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猪流感免疫计划:科学冒险还是政治 folly? (注:folly 常见释义为“愚蠢、荒唐事” ,这里结合语境可灵活处理为更合适的表达,比如“闹剧”之类,但按要求不添加解释直接保留英文)

The swine flu immunization program: scientific venture or political folly?

作者信息

Wecht C H

出版信息

Am J Law Med. 1977;3(4):425-45.

PMID:206136
Abstract

The author of this Article, an internationally recognized coroner perhaps best known among laymen for his incisive and tenacious criticism of the Warren Commission report on the Kennedy assassination, turns his attention to the federal government's 1976--1977 Swine Flu Immunization Program. Dr. Wecht contends that although this program may have been viewed by its key proponents as having great public health importance, or perhaps even political value, its creation and continuation nevertheless were scientifically unjustified. Furthermore, he contends, the federal government failed to inform the public adequately of important facts about the program's origins and progress, and it mismanaged the program in several important respects. Among the topics he discusses are swine flu's epidemiological history (including the 1976 Fort Dix outbreak that propelled swine flu into the national consciousness); the key elements leading to the government's decision to immunize; the government's failure to reevaluate the program seriously as problems arose; the shortcomings of the federal swine flu statute; the inadequacy of the government's investigation of the deaths of three persons in Pittsburgh within a few hours after being vaccinated (a matter that was of immediate concern to the author in his role as Coroner of Allegheny County, Pennsylvania); the long-delayed termination of the program following the emergence of a possible statistical link between the immunizations and an increase in the incidence of the Guillain-Barré Syndrome; the financial and human costs of the program; and the need for calmer, more objective decision making in future situations where immunization of the general populace is being considered.

摘要

本文作者是一位国际知名的验尸官,在外行中或许最广为人知的是他对沃伦委员会关于肯尼迪遇刺案报告的尖锐而执着的批评,他将注意力转向了联邦政府1976 - 1977年的猪流感免疫计划。韦克特博士认为,尽管该计划的主要支持者可能认为其具有重大的公共卫生重要性,甚至可能具有政治价值,但其设立和延续在科学上却毫无依据。此外,他认为联邦政府没有充分向公众告知该计划起源和进展的重要事实,并且在几个重要方面对该计划管理不善。他讨论的主题包括猪流感的流行病学历史(包括1976年迪克斯堡疫情,该疫情使猪流感进入了全国的关注视野);导致政府决定进行免疫接种的关键因素;随着问题出现政府未能认真重新评估该计划;联邦猪流感法规的缺陷;政府对三名在匹兹堡接种疫苗几小时后死亡人员的调查存在不足(作者作为宾夕法尼亚州阿勒格尼县验尸官,此事是他当时立即关注的);在免疫接种与格林 - 巴利综合征发病率增加之间可能存在统计关联后,该计划的长期拖延终止;该计划的财务和人力成本;以及在未来考虑对普通民众进行免疫接种的情况下,需要更冷静、更客观的决策。

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