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Retro Baltimore: Coronavirus vaccine distribution marks divergence from 1918 influenza

In the midst of what might be the darkest chapter of the coronavirus pandemic, news of a vaccine arriving at hospitals around the country this week has provided some cause for hope.

Throughout the course of the COVID-19 pandemic, it has frequently been compared to the 1918 influenza outbreak. But with this latest development, history is at last diverging. Unlike the Pfizer-BioNTech vaccine, which was approved for emergency distribution in less than a year, it took over two decades after 1918′s H1N1 virus had run its course for an effective flu vaccine to become available to the American public.

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But that doesn’t mean scientists weren’t chasing down a miracle cure along the way. According to a post written by Karie Youghdahl for The History of Vaccines — a blog kept by the College of Physicians of Philadelphia — U.S. and European researchers and healthcare workers immunized hundreds of thousands of people with experimental vaccines throughout the pandemic, though they never conceived a serum that prevented viral influenza infection.

This Library of Congress photo shows a demonstration at the Red Cross Emergency Ambulance Station in Washington, D.C., during the influenza pandemic of 1918.
This Library of Congress photo shows a demonstration at the Red Cross Emergency Ambulance Station in Washington, D.C., during the influenza pandemic of 1918. (Library of Congress/AP)

Decades ago, as The Baltimore Sun tracked the spread of the influenza in the city, it also followed advances in this multifaceted — and scarcely regulated — campaign for a vaccine, sending up flares of hope in one article, only to temper them in the next.

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On Oct. 1, 1918 — a date in the early stages of an outbreak that would eventually kill at least 675,000 Americans — The Sun reported a surge of more than 1,000 influenza cases at Maryland’s Camp Meade in just one day. In the same story, however, the paper introduced the discovery of a serum, “made from influenza germs obtained from persons in the early stages of the malady,” with the promise of treating the disease.

At the time of The Sun’s article, the vaccine was being prepared for distribution in small quantities. A little under two weeks later, the man behind the serum — Dr. William H. Park, New York City Health Department’s head bacteriologist — wrote in the New York Medical Journal that he was vaccinating employees at large companies and soldiers in army camps, according to Youngdahl’s blog post.

One day earlier, The Sun had announced that the city’s health department had received enough doses of a different vaccine from the Army Medical School for 100 inoculations. The story quoted the city’s bacteriologist, Dr. William Royal Stokes, who said the injection was “very effective” against three forms of pneumonia that generally proved to be fatal. Stokes also said he had inoculated himself with the vaccine, along with several other health department employees.

FILE - In this November 1918 photo made available by the Library of Congress, a nurse takes the pulse of a patient in the influenza ward of the Walter Reed hospital in Washington.
FILE - In this November 1918 photo made available by the Library of Congress, a nurse takes the pulse of a patient in the influenza ward of the Walter Reed hospital in Washington. (Library of Congress/AP)

But in a report on a meeting of the American Public Health Association two months later, The Sun struck a much less optimistic tone. According to the story, the doctors attending the meeting disagreed over the best methods of preventing the spread of the flu, with some admitting that they had not yet found a successful way to combat the disease.

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The article also captured the divergence in medical opinion over the value of the vaccines that were on the market at that time.

At the meeting, Park criticized the indiscriminate use of “stock vaccine” and argued that until its efficacy could be established, it should only be used in controlled cases. However, New York Health Commissioner Royal Copeland — who had initially expressed confidence in Park’s vaccine — threw his support behind a new vaccine being developed by Dr. E.C. Rosenow of the Mayo Clinic, which Copeland said had seen success in Chicago and the Midwest.

Copeland’s confidence seemed to have won The Sun over.

“If this fact is established, it would be a good idea to have plenty of this Rosenow vaccine handy in Baltimore,” the article concluded.

By August of the following year, though, the city’s health commissioner told The Sun that knowledge of the cause, prevention and spread of the influenza remained meager. Furthermore, the commissioner went on, all theories advanced by physicians were “embryonic” and their results had yet to be tested.

At that time, the country’s best hope seemed to rest on an anti-pneumonia vaccine, which Baltimore health physicians were then experimenting with, according to The Sun. Should the serum prove effective, the health commissioner advised that every person in Baltimore should be inoculated “at the first appearance of influenza.”

But more pressing concerns were upon the city: a second wave of the disease seemed to be looming, and Baltimore was scrambling to make preparations. The American Medical Association had requested funding from Congress with which it could fight the flu in the fall, but lawmakers had not yet taken action. Sound familiar?

As the city buckled down, health commissioner Dr. John D. Blake urged Baltimoreans to protect themselves from the disease — advice he doubted anyone would follow.

“Dr. Blake said warning the public against influenza was like ‘casting pearls before swine,’” The Sun wrote. “The public, he said, would not take precautions until the disease was in its midst, and then it was too late.”

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