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Swine flu affair: a very good book with a very bad title
108
TIBS - March 1983
This book has much to commend it in content and in presentation. Medical and other health science students will enjoy it. Though they will question whether they should master all the material presented
Swine flu affair: a very
during the time allotted for their study of biochemistry, they will recognize the book as a useful resource and not part with it till their clinical studies are completed. Many teachers of biochemistry will want a copy
good book with a very bad title
Pure Politics and Impure Science - the Swine Flu Affair
by Arthur M. Silverstein, The Johns Hopkins University Press, 1982. £8.75 (xv + 176 pages) 1SBN 0 801 82632 2 The author has written a superb account of the complex affair of the swine flu vaccination program of 1976. It is written in a language which may be understood by lay-persons, and with an objective viewpoint sympathetic to both the scientists and politicians who were involved. Two key points emerge in explanation for what has been called a 'fiasco'. The first was that the expected swine flu epidemic did not materialize. The second was that, following vaccination, there was a significant increase in the incidence of the crippling and sometimes fatal disease called Guillain-Barr6 syndrome. Neither could have been predicted from the best scientific evidence available when President Ford announced the vaccination program. As a staff member of Senator Edward Kennedy's Senate Health Subcommittee, the author had a unique opportunity to watch the political manoeuvring that was set in motion when the insurance industry refused to assume liability in case of vaccination accidents. The story once again demonstrates the haste that dominates legislative decisions. Unfortunately, this haste was unavoidable in view of the set of circumstances. Four conclusions are listed: (1) The decision in March 1976 to mount a National Immunization Program against swine flu was correct; (2) The initial decision to vaccinate the public rather than stockpile the vaccine was correct; (3) The National Immunization Program was administered conscientiously if somewhat ineptly by those in charge; (4) There were no real 'culprits' in 1976. Among the major lessons cited for the future are that there should be a built-in mechanism for re-evaluation after the decision to start such a large-scale vaccination program. Closer attention must be paid to public relations and the insurance liability problem must be solved in advance. The author hopes that the bad experiences of 1976 will not jeopardize a future program when the need for mass vaccination arises. In fact it seems likely, he concludes, that
handy as a reference, if only for much of the material that is not presented in the more popular textbooks. F. VELLA F. Vella is at the Department of Biochemistry, University of Saskatchewan, Saskatoon, Canada.
fatal encephalitis not interfere with the successful erradication of smallpox by vaccination? In medicine one always has to weigh one risk against another. What would Mike Wallace have said (had he survived) if there had been an influenza pandemic and no vaccination program ? My second objection concerns the title of the book. There was nothing 'impure' about the science in this story, nor were the politics pure. The advice given by the scientists was the best available at the time. The public must learn that scientists are not infallible and that our knowledge of infectious diseases is still incomplete. The tragedy of the victims of the Guillain-Barr6 syndrome calls for more study and not for televised demagogic objections to vaccination. A better title for the book would have been Pure Science, Impure Politics and
such a time will come. This reviewer is in disagreement with the author on two issues. There was a culprit in this story: it was the news media. The deaths of three elderly people, shortly after receiving the vaccine, were blown completely out of proportion. It was irresponsible reporting. On 4 November 1979, the problem of compensation for victims of Guillain-Barr6 disease was aired on the television program 'Sixty Minutes'. Mike Wallace irresponsibly created the impression that there was wilful deceit on the part of the officials of the Communicable Disease Center. He claimed that they supressed information on the possibility of contracting Guillain-Barr6 disease following vaccination. Such evidence could not have been available because of the rarity of the Some Irresponsible Reporting. disease. In fact, this information only came to light because of the large number of peoEFRAIM RACKER ple vaccinated in the 1976 program. Moreover, would a statement regarding this Efraim Racker is Professor of Biochemistry at the rare disease have made any difference in the Section of Biochemistry, Molecular and Cell Biolnumbers of voluntary vaccinations? Why ogy, Division of Biological Sciences, Cornell Unidid the statement warning against a rare, versity, Ithaca, NY 14853, U.S.A.
Scientific gamesmanship W i n n i n g the G a m e s Scientists Play
by Carl J. Sindermann, Plenum Press, 1982. $15.95 (xii + 290pages) 1SBN 0 306 41075 3 One of my favourite publications over the years has been the Journal oflrreproducible Results, that fine collation of scientific humour, parody and oddity. Editor Alex Kohn does a fine job in pulling together spoof papers, delightful snippets and other material in a field that is, frankly, more notable for ambition than for performance. There is nothing more ghastly than the failures of chemists, physicists and biologists when they set out to be funny and fail. So it is not altogether surprising that, among the many goodies which turn up in J.I.R., occasional unwitty, overwritten, unmemorable contributions do slip through the net and into print. They invariably come from American laboratories. So it is with Winning the Games Scientists Play. Author Sindermann has played many games himself, as director of the Sandy Hook Marine Laboratory, New
Jersey, and as an international activist in oceanography, and he sets out here to run through the rules and pitfalls. The problem is that it is by no means always clear when he is being wise and when he is being witty. Take this, for example, which is typical of both the book andJ.LR, at their most tiresome: 'If the research supporting a proposed paper has been started or completed without a decision about first authorship, then the sequence of authors should be determined by a complex formula, whose major elements are: Conceptual input (C), Planning input (P), Data acquisition (Dac), Data analysis (Dan), Hours of invested time (T), Preparation of first draft (Pd) and Final editing (Ed). Each element is weighed, and the formula becomes: 4C + 2P + 2Dac + 2Dan + P d + Ed T i
'Assignment of values for each element is done by a select committee of peers. Differences among total scores must be tested for statistical significance, and where sig-
TIBS - March 1983
This book has much to commend it in content and in presentation. Medical and other health science students will enjoy it. Though they will question whether they should master all the material presented
Swine flu affair: a very
during the time allotted for their study of biochemistry, they will recognize the book as a useful resource and not part with it till their clinical studies are completed. Many teachers of biochemistry will want a copy
good book with a very bad title
Pure Politics and Impure Science - the Swine Flu Affair
by Arthur M. Silverstein, The Johns Hopkins University Press, 1982. £8.75 (xv + 176 pages) 1SBN 0 801 82632 2 The author has written a superb account of the complex affair of the swine flu vaccination program of 1976. It is written in a language which may be understood by lay-persons, and with an objective viewpoint sympathetic to both the scientists and politicians who were involved. Two key points emerge in explanation for what has been called a 'fiasco'. The first was that the expected swine flu epidemic did not materialize. The second was that, following vaccination, there was a significant increase in the incidence of the crippling and sometimes fatal disease called Guillain-Barr6 syndrome. Neither could have been predicted from the best scientific evidence available when President Ford announced the vaccination program. As a staff member of Senator Edward Kennedy's Senate Health Subcommittee, the author had a unique opportunity to watch the political manoeuvring that was set in motion when the insurance industry refused to assume liability in case of vaccination accidents. The story once again demonstrates the haste that dominates legislative decisions. Unfortunately, this haste was unavoidable in view of the set of circumstances. Four conclusions are listed: (1) The decision in March 1976 to mount a National Immunization Program against swine flu was correct; (2) The initial decision to vaccinate the public rather than stockpile the vaccine was correct; (3) The National Immunization Program was administered conscientiously if somewhat ineptly by those in charge; (4) There were no real 'culprits' in 1976. Among the major lessons cited for the future are that there should be a built-in mechanism for re-evaluation after the decision to start such a large-scale vaccination program. Closer attention must be paid to public relations and the insurance liability problem must be solved in advance. The author hopes that the bad experiences of 1976 will not jeopardize a future program when the need for mass vaccination arises. In fact it seems likely, he concludes, that
handy as a reference, if only for much of the material that is not presented in the more popular textbooks. F. VELLA F. Vella is at the Department of Biochemistry, University of Saskatchewan, Saskatoon, Canada.
fatal encephalitis not interfere with the successful erradication of smallpox by vaccination? In medicine one always has to weigh one risk against another. What would Mike Wallace have said (had he survived) if there had been an influenza pandemic and no vaccination program ? My second objection concerns the title of the book. There was nothing 'impure' about the science in this story, nor were the politics pure. The advice given by the scientists was the best available at the time. The public must learn that scientists are not infallible and that our knowledge of infectious diseases is still incomplete. The tragedy of the victims of the Guillain-Barr6 syndrome calls for more study and not for televised demagogic objections to vaccination. A better title for the book would have been Pure Science, Impure Politics and
such a time will come. This reviewer is in disagreement with the author on two issues. There was a culprit in this story: it was the news media. The deaths of three elderly people, shortly after receiving the vaccine, were blown completely out of proportion. It was irresponsible reporting. On 4 November 1979, the problem of compensation for victims of Guillain-Barr6 disease was aired on the television program 'Sixty Minutes'. Mike Wallace irresponsibly created the impression that there was wilful deceit on the part of the officials of the Communicable Disease Center. He claimed that they supressed information on the possibility of contracting Guillain-Barr6 disease following vaccination. Such evidence could not have been available because of the rarity of the Some Irresponsible Reporting. disease. In fact, this information only came to light because of the large number of peoEFRAIM RACKER ple vaccinated in the 1976 program. Moreover, would a statement regarding this Efraim Racker is Professor of Biochemistry at the rare disease have made any difference in the Section of Biochemistry, Molecular and Cell Biolnumbers of voluntary vaccinations? Why ogy, Division of Biological Sciences, Cornell Unidid the statement warning against a rare, versity, Ithaca, NY 14853, U.S.A.
Scientific gamesmanship W i n n i n g the G a m e s Scientists Play
by Carl J. Sindermann, Plenum Press, 1982. $15.95 (xii + 290pages) 1SBN 0 306 41075 3 One of my favourite publications over the years has been the Journal oflrreproducible Results, that fine collation of scientific humour, parody and oddity. Editor Alex Kohn does a fine job in pulling together spoof papers, delightful snippets and other material in a field that is, frankly, more notable for ambition than for performance. There is nothing more ghastly than the failures of chemists, physicists and biologists when they set out to be funny and fail. So it is not altogether surprising that, among the many goodies which turn up in J.I.R., occasional unwitty, overwritten, unmemorable contributions do slip through the net and into print. They invariably come from American laboratories. So it is with Winning the Games Scientists Play. Author Sindermann has played many games himself, as director of the Sandy Hook Marine Laboratory, New
Jersey, and as an international activist in oceanography, and he sets out here to run through the rules and pitfalls. The problem is that it is by no means always clear when he is being wise and when he is being witty. Take this, for example, which is typical of both the book andJ.LR, at their most tiresome: 'If the research supporting a proposed paper has been started or completed without a decision about first authorship, then the sequence of authors should be determined by a complex formula, whose major elements are: Conceptual input (C), Planning input (P), Data acquisition (Dac), Data analysis (Dan), Hours of invested time (T), Preparation of first draft (Pd) and Final editing (Ed). Each element is weighed, and the formula becomes: 4C + 2P + 2Dac + 2Dan + P d + Ed T i
'Assignment of values for each element is done by a select committee of peers. Differences among total scores must be tested for statistical significance, and where sig-