Question

1. What significance does the case of Ethics of Administering Anthrax Vaccine to Children have regarding disease prevention and control? Explain your answer.

Answer 1

Ethics of Administering Anthrax Vaccine to Children

Background of the problem

• To prevent bioterrorism attack, Obama  administration suggested to test the existing anthrax vaccine on kids.
• It is found effective among adults and already been tested on adults and administered to millions of members of the military, especially those involved in bioterrorism defense.
• National Biodefense Safety Board, recommend that the studies proceed if outside experts determined they could be done safely and ethically.

Anthrax

• Anthrax is an infection caused by the bacterium Bacillus anthracis. It can occur in four forms: skin, lungs, intestinal, and injection.
• Human infection may occur by three routes of exposure to anthrax spores: cutaneous (through the skin), gastrointestinal (by ingestion), and pulmonary (inhalation). In North America, human cases of anthrax are infrequent.

Anthrax vaccination

• The only licensed anthrax vaccine, Anthrax Vaccine Adsorbed (AVA) or BioThraxTM is indicated for active immunization for the prevention of disease caused by Bacillus anthracis, in persons 18 – 65 years of age at high risk of exposure.
• The vaccine was developed from an attenuated strain of B. anthracis.
• According to CDC those who recommeds to get anthrax vaccine are

1. People who are at an increased risk of coming into contact with the bacteria that cause anthrax because of their job
2. People who have been exposed to the bacteria that causes anthrax

Ethics of drug administration

• Ethical issues related to medical errors can be categorized around four ethical principles: autonomy and right to self-determination; beneficence and nonmaleficence; disclosure and right to knowledge;and veracity

1.Autonomy and Right to Self Determination

• Healthcare providers have an ethical obligation to inform patients about their ongoing plan of care, including if a medical error has occurred.
• Healthcare providers are also obligated to assist patients in making decisions including medication error and potential adverse effects and follow their instructions for treatment so that minimize harm from the error.

2.Beneficence and Nonmaleficence

• This may create moral conflicts for healthcare providers in terms of balancing projected benefits with possible risk for the patient.

3.Disclosure and Right to Knowledge

• Healthcare providers have an ethical obligation to disclose information that patients need for informed decision making.
• The patient’s bill of rights calls for full disclosure of a medical error

4.Veracity

• The principle of veracity requires healthcare personnel to provide comprehensive, accurate, and objective information in a manner that helps patients understand the information.
• Telling the truth about medical errors helps to establish trust.

Anthrax vaccination administration in children ethical considerations

• A major ethical consideration in “pre-event” trials, in which testing occurs before an actual or imminent attack, is that children do not stand to benefit directly from participating in the study, and so risk must be kept very limited and small.
• Bio ehtics commision recommends  many significant steps would have to be taken, including additional minimal-risk research with adult volunteers, before pediatric anthrax vaccine trials prior to an attack should be considered
• the individual is given enough information about the risks and benefits of a trial to make a decision about participating in vaccination
• Since the children are not in a possition to give informed consent, or desicion making ethical consideration should be more focused
• Ethical principles includes. Information necessary to make a decision must be presented—that is, the risks and benefits, if any, of participation., The information must be presented at a level that can be understood by the patient or study subject.,Participation must be voluntary, and be free of coercion or pressure is questionable when it comes to children