The Supreme Court of the United States heard arguments in a very interesting case concerning health care on Tuesday.  This case has nothing to do with President Obama’s new health care plan, but is nonetheless important.  The case centers on the very specific question of whether a 1986 law establishing a no-fault compensation system for injuries resulting from vaccines limits the avenues of litigation for such claims; the implications, however, reach far beyond and could have a drastic impact on the health of the nation.

The parents of Hannah Bruesewitz brought the case before the court.  The now 18-year-old Hannah suffered seizures and subsequent developmental issues beginning shortly after receiving the DTP vaccine, which protects against diphtheria, tetanus and whooping cough, when she was six months old.  Her parents believe the seizures were complications from the vaccine and that the vaccine manufacturer was aware of the dangers but kept a safer version of the vaccine off the market to increase profitability.  Their claim was first brought before the so-called Vaccine Court, the body established under the 1986 federal law, where it was dismissed.  The Bruesewitz family brought the case before lower courts which also dismissed the case, all of them ruling that Congress set forth a specific means for litigating vaccine injuries cases through the Vaccine Court.

In arguments that were presented and then tested by the justices, a central theme emerged: protection of the population through viable vaccines.  Counsel for the Bruesewitz family argued that the vaccine law simply set forth one means of pursuing damages from manufactures while leaving the door open to other litigation in state courts.  Mr. Bruesewitz says he isn’t looking to punish Wyeth Pharmaceutical, the manufacturer at the time that has since been bought by Pfizer; rather, he hopes to increase the threat of litigation in order to encourage the pharmaceutical companies to produce safer vaccines.

Pfizer also argued for public safety, but from a completely different angle.  The argument they presented before the court was that allowing such cases to proceed in state courts would have a severe economic impact on the vaccine manufacturers as they would have to defend numerous such cases every year.  They further stated that such suits held the potential of driving pharmaceutical companies out of the vaccine market due to increased risk and legal fees.  This decline in the number of producers would not only affect the amount of vaccines made each year, but would also limit the amount of research that could be done on future vaccines.

The court could come down on either side of the issue, but the arguments presented to the justices by Pfizer raise two valid points about American health care.  The first is that we rely on vaccine manufacturers to produce the needed vaccines for the population today and to develop the vaccines that will be needed in the future.  Added costs — and these could be quite high even if only a few cases go against the companies — increase the burden on the producers and could very easily drive some out of the market.  The effect this has on our public health is obvious and direct: Fewer producers mean fewer vaccines and that leads to more illness.

The second danger comes from many of the cases waiting to go before state courts and the “anti-vaccination” climate associated with them.  A large number of these cases claim vaccines caused autism in children.  These cases routinely come before the Vaccine Court only to be dismissed for lack of any strong scientific evidence to support such claims.  Despite the lack of scientific evidence, this “anti-vax” notion is gaining support.  Unfortunately, such beliefs can have tragic consequences.  California has been at the center of the wave forsaking vaccines, but this year it has experienced an outbreak of whooping cough affecting over 5,200 children — a magnitude not seen since 1950.  Michigan has also seen a drastic increase in whooping cough with over 600 children affected.

These two dangers are actually closely related.  As a society, we depend on what is called herd immunity.  If most of the people in community are immune to a disease, then the odds of someone in that community — even if they are not immune — are greatly decreased.  As people stop getting vaccinated, the overall immunity of the group goes down and the risk soars.  This is particularly dangerous for the very young and very old in societies who possess weaker immune systems to fight off ailments they do contract.

Sickness is never a pleasant thing, but if it could be avoided in the first place, it is truly tragic.  When people choose to ignore medical research in favor of unsupported theories about the dangers of vaccines, they put more than themselves at risk.  Similarly, an undue economic burden preventing adequate availability of vaccines severely endangers the public well-being. Vaccinations, as unpleasant as they might be, must continue to be the norm in the United States.