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This was followed by a note from the Secretary of HEW to the Director of the Budget in which he stated: There is evidence there will be a major flu epidemic this coming fall. The indication is that we will see a return of the 1918 flu virus that is the most virulent form of flu. In 1918 a half million people died. The projections are that this virus will kill one million Americans in 1976.
There was no basis in fact for these exaggerated predictions, but they put President Ford, who was seeking re-election, in an untenable position. He was given only two options, neither reasonable: either support a massive, unprecedented vaccination effort for a pandemic that never happened or reject the proposal with the (un- known) risk that a pandemic might occur. IF he chose the former, it might turn out to be a waste of time and money if a pandemic did not materialize; if he chose the latter, and a pandemic did occur, he would be a goat. He chose the former as the presumably safer alternative.
As the year progressed, there was never another case of influenza A/New Jersey/1976 identified in the U.S. Nevertheless, the program lurched forward. Mass immu- nizations were begun in October 1976. By December 16, some 40 million persons had been immunized. Also by December, there were reports of an unusually high incidence of Guillain-Barre syndrome among vaccinated
persons, 11 times higher than baseline, a risk not stated in the consent form created for the immunization program. The pandemic prediction was a false alarm and now people were being injured. The program was quickly suspended, never to be resumed. It was finally officially canceled by Sec. Califano in March 1977.
The mistakes and lessons learned are too numerous to delineate in full here. They take up a whole chapter of the book. To compare and contrast the events of 1976 with the current, necessary, mostly successful COVID-19 mass vaccination program, one in which the scientists were right and former president Trump and his minions were wrong, could be the basis for several PhD dissertations.
There were some benefits of the fiasco. Changes for the better emerged in three broad, interlocking domains: A national commission on immunization policy was formed; clarity, and an expansion of the federal role, in liability assignment for immunizations was achieved; and an expanded role for the federal government in influenza immunization was defined.
For those who are interested, The Swine Flu Affair: Decision-Making for a Slippery Disease, can be download- ed for free from the Natio•nal Academies Press. I recom- mend having a look at it.
Volume 73 • Number 4 Washtenaw County Medical Society BULLETIN 9