For me, one of the few pleasures of the first, terrifying weeks of coronavirus was the large number of historical articles reflecting on the lessons of the 1918 influenza pandemic. I suspect I was the only reader who thought, “All this fuss over influenza is so overblown! They found an effective vaccine almost immediately! Why is no one talking about that?!”

Consulting my research notes from 3.5 years prior, I saw that my memory was correct: the Homestead newspaper did report a remarkable story of inoculation success. The following two headlines from the Homestead Daily Messenger bookend the inoculation narrative that so misled me.

To summarize: At the peak of the influenza epidemic, the Carnegie Steel Company decided “to inoculate all its employees and their families without charge.”  Then, within weeks, they announced that “the vaccinations have accomplished excellent results.” While everywhere else the pandemic raged unchecked, in Homestead they eradicated influenza and reduced the fatality rate of those infected.

There are two problems with this story. First, the steel mill never did anything nice for its employees without a reason. What were they up to? Second, it was not until 1933 that scientists discovered the actual cause of influenza and developed the first effective vaccine! What in the world was injected into the people of Homestead, and did it really work as well as advertised?

Influenza arrived in Homestead in early October 1918 at the climax of World War I. Homesteaders had long understood that their patriotic duty was to produce steel for war materiel, and for months they had proudly set production records. But now, with the Germans finally on the run and the army demanding even more steel to keep up the push, the pandemic threatened everything at the most critical hour.

By mid-October, “all departments of the [Homestead] mill [were] badly crippled by either the men ill themselves or members of their family being ill and they having to stay home to attend to them.” 20 to 25% of the men were out. Seeing these numbers, the military fretted that “the production of war material is already seriously hampered” and “will fall short of requirements.”¹

War made Homestead’s defense workers into essential workers. Something had to be done.

By this time, promising news was circulating about influenza inoculation programs in places like military training camps where the pandemic had hit weeks earlier. The Carnegie Steel Company decided to inoculate all its workers, and with death all around them, its workers were pleased to receive a life-saving treatment.

But why did the company do it? For patriotism? For profit? Or, given the iffy understanding of the science in 1918, was there some other motive?

Today we know that influenza is caused by a virus, but in 1918 scientists believed they were chasing a bacteria. Experts debated whether Pfeiffer’s bacillus was the elusive culprit, with each camp championing a different category of vaccine—pure vaccines comprised only of Pfeiffer bacilli, or mixed vaccines with Pfeiffer’s and other bacteria, ideally cultured directly from patients’ sputum and adjusted to match local conditions. The pure vaccines placed a bet on the probable culprit. The mixed vaccines—which Homestead’s steelworkers got—chased a grab bag of possibilities, including the sources of the secondary infections that accompanied fatal cases of influenza.

From hypothesis to injection, all of this played out on a time scale of just weeks in sites around the country. To obtain the necessary volume of serum in this time frame, Carnegie Steel had to rely on commercial vaccines manufactured before the pandemic. (And to overcome the shortage of nurses available to administer the vaccine, the Homestead Works commandeered the town’s teachers, who were out of work during the school closures.)

The average person in 1918 could not have known any of this science. The Allegheny County Medical Society published a bulletin flatly stating, “At present there is no vaccine, serum or inoculation which will secure anyone against influenza.” This pronouncement received no coverage in the press. The Pennsylvania Department of Health noted that commercial vaccines were “utterly valueless.” This statement was buried in the papers, and no one connected the dots that such vaccines were exactly what Carnegie was administering. In fact, when military and industrial leaders touted the effectiveness of Carnegie’s inoculation program at a war production meeting, their reassurances made the front page of the papers, unquestioned.

If contemporary medicine didn’t actually support inoculation, why did so many industrial and military facilities persist?

The most generous interpretation I can offer is that the acknowledged absence of standards for vaccine trials made it impossible for scientists to understand what they were learning as they were learning it.

However, a University of Pittsburgh report from 1919 offered an alternate explanation: The chief surgeon for the [Carnegie Steel] company pushed the vaccine “to allay panic among the employees at a time when an interruption of manufacturing and mining pursuits might be disastrous to the entire country; and he did it with the assurance that if the vaccine did no good, it would at least do no harm.”²

All across its facilities the steel company administered a scientifically suspect vaccine on the basis of wishful thinking—yet somehow in Homestead they published in the town’s newspaper a “partial report” with a table of data that showed that the vaccine had worked marvelously!

Tellingly, when the University of Pittsburgh published Carnegie Steel’s aggregate data in 1919, they specifically excluded the Homestead Works’ figures. The Homestead newspaper data claimed that inoculated people contracted influenza 3% of the time, compared to 17% in the vetted Carnegie data. Without a vaccine, the Homestead data showed, a person was 50 times likelier to die; in the rest of the Carnegie data, only 3 times.

So, a final question we can never answer: was the Homestead data real data from a bad collection protocol? Or was it fake data presented to bolster the confidence of the workers at Carnegie’s most important defense plant?

In the end, the chief surgeon was right. No actual harm was done. Rather, by the end of 1918, the lessons learned from this mess of data led to the first guidelines for American vaccine trials.

As for the ways the steel mill tried to exert control over its workers, change there came far more slowly. A year later, when 20-25% of the Homestead workforce was once again absent, this time because the Great Steel Strike of 1919 had begun, the paper’s headline read, “All Quiet At Steel Works And Few Men Out On Strike.” The paper was still spreading the steel mill’s propaganda.

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I share this research with some trepidation, knowing that it is the sort of thing anti-vaxxers might seize upon.

I dredged up this forgotten history because, well, that’s what I do. But beyond the surprising twists of the story, it sheds light on the troubled relationship between labor and capital in Homestead during the non-union decades. Sometimes revisiting the past reminds us that we haven’t traveled as far as we’d like to think.

Out of the shortcomings of 1918 arose the knowledge and methodology that make an effective coronavirus vaccine possible today. We have the science they did not to identify the causal agent of our pandemic. We have the procedures they did not to test a vaccine candidate’s effectiveness. We have the process they did not to ensure the general population does not receive an ineffective or harmful vaccine. Even lay people can review the scientific progress—hence the debates happening right now in the press about the various trials. Sometimes revisiting the past reminds us that we’ve made real progress.

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Bibliography

• The 1918-19 Spanish Influenza Pandemic and Vaccine Development
• The State of Science, Microbiology, and Vaccines Circa 1918
• Studies on Epidemic Influenza Comprising Clinical and Laboratory Investigations
• The fog of research: influenza vaccine trials during the 1918-19 pandemic

 

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1. The Daily Messenger, Oct. 22 & Nov. 1, 1918; The Gazette Times, Oct. 28, 1918, p. 1; The Pittsburgh Sunday Post, Oct. 20, 1918, Section 3, p. 6 ↩

2. “The Prevention of Epidemic Influenza with Special Reference to Vaccine Prophylaxis,” Studies on Epidemic Influenza, The University of Pittsburgh, 1919 ↩