The 1978-79 Flu Program

GAO reviewed the 1978-1979 flu program as carried out by the Departments of Health, Education, and Welfare (HEW) and Justice. Congress expressed concern over the need for a Federal flu program, its liability, and HEW ability to plan and implement a safe and effective program. Congress funded the program at the requested level and immunizations began in late October 1978. The effectiveness of the 1978-79 flu program in preventing excessive mortality among high-risk individuals is unknown. It is difficult to conclude that the vaccine was effective in preventing excess mortality. The uncertainties about the nature and behavior of flu viruses resulted in controversy over HEW predictions and the need for implementation of a flu program. HEW assumed that high-risk persons would desire vaccination. However, their specific responses to the question on willingness to be immunized were not separately analyzed. Uncertain and late program funding attributed to the small number of people vaccinated during the program. HEW needs to seek congressional funding based on incomplete information about the nature and behavior of the expected flu. In determining the role of the Federal Government and the amount of funds to be spent, the Secretary of HEW should consider: the extent and severity of flu expected, the extent of demand measured in the target population, and the capability of existing public and private settings to meet that demand. The Secretary should establish a time-phased approach to the program similar to that already established for dealing with potential flu pandemics.