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cautionary tales from u.s. history on rushing vaccines

trump has suggested a vaccine could be ready in fall. but hasty efforts have gone wrong before.

history of rushed vaccines
president gerald ford receives a swine flu innoculation from his white house physician, dr. william lukash. gerald r. ford library/ national archives and records administration
u.s. president donald trump’s response to the coronavirus pandemic has ranged from lackadaisical — it will go away on its own — to troublingly aggressive — promising a vaccine this fall.

though infectious disease expert dr. anthony fauci and other researchers are urging caution, noting that vaccine trials can take months and even years to get right, trump continues to contradict them. during a press briefing friday, trump said a vaccine could be ready “before the end of the year and maybe even before nov. 1. i think we can probably have it sometime in october.”

the food and drug administration, which reviews vaccines, could technically issue emergency use authorization or even approve a vaccine if the science was promising. medical experts worry that trump may be motivated to push through a vaccine for covid-19, which has infected more than 6 million amercians and killed more than 189,000, before it’s safe.
vaccines are incredibly important to public health and have saved millions of lives in mass immunization efforts to stop the spread of diseases. but some efforts to rapidly create and distribute a vaccine have had very serious consequences. here are two examples from american history where things went wrong.

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the cutter incident – 1955
scientists scrambled for a polio vaccine amid mid-century outbreaks. the highly infectious virus invades the nervous system and can lead to paralysis or even death, and frequently infected children. polio cases ramped up in the late 1940s and early 1950s and outbreaks often peaked during summer. in an echo of current concerns about the coronavirus pandemic, officials mandated quarantines on specific homes or even towns and parents kept their kids indoors.

according to the centers for disease control, “ outbreaks in the u.s. increased in frequency and size, disabling an average of more than 35,000 people each year.” in canada , polio cases peaked in 1953 with nearly 9,000 cases and 500 deaths, making it the most serious national epidemic since the 1918 spanish flu. about 11,000 canadians were paralyzed between 1949 and 1954.

biographical accounts detail round-the-clock work for a vaccine at the national institute of health in the united states. in 1952, jonas salk and a team at the university of pittsburgh developed the first effective polio vaccine. mass immunization campaigns were launched after licensing in 1955.
 children line up to receive the polio vaccine in mississippi, 1956.
children line up to receive the polio vaccine in mississippi, 1956. mississippi department of archives and history
cutter laboratories produced the salk vaccine, which was supposed to contain inactivated polio. despite safety protocols, children were given a vaccine which contained the live virus.

according to paul a. offit, director of the vaccine education center at children’s hospital of philadelphia and author of “the cutter incident,” 120,000 children in the u.s. were given the cutter vaccine in the spring of 1955. fifty-one were paralyzed, five died and 40,000 kids came down with “abortive” polio, which included symptoms such as fever, sore throat, headache, vomiting and muscle pain.

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this fatal mistake in the manufacturing process led to more regulations.

the cdc says the “cutter incident was a defining moment in the history of vaccine manufacturing and government oversight of vaccines, and led to the creation of a better system of regulating vaccines.”

polio vaccinations resumed in autumn, leading to a steep drop in cases. by the 1970s, there were fewer than 10 in the u.s. canada was declared “polio free” in 1994.
swine flu – 1976
 this 1976 photograph showed an adult receiving a vaccination with a jet injector during the swine flu nationwide vaccination campaign, which began october 1, 1976.
this 1976 photograph showed an adult receiving a vaccination with a jet injector during the swine flu nationwide vaccination campaign, which began october 1, 1976. centers for disease control and prevention

in early 1976, two u.s. military recruits at fort dix, new jersey, came down with flu-like illnesses that raised red flags for the cdc. researchers discovered it was the swine flu and similar to the virus that caused the 1918 pandemic.

the advisory committee on immunization practices of the united states public health service quickly met to discuss recent findings about the h1n1 new jersey strain. since the strain could be transmitted person-to-person, they feared a pandemic.
despite a more cautious approach from the world health organization, the u.s. government launched an immunization program in an effort to stave off a pandemic, fearing a repeat of the spanish flu. emergency legislation was signed in april 1976.

the aggressive campaign to stop the spread of swine flu saw 45 million americans vaccinated within ten months, including president gerald ford. critics suggested this quick approach to flu outbreak prevention may also have been politically motivated, given that ford was up for re-election in november.

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a recent article in the journal of the american medical association damned the government response: “poorly conceived, the attempt to vaccinate the u.s. population at breakneck speed failed in virtually every respect. safety standards deteriorated as one manufacturer produced the incorrect strain. the vaccine tested poorly on children who, depending on the form of vaccine tested, either developed adverse reactions with high fevers and sore arms or did not mount an immune response at all.”

the journal also notes that the vaccine was linked to guillain-barré syndrome, which can cause muscle weakness or paralysis, “in a very small number of cases, a finding that remains controversial.”

discover magazine points out that scientists later learned the strain was not, in fact, related to the 1918 pandemic and swine flu numbers never took off around the world as feared. the vaccine campaign was brought to a halt and the public backlash was swift.

researchers and medical experts have pointed to the overzealous 1970s swine flu campaign as sowing the seeds for vaccine hesitancy among many americans today.

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