It is hard to coordinate legal and public health protection of the public.

Especially when the public is inadequately educated and dominated by poor perceptions of relative risks.

I have been listening to a discussion of Paul Offit's book, The Cutter Incident: How America's First Polio Vaccine Led to the Growing Vaccine Crisis. The author and his discussants make a number of great points.

• Public health is a great investment that we underfund. As a society we should spend more on preventive measures of public health, even were that to mean we spend less on curative medicine.
• Vaccines have been a key means of prevention.
• The tort system makes companies pay for the victims of adverse effects of immunization but not for the adverse impacts of failure to immunize. The result has been a refusal of companies to manufacture a number of vaccines that could have important benefits to the public (that is, vaccines that would prevent many worse problems than they cause.)
• Juries and judges don't have the scientific expertise to make good judgments on causality of side effects of vaccines, and the adversarial process limits the information that is available to them.
• A change in the law which provided public funding for the victims of adverse effects of vaccines, but which placed the decision in the hands of scientificallty trained referees has done a lot of good, but the exceptions to its coverage leaves areas in which companies still refuse to supply useful vaccines.
• We need a good way to compensate the people who suffer from adverse effects of public health programs. We should see them as heroes, comparable to the soldiers who fall on grenades to save their buddies.
• There is an argument that liability law is intended to encourage good manufacturing practice by penalizing companies that produce defective products or that fail to adequately warn consumers, but that they are not good means of compensating the persons suffering from adverse effects of public health programs.
• Bad things happen. It makes little sense to compensate people who suffer adverse consequences of public health interventions when there would have been a lot more people suffering worse adverse consequences of failure to take those public health measures. Compare the situation in which 100 people suffer an adverse impact of a product where no one would have been affected had the product not been distributed, and the situation where 100 people are affected, but 1000 people would have been affected had there not been the product.
• The interesting example was of a patient in an emergency room who had 90 percent chance of dying without a drug, but a 50 percent chance of dying with the drug. Why would you require compensation to the people the drug did not save. If you did require that compensation, but did not require compensation for those who died without the drug, no one would provide the therapy. Yet clearly it is better to save 40 percent of the patients than not to do so.
  

I need to better understand the concept of "strict liability", its development in the legal system, and its policy implications.