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Grancey · 04-27-2009, 08:29 AM

When I heard the reports of this last week, it brought back memories of 1976 when my father and I stood in line at our local shopping mall to receive the Swine Flu vaccine. It was a scary time then and a scary time now. This is a link to an article concerning the 1976 scare. It is quite interesting if you don't know anything about it. (My father and I suffered no negative results of taking the vaccine)

Medical News: Is This Swine Flu a Case of Déjà Vu?

Quote:

BALTIMORE, April 26 -- Before public health officials rush into a large-scale vaccination program, they will undoubtedly look at lessons learned from the last public campaign against swine flu.

That began in February of 1976, in the heat of a presidential primary, when a 19-year-old Army recruit at Fort Dix, N.J., suddenly took ill and died.

Four other soldiers were soon hospitalized, and within two weeks, Army doctors said they were looking at an outbreak of swine flu.

At the time, epidemiologists believed that a related strain of swine flu had been responsible for the great "Spanish Flu" pandemic of 1918-20, which killed more than half a million Americans and at least 20 million worldwide.

That's not so clear today. A recent genetic reconstruction of the 1918 virus by a team of public and private researchers suggests that it was a strain that never actually passed through swine but jumped directly from birds to humans.

The nation's response was a hasty but ambitious inoculation program with the unprecedented goal of reaching the entire population.

In the end, only 24% of Americans actually got swine flu shots before embarrassed public health officials called a halt to the campaign.

One reason was that the swine flu pandemic they had feared never materialized.

Another was a problem with the vaccine, which was linked to some 500 cases of Guillain-Barré syndrome and at least 25 related deaths from pulmonary complications.

Although most agree that it was a public relations disaster, health historians still debate the merits of the 1976 swine flu vaccination campaign.

Critics call it one of the worst medical boondoggles in modern history. Defenders say it's a classic case of aggressive public health mobilization that saved the nation from a modern plague.

The 1976 public outcry over swine flu spread slowly at first, but gained traction after it appeared that 200 or more soldiers at Fort Dix had come down with flu-like symptoms, although most of the cases were mild.

According to a 2005 review by David Sencer, M.D., M.P.H., who was director of CDC at the time, and J. Donald Millar, M.D., D.T.P.H., who directed the swine flu vaccination program and later became Director of the National Institute of Occupational Safety and Health, most isolates from the infected soldiers turned out to be the seasonal flu strain current at the time, A/Victoria/75 (H3N2).

But Sencer and Millar recalled that two samples were more mysterious, and the CDC laboratory subsequently identified them as "A/New Jersey/76 (Hsw1N1), similar to the virus of the 1918 pandemic and better known as 'swine flu.' " (See Reflections on the 1976 Swine Flu Vaccination Program)

Timing was an issue. Flu pandemics were appearing roughly every 11 years, and scientists believed that it took about 50 years for a particular flu strain to recycle itself.

That would make the late 1970s a perfect time for a renewed assault by the 1918 strain.

On the upside, with the North American flu season almost over, drug manufacturers were still in a position to produce new batches of vaccine fairly quickly, and the H1N1 strain was already included in vaccines designed for the military.

Worried about the potential for a serious outbreak during the next flu season, especially since no one in the population under the age of 50 had residual antibodies to the H1N1 strain, the CDC and other public health agencies recommended a massive public vaccination program.

Congress agreed to spend $137 million for the vaccine.

Another prominent player was President Gerald R. Ford, who had assumed office in 1974 on the resignation of Richard M. Nixon and was engaged in a tough primary for the full-term Republican nomination.

Ford made a point of pushing for the program. His public inoculation was designed to convince Americans that it was important to get a flu shot -- and, according to political historians -- convince the party that he was the leader they wanted.

But the National Influenza Immunization Program ran into trouble almost immediately. First, the pharmaceutical manufacturers refused to produce the vaccine unless Congress gave them immunity from liability from lawsuits involving adverse reactions.

"While the manufacturers' ultimatum reflected the trend of increased litigiousness in American society, its unintended, unmistakable subliminal message blared, 'There's something wrong with this vaccine,' " Sencer and Millar recalled.

"This public misperception, warranted or not, ensured that every coincidental health event that occurred in the wake of the swine flu shot would be scrutinized and attributed to the vaccine," they wrote.

There were a variety of startup problems, too. One was a miscalculation that resulted in doses that were only half the strength that the manufacturers expected, leading to early shortages.

Then, when the immunization program began, it became clear that the vaccine was not as effective in children as in adults. So they required two doses, leading to further shortages.

Meanwhile, three elderly patients in Pennsylvania died after receiving the vaccine. Headlines across the country screamed the fact. Although their deaths were never tied to the vaccinations, the publicity further undermined public confidence in the program.

More damning were reports of Guillain-Barré Syndrome (GBS), which is relatively rare in the general population but 10 times more prevalent among those who received the swine flu vaccine -- particularly those whose immune systems may have already been compromised.

By December 1976, when 40 million Americans has received swine flu inoculations, there was no evidence that the strain would turn into a pandemic. In fact, it virtually disappeared. With public support evaporating, the government called off the immunization campaign.

Critics say the program was too hasty and ill conceived -- and that it ultimately undermined the public's confidence in the nation's public health apparatus.

But Sencer and Millar, who were in the thick of the fight, said they had no regrets.

"When lives are at stake, it is better to err on the side of overreaction than underreaction," they wrote. "Because of the unpredictability of influenza, responsible public health leaders must be willing to take risks on behalf of the public."

Wash your hands. Be diligent. Officials are saying they won't know until Friday how this is really going to effect us.