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Who should get the vaccines?

A bottle of vaccine against the H5N1 virus and syringe at the French zoo of La Palmyre in western France.

KAI RYSSDAL: A rare bit of good news about bird flu today. Researchers in the Netherlands announced migrating birds don't seem to be spreading the disease. Nevertheless, experts still want to be ready. And to have a vaccine. But, Helen Palmer reports from the Health Desk at WGBH, those shots are likely to be in short supply.


HELEN PALMER: The White House road map for fighting pandemic flu doesn't spell out exactly who should get vaccine if it's in short supply. But it could be a tough choice. [Sound: How the hell do I become the guy who has to make the decision who gets vaccinated and who doesn't? I mean, how do you make a decision like that?]That's Stacy Keach as the head of Health and Human Services in an ABC show broadcast a couple of nights ago: "Fatal Contact, Bird Flu in America". He had just 200,000 doses to hand out. In real life, there are 8 million doses of experimental vaccine in the national stockpile. And there are guidelines as to who should get it. Dr. William Schaffner teaches preventive medicine at Vanderbilt University.
DR. WILLIAM SCHAFFNER: At the very front go the people who actually make vaccines. And then next in line will be the healthcare workers who will care for the sick.

Schaffner says after that it's the usual flu vaccine priorities — the sick and elderly, very young children, and then the rest of us. But an article in Science magazine today questions those priorities. Of course vaccine and health workers should lead the pack — but then?

EZEKIEL EMANUEL: It's much more ethically justifiable to give to young people, young adolescents, people just starting out in their independent life.

Ezekiel Emanuel is a bioethicist. He says this isn't cruelty to Granny, it's just what's fair.

EMANUEL: Granny has had the opportunioty to live a full life and someone who's 18 or 20 is just starting out.

Emanuel wants his article to create a dialogue, maybe even change current priorities.

Vanderbilt's William Schaffner says dialogue's just what we need — and a national plan we can all accept as fair.

In Boston, I'm Helen Palmer for Marketplace.

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