Begley S L
Yale J Biol Med. 1977 Nov-Dec;50(6):645-56.
The program to immunize 210 million Americans against swine flu failed. It set back the Federal government's relations with state health agencies, private physicians, pharmaceutical manufacturers, and the insurance industry. It increased mistrust of immunization programs and of government health programs in general.The well-intentioned plan had far-reaching consequences because its scope and the speed with which it was implemented were overreactions to the threat. Its size magnified every one of its faults, legal, medical and political. Organizational and scientific capacity were less than expected. Local health agencies could not administer the program with the inadequate funds from HEW and pharmaceutical companies could not produce a safe, effective children's vaccine.Because of the urgency given the program, Congress neglected the opposition of consumer advocates and state health officials, and did not spend time trying to include immunization against childhood disease in the swine flu program.The failure illustrates the dangers of hasty decisions, of considering only direct medical costs and benefits and not social and political effects on health policy, of launching a public health program whose scientific basis is weak and whose administrative requirements are untested.
为2.1亿美国人接种猪流感疫苗的计划失败了。它使联邦政府与州卫生机构、私人医生、制药商以及保险业的关系倒退。它加剧了人们对免疫计划以及总体上对政府卫生计划的不信任。这个善意的计划产生了深远的影响，因为其规模以及实施速度是对威胁的过度反应。其规模放大了它在法律、医学和政治方面的每一个错误。组织和科学能力低于预期。地方卫生机构因来自卫生、教育和福利部的资金不足而无法实施该计划，制药公司也无法生产出安全有效的儿童疫苗。由于该计划的紧迫性，国会忽视了消费者权益倡导者和州卫生官员的反对意见，也没有花时间将针对儿童疾病的免疫接种纳入猪流感计划。这次失败说明了仓促决策的危险，说明了只考虑直接医疗成本和效益而不考虑对卫生政策的社会和政治影响的危险，说明了启动一个科学依据薄弱且行政要求未经检验的公共卫生计划的危险。
