Lessons From 1976 Flu Vaccinations

Thirty-three years ago, the U.S. launched an unprecedented effort to fend off a swine flu epidemic by vaccinating every person. The program was eventually halted when the flu failed to materialize and the vaccine itself was linked to harmful side-effects.

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A generation ago, another swine flu scare prompted an unprecedented effort to vaccinate virtually everyone in America. The campaign eventually came to be seen by some as a dangerous over reaction. That particular strain of flu virus never grew into a pandemic, but harmful side effects from the vaccine did appear.

NPR's Scott Horsley reports on the lessons of 1976.

SCOTT HORSLEY: It began in February with one dead soldier. Eighteen-year-old David Lewis collapsed in the middle of a five-mile training hike at Fort Dix, New Jersey. When tests revealed that Lewis had swine flu, it made national news.

(Soundbite of a news archive)

Unidentified Man: The rare and deadly flu strain called swine flu killed an Army recruit at Fort Dix, New Jersey. When tests revealed that Lewis had swine flu, it made national news.

Unidentified Man: The rare and deadly flu strain called swine flu killed an army recruit at Fort Dix, New Jersey, and infected three others. This is the same strain that is believed responsible for 20 million worldwide flu deaths in 1918.

HORSLEY: The specter of that 1918 epidemic haunted scientists at the Centers for Disease Control, like Phillip Gratzer(ph). They were afraid of what might happen if a novel virus hit a population with little or no immunity.

Mr. PHILLIP GRATZER: Some of my relatives had died in the 1918 influenza outbreak, and my mother and father always told me their stories. And that's what really drugged the CDC at that time to make a calculated decision of let's be prepared.

HORSLEY: Then, as now, the outbreak occurred at the end of one flu season. And scientists believed if they hurried, there might be time to protect the public before the next flu season began the following winter. Within weeks, their audacious recommendation was approved by President Gerald Ford.

President GERALD FORD: I am asking the Congress to appropriate $135 million prior to their April recess for the production of sufficient vaccine to inoculate every man, woman and child in the United States.

HORSLEY: It was a massive undertaking. Shots began in October, and within two and a half months, 40 million Americans had been vaccinated against swine flu, including a smiling President Ford.

Pres. FORD: Let me state clearly at this time: No one knows exactly how serious this threat could be. Nevertheless, we cannot afford to take a chance with the health of our nation.

HORSLEY: And yet, the government was taking a chance. The feared swine flu epidemic never materialized, but the vaccine became linked to a rare nerve disorder called Guillain-Barre syndrome.

By December of '76, it appeared the flu shot posed a bigger threat than the flu itself, and red-faced officials halted the vaccination program.

Harvey Fineberg, who co-authored an official review of the episode, says one lesson is not to act prematurely. Fineberg also says policymakers should insist that scientists estimate the likelihood of different events, not settle for a vague but ominous warning.

Dr. HARVEY FINEBERG (President, Institute of Medicine): The scientists that said an epidemic is possible could always say it was possible, even when it went from being 10 percent possible to be one in a million possible.

HORSLEY: The '76 flu scare is now taught as a case study in government and public health courses. But like most case studies, its lessons are not entirely clear cut.

Michael Hattwick, who ran the CDC's flu tracking center at the time, says while much of it was done looks unnecessary, in hindsight, at the time, it seemed courageous.

Dr. MICHAEL HATTWICK: There was always the fear of doing too little. I think this time, there'll be more fear about doing too much and that may be a lesson we learned from '76.

HORSLEY: For flu researchers, 1976 has become a cautionary counterpoint to 1918. Both call for a certain humility in the face of a Wiley(ph) and unpredictable virus.

Scott Horsley, NPR News, Washington.

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