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Within days of the identification of the 1918-like H1N1 virus from Fort Dix, representatives from the military, the National Institutes of Health, the Food and Drug Administration (FDA), and the New Jersey Department of Health met to determine a plan of action, which included heightened disease surveillance in and around Fort Dix, determining whether infected individuals had prior contact with pigs (which turned out to be negative), and serologic testing of recruits to determine viral spread at Fort Dix (Sencer and Millar, 2006). While the virus had spread from person to person among more than 200 military recruits on the base, no additional cases of swine flu were ever detected in the community surrounding Fort Dix. These findings were reviewed by the Advisory Committee on Immunization Practices (ACIP) of the U.S. Public Health Service, which concluded that the new virus had pandemic potential and that an immunization program should be launched in order to reduce the morbidity and mortality associated with a possible influenza pandemic.

After considering several alternative responses to these recommendations, Sencer, in his capacity as director of the CDC, proposed that private pharmaceutical companies under contract to the federal government should produce enough vaccine to immunize the entire U.S. population against H1N1, and that immunization should proceed as quickly as possible through federally funded programs organized and conducted by state health departments (Sencer and Millar, 2006). Federal legislation5 to this effect was quickly passed and vaccine production and testing began. Progress toward mass immunization was temporarily stalled when the vaccine manufacturers demanded indemnification against claims of any adverse reactions associated with the vaccines. After the federal government acceded to this demand, more than sufficient vaccine was produced to immunize more than 40 million people within 10 weeks, beginning on October 1, 1976.

After cases of Guillain-Barré Syndrome (GBS)—an extremely rare disorder in which the body’s immune system attacks part of the peripheral nervous system—were diagnosed in some recipients shortly after vaccination with the swine flu vaccine, anxiety arose about whether the vaccine was causally associated with this rare disorder. On December 16, federal officials suspended all immunizations in order to investigate this possibility. This action essentially ended the swine flu immunization program. According to Sencer, despite the controversy it engendered, this program achieved success in several areas, most notably surveillance for disease transmission and adverse events associated with the vaccine, as well as the rapid and effective implementation of mass immunization on an unprecedented scale.

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National Influenza Program (P.L. 94-380): An act to amend the Public Health Service Act to authorize the establishment and implementation of an emergency national swine flu immunization program and to provide an exclusive remedy for personal injury or death arising out of the manufacture, distribution, or administration of the swine flu vaccine under such program. For more information, see http://thomas.loc.gov/cgi-bin/bdquery/z?d094:SN03735:@@@L&summ2=m& (accessed November 5, 2009).



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