The Feds are apparently planning a mass inoculation drive to vaccinate people against the Swine Flu. From the story:
Government health officials are mobilizing to launch a massive swine flu vaccination campaign this fall that is unprecedented in its scope — and in the potential for complications. The campaign aims to vaccinate at least half the country’s population within months. Although more people have been inoculated against diseases such as smallpox and polio over a period of years, the United States has never tried to immunize so many so quickly. But even as scientists rush to test the vaccine to ensure it is safe and effective, the campaign is lagging. Officials say only about a third as much vaccine as they had been expecting by mid-October is likely to arrive by then, when a new wave of infections could be peaking. Among the unknowns: how many shots people will need, what the correct dosage should be, and how to avoid confusing the public with an overlapping effort to combat the regular seasonal flu.
I am sympathetic to the need to be prepared, and understand the impetus, but this doesn’t sound good at all. I’m old enough to remember the Gerald Ford Swine Flu inoculation debacle. It helped ruin his presidency. and as I recall, caused much more harm–hundreds of cases of Guillain-Barre Syndrome, including some deaths–than good. The current Swine Flu doesn’t seem to be especially virulent or particularly dangerous–so far–and if that is true (someone, please correct me if I am wrong), I wonder if it is worth the resources and the potential to interfere with normal flu shots to roll out a huge inoculation campaign for which we are not really prepared.
These days, policy is too often driven by a tabloid sensationalism. The Swine Flu has reached the pandemic stage. There are certainly things we can and should all do regardless of inoculations to prevent infection. But this rush-rush and seeming panic makes me think of the botched Fed/State/Local response to Hurricane Katrina; not enough planning, not enough resources, etc. I hope I am wrong, but the poorly administered little “Cash for Clunkers” program doesn’t give me any cause for confidence.
August 23rd, 2009 | 8:46 pm
I know at least one person who was a confirmed case. It may not be (normally) fatal but it’s very nasty, and very contagious, and with school starting up there will be ample opportunity for contagion.
The CDC et al may feel compelled to push this a bit harder due to the influence of the anti-vaccine “activists,” most often seen via that bastion of rational medical knowledge, Oprah. Now THERE is some fertile ground for you, Wes. What are the bioethical ramifications of refusing to have your child vaccinated and then sending that kid out into the public?
August 23rd, 2009 | 11:02 pm
From a reader: “I am by no means an expert (or even close to being one) on the H1N1 virus, but I have been following the news pretty carefully and trying to learn as much as I can. I agree with you that the federal government doesn’t have a great track record in coordinating and implementing massive services for the people, however, in the case of this particular strain of flu virus, anything they do in the way of vaccination might be better than nothing. Because H1N1 is a new strain, never before seen, no one has any immunities to it (unless someone has had a viral infection in the past where part of that virus’s components happens to be shared with part of the H1N1 virus’s components and so has conferred some partial immunity). Consequently, there is a great possibility that the virus will be able to move practically without restraint among groups of people who live and work in close proximity – schools, dorms, workplaces, military, large families, etc. Since H1N1 has also caused deaths in age groups not usually targeted by seasonal flu viruses and in seemingly healthy persons with no underlying medical conditions, there is great concern for the potential for many more deaths than we’ve seen so far simply because this isn’t our normal flu season yet – it doesn’t really get going here in the U.S. until November or December (or sometimes even later, depending on the weather). So far, I have not dismissed the potential threat from H1N1 as too much hype, but have been willing to take it seriously and wait to see what happens, all the while doing whatever I can to minimize risk of exposure (wash hands, use hand sanitizer, ask students to cover their mouths when coughing or sneezing, stay away from sick people, etc.). The public school I work at starts back on August 31, and I’m going to be diligent to look for warning signs and symptoms of the flu, and tell students to stay home if they have any. It’s not worth the risk of having a school-wide epidemic.
I hope this has been helpful; it helps me to put my thoughts into words, if only to reaffirm the need to be on guard, not in a panicky way, but in a thoughtful and responsible way.”
August 23rd, 2009 | 11:05 pm
I am not saying do nothing with regard to inoculations. I am saying don’t try to do more than can be done competently and safely. I am worried that this is being pushed too fast for reasons that are not solely based on public health concerns.
But, I am open to persuasion on the other side.
I haven’t gotten into the vaccines issue. But I think that the government has the right to require children to be vaccinated for certain contagious diseases before entering school. Not for conditions, such as the virus that can cause cervical cancer, which is not contagious in the sense that I think mandatory vaccines are acceptable.
August 24th, 2009 | 9:44 am
Guillan Barre is extremely nasty and dangerous. Surely people should be able to have some say in just how much weight they want to give to an increased risk of having it vs. the swine flu.
August 24th, 2009 | 10:38 am
Lydia, not to pick on you, but Guillain-Barre was associated with the 1970′s vaccine, not the current H1N1 vaccine. Unfortunately this sort of mixup is how irrational fears get spread.
Not to say there isn’t reason for caution. If they give this to enough people, surely some will have an adverse reaction. But the same is true of aspirin, not to mention peanut butter. There’s always a risk.
Everything’s about the percentages, like it or not. The damages that entail from getting H1N1 are not so great as, say, polio or smallpox. So I don’t expect everyone to get this shot and I’m not too worried if they don’t. I just hope people make rational informed decisions.
August 24th, 2009 | 10:47 am
Some of the right-wing crowd have been saying that the Obama administration will use just such a threatened pandemic of H1N1 to push through health reform this fall. Now it looks as if this might come true…
August 24th, 2009 | 12:03 pm
Padraig, the question is whether there is some reason to think that the present vaccine is sufficiently different in the relevant way from the 1970′s vaccine that it does not pose an increased risk of GBS. As far as I know, the exact mechanism by which the 1970′s vaccine apparently caused GBS was never ascertained, so we are working in a fog as far as saying that the present vaccine would be better. We know that it would be different in that the strain of swine flu against which it’s been developed is somewhat different, but is that the relevant factor for risk of GBS? As far as I know, nobody knows. If you have evidence that the present vaccine poses a _lesser_ risk of GBS than the 1970′s vaccine, despite their being vaccines for related diseases, by all means, bring it forward. In the meanwhile, the analogy to peanut butter seems somewhat misplaced.
August 24th, 2009 | 12:05 pm
Btw, Padraig, and FYI, in the U.S. nobody vaccinates for smallpox anymore. They regard smallpox as having been effectively eradicated. Just thought you might want to update your information, there.
August 24th, 2009 | 5:52 pm
Lydia-
Quibble; the general public isn’t vaccinated for small pox. I’m practically a dang kid (born in 83) and I, along with most of the folks who have been in the military in the last decade, have been vaccinated for smallpox. Civilians headed for any area where there is even a bit of worry that someone might use bio-agents are generally vaccinated, too.
Re, H1N1: the CDC says we’re actually a bit *low* for hospitalizations for the flu– although (or possibly because, I’d say) folks are more likely to go to the doctor’s when they do have flu symptoms.
Since H1N1 responds well to antiviral meds, I can’t see a reason to take the risk of mass-immunization. Prepare to be ABLE to to it, or– better yet– build up a supply so folks can volunteer to get vaccinated.
I’d also point out that something like 70% of the deaths attributed to swine flu have been in Latin America, rather than someplace with relatively good health care.
August 25th, 2009 | 1:48 pm
This swine flu is the biggest bunch of fear-mongering hype I have heard in a long time. The death rate is minuscule. You have a far greater chance of dying in a car accident than you do from getting this thing and dying from it.
It should be obvious that all of this hype is being generated for the purpose of generating more funding for the bureaucracies such as the CDC and WHO. This is Pournelle’s Iron Law of Bureaucracy in action.
I have no intention of getting any vaccine at all. The Guillan Barre disease is real and is the exact same problem they had with the vaccines that were manufactured for the 1976 outbreak of swine flu (which was also a non-event).
I cannot believe how many people are being suckered into this swine flu hype.
August 25th, 2009 | 1:51 pm
Another point to make about swine flu is that it is deliberately be obfuscated with the 1918 pandemic. I say this is deliberate because it is well-known among medical professionals that the 1918 pandemic was an avian flu and not a swine flu.
August 29th, 2009 | 12:52 pm
kurt9: You’re only partly correct. The 1918 pandemic was a strain of H1N1, as is the current swine flu. H1N1 can infect birds, pigs, and humans.
The danger of the current vaccine is that it will contain squalene as a adjuvant–a sort of accelerant to make the vaccine more effective.
My wife writes at her blog:
Which begs the question: how many vaccines contain squalene, and how many of us today suffer from auto-immune diseases like fibromyalgia as a result?
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