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January 2010

In 1976, Fred Abrahamson administers the swine flu vaccination program in Washington State. Now, he looks back.

Then and Now: Swine Flu Immunization

 

jet injectors and a brewery...
how can this immunization program go wrong?

then...

In 1976, Fred Abrahamson administers the swine flu vaccination program in Washington State. He and his colleagues use jet injector guns to quickly immunize people. Government storage facilities are overwhelmed, so 100,000 vaccines are stored at the Olympia Brewing Company. Three station wagons, 30 jet injector guns and three million cotton balls later, about 350,000 Washingtonians are immunized.

now...

Fred Abrahamson discusses the 1976 Washington swine flu vaccination program


What was your role in the 1976 swine flu vaccination program?

I was involved because I was with the Washington State immunization program. We were the ones responsible for providing biologicals to all local health jurisdictions (LHDs). So when the Ford Administration decided we needed to take action because of the public health threat posed by swine flu, we got involved.

The CDC immunization program implemented what was to be the 1976 swine flu immunization program. As a result of my normal involvement in the immunization activities, I became involved in the swine flu program. I was the person responsible for all of the logistics and for providing all needed materials for the clinics to the LHDs involved.

This meant that I provided not only vaccine, but everything needed to set up an immunization clinic. For example, I purchased and distributed 3 million cotton balls as part of my duties.

How was the vaccine administered?

We used jet injector guns to do the immunizations. They were hydraulically operated guns of good size, maybe about 10 or 11 inches in length. You held it as if it were a gun. The hydraulics were on the floor and a hose ran up to the gun. When you pushed down on the foot lever, it would draw back the cylinder and allow the cylinder to put vaccine in the arm. You could load up 50 doses at a time.

We conducted mass clinics. Acetone was used because when you swipe acetone on skin, it dries very quickly. Alcohol does not dry very quickly and makes the skin slippery. The nozzle of the gun had a small hole in middle of it. You would take a person’s arm and force the gun into the arm and then shoot it. You had to hold person’s arm, though. If people’s arms moved, the shot of vaccine would lacerate the arm.

These jet injector guns would allow us to immunize hundreds an hour. This was much quicker than having to draw each dose and inject it. Some places, we had people waiting all the way out into the parking lots of malls and schools.

Did you administer the vaccine yourself?

I trained nurses how to use the jet injector gun. I was assigned as a physician’s assistant, classification 3 in those days even though I did not have medical training. But they needed to have technicians that knew how to use the vaccine gun and could train people and provide immunizations when there were not an adequate number of personnel to do the immunizations.

What was the busiest clinic you conducted?

The Southcenter shopping mall just south of Seattle. Over a weekend we gave about 50 thousand shots. Overall, I believe we gave 350 thousand shots in Washington State. It was not nearly the response that we hoped given all the advertisement and concern, but all in all it wasn’t too bad.

How did you store and manage the vaccine supply?

We got vaccine shipped to Olympia where our office was. We got so much of it, we stored it at the Olympia Brewing Company because they had ideal temperature conditions. The vaccine had to be below 42 degrees, but no lower than 37 degrees. The refrigerators at our office were good sized but could only handle a few thousand doses. We had 100 thousand doses.

How long did it take to prepare for and conduct the swine flu immunization program?

We had a lot of time to get prepared—about two months. It’s true we had 35 different LHDs we were working with, but we had already been working with them on other vaccinations. This meant the workforce was already trained and ready. I think it was a more centralized effort than the current H1N1 efforts.

Once we started to give vaccinations, we did so for about two months. There were three of us actively involved from the state. We knew how to maximize efficiency at clinics and to plan traffic flow. Local medical personnel would administer the vaccinations, but we would wrap things up and take all equipment and sanitize it. We carried a portable autoclave. We traveled around the state coordinating clinics.

Do you think the vaccination program produced the desired results?

I think the lack of a 1976 pandemic can be attributed to the vaccination program. I am not aware of any diagnosed cases after the vaccine began to be administered. Of course, some said that this would have been the same if the vaccination program hadn’t happened.

Have you noticed any differences between public health response to swine flu in 1976 and now?

From my perspective, people are more leery of government than they were in the 70s. People much prefer their private health care providers administering the immunizations than going to the local health department.

 

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