Lack Of Planning Causes The Flu Shot Flop

Ocean County Observer

January 10, 1977

Now that the great Influenza Vaccine Program has “flu the coop,” and the swine flu program is dormant if not dead, it is appropriate to ask, “What went wrong?”

The decision to protect Americans from swine flu was correct. What was wrong, of course, was the manner and the timing of the program.

In the first place, the occurrence of a single case of swine flu does not herald an imminent epidemic. It does, however, herald a possible epidemic. The big question is, of course, when will the epidemic strike?

If flu vaccines afforded permanent protection, then the decision to immunize the nation had validity. But flu vaccines confer immunity for only a short period of time, possibly six months. Flu pandemics come in waves, the first mild, the second more severe, and the third usually lethal. Thus we might assume that swine flu is seeding itself around the world, and the pandemic might strike next winter – or the winter thereafter. Will there be enough vaccine to go around by then? Will there be enough eggs to make vaccine?

The program also suffered because it was beknighted with political overtones, and introduced to the public directly via the media, instead of being introduced via the medical profession. Thus every statistic became public knowledge, every illness in anybody receiving the vaccine was headlined, a scare tactic sure to frighten prospective inocules.

There were peculiar aspects of the vaccine that still haven’t been unraveled. For example, why was only one injection required for those over 25, and two for the younger age group? Surely adolescents have competent immune mechanisms. The fact that those over 25 years of age seemed more reactive to the vaccine suggests that this age group must have come in contact with swine flu in the past; that swine flu must have been endemic up until around 1950 – despite the fact that records suggest it disappeared in the 1930s. It is axiomatic that, to immunize against a new agent, at least two inoculations are required. It suggests that the agent against which the individual is being inoculated is not new, that the individual had been exposed to it some time in the past.

By going over the heads of the doctors, directly to the public, the doctor was by and large bereft of clinical experience with the vaccine, and thus could not answer questions about it or advise their patients properly. The doctor is only able to advise about matters with which he has had personal clinical experience. In the normal course of events, the doctor immunizes a certain number of patients yearly against a variety of diseases, and thus develops a feedback from patients when adverse effects occur. This forms the basis of an opinion which can be translated into advice to patients. By skipping over the doctor, the important feedback mechanism was eliminated; the government became the doctor and got scared by what is considered adverse publicity. Let this be a lesson to the government. It can’t be doctor to all the people all the time, perhaps not even any of the time.

Had the program been handled properly, the Communicable Disease Center and the Pharmaceutical companies would have decided to embark on a program to stockpile over a period of time vaccine against swine flu and A-Victoria, as well as its staple A and B vaccines. These could have been meted out to physicians when the need for them developed. If a serious collection of cases developed, or epidemic pockets were noted at various sites in the world, the stockpile could have been distributed in time to break the back of the lethal national epidemic.

Hopefully, the vaccine itself will survive, unscathed from this worthy program that became a political omelet, and that it will be available for distribution through proper medical channels when and if a pandemic develops.