As the dreaded autumn wave ends and official deaths remain relatively low, the backlash against the H1N1 pandemic response is in full swing. Claims range from a massive overreaction by health authorities to a conspiracy cooked up by big pharma. But while swine flu may have boosted profits for vaccine manufacturers, the reality of the pandemic is more complicated.
First off, the pandemic isn't over. While cases in western Europe and North America have tailed off, the virus is still spreading in eastern Europe, Africa and Asia. Meanwhile, Europe and North America could see cases rise again, if the flu pandemic of 1957-8 is anything to go by.
By January 1958, following an initially low death rate, officials assumed the pandemic was over, and vaccine went unused. But then there was a wave of deaths in the US in February, which might otherwise have been avoided (see graph). "They had vaccine but they didn't encourage its use," says Anne Schuchat of the US Centers for Disease Control and Prevention in Atlanta, Georgia. To prevent a similar scenario, the CDC recommends continued vaccination. Yet several countries and US states have vaccine gluts, and many European countries are cutting orders and selling or giving vaccine away.