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Vaccines and Lotteries: Part II

Vaccines and Lotteries: Part II

In a previous article I talked about how vaccine recipients are in a sense playing a lottery. Most individual receiving a vaccine will benefit, but a few will not mount an adequate immune response and the vaccine will fail. The vaccine lottery, however, has a lot of winners and only a few losers, unlike the Powerball lottery. The only consistent winners in the Powerball lottery are the state governments who win with every ticket sold!

What if you were the lottery's primary beneficiary? Let’s pretend a federal lottery is begun with all profit (several billion dollars per year) to be allocated to the NIH to spend as they see fit. Assume you are in charge of the NIH with the power to distribute these funds for research. You decide to focus the funding from this windfall in a single area—influenza. Following is a list of options for that area prepared for you by your staff. Which do you think would provide the most benefit?  There’s no single “correct” answer here, but in my opinion, some choices are better than others.

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Imaginary Influenza Programs to Receive Federal Lottery Payout

A. Influenza remains a huge problem for the US with tens of thousands of excess deaths per year, mostly in the over-65-years-of-age cohort. You will use the funding to boost the influenza vaccination rate in this age group with advertising, free home visits, vaccine clinics in retirement areas, etc. You will also mandate use of the “high-dose” vaccine which has been documented to be more effective than the regular flu shot.

B. The efficacy of the influenza vaccine leaves a lot to be desired. You decide to fund research into a better vaccine. Your staff is confident it can get the efficacy up to perhaps 90%.

C. Data from Japan and the US suggest that children are the primary vectors of influenza, giving it to each other at school and then bringing flu home and transmitting it to parents and grandparents. You will use the funding to start an in-school vaccination program. Your staff assures you that the political climate is right for making flu vaccine a required vaccine for school attendance. More than 95% of children would get vaccinated with this option.

For answer and discussion, please click here.

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