# 1269
Thirty-one years ago, after a handful of soldiers fell ill with Swine Flu at Fort Dix, New Jersey, the decision was made to inoculate a nation against a feared pandemic. That pandemic never materialized, and three decades later there is much discussion over whether it should have even been attempted.
Today, there are voices raised once again with this same proposal. Only this time, the voices are coming from the UK.
First, this article from The Times. Then a discussion.
From The Times
November 19, 2007
Ministers urged to consider jabs for all to fight any pandemic
Mark Henderson, Science Editor
Mass immunisation against H5N1 flu could reduce the impact of a pandemic to normal seasonal levels if combined with extensive use of antiviral drugs, government scientific advisers have concluded.
Research presented to the Department of Health has suggested that inoculating the entire population with a “pre-pandemic” vaccine that does not precisely match the pandemic strain could confer sufficient immunity to cut infection dramatically. Such a strategy would have to be combined with stockpiling enough of the antiviral drug Tamiflu to treat 75 per cent of the population, the department’s Pandemic Influenza Scientific Advisory Group (SAG) said. This would allow every infected person to be treated while the drug was given preventively to those in infected households.
This would minimise death and illness in a pandemic that could affect up to half the population, but would be hugely expensive and require a massive revision of pandemic plans. The Government has ordered 14.6 million doses of Tamiflu, enough to treat 25 per cent of the population. The SAG has recommended raising this to 50 per cent, at a cost of about £150 million. Health ministers are understood to have accepted this advice but it has yet to be approved by the Treasury.
The more drastic pandemic plan would require a further 15 million doses of Tamiflu, as well as spending hundreds of millions of pounds on prepandemic vaccine. Only 3.3 million doses of pre-pandemic H5N1 vaccine have been ordered, for essential workers. The pre-pandemic vaccine that has looked most promising in early trials, which is made by GlaxoSmithKline, has not yet received regulatory approval. Also the vaccines have a shelf life of only three years.
Pre-pandemic vaccines use the strain of flu that is predicted to have the biggest risk of mutating so that it passes from person to person. The vaccines would not be a precise match to the pandemic strain but are forecast to offer some protection.
Professor Neil Ferguson, of Imperial College, London, a leading flu epidemiologist and a member of the SAG, said: “I am not yet sure what the best course of action is, but the Department of Health should certainly do the cost-benefit analysis.”
The Department of Health said: “We are continuing to keep the situation under review.”
Frankly, I'm astonished.
Not that this might not be a reasonable option, but I'm astonished than anyone is actually proposing it. It has just about every downside imaginable, except one.
It might save millions of lives in a pandemic.
I've underlined `might' because that is the operative word. It might, or it might not. We simply don't know.
A pre-pandemic vaccine is a crap shoot. And it is one that isn't without some dangers, as well.
No vaccine is 100% safe. You attempt to inoculate a large segment of society, and even the safest vaccines will produce a few unwanted, and oft times tragic, side effects.
We saw that in 1976 with the Swine flu vaccine, as I detailed in A Case of Deja Flu.
Of course, if you know a virulent and deadly flu is coming, and you have a vaccine that will probably mitigate the disease ( even if only partially) it would make sense to use it. It wouldn't take much of a pandemic to far exceed the death and misery any vaccine is likely to cause.
The problem is, you'd have to manufacture and dispense the vaccine before a pandemic struck. You'd have to gamble that the pandemic is going to happen, and act before it does.
And that requires a good deal of money, and something even far more rare: political courage. For this to happen, someone (probably a lot of `someones') would have to risk being wrong.
Of course, there are some nations who have already indicated that they are pursuing a pre-pandemic vaccine policy.
Switzerland has reportedly purchased 8 million doses of pre-pandemic vaccine, enough to inoculate their entire citizenry. Denmark, it was widely reported last January, ordered in enough pre-pandemic vaccine for half of their population. And in Australia, there has been talk of inoculating their entire nation.
That nations such as the UK, Denmark, Switzerland, and Australia are seriously considering, or actively pursuing, a mass pre-pandemic vaccination plan is testament to just how worried they are over the effects of a severe pandemic.
