The forgotten pandemic and its lasting legacy
The Hong Kong flu pandemic of 1968-70 is often described as the forgotten chapter of modern health crises, largely because it unfolded alongside era-defining events and headlines. In Australia, about 10,000 people died from influenza during those two winters. For infectious-disease expert Dr. John Gerrard, Gold Coast University Hospital, the tragedy is also deeply personal: he was six years old when his elder brother Stephen died in the Hong Kong outbreak.
Historians note that influenza pandemics have punctuated the past century, with the Spanish flu in 1918, the Hong Kong flu a generation later, and then COVID-19. Yet the legacy of these outbreaks persists in today’s public health practice, including how vaccines are developed, stocked, and used to protect vulnerable populations.
Parallels with COVID-19: mortality and age patterns
Recent analyses comparing two Hong Kong influenza seasons with the COVID-19 period 2020-23 show striking similarities in excess mortality: roughly 87.3 to 91.4 deaths per 100,000 people. However, the age pattern differed. About 30% of Hong Kong influenza deaths occurred in people under 65, compared with around 11% of COVID-19 deaths in those under 70. These figures matter for how we prioritize vaccination and communicate risk during flu seasons that coincide with other emerging pathogens.
Public health responses then and now
The 1969 “flu furore” reflected early concerns about vaccine supply ahead of a predicted winter surge. Public anxiety over vaccine availability echoes today’s debates about supply chains and equitable access, underscoring a throughline in pandemic responses across eras.
Vaccine supply, trust, and lessons for preparedness
Australia had the capacity in 1968 to mass-produce influenza vaccines at CSL. Yet public criticism followed the decision to send 1.3 million Hong Kong influenza vaccine doses to Britain to help with its winter surge. Gerrard notes that such decisions sparked consternation, highlighting how vaccine distribution policies can influence public trust even decades later.
Beyond logistics, the lessons remain clear: vaccines save lives. Gerrard argues that high vaccination coverage dramatically reduces mortality in a pandemic, and he points to historical and contemporary data to support strong immunisation campaigns as a core preparedness strategy.
Lessons for preparedness and the path forward
Today’s clinicians watch influenza seasons that can rival or exceed COVID-19 waves in burden. Gerrard treats flu patients and has heard from many who regret not getting vaccinated. The overarching message is simple: vaccination and preparedness are still our most effective shield against severe disease and hospital surge during respiratory pandemics.
A personal perspective: a life shaped by pandemics
Gerrard’s professional life mirrors the arc of pandemic history: memory of loss, a commitment to science, and a continuous push for better vaccine supply, faster access, and clearer public guidance. He notes that the current flu season has, at times, been as severe as COVID-19 in the earlier stages of the pandemic, reinforcing the ongoing relevance of vaccination as a daily health decision.
Conclusion
The Hong Kong flu may be labeled forgotten, but its lessons are enduring: vaccines, robust supply chains, and transparent public health messaging save lives. As Australia and the world confront future influenza waves and potential new pandemics, the core guidance remains unchanged—protect the young and vulnerable through vaccination, preparedness, and proactive policy.
