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The Free Market and Vaccines, Part 2

Dr. Marc regularly answers readers' questions on matters relating to medicine, healthcare and politics. To send a query, click here.

Dr. Marc Siegel

February 3, 2005

In reference to Margaret, who is 70 and resides in Pennsylvania, and her smallpox vaccine at 6: Do you really think that vaccines are uniformly helpful, even with so much controversy about their use and purpose? I have read that the flu vaccine, for example, does not even deter the flu.The vaccine itself is loaded with metals such as mercury and aluminum. One shot, not too bad; two shots, not too bad; but what of the user who has had shots year in and year out? Isn’t a good healthy diet, excercise and a positive outlook on life all that is needed to stay healthy? What are the benefits of the vaccines available to us and what are their downsides as well?

Dr. Marc regularly answers readers' questions on matters relating to medicine, healthcare and politics. To send a query, click here.

BOB LYNCH JR. Medford, NY

Dear Bob,

I do think we use vaccines to treat fear as much as actual disease, and then we become too afraid of our vaccines. I do think the uses of these vaccines can be exaggerated, as surely the smallpox vaccine has no use whatsoever right now. But flu vaccine is 40 to 60 percent effective, and that’s nothing to “sneeze at,” especially in high risk groups.

In my view, pharmaceutical drugs are a leading cause of death in the US today, and have been for several years now. If you doubt this or have any questions about this statement, I can supply all of the evidence necessary to convince you. In almost sixty-five years of life, I have yet to know of a drug that has ever cured anything!

J.F. GALBRAITH JR. Mahopac, NY

Dear J.F.,

Many prescription drugs are more dangerous than we realize, while with others we are manipulated to panic. I have seen the benefits of these drugs first hand, but I have also seen their abuses. They have saved lives, and they have also taken lives. We need a balance, more sense, a greater perspective, more vigilance, more independence from drug companies, a ban on direct-to-consumer advertising, an ability to negotiate prices and more FDA independence from drug companies’ pockets. I do not agree with you that prescription drugs, on balance, cause more harm than good. But please do send me the information. I will gladly share it with my readers.

The state government here in Massachusetts has commandeered all the flu vaccine in the state and is deciding who will get it. There is none available other than through them. And since I don’t meet their guidelines (but think I need it anyway), I’m obviously upset at this level of government involvement in the process.

RICHARD WATERHOUSE Lowell, MA

Dear Richard,

By now the state may have freed up some supply for you–the problem is ultimately one of distribution. Too much flu vaccine in corporate offices and supermarkets, not enough for people outside of those environments who really need it. The purpose of more government involvement is to ensure that 100 million doses are fairly distributed. And let’s face it, without guaranteed purchases, drug companies aren’t going to make enough of a generic product that’s very expensive to manufacture because of sterilization procedures. So I’d argue that, on sum, government involvement in this process isn’t all bad.

Why has there been such alarm at the lack of sufficient flu vaccine supplies? I remember a time when there were no flu vaccines at all and no one panicked. I also know that many people die each year from the flu even with the vaccine, and I also know that those at greatest risk are the elderly or immuno-deficient people, which does not include the majority of the population. If we can still get the flu with the vaccine and if those that really need the vaccine are a minority, why is there such a panic?

PAUL KOLECKI New York, NY

Dear Paul,

The panic has diminished, which only proves how ludicrous it was in the first place. The flu vaccine is useful, and somewhat protective, but not a panacea, and not worth the worry when it’s not widely available. In fact, I know a 90-year-old woman in Austria who not only doesn’t believe in flu shots but believes in fresh air and cold showers even in the heart of winter. Now I believe in flu shots, but I believe in her methods too.

In exactly what industry does government manufacture a quality inexpensive product or offer a cost-effective service? The drug (and vaccines) market is messed up. The patient typically doesn’t care what a drug costs. When a drug leaves the prescription market and enters the consumer market, the prices drop considerably.

THOMAS ERB Baltimore, MD

Dear Thomas,

I’m not exactly sure what your point is, but I think it’s basically that government involvement in the drug distribution and manufacturing process is a problem. Yes, the drug and flu vaccine market is messed up. But this is mostly because private enterprise dictates prices and supply, not the government. I believe that the public has the right to negotiate for lower prices by bulk buying through the 40-plus-million Medicare cohort. I also believe the government must play a much larger role in flu vaccine manufacture and delivery because of an issue of public need. I’m not sure what that will do to the cost of vaccines, but I seriously doubt it will raise the price.

Dr. Marc SiegelDr. Marc Siegel is a practicing internist and an associate professor of medicine and a fellow in the Master Scholars Society at New York University School of Medicine. He is a weekly columnist for the New York Daily News, a frequent contributor to the Los Angeles Times, the Washington Post and The Nation. He is a member of the board of contributors at USA Today. He appears frequently on CNN, the Fox News Channel, and the NBC Today Show. He is the author of False Alarm: the Truth About the Epidemic of Fear and most recently, Bird Flu: Everything You Need to Know about the Next Pandemic (Wiley).


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