The following HTML text is provided to enhance online
readability. Many aspects of typography translate only awkwardly to HTML.
Please use the page image
as the authoritative form to ensure accuracy.
The Swine Flu Affair: Decision-Making on a Slippery Disease
outbreaks, the monovalent vaccine should continue in suspense.
The next day the Secretary announced his acceptance of those recommendations. One of the things he had sought from his procedure was an opportunity to tell the press: ‘Everything I heard, you heard if you sat through the meeting.” Now he could do just that, and did. He could also say to interest groups and critics of every sort: “You had a right to be heard, and a chance; nothing was done behind your back.” After the swine flu program, Califano thought these things great assets, and still does, elements in building (and rebuilding) credibility. Media reaction to his limited resumption strengthened that belief. Harry Schwartz wrote still another editorial for the New York Times: "… The Government stands now where it should have stood all along: focused on high-risk individuals and poised to do more, but only if necessary.”30
The Washington Post editorialized:
It was not an easy decision to make, given all the unknowns and unknowables involved, and it strikes us as a sensible one that carefully balanced all the risks involved. But what struck us almost as forcefully was the wide-open way that it was made—the “sunshine” approach, if you will.31
We have heard but one caveat, procedural not substantive. Stallones, who had flown up from Texas for the meeting, found the conference room repellent—cold decor with chilly temperature—and fellow-panelists excessively Eastern: New York-Boston almost all. He commented to us:
I am not very enamored of the Eastern establishment, nor do I much enjoy being practically alone in it…. Surely they could try harder on that dimension.
Surely they can, but not perhaps a Fredrickson or a Hamburg in an hour’s time.
The improvised procedure of February 7 worked so well that a month later, when it came time to review ACIP recommendations for the 1977-78 flu season, a comparable ad hoc group at Califano’s level was again laid on; he again received its views, again he took them as his own. Not surprisingly, the recommendations were conservative as first proposed from CDC and as approved by him: private manufacture of Victoria vaccine for high risk groups. Here was a complete reversion to 1975, no Federal programming at all. Despite an unexpected epidemic of the Texas strain (akin to the Victoria), this outcome was as well received in public as the last and carried Federal policy along until the news of Russian flu late in 1977.
With these two ad hoc performances in February and March, Califano put a period to the swine flu program. What remained were doses in the refrigerator, consent forms on the shelf, and policy issues he had not yet addressed.