A partial resumption of the $135 million national swine flu inoculation program was recommended here today by the federal Center for Disease Control despite what its officials called "an apparent but low risk" of Guillain-Barre paralysis in "1 per 100,000 to 200,000 vaccinations."
The partial resumption is aimed at providing the shots for older persons and the chronically ill, but would also make the vaccine avilable to anyone else who wanted it.
The recommendation was made just after it was learned that a Wisconsin high school student, 13, with swine flu caught from diseased pigs passed the disease last month to one and possibly two of his classmates. All were only mildly ill, but it is the first known instance of human-to-human swine flu transmission since the disease hit 12 soldiers at Ft. Dix, N.J., killing one, last January.
The Ft. Dix event triggered a national swine flu vaccination effort that rapidly ran into trouble after trouble, culminating in a Dec. 16 moratorium on the shots caused by the discovery of 292 cases of Guillain-Barre syndrome and 10 deaths among the vaccinated.
Today's recommendations were not directly related to the new Wisconsin cases, however. The three illnesses in Ixonia, a small town in central Wisconsin, apparently have not spread and there is no influenza epidemic there or "reason for general concern," Dr. David Sencer, CDC director, emphasized.
Sencer made the recommendation to lift the month-long moratorium to Dr. Theodore Cooper, assistant secretary for health at the Department of Health, Education and Welfare, late this afternoon.
He did so after a committee of scientist-advisers agreed after four hours of discussion that "now that the risk of Guillain-Barre is better defined, we can offer the vaccine again to those who want it, so long as they are fully informed of the risks."
"I've read the recommendation to Dr. Cooper and he agrees with the general gist of it," Sencer announced. "But the wording has to be gone over by all the committee members and the action has to be reviewed by the HEW general counsel."
"What we're saying is that its now up to local health officers' and doctors' and individuals' discretion to give or take the shots," Spencer said. "We don't think there will be any widespread resumptions of public vaccinations, but we do think the vaccine should be available now to the elderly and chronically ill whose risk from influenza, if it comes, is far greater than their risk from the vaccine."
Specifically, he and his vaccine advisers agreed that:
He moratorium on use of influenza vaccine be lifted," so doctors and health departments may offer the vaccine to those of high health risk; also, that the health officers "may proceed with immunizing the general population if they think it advisable.
In all cases health officers, doctors and the public should be fully informed of the risk for the Guillain-Barre syndrome.
All health officers "should remain ready to reinstitute the active vaccination of the general public of increased swine influenze virus transmission is detected."
The same advisory committee and Sencer agreed here two weeks ago that they could not yet recommend a resumption of shots because they were still uncertain of the extent of Guillain-Barre, though the Association between the shots and the occational paralysis seemed all but proved.
The evidence for that association is even stronger now, they agreed today. They heard latest figures indicating that the risk of this syndrome is 11 times greater among adults who got the swine flu shot than among other persons and 18 and over. The risk among those younger than 18 is harder to assess, because few children were inoculated and there has been only one Guillain-Barre case in anyone under 18.
Forty million Americans are categoried as being old or chronically ill. Of that 40 million, 14 million have not received swine flu vaccinations. An estimated 50 million Americans in all have received the inoculations.
Persons in the high-risk category will get a bivalent or double vaccine against both swine flu and A Victoria flu, the strain that hit the country hard early last year, causing and estimated 20,000 deaths from flu and pneumonia.