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On Making Decisions -- Personal and Public
By Richmond Shreve, Posted by Richmond Shreve (about the submitter) Page 1 of 2 page(s)
For OpEdNews: Posted by Richmond Shreve - Writer
Yet others point to credible evidence that the effectiveness of flu
vaccination may be marginal and some go so far as to accuse the
vaccine makers of working a scam to enhance their profits.
Extreme groups oppose all vaccination programs for a host of reasons,
though their arguments are often grounded in wrong information and fear
mongering.
Various public figures have exploited the muddle to catapult themselves
into the headlines with outspoken opinions. Rush Limbaugh said bluntly
"screw you Miss Sebelius" underscoring his unwillingness to accept the
Health Secretary's urging
that everyone get vaccinated.
In the midst of all the emotion and controversy, how does one come to a
decision? This is one of those situations where inaction is itself a
decision.
The flu epidemic will advance regardless of what we decide
individually,
and not deciding ends in not getting a
vaccination before we are exposed.
My Decision Process
Business people often use models to alanyze important decisions. The
aim is to quantify
the elements that contribute to a rational decision and select a course
that has the best chance of a good outcome with acceptable risk.
Although these models may involve sophisticated statistical and
mathematical constructs, the principles are applicable to less
structured decision processes. The elements are these for a personal
decision:
By way of illustration. If I am thinking about buying a lottery
ticket, I know the odds of winning. My
downside risk is that I will likely not recover even the price of the
ticket, but that's no big deal -- I know I won't miss any meals. The
upside is that I could become fabulously wealthy overnight. Also there
is an
immediate gratification of enjoying that dream. It's not a tough
decision to make because the costs and risks are very low.
With the flu vaccine the analysis becomes more difficult. The
upside benefit is that by getting the shot I will make my immune system
better able to repel H1N1 infection should I be exposed. (We'll get to
the matter of confidence in these assumptions later.) There is also the
societal benefit that I will be helping to prevent the spread of the
virus to others.
The downside is that I may have some brief discomfort, and that
society (Medicare) will be charged for the vaccine. I may also be
exposing myself to risks of immediate adverse reactions and long term
side effects.
I place a lot of confidence in health officials, and having read
information from institutions I respect like Johns Hopkins and Mayo
Clinic, I'm 90% sure that a vaccination will give me a better chance of
avoiding Swine Flu. How much better is unclear. Also, I have received
the seasonal flu vaccine every year, including this year, with no
adverse reactions or other bad effects, and though I have had some
nasty colds, I haven't come down with a dangerous case of flu so far as
I know. The
H1N1 vaccine is made in the same way as the seasonal vaccine, so I
don't expect any new risks to emerge.
I don't place much confidence in the anti-vaccination information for a
number of reasons. Firstly, the institutions that I trust say that the
facts don't support claims that vaccines may cause autism, or that the
ingredients of the vaccine are potentially toxic. Second, I perceive a
conspicuous effort to make their case by denying or ignoring contrary
information -- they lack objectivity. But most persuasive to me is the
alarmist quality of their literature and their implicit distrust of
science.
It comes down to this: the down-side risks of getting the vaccine are
questionable and small, and the upside benefit, while of uncertain
size, is still the best defense available against a virus that, this
early in the season, is already causing serious illness
and death . My decision? I'm getting the vaccination as soon as it is
available to me.
Public Officials and Professionals
The decision process I describe here is one I have used with
considerable success in business for
most of my career. My decisions
have been low profile. The outcomes would not likely affect my standing
in my profession or the community. This is not true for public
officials or members of a mature profession. These people are
highly visible and accountable to their peers and the public. So there
is more at stake for the Secretary of Health and Human Services, or the
doctors at Hopkins or Mayo when they decide and recommend.
The downside of not recommending flu vaccination is the suffering and
deaths that might otherwise have been avoided. If people are vaccinated
and the vaccine proves
inadequate to quell the epidemic, the officials at least haven't failed
to
provide the best defense possible. But if they side with those against
vaccination and are wrong, people will have sufferd and died needlessly.
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