The Eastern Health Board has acted with commendable speed in setting up an independent inquiry into the administration of the wrong booster vaccination to a group of children in Newbridge, Co Kildare, earlier this week. A full disclosure of the facts and the individuals involved in the case, is necessary to allay public concern at what seems, on the face of it, to have been a gross violation of trust. There must be no suspicion of cover up.
After the initial error was made, the first priority has been to ensure that the children did not suffer any harm from the use of the wrong vaccine and that their parents' totally understandable alarm and sense of grievance were dealt with fully and without holding back any relevant information. The steps taken by the EHB, as detailed by its director of public health, Dr Brian O'Herlihy, yesterday, may have removed any immediate reason for anxiety by anyone, helped by the fact that, as the days have passed, no serious adverse effect has been reported and all the children seem to be in good health.
But the parents and the public are entitled to ask whether the absence of damaging consequences has been the result, to some extent, of luck and if the three in one vaccination really is as innocuous as Dr O'Herlihy states. Can it be administered to all children in the age group concerned, with no contra indication? Including those who may have reacted against it when it was administered to them as babies? There is something very frightening about the inference that 66 doses were given without anyone noticing at any point that it was the wrong vaccine. Was there a possibility that an entirely inappropriate product could have been used without anyone bothering to check?
The report of the independent inquiry group will, no doubt, address these and similar issues, and the EHB has promised that it will also "review protocols to ensure that (such a case) cannot happen again". (It is disturbing that existing protocols did not prevent it from happening at all.) But the central issue has not been referred to by Dr O'Herlihy though it raises profound ethical questions: the parents of all 66 children had given their consent to the use of the two in one vaccine, and had refused to accept the vaccine that was actually given. That is a serious breach of confidence, violating a fundamental rule of medicine. Whatever the state of the protocols, nothing like that should have been remotely possible. Any routine administration of medicaments must include a check that the patient or a guardian agrees to its being used. The danger otherwise is that medicine becomes depersonalised.
There must also, until the full facts have been ascertained, be a suspicion that the commitment by the medical profession to the three in one vaccination may have overridden, in this case, the parents' right to decide. The tragic case of Kenneth Best will be in many minds, and whether or not the same risk is involved as when he received the vaccine in 1969, severely damaging his brain, it still remains the right of parents to choose, however much doctors may disagree with their choice, arguing the balance of statistics.
A mood of anger and outrage has developed in this State at the succession of blunders, incompetence and failure of those responsible at various levels of the public service and the legal system. While the Kildare case mercifully does not bear comparison with the hepatitis C scandal, it displays a casualness that might, in other circumstances, have been lethal.