of cow flu is the most effective way to prevent illness. First, it must be known how potentially dangerous cow flu is to human beings to assess the soundness of the argument. If there is a potentially harmful reaction to the vaccine but no chance of fatal reaction to the illness itself (and if the illness was mild and short-lived in humans), then the argument would be weakened because routine administration would not be necessary and worth the possible risk. It may also be the case that the illness is highly contagious, affects vulnerable populations such as the young and elderly with greater severity, and has possible life-threatening implications. If this were the case, then the argument that routine administration of the inoculation could not be permitted due to a small possibility of an adverse reaction would be weakened: being vaccinated for an illness with a high likelihood of death would outweigh the potential likelihood of dying from the vaccine in terms of a utilitarian, public health perspective. There is no way to assess the pros and cons of either decision with concrete data about the illness itself.

Similarly, more data would be needed on the probability of an adverse reaction to the inoculation itself. Many of the most successful public health initiatives in history have been based on a utilitarian logic that prioritizes the well-being of the many over the possible adverse loss of a few. Using this logic, one would be able to weigh the chances of dying from the illness versus the chance of dying from the vaccine and make an informed choice - both as an individual and as a matter of public policy. This calls into question that specificity of the language used by the author: in matters of life and death, and for policy recommendations, words such as "small" and "many" are not helpful. If there was a 1 in 10 chance of dying as a result of the vaccination, that might be 'small' compared to 50%, but such a vaccine could not be endorsed as a safe treatment to the illness. The argument is also based on the assumption that fatal reactions are due to the vaccine itself - whereas it might be the case that certain individuals might have additional risk factors that increase the likelihood of allergic reaction (history of reactions to vaccines, suppressed immune systems, contraindicated medications, allergies to ingredients of the drug, etc.) which - if these could be identified beforehand - would weaken the argument that routine administration should not be permitted. T

Although it does not directly speak to whether routine administration of the inoculation should or should not be permitted, it would be beneficial to know the ways in which the cow flu illness is transmitted, who is at risk, and whether there are alternative approaches to keeping people healthy that - if they were effective - would weaken the idea that routine administration of inoculation would be the safest way to save lives. It could be that the spread of the illness itself is through consumption of infected meat. If this was the case, it may be the case that routine administration of cow flu vaccine in areas where infected cows were present would not really save many lives because of the way that meat in the United States is processed, transported, and distributed for human consumption. The location of a specific outbreak in cows may provide information about what products need to be recalled or tested, but inoculating the individuals in the community directly around the identified farm rests on the assumption that they are the ones primarily consuming the infected meat.

Finally, the claim itself rests on the assumption that because there is a risk in a particular treatment, that the treatment should not be permitted in its entirety. There are a variety of medications that doctors prescribe that have the potential for even life-threatening reactions. Doctors are required to inform patients of these risks and of ways they can minimize and respond to adverse situations should they arise. If individuals were prohibited from being vaccinated against polio due to the small likelihood of an allergic reaction, then polio would not be (virtually) eradicated as it is today. If informing individuals of the potential risks while also communicating the benefit of the inoculation - not just to themselves, but to those around them in terms of herd immunity - were practiced, then it may be the case that most individuals would still opt in to the immunizations, which would weaken the ethical/practical foundation on which the final claim of the argument depends.