Children with chronic health problems should be the first to receive a vaccine being developed against the new Russian influenza, a panel of experts on infectious disease recommended yesterday to Health, Education and Welfare Secretary Joseph Califano.
However, while the group specified the types of vaccine to be used and those who should receive it, the experts stopped short of recommending how involved the federal government should become in supplying the vaccine.
Citing liability problems raised by the 1976 national swine flu immunization program, the experts meeting yesterday at HEW headquarters here said that those problems must be resolved before the government embarks on another mass inoculation campaign.
The federal government has been sued for many millions of dollars by patients and relatives of patients who suffered from Guillain-Barre syndrome, a disease that causes temporary paralysis, after receiving swine flu shots in 1976.
Five hundred and thirty-five persons, out of about 40 million who received swine flu vaccine, reported getting the syndrome and 28 of them died.
Califano said yesterday he has asked another group of experts to provide advice on how the government can handle the problem of liability arising from vaccination programs.
Dr. William H. Foege, director of the federal Center for Disease Control, said at yesterday's meeting that the chances of someone developing Guillain-Barre syndrome after receiving a flu shot are about the same as they are being struck by lightning in any given year.
According to statistics presented at the meeting, the risk of dying from influenza is 1,000 times greater than the risk of dying from Guillain-Barre.
Officials stressed that there are still many unanswered questions about the Russian flu. Although the disease does not appear to be any more serious than any other type of influenza, the severity of flu-strains varies from epidemic to epidemic, and from year to year.
Additionally, although the mortality rate in the Soviet Union was much lower than it has been with other forms of influenza, the major epidemic in the Soviet Union peaked before the prime season for bacterial pneumonia - January and February - and bacterial pneumonia is one of the prime influenza-connected killers.
It is possible, therefore, that mortality rates in this country could be higher than in the Soviet Union because the outbreak here, which was first isolated last week in Wyoming, is beginning at the peak of the bacterial pneumonia season.
According to Dr. Michael Gregg, who was part of a CDC team that visited Russia, "the age groups over 30 were minimally involved. There was no difference in (infection rates) in the 40- to 50-year-old group" and the older groups.
As with all unfluenzas, the attack rate was highest in those 20 and younger, according to Gregg, who also said that the epidemic peaked extremely rapidly, with the disease spreading across the entire Soviet Union in about a month.
Dr. June Osborn, professer of medical microbiology and pediatrics at the University of Wisconsin and the person asked to summarize the day's discussion, said the Russian flu could be expected to spread in this country "before the end of April . . . and may well be the dominant strain (of flu) for the . . . decade."
Referring to the fact that some people accused the experts of crying wolf last season when the swine fle failed to appear, Osborn said, "Since we do have a wolf is, we can avoid some of "the skepticism generated by the swine flu program.
Those in the 24 to 33-year-old age group have an "even shot" at avoiding the new flu because of the immunities they got from exposure to similar flu strains earlier, she said, and those up to age 44 have a "good chance" of not getting it.
The highest priority in national influenza policy in not avoiding illness, but avoiding death. The group recommended that preference in receiving shots be given first to:
Those 24 and under suffering from chronic conditions placing them in the so-called high ris kcategory;
Then, to all others suffering from chronic conditions, such as heart and kidney dieases;
Next, to all those 65 and over not in any other high-risk group;
And then to those over 50 and persons considered to be in vital occupations.