By Peter Chow
In January 1976, several soldiers at Fort Dix, New Jersey, complained of a respiratory illness diagnosed as influenza.
Private David Lewis, 18, had flu symptoms and, although he was allowed to stay in the quarters for 48 hours, loaded his 50-pound bag and joined his platoon for a forced march. 5 miles all night in the bitter winter of New Jersey.
After a few hours, he collapsed. He died just hours after arriving at the base hospital.
You will never know for sure if he died because he was infected with a particularly deadly and virulent strain of influenza, or if he died because he made a forced march during the night in winter while in full viremia with a moderately dangerous strain of influenza. .
It is extremely rare for a healthy adolescent to die from the flu. However, a feature of the Great Influenza Pandemic of 1918 was the spectacular ability of the virus to kill young adults.
The New Jersey Department of Health tested samples of soldiers from Fort Dix. The majority of the samples were from the most common influenza A / Victoria / 75 strain, A / H3N2 influenza, which was the most common influenza strain in the world in January 1976.
But two were not, including Private Lewis’ samples. The atypical samples were sent to the Centers for Disease Control in Atlanta, Georgia, who found evidence of H1N1 A swine flu, dubbed influenza A / New Jersey / H1N1 and antigenically closely linked to the 1918 influenza pandemic. has killed 50 million people worldwide.
Finally, 155 cases of H1N1 flu were discovered at Fort Dix. All American healthcare facilities were eagerly awaiting signs of a further massive spread.
The consequences of denying the possibility that Private Lewis’ death was the harbinger of an epidemic similar to that of 1918-1919, and then of seeing such a devastating event grab the country unprepared, were simply too dire. The CDC has rightly been overwhelmed by fear of seeing hundreds of thousands of deaths attributed to health officials who had chosen to take a wait-and-see approach.
The Center for Disease Control verified the results and informed the World Health Organization. On February 13, the CDC sent a memo detailing the evidence of a swine flu epidemic and calling for mass vaccination, asking for $ 135 million for the development and distribution of a vaccine.
President Gerald Ford was officially informed of the epidemic and the proposed vaccination program on March 15. He met with a “blue ribbon” panel that included the inventors of the polio vaccine Jonas Salk and Albert Sabin. Ford then made a television announcement in support of the mass vaccination program.
Congress had no choice but to support the president. A bill approving $ 135 million for the swine flu vaccination program was passed on April 5.
By signing the bill, Ford abandoned any pretense of doubt or conjecture, claiming that the Fort Dix virus “was the cause of a pandemic in 1918 and 1919 that killed more than half a million people. United States “.
For several months, the four pharmaceutical companies that developed the vaccine – Merck’s Sharp & Dohme, Merrell, Wyeth and Parke-Davis – refused to sell the vaccine they had manufactured to the government until they received compensation of full responsibility and guaranteed profit.
Congress ended up passing a bill that guaranteed their profits and officially waived corporate responsibility for swine flu vaccines.
Merck made the first shipment of vaccines to state health services before September 22. The first swine flu inoculations were given at the Indiana State Fair.
The president and his family were vaccinated in front of television cameras.
Then, at the end of November, cases of Guillain-Barré syndrome affecting vaccinated patients were reported in several states.
Guillain-Barré syndrome (GBS) is a rare muscle weakness, generally reversible, sometimes fatal, with rapid onset caused by the immune system damaging the peripheral nervous system. The initial symptoms are usually changes in sensation or pain accompanied by muscle weakness, beginning in the feet and hands, often extending to the arms and upper body, with both sides involved. Symptoms can develop over several hours to a few weeks. During the acute phase, the disorder can be life-threatening, with around 15% of people developing weakness of the respiratory muscles and, therefore, requiring mechanical ventilation. Some are affected by changes in the function of the autonomic nervous system, which can lead to dangerous abnormalities in heart rate and blood pressure.
The underlying cause is an autoimmune disease in which the body’s immune system mistakenly attacks the peripheral nerves and damages their myelin isolation. Sometimes this immune dysfunction is triggered by an infection and rarely by vaccination.
New cases of Guillain-Barré were reported in early December and the investigation into these cases has spanned eleven states. On December 16, a suspension of the vaccination program was announced by the CDC. The CDC estimated that the incidence of Guillain-Barré was four times higher in those vaccinated than in those not receiving the swine flu vaccine.
Of the 45 million people vaccinated against swine flu in 1976, 450 people developed Guillain-Barré syndrome, a prevalence of 1 in 100,000.
The vaccination program was over. H1N1 never appeared. December 1976 was notable for the absence of an influenza epidemic.
Lawyers have flooded the U.S. Attorney General’s Office with claims on behalf of clients alleging damage of any kind as a result of the swine flu vaccine. 4,181 applications were filed for a total of $ 3.2 billion. After a decade and a half, the government would settle 393 claims for $ 37,789,000. An additional 1,605 cases would be referred to the courts, 110 resulting in judgments against the federal government for a total of $ 47,693,000.
In the end, the United States government paid over $ 100 million in taxpayer dollars to applicants for the swine flu vaccine.
The 1976 swine flu debacle created a precedent that would haunt all immunization efforts in the United States for decades and shake the confidence of vaccine manufacturers and their insurers, not only for their American markets, but for worldwide. Most pharmaceutical companies have completely abandoned vaccine production, leaving only four companies involved in vaccine production.
However, the swine flu case does not tell us whether, in the face of scientific uncertainty, it is better to favor caution or aggressive intervention.
The deterrent effect of this tsunami of swine flu vaccination litigation prevented the federal government from purchasing mass vaccination for decades to come.
There was no national program in 2009 when another H1N1 swine flu virus A became pandemic and infected approximately 60 million Americans and killed 12,469 people. Instead, the Food and Drug Administration approved four vaccines that were biological cousins of existing influenza inoculations. They were widely distributed to the groups most at risk, but were less effective for adults than for children.
Much of the American public’s reluctance to adopt vaccines – the flu vaccine in particular – can be attributed to the lasting effects of the failed 1976 campaign to massively vaccinate the public against a strain of the swine flu virus. . This government-led campaign was a debacle that put an irreparable dent in future public health initiatives, while contributing to public skepticism about influenza vaccination and vaccines in general.
The world is racing to develop a vaccine for Covid-19. Efficacy and safety are paramount and must be firmly established before the start of mass vaccination.
It may not be as quick and easy as people think.
The legacy of public health from the 1976 swine flu outbreak …
Sep 30, 2013
The shadow of the 1976 swine flu vaccine “Fiasco …
Feb 6, 2017
Reflections on the 1976 Swine Flu Vaccination Program – CDC
Feb 16, 2012
1976 swine flu: lessons from the past – WHO