By Marc Fisher
Sunday, May 3, 2009
Swine flu is in the air, but the bug to watch out for is the germ of fear.
The school year was coming to a close, and federal health officials, having convinced the president that swine flu was likely to infect huge numbers of people in just a few months, were racing to make a good vaccine for children.
So in May of 1976, doctors at Children's National Medical Center turned to kids they knew best. The president of the hospital's board had his kids at Beauvoir, the private elementary school on the grounds of the National Cathedral. The principal, Frances Borders, agreed to have her students participate.
Twenty-four Beauvoir students were inoculated, along with 50 children of hospital employees and 43 kids enrolled in the hospital's comprehensive care program.
Lorin Spangler Young was one of the Beauvoir kids who got the shot. She was 6. I found her last week in Fort Collins, Colo., where she teaches in an elementary school. Young remembers talking to her mother about whether to get the shot: "She gave me the option, and I chose to do it." She recalls going to school that day: "I stifled the tears and walked into the library." She remembers the shot itself: It hurt.
But she had no idea that she had participated in an experiment until I told her. "I thought it was a regular influenza shot," she says. She says her mother doesn't recall that fact, either.
The families that participated in the test likely knew nothing about the debate among doctors over whether children needed to be inoculated, especially since early evidence was that that year's strain of swine flu had only a minor effect on kids.
The permission form parents signed noted the possibility that the vaccine could cause an allergic reaction, but there was no mention of paralysis. Seven months after the experiment, the District hurriedly closed its vaccine centers and federal authorities began investigating links between the vaccine and Guillain-Barré syndrome, which causes paralysis.
Twelve Americans who got the swine flu vaccine died of Guillain-Barré; more than 400 were at least temporarily paralyzed. The government was left with a stockpile of 63 million doses of vaccine.
There's no record of any Beauvoir children suffering lasting ill effects from the experiment, but over time, Young has generally become wary of "taking steps that are not medically proven. It's very much up to the consumer to research what's really going on," she says.
Even when we know we're overreacting, we seem unable to halt the panic. We ride a pendulum that swings from too much reaction to too little. The debacle in 1976 spread enough cynicism about flu shots that millions of Americans shied away from the vaccinations for years thereafter, even when vaccines were safe and effective.
This time, the huge, post-9/11 investment in emergency preparedness has made us especially susceptible to scare stories, and to a false optimism that we're ready to handle whatever comes.
Last week, when an eighth-grader in Northwest Washington looked as if he might be the District's first case of swine flu, the communication between an anxious family and public health officials bred anything but confidence.
The boy showed up at his doctor's office with a 103-degree fever, headache, muscle aches, congestion and the blahs. Looks like flu, said Howard Bennett, the pediatrician. He had the patient swabbed, and the test came back positive for Influenza A -- consistent with, but not proof of, swine flu.
Add the fact that the family, who asked not to be named, had recently traveled to Mexico, and Bennett reported the case to the city's health department, as he was supposed to. City health officers said that they were concerned and that they'd be right over to pick up the specimen to determine if this was indeed swine flu.
While they waited, the family took it upon themselves to pull their other children out of school and put themselves in home quarantine. Missing a day of school and work seemed a small sacrifice to prevent potential infection of others.
But two days went by before D.C. health officials picked up the specimen, tested it and delivered the verdict: Not swine. By then, the boy was fine, and everyone got back to school.
"You shouldn't have to wait days for this," Bennett says. "Having 24-hour turnaround is very important so you can know whether to keep kids out of school or not."
Dena Iverson, the health department's spokeswoman, says that the city has so far handled 28 suspected cases of swine flu but that this one didn't quite rise to that level. "It was a case of interest but not of suspicion," she says, mainly because the family's trip to Mexico had ended too long before the onset of symptoms to raise alarms.
Once the city did get hold of the specimen, it handled the testing and results quickly, but neither the doctor nor the family had received any notice that the District was putting their case on a slower track.
The lesson here is that none of us makes particularly good decisions in the throes of fear. After the 1976 fiasco, a Harvard study of what had gone wrong concluded that health officials put too much confidence in "theories spun from meager evidence," government leaders put too much trust in medical specialists and everyone exhibited "premature commitment to deciding more than had to be decided."
There is, indeed, a real infectious disease afoot. Its name is fear.