Harvard Study, UHS Disagree On Swine Flu

Officials at the University Health Services will advise all undergraduates to be vaccinated against swine flu in sharp contrast to Massachusetts policy and to a just-completed Harvard Medical School study that will recommend against mass immunization of young adults.

UHS hopes to offer the controversial vaccine to “high-risk” patientsthose over 65 or with chronic illnesses late in October, and to the rest of the University community two or three weeks afterwards. In line with federal policy, the clinic will urge all but children to roll up their sleeves for the vaccine.

The state department of public health, on the other hand, will recommend the vaccine only to high-risk groups, suggesting other citizens weigh the risks and benefits for themselves.

“There is no medical evidence to justify a mass program,” Tony Dutra ’74, head of the Massachusetts swine flu project, said yesterday.

The Harvard study, appearing today in the New England Journal of Medicine, estimates the cost-effectiveness of a mass immunization program and concludes that vaccination makes sense for most adults.

But last night Stephen C. Schoenbaum, assistant professor of Medicine at the Peter Bent Brigham Hospital and one of the study’s directors, said, “I would prefer to immunize young adults under 25 only if they have some chronic illness.”

Sholem Postel, associate director of UHS, said last night that he had not seen the Harvard study, but said it was unlikely to prompt UHS to alter its plans.

Clinical trials this summer showed the swine flu vaccine to be considerably less effective among young adults than among older people. The vaccine successfully produced antibodies in about 50 percent of subjects under 25, compared to a success rate of 70 to 90 percent in the older population.

In addition, the Harvard study compiled its figures before the federal government revealed that what may be a crucial component of the vaccine is missing. No one has yet explained what slip-up in the manufacturing process caused the vaccine to be produced without neuraminidase, an enzyme some scientists believe important in triggering a second-line defense to the disease.

Postel said that the clinic is recommending immunization as a “general public health measure,” but that it might be “reasonable” for an individual student to postpone vaccination until—and unless—swine flu reappears. When asked whether such a position might discourage student response, Postel said, “You’re not kidding it will.”

The swine flu program has been shrouded in controversy from its inception. Last March, President Ford recommended a crash program to vaccinate “each and every American” against swine flu, after one soldier died in an isolated outbreak of the disease at Fort Dix.

Critics, including a minority of state health officials, Ralph Nader’s Health Research Group, The New York Times, and health officials and medical journals in England, France and Canada, have disputed government estimates of the likelihood of an epidemic, its probable severity and the effectiveness of the vaccine itself.

Sidney Wolfe of the HRG said this summer, “The major disease in the U.S. this year related to Fort Dix will not be swine flu but, rather, swine flu vaccine disease.” The Lancet, a respected British medical journal, concluded that the swine flu virus “seemed to be not very good at infecting man and may have died out as a result” and implied that the U.S. response to a minimal danger,” and suggested that the government stockpile the vaccine and administer it only if swine flu reappeared.

The government has responded to that suggestion by claiming that given the logistics of mass immunization, 12 weeks or more might elapse between the initial discovery of swine flu and the protection of the American population--too long to stave off an epidemic.

But Dutra estimated that his office could “get the vaccine into people’s arms” three to five weeks after swine flu appeared, which Dutra said would be “plenty of time,” because even if swine flu returns it will probably do so in small, sporadic outbreaks.

“There is absolutely minimal to the nth power chance of a pandemic this winter,” he added.