Abstract
In 1918, a crude influenza vaccine made from chemically inactivated, mixed cultures of respiratory bacteria was widely used prior to the understanding that influenza was caused by a virus. Such vaccines contained no viral material and probably consisted largely of bacterial endotoxin. The Australian military used such a vaccine on Samoa in December 1918 and thought it was valuable. Post hoc analyses suggest that the mixed respiratory bacteria vaccine may have actually been of some benefit, but the mechanism of such protection is unknown. Although such a crude vaccine would not be considered in a modern setting, the rapid use of problematic vaccines still remains a risk when new influenza types suddenly appear, as in 1976 and 2009.
Highlights
Epidemic lethal infections hold a particular terror for humans that has only been partially resolved by the modern medical practice of immunization
Since Haemophilus influenzae was thought to be the causative agent from the previous 1890 pandemic, a mixture of common respiratory bacteria was made into a vaccine and given to more than 400,000 Australians [2]
As it was the primary intervention used by the Australian military medical relief mission sent to Samoa in December 1918, it is illustrative to examine how this vaccine was employed [4]
Summary
Epidemic lethal infections hold a particular terror for humans that has only been partially resolved by the modern medical practice of immunization. As New Zealand was facing pandemic influenza, the as-yet-unaffected Australia was asked to send help in the form of a medical relief team on the naval cruiser HMAS Encounter (Figure 1B) [10]. HMAS Encounter arrived off Apia, Samoa on 3 December 1918 as the influenza epidemic was waning and assisted with the on-going medical relief.
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