Political Sapphire: Shades of Tuskegee?


Realizing that everyone (myself included) is still reeling about Bush's "throw down the gauntlet on our democracy" moment yesterday, this one deserves our some of our attention nonetheless.

In today's Chicago Sun Times was printed this rather understated health news:

In an isolation ward of a Baltimore hospital, up to 30 volunteers will participate this April in a bold experiment: A vaccine made with a live version of the most notorious bird flu will be sprayed into their noses.

I think we need to parse this article just a bit.

Step One: The easy part is parsing the phrase "most notorious bird flu"? There is no confusion about this one: the "most notorious" bird flu is H5N1, the avian flu strain that has earned the fear and loathing of not only much of the Asian Peninsula but even landed on American policians' radar because of the fears of a pandemic rivaling the lethal Spanish Flu Pandemic of 1918-1920, which is reported to have killed between 20 and 50 million people worldwide, depending on whose numbers you go with.

Step Two: The NIH lead scientist supervising this clinical trial describes this upcoming trial as "high risk, high reward" and says that it has the potential to lead to information that will save tens of thousands of lives.

OK, there are two ways to interpret the "high risk" part (the high reward part seems clearly explained.) The first is that this is a "high risk" experiment because this type of experiment has never been tried before so the hypothesis (i.e. nasal spray delivery of live virii is an effective method of developing anti bird-flu antibodies") is high-risk, i.e. meaning high likelihood that it will be disproven. But that interpretation is debunked by the article itself - the article says that this type of delivery system has had a high success rate in other contexts.

So the most likely meaning is the other one: this experiment is "high risk" for its subjects. As in "the subjects people have a very high risk of problems arising from this experiment, even if we learn lots about HN51 nasal vaccines that can help lots of others".

Given this, why is that same article repeatedly trying to reassure us with the words "It should be safe"? If it's safe, it is a low-risk experiment, right? The use of the words "high risk" make no sense.

Not until you think about the Tuskegee Syphilis Study, anyhow.

Political Sapphire: Shades of Tuskegee?


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