The following article was published in Israel’s Ha’aretz newspaper several weeks ago. Note the part highlighted in yellow and draw your own conclusions… oddly enough, the issue of an ethical dilemma is not mentioned in later articles on the subject…
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July 31st 2013
By Dan Even
The Health Ministry is preparing for a campaign to inoculate children in the south of Israel with a live attenuated vaccine against polio, in light of the continued spread of the disease through the region’s sewage systems. However, a final decision will only be made this weekend and announced on Sunday.
The new inoculations would be on top of the regular polio shots given to all children at 2 months, 4 months, 6 months and 12 months, and then again in second grade. Those shots contain the dead polio virus.
As Haaretz reported three weeks ago, any decision to revaccinate children with a live-virus vaccine involves an ethical dilemma, since the goal isn’t to protect the children themselves as they are already protected by the dead-virus vaccine. Rather, the goal would be to protect those around them, and especially their parents and other relatives. The live attenuated virus will commonly spread to other people, and thus inoculate them as well.
Revaccination involves virtually no risk that the children themselves will contract polio, with only one known case of a child who contracted polio from a live-virus vaccine after previously being inoculated with the dead-virus version.
Until 2005, Israel regularly vaccinated children with the live attenuated virus, which is administered orally. But in exceptional cases, the live attenuated virus can cause polio in other people who contract it from the inoculated child, especially if they already have weakened immune systems – for instance, because they are seriously ill.
This is why the Health Ministry ultimately stopped the practice, and one reason why it is still weighing the benefits of a new inoculation campaign.
To reduce the potential risks, the ministry has ordered drops containing only two strains of attenuated polio virus, rather than the three contained in the drops used until 2005.
The ministry said it is currently consulting with leading experts in the field, including senior pediatricians and family doctors, as well as public figures and officials from the affected municipalities, on whether to launch the campaign.
Meanwhile, it is continuing to collect stool samples from residents of the south in order to assess the spread of the disease. Thus far, it has collected 2,300 samples, from which it has identified seven Israelis who definitely carry the virus and 10 suspected carriers. However, none of them have come down with active polio.
Israel hasn’t had an active polio case since 1988, when 15 people came down with the disease, mostly in Hadera and Or Akiva. All suffered some degree of paralysis.
The current polio outbreak began in late May. The virus was first detected in the sewers of the Bedouin town of Rahat in the Negev. It later spread to the sewage systems of several other southern towns, including Be’er Sheva and Ashdod.
Over the past month, it has also spread to several towns in central Israel, including Ramle, Lod and Modi’in. The Health Ministry thinks the disease arrived from Egypt.
The ministry believes the fact that no active polio cases have yet occurred, despite the spread of the disease, is because such a high percentage of the population has been vaccinated against polio – an estimated 94 to 95 percent.
Worldwide, only five countries are known to have people with active polio. In three of them, Pakistan, Afghanistan and Nigeria, the disease is considered endemic, while in the other two, Somalia and Kenya, only a few isolated cases have been identified since the start of 2013. Should anyone here come down with an active case of the disease, Israel would join this dubious list.