Sunday, May 19, 2024

The self-interest of the government health bureaucracy which saw in the swine flu threat the ideal chance to impress the nation.

From Flu: The Story of the Great Influenza Pandemic of 1918 and the Search for the Virus That Caused It by Gina Kolata.  Page 171.   

Calling on neurologists in eleven states to report all new cases of Guillain-Barré, the Centers for Disease Control soon got what it feared: doctors from across the country started sending in reports of recently immunized patients who developed the nerve disease.

The reports were ominous, some medical experts said. Few people with Guillain-Barré syndrome became ill in the week after they were vaccinated. Most got sick two to three weeks after their flu shot and few got the neurological illness four or more weeks after their inoculation.

Dr. Lawrence Schonberger, a young medical epidemiologist at the Centers for Disease Control, was put in charge of analyzing the data. The more data he got, the worse it was starting to look and the more scientists and administrators at the agency began to wonder what they should do. After all, the Centers for Disease Control had started this major immunization campaign and now it looked like not only was there no danger from swine flu but the vaccine itself might be injuring people.

“I would present what I was doing at higher and higher levels at the CDC,” Schonberger said. “It peaked when I was talking to the director of the CDC.” On a conference call while Schonberger sat in the office of David Sencer, the director, were leading academic experts who were helping Sencer decide what to do. The decision was that the association was not quite pinned down. On Wednesday, December 15, the Centers notified doctors across the nation that they should continue giving swine flu shots.

Schonberger felt that he just hadn’t made himself clear. “It was visual, I could see the visual and say there’s a pattern here. I wasn’t sure I could communicate that,” he said. He woke up from his sleep at two o’clock the next morning, shouting to his wife, “Rachel—I’ve got it.” He suddenly knew how to analyze and present the data so that everyone would see why he was convinced that the vaccine was causally linked to Guillain-Barré syndrome. That morning, he rushed to work and began redoing his analysis. A couple of additional cases of Guillain-Barré syndrome had been reported by then, making the association stronger. This time he was persuasive. On Thursday, December 16, Sencer conceded that the swine flu vaccination program must be stopped because of the possibility that the vaccine might be causing Guillain-Barré syndrome.

That day, with President Ford’s agreement, Dr. Theodore Cooper, Assistant Secretary of the Department of Health, Education, and Welfare, announced that the swine flu immunization campaign was over. There had been not a single case of swine flu and the prospect of any danger at all from the vaccine was chilling.

The press was not kind. Harry Schwartz, the New York Times editorial writer, termed the swine flu campaign a “fiasco.” Writing on December 21, he blamed, among other things, “the self-interest of the government health bureaucracy which saw in the swine flu threat the ideal chance to impress the nation.”

Reports of Guillain-Barré cases continued to pour in to the Centers for Disease Control. But even as the toll of the injured and dead mounted, some scientists echoed the concerns that Kurland had voiced early on. The problem, some neurologists told the federal scientists, was that the disease was poorly described and so doctors could include a variety of symptoms under the rubric “Guillain-Barré.” At a meeting on December 29, Dr. Dale McFarlin, who was chief of the neuroimmunology branch at the National Institute of Neurological and Communicative Diseases, spelled out his concern. “I think until you have some hard-nosed criteria,” he said, “these data don’t really mean very much.”
    
But, at a time when ironies and mistaken assumptions were making a shambles of the swine flu vaccine, the secret irony of the Guillain-Barré link was perhaps the wryest one. The whole alarm came about because the Minnesota doctor who first reported a flu shot patient who got the disease had misheard an audiotape. He thought the tape warned that Guillain-Barré syndrome might follow flu shots. In fact it said just the opposite. It had used the disease as an example of how a faulty association could be drawn between a disease and the vaccine if, by chance, a person who had had the vaccine happened to become ill for reasons having nothing to do with the vaccine.

No comments:

Post a Comment