Flu Shots

ROLL UP YOUR SLEEVE AMERICA, says the U.S. Public Health Service's bright new slogan. Yet as the nation's highly touted program against swine flu began last week, most Americans who wanted to take the slogan's advice stood only to get a cold shoulder. Despite the Ford Administration's original vow to vaccinate 200 million Americans against the dread virus--a form of which possibly caused some half-million deaths in the U.S. alone during the 1918-19 influenza pandemic--only a few health centers round the country were ready to give the shots. Indeed, federal distribution of the vaccine was so erratic that a health official in Portland, Ore., remarked: "We didn't even know we'd received a batch until we read about it in the newspaper."

Last week's snafus were hardly surprising. Since President Ford announced the mass immunization effort last March, it has been snarled in confusion and controversy, including a hassle over whether the Government would protect the four manufacturers of the vaccine against possible lawsuits resulting from its use. (It will.) As a result, production is far behind schedule. By November, when the flu season normally begins, the companies will have produced only about one-quarter of the 215 million doses originally expected. Availability aside, the vaccine's effectiveness remains questionable. Experts' estimates of the degree of protection it will provide range from 20% to 90%.

Some doctors, of course, are still skeptical that there is anything to guard against. Since the virus first appeared among Army recruits at Fort Dix last winter--one of whom died--there has not been a single confirmed additional case of swine flu. Either the infection is not very contagious, say the scoffers, or the Fort Dix flu cases were just a medical fluke.

Nonetheless, since the flu season --to say nothing of the election--is only weeks off, federal officials are taking no chances. As the vaccine is produced, it is being shipped to the states in quantities roughly proportional to their population. State health officials, in turn, are making shots available through a variety of channels: hospitals, schools, factories, libraries, churches, even special clinics set up at shopping centers. Under the $135 million program, the vaccine will be free. Private doctors will be allowed to charge an administering fee, but it probably will be modest. The Medical Association of Georgia, for example, has suggested physicians charge $1.50, the same amount it costs the state to give the shots.

The federal program is providing two types of vaccine: monovalent, which offers protection only against swine flu, and bivalent, which also contains vaccine against last year's prevailing A/Victoria influenza strain. Because the virus used in producing the vaccine is cultured in eggs, the shots should not be taken by those who are severely allergic to eggs. The current recommendations of federal health officials:

R For those 65 years and older or chronically ill, who could be hardest hit by any epidemic--bivalent shots. The officials are also advising (but not providing) a shot against an older flu strain. Hong Kong B, which could also reappear in the coming weeks.

R For the general population aged 18 and over, including pregnant women --monovalent shots.

R For youngsters three to 18 years --no vaccinations at all at present, unless they suffer from such chronic illnesses as asthma, diabetes, heart or kidney disease. In these cases, the officials are recommending two doses, four weeks apart, of a bivalent vaccine that is made from only part of the swine flu virus and seems to cause less severe side effects among youngsters.

R For children under three--no decision yet on whether anyone this young should receive the shots.

To many, such guidelines may be academic. According to a recent Gallup poll, only 53% of Americans plan to take the shots. That, however, could change rapidly if swine flu suddenly erupts in the nation.

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