25375 The Importance of Trust In the Vaccine Safety Enterprise

Tuesday, March 29, 2011
Columbia Hall
Thomas May, PhD , Associate Professor of Bioethics, Medical College of Wisconsin

Background:  The importance of trust is well known and often discussed in the healthcare literature, most visibly in the context of the Physician-Patient Relationship, where its importance has been emphasized for decades.  Just as well known, though less visibly discussed, is the importance of trust in the vaccine enterprise.  This is unfortunate, as the effects of lack of trust are even more directly tangible, and the challenge of establishing trust more difficult than in acute care medicine.  I will examine the challenges of establishing trust in the vaccine enterprise, and will argue that the importance of establishing trust requires that we separate the concern with safety from other purposes and aspirations in the vaccine enterprise.

Setting: I will examine the different aspects of trust in the acute and public health settings. 


Project Description:  Vaccination represents a much less conducive circumstance for establishing trust:  allowing oneself to be injected with an attenuated version of a disease in order to cause an immunological reaction where there are no imminent related health problems, requires a greater level of trust than does allowing intervention in circumstances of imminent need. The type of trust necessary for successful vaccination programs is trust in the vaccine safety process, a process which must be seen to be aimed toward a concern with safety at an individual level.

Results/Lessons Learned:  The vaccine safety system must – and the public must believe it to – be independent of vaccine promotion.  Only by establishing that the vaccine safety system has as its goal the accurate assessment of risks independent of the effect this might have on vaccine coverage rates can the trust necessary be engendered.