Mid-March, 2009. La Gloria, a town of about 2243 people, in the state of Veracruz, Mexico. Not much of town, though it looks pretty, perched amongst hills. About half of this small population works in Mexico City, about 200 kms away, during the week. About 60% of the town is sickened by a respiratory illness whose cause was unknown. Later, this illness is called the swine flu, caused by a virus, H1N1. Three children die, the cause unknown, because the swine flu has not been identified yet. Only one is later tested for swine flu, the other two buried before the disease is named.

End March, 2009. A nine year old girl living in a California county bordering Mexico is taken ill and is later confirmed to have suffered from the swine flu. Another 10 year old boy in nearby San Diego county also falls victim to the swine flu.

Mid April, 2009. The CDC receives mucus samples from the girl and the boy and identify the virus as a new strain of the swine influenza, A(H1N1).

April 21, 2009. The CDC alerts physicians of a new strain of an Influenza A virus, called A(H1N1). This news is the first report of the disease in an English media. The swine flu is also the cause of the deadly 1918 influenza pandemic in which 50 million people were killed and 500 million infected.

End April, 2009. An entire school district just outside San Antonio, Texas, is closed to prevent spreading of the influenza. About 53,000 students are out of school in Texas and more school closures are planned. Some schools in Chicago and New York close to prevent spreading of the disease. A 23-month old Mexican child in Texas dies, the first casualty outside Mexico.

May 1, 2009. Mexico shuts down for five days to battle the epidemic. Fear runs wild through the streets.

May 16, 2009. India confirms its first case of swine flu, in the southern city of Hyderabad.

August 4, 2009. A 14 year old girl in the western city of Pune dies of swine flu, the first reported death due to the disease. Her death is all the more shocking because it is caused by a delay in identifying her illness as the swine flu. The delay also means that a drug, Tamiflu, that could have saved her life, is not given. There is outrage over the incident. Ineffectual enquiries are launched as is the norm. Worldwide, about 800 people have died of the disease so far.

August 13, 2009. Mumbai, India’s commercial capital, begins a week long shutdown of all schools and colleges and a three day shutdown of movie halls to prevent the spreading of the epidemic. 19 people have died in India alone and 1,126 worldwide.

September, 2009. A second wave of the epidemic hits the US, prompting school closures in eight states.

October 23, 2009. US president Obama declares a national emergency over the swine flu.

Eight months after it first surfaced, the ripple effect triggered by the pandemic touches our house. Swine flu vaccines are in short supply and the demand is aplenty. Santa Clara county has received only 55,000 of the expected 211,000 so far. Pediatrician offices have not received any supply of the vaccine, and expect supplies to be delayed even further.

When the vaccine was first announced, Shanthala and I were skeptical of giving it to Maya. We were worried about the possible side effects of a new drug, hardly tested. In 1976, the US government provided mass immunization against a similar swine flu pandemic. 500 people came down with a neurological disorder called Guillain-Barré syndrome and 25 people died. The Daily Mail paper in the UK carried a story that said that a leaked letter by the Govt to senior neurologists linked the new vaccine to the possibility of acquiring GBS. The vaccine was withdrawn within ten weeks of its premiere and the US government paid out millions to settle with those who were affected by the vaccine. But despite intense scrutiny for possible side effects, the current swine flu shot seems to have no serious side-effects, at least not GBS. It’s well past ten weeks by now.

Shanthala is administered the vaccine in her hospital as she is a health care worker. We’re traveling to India shortly and she’d like Maya to get a shot as well. Shanthala rarely stresses on the need for medication and so when she does so this time, I take it seriously. Shanthala and I find out that the Santa Clara county is holding a vaccine clinic on Saturday in multiple places, including the Santa Clara county fairgrounds. We decide to try our luck at a local county clinic that is also participating in the vaccine program.

Saturday, 8:15am. I had read reports of vaccine clinics in New York city running quite empty as few people showed up to get the shot. So, even though Shanthala wanted to go early and wait in line, I dallied and we eventually ended up going around 8:15 or so. I expected some rush, but not the pandemonium that we encountered. The line had circled the building almost twice already. I drop Shanthala off and headed back home. Shanthala reports later that the line had started at 4 am that morning. By 6 am, the parking lot was full. The clinic was not slated to open till 9:30. At the main swine flu clinic at Santa Clara county fairgrounds, people started lining up at 3 am in the morning, according to reports.

9:45 am. Shanthala calls to say that there was chaos and that she and several others had approached the few police officers to fetch reinforcements. People were drifting in and trying to get to the head of the queue, to either sneak by or to ask questions and were pushed and wrestled by the people already waiting in line. She asks me to park the car some distance away and use a stroller to get Maya to the clinic.

10:15 am. Shanthala calls to report that about 70-80 pregnant women were first let in to be administered the vaccine and that the rest were waiting. She says that there was some talk of giving tickets to people in line with kids.

10:30 am. Shanthala asks me to head over right away with Maya because there was talk that the tickets would not be issued to people without kids, even though the shot was for a kid.

10:50 am. I park about half a mile away and walk to the clinic. Maya has had a little meal and is not very fussy, though she protested being put in the stroller. She wanted to push the stroller. As we approach the clinic, passersby tell me that the vaccine is over. When we arrive, Shanthala says that she got a ticket already. She is number 807. How long do we have to wait, I wonder. An hour ? I see an official looking announcer with a bullhorn and approach him for details. He says that only about a 100 people have gotten the shot so far. Someone else asks how long it would be till his turn came up. He has a number in the 500 range. At least four hours, says the official. Four hours ! Are those with a ticket at least guaranteed a shot, I ask. Yes, he says. There are a 1000 vaccines.

I drift back to Shanthala to report the news. She’s gotten acquainted with the other folks in the line. There is a Chinese couple with a three and half year old son and an Indian couple with a four year old daughter. We decide to take turns to go get lunch and relax a bit. The Indian couple take off first, we next. There is a nearby Indian restaurant we’ve not been to. I see a few colleagues from work also waiting in line.

1:00 pm. Lunch is long over as is Maya’s patience. We’ve walked her several times, had her push the stroller a few times. It is her nap time now and she’s getting tired. I had shrugged Shanthala’s suggestion earlier that I take her to the park. People in line are eating take-away meals, mostly burgers and fries. A kid ahead of us plays a mouth organ (harmonica) and Maya watches him in fascination. The official announcer comes around announcing that they’ve vaccinated up to ticket number 450 now. It is a little nippy in the shade, but comfortable in the sun. A mom sits down on the sidewalk and reads a story to her son. A few other kids settle down next to her and it is story time all of a sudden.

1:30 pm. Maya is getting more restless and Shanthala asks me to take her home for a nap. I argue that I can put her down right there, but Shanthala thinks Maya won’t nap with all the noise. Maya really loses it now and I hurry away to the car with her strapped in the stroller. She’s miserable and wails as loudly as she can all the way to the car and all the way home. Her wailing sets me on the edge after a while and I yell at her to be quiet. She falls asleep just as we reach home. She’s exhausted from the crying. It is almost 2 pm. I put her down on the bed and lie down next to her.

2:35 pm. Shanthala calls to say that she’s nearing the head of the line and asks me to head over right away. I pull everything together first before waking Maya. I expect her to start wailing again, but she is quiet. I park in the parking lot of the apartment complex right opposite the clinic. Maya doesn’t want to get in the stroller. I hold her and pushing the stroller race across the street, jaywalking right in front of the cop patrolling the entrance. We reach the clinic closer to 3.

3:25 pm. Maya is given the vaccine, a shot to the thigh. She wails for an instant before quieting. We arrive home by 4, exhausted.

NYT is running an article today speaking of this rift in behavior between parents who’re lining up to receive the vaccine and those who remain skeptical and refuse it. A friend I spoke to expressed similar skepticism and said that most people recovered quickly even if infected and so she didn’t want her three year old daughter to get it. In the NYT article, a historian, David Oshinsky, notes that when polio vaccination was first offered in 1954, more than a million people showed up with their kids for the trial. Dr. Oshinsky says of those parents: “They also had lived through virulent epidemics. That to me is probably the biggest issue of all. You’re dealing with parents [the current generation] who’ve never seen a smallpox epidemic, a polio epidemic.”. A doctor is also quoted in the NYT article saying: Dr. Offit wondered if people were more comfortable with sins of omission than of commission. Rather than inject a foreign substance into your body, he went on, “you’ll take your chances with a natural virus infection, which may or may not kill you.”

Lest you think that this behavior is East Coast schizoid, LA Times reports that only 5% of Californians intend to get inoculated, a number that remains constant across the socio-economic spectrum. And the reason the Californians don’t want to get vaccinated ? Not safety, but convenience (though among the most vulnerable, blacks and Latinos, safety was the number one concern). In the article, a 24-year old is quoted as saying: “A lot of people my age have the mentality they’re invincible and nothing can happen to them”.

Part of what is prompting these fears seems to be the ghost of 1976. Part of it is the drivel in the media from the likes of Bill Maher who oppose even pregnant women (the riskiest category for getting the disease) from getting a vaccine. In the article reported in NYT, I had to support the Republican doctor from Tennessee, Dr. Bill Frist over the unsubstantiated statements of Bill Maher. Maher seemed to forget that scoring points against unscientific Republicans may drive up the ratings, but not just opposing any Republican and unscientific liberals don’t come off sounding any less inane. The pundits in the US are remarkably ignorant and unscientific, be it on the issue of global warming, evolution or in this case, vaccines (I hope I’m not tempting fate by laughing at the skepticism of these people). The LA Times article reported that people who identified themselves as conservative Republicans were twice more likely to suspect vaccine safety compared to liberal Democrats. I guess, Bill Maher wanted to even things out a bit.

References:

• 2009 Swine Flu Pandemic Timeline – Wikipedia
• La Gloria village slideshow, Guardian, UK

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