“Something’s coming at us,” says Bruce Gellin, MD. “And we don’t know what it is.”
Dr. Gellin, head of the federal government’s vaccination program, is facing the greatest challenge of his career. It’s his job to coordinate the biggest vaccine effort ever, against a threat whose magnitude is still unclear, using a vaccine that has only just been created and whose side effects are still being identified.
But Dr. Gellin, a graying infectious-disease specialist with a youthful insouciance, seems remarkably calm about it. “Anxious isn’t a word that comes out of his lips,” says his wife, Sharon, a nurse. “He’s more likely to say, ‘This will be interesting.’ ”
Swine flu blasted its way into public consciousness last spring — only to disappear from headlines for weeks at a time as health-care reform and its angry protesters took center stage. But behind the scenes, a vast team of doctors and scientists have been working nonstop, ignoring trivial matters like the need for sleep and, in some cases, personal catastrophe. They’ve accomplished remarkable things: Within a few months of the April discovery that a new pathogen was spreading fast through humans, scientists had identified all of the virus’s genes. Public health experts and policymakers had decided, first, that a vaccine ought to be made and then that it ought to be used. And manufacturers had begun producing tens of millions of doses and started testing them on volunteers. All without knowing just what to expect come fall and winter, when the flu typically intensifies.
“We didn’t have a crystal ball,” says Dr. Gellin. “You have to recognize that there are unknowns, but you have to make decisions.”
For months, his BlackBerry has been going off at all hours, with calls and messages from colleagues in Australia, Europe, and Atlanta, where the Centers for Disease Control and Prevention is headquartered. Everyone is wrestling with the same concerns:
- Will the vaccine arrive in time? Grown in fertilized chicken eggs, like all flu vaccines, this one is yielding only about a third as many doses per egg as usual. The aim is to inoculate as many as 160 million Americans, but far fewer doses may be ready by the end of October, by which time sniffling children may well be quickly spreading the disease.
- If the vaccine is ready, will the public accept it? Swine flu set off alarm bells in April because it was completely unfamiliar — researchers eventually realized it contains genes from swine, bird, and human flu viruses — and because it hit Mexico hard enough to shut down its capital. But many Americans now think of the virus as mild. And people tend to be suspicious about vaccines, especially those recommended for kids and pregnant women. Up to 20 percent of all pregnancies are naturally cut short by miscarriage, so some women will no doubt miscarry after being vaccinated. Will people blame these and other problems on the vaccine?
“This pandemic is a chance to strengthen our vaccination program — or really set it back,” Dr. Gellin says.