A Perfect Pandemic
It started in January. By the end of the year, 25% of the United States had been vaccinated for a mysterious virus that looked similar to the one that caused the catastrophic 1918 flu outbreak.
In 1976, President Gerald Ford was presiding over a depressed economy and a country trying to heal from the wounds of Watergate and the war in Viet Nam. Technically, he had never been elected in the first place. He was appointed Vice President and later President after Spiro Agnew and Richard Nixon both resigned in ignominy. Many people were angry with him for pardoning Nixon.
A pandemic was the last thing the President needed.
An outbreak of respiratory illness, presumed to be flu, was reported by Fort Dix in New Jersey. Seven of the saliva samples that couldn’t be identified locally were sent to the laboratories at the Centers for Disease Control. Five were identified as Type A/Victoria flu. The other two samples…were not.
The sense of urgency to identify the unknown virus grew as the Army private who donated one of the samples collapsed and died after a five mile march.
By mid February, the CDC had notified scientists and health officials across the country that a swine flu type virus had been discovered. An emergency meeting was set up at the CDC, attended by representatives of the Army, the Food and Drug Administration, and the National Institutes of Health. Work on a vaccine started the next day. The World Health Organization was notified of the swine flu finding two days later.
On February 19, the CDC held a press conference to announce the swine flu at Fort Dix. No reference was made to the 1918 Spanish flu pandemic that killed over 50 million people. It was brought up in a press question and noted in much of the media coverage.
Thus began the scramble to come up with a vaccine. It was off to a slow start, since many samples that Fort Dix sent to manufacturers did not survive. One company started work on the wrong flu strain and didn’t realize the mistake for a few weeks.
Further glitches came when insurers declined to cover the drug companies for liability for adverse outcomes, which were almost expected with any pharmaceutical product brought to market quickly. The federal government was pressured to take over liability.
President Gerald Ford met with advisors and scientists. Most advised a “go or no go” scenario for general vaccination. Many people were already getting an annual flu vaccination and it could be added to the mix. A small minority recommended manufacturing and stockpiling a vaccine while waiting to see where the virus turned up.
President Ford listened to the scientists and requested $135 million for a mass vaccination program. The election had to be on his mind, and the results of both the vaccination campaign and the election were by no means certain.
Weary from years of war and scandal, people embraced the bicentennial anniversary of the nation and celebrated with lots of parades and fireworks.
I entered the periphery of the story in March, 1976, when I joined the Army as a Private First Class. One of the first things they did to new recruits was give them a physical examination and update all their vaccinations. There was no choice to opt out.
“You’re in the Army now and you belong to us. If you get a sunburn, you’re damaging government property.” My Drill Sergeant at Fort McClellan, Alabama (closed in 1995 and now a wildlife refuge).
We were at the end of the 1975–76 flu season, but we still got that season’s “cocktail,” made up of strains that started in the Asia and worked their way to the West much more slowly than they do today. That season it was Types A/Port Chalmers, A/Scotland, and B/Hong Kong.
They don’t always get the mix right, and cases of A/Victoria were emerging around the country. The novel (new) virus was dubbed A/New Jersey. If it became a pandemic, it could be called the American virus.
Compare the timeline so far with that of Donald Trump’s Pandemic in 2020. There was identification and the hope of a vaccine, in part to help Presidential election worries for someone who had never won the nationwide popular vote. But at this point, President Trump was still in denial or lying, and said repeatedly that ‘it will just go away.” What had been a good economy was faltering as businesses and individuals tried to manage in the new normal of life with coronavirus.
A big difference in 1976 was that personal protective equipment was rarely used. There were no pleas for public hand washing, mask wearing, and social distancing. Life went on as normal.
The virus was contained at Fort Dix, where the Basic Training units generally kept to themselves anyway. A few swine flu cases popped up in other places, but were associated with people who had contact with swine. No link had been found to swine in the Fort Dix patients. About 200 new recruits and one staff member tested positive for A/New Jersey. It was never found outside of Fort Dix and disappeared in February.
Around the same time, a known flu, A/Victoria, was active in New Jersey and killed ten people in the state between January 31 and March 17. Later study suggested it might have overwhelmed the less easily transmissible A/New Jersey and stopped its spread.
The vaccination program continued, along with surveillance for new cases. A poll taken in August showed that 93% of Americans were aware of the immunization program and 52% intended to get a shot. The first vaccinations were given on October 1.
I was enrolled in the Army nursing program at Fort Bragg, North Carolina. Over two days, everyone lined up to get the new vaccination. The only way to opt out was if you were pregnant or allergic to eggs. The attenuated (weakened) “live” vaccine was grown in eggs, so millions were used. I had a sore arm for a few days, but many people complained of feeling very sick afterwards.
On October 11, three elderly people died shortly after they got the shot at the same Pittsburgh clinic. Health officials in nine states closed down their vaccination programs pending investigation. Autopsies showed all three had heart attacks and there was no evidence that they were related to the vaccine.
By October 14, the death count was up to 33. President Ford got the shot on national TV to encourage people to get vaccinated.
On October 22, the CDC announced 44 vaccinated people had died so far but there was no known connection to the vaccine. Deaths were determined to be at a normal rate for the population.
On November 12, a case of Guillain-Barre was identified in Minnesota. Three more in Minnesota and three in Alabama were reported by December 2. The CDC started an investigation. By December 14, there were 54 cases in ten states, 30 of whom had received the shot between one and thirty days before onset of symptoms.
I was going to nursing school and spent many hours working in the base hospital. One of my patients around this time was “Henry,” a handsome young black sergeant in his early twenties. He complained of leg weakness so was admitted to the hospital for observation. They liked to keep soldiers out of the barracks if they weren’t sure what was wrong with them.
Initial testing was inconclusive, but after about a week they decided he had Guillain-Barre. I had never even heard of it, but I was in a teaching hospital so there were plenty of people around to educate me. It was the first case they had seen there, and they thought it was related to his swine flu vaccination.
In Guillain-Barre syndrome, the immune system attacks the nerves. Henry went from numbness in his feet to pain shooting up his legs. It seemed like every day the disease progressed further up his body. I tried to provide moral support, since his family lived far away and he was cut off from his buddies in the barracks. We had no cell phones for immediate communication and entertainment. Social media was a newspaper. Despite his problems, Henry had a ready smile and liked to tell jokes.
One day, I came in and there was someone else in his bed.
“What happened to Henry?” I asked the charge nurse, a little afraid of what I would hear.
She told me he had been moved to the intensive care unit. The disease had progressed to his respiratory muscles and he needed a ventilator to breathe. I was unable to visit, but I tried to keep tabs on him. After a couple of months he moved to the rehabilitation unit. He needed to learn to walk again.
On December 16, the vaccination program was suspended after over 45 million people had been vaccinated.
This was a perfect pandemic.
It was not technically a pandemic, since the virus never showed up outside of Fort Dix. Although both were H1N1 strains, further study showed it was not that similar to the Spanish flu. Only one person died, and that could have been due to that five mile forced march when he was not fully recovered from the flu.
The vaccination program, however, was a disaster.
There was a huge public backlash as deaths ticked up and the whole thing was suspected to be politically motivated. None of the deaths were directly linked to the vaccine, but many people got sick from the “live” virus.
Almost five hundred people got Guillain-Barre. There was no certain link to that either, but the numbers were well above normal.
Many cases of measles were reported as routine childhood immunizations lagged because resources were redirected to the influenza program.
The government spent millions litigating liability claims.
The CDC lost a lot of credibility. Its director was fired. The subsequent HIV epidemic was slow in getting addressed.
Jimmy Carter became president.
Of course there is not much comparison with the present COVID-19 pandemic. Thousands of people die of the flu every year, but we are way above normal.
But this is a cautionary tale about the vaccine.
The reason for caution is that there are side effects. We don’t have a vaccine yet so they are unknown.With over six million cases, a few hundred getting some awful disease might be considered an acceptable side effect. But what if the vaccine only works for a limited time and thousands of people die or are left with devastating disabilities?
Lesson learned: Rushing the vaccination program for political expediency before efficacy and side effects are understood might cause unforeseen tragedy for years to come.
