Ethical aspects of vaccination.

Vaccination has become a universal medical intervention. The yearly number of vaccinations is estimated to be more than one billion. However, vaccinat ion is still too often poorly administered, representing an inadmissible da nger, or not done at all, even when the risk justifies its use. Vaccination is a veritable medical treatment for healthy individuals (mainly children) , falling within the scope of legal obligation. Above all, it must not run a risk to the immunized subject. However, actions other than the use of the product termed 'vaccine' are involved in the vaccination procedure. Though manufacturing and monitoring of vaccine production are very carefully done , packaging, shipping and stocking must conform to the prerequisites of qua lity. Vaccination safety also results from the proper administration of vac cines. However, post-vaccination surveillance has revealed dangerous practi ces, notably the use of non-sterile material in the administration of injec tions. The consequences are sometimes devastating. It is absolutely necessa ry, therefore, to urgently investigate ways to limit and eliminate this ris k, and to assure the proper use of vaccines. A further worry is the decisio n that vaccination will not be introduced when in fact epidemiological cond itions require it. When a vaccine does exist, the decision to not vaccinate even when an epidemic is threatening is a public health error, as numerous are the examples of epidemics of meningitis and yellow fever could have be en avoided.