Remember the 1976 swine flu scare, when the federal government tried to have the entire US population immunized against the disease? Neustadt and Fineberg--specialists in political and medical decision-making, respectively--believe that there are practical lessons to be learned from the incident; and that's arguable. (The #1 lesson seems to be the capriciousness of the flu virus.) Nonetheless they provide an interesting and pointed account of a confusing affair. The immunization campaign was not a fiasco, they stress, but the result of decisions that anyone might have made under the circumstances. From the moment an army recruit died in the outbreak of swine flu at Fort Dix in January 1976, there was an urgent sense of ""go or no go""--owing to the pressures of time, memories of the disastrous 1918 flu epidemic, White House fears of appearing weak or indecisive in an election year. Complicating factors--the discovery of Legionnaire's disease, an egg shortage (the vaccine is grown in eggs), the demand of the vaccine's manufacturers for liability coverage, serious neurological complications in persons receiving the vaccine--only contributed to the feeling of urgency, without affecting the course of action. The experience, Neustadt and Fineberg note, leaves key issues undecided: Should there be a national commission on immunization policy? An expanded federal role in influenza immunization? Who can provide liability coverage for pharmaceutical companies (and others) who might be named in cases of adverse side effects? Their suggested reforms in the decision-making process--periodic reevaluation, cooperation with the media--are somewhat elementary and obvious. (These pertain most, one suspects, to the appended directions for classroom use of the study.) But whether or not they know how to prevent the same things from happening again, it's good to understand what happened before.