Monday, August 24, 2009

A Self Inflicted Flu Shot Wound



# 3662



A new poll of GP’s out of the UK this morning, along with an ongoing poll on the allnurses pandemic flu forum, and a study which appeared in the Emerging Health Threats Journal  all point to a major obstacle facing public health officials with this fall’s planned pandemic vaccination campaign.


With the H1N1 virus having been widely promoted by government officials and the media as being `mild’ for the vast majority of people - there is growing resistance to the idea of taking an experimental vaccine to prevent the illness.


And given that vaccination is the centerpiece of the US, UK, and Canadian pandemic plan, a reluctance by the public in general and health care workers in particular to take the jab could prove a major set back.


This morning, the UK website PULSE TODAY, essentially a trade paper for the medical profession, has a snap poll of GPs in Britain that finds that nearly half would refuse the pandemic flu vaccine this fall.



One in two GPs 'will refuse swine flu vaccine'

24 Aug 09

By Lilian Anekwe

Exclusive: Nearly half of GPs have decided to not be vaccinated against swine flu once a jab becomes available in the autumn.


A snapshot survey of GPs conducted by Pulse found that 56 of the 115 GPs surveyed said they did not intend to receive the jab.


Last week chief medical officer Sir Liam Donaldson announced GPs and frontline healthcare workers would be given top priority in the queue for the swine flu vaccine.



But the Pulse poll shows the extent of the reluctance amongst GPs to have the jab. Of the 115 GPs surveyed, 56 said they did not intend to be vaccinated, 48 said they would have the jab when it was available, and 11 were undecided.

(Continue . . . )



Meanwhile, on the forum, they have a poll and discussion thread on whether nurses and other HCWs would take the pandemic vaccine, and the results there are quite similar.

While the number of respondents so far are low, opinion is split 40% for and 40% against the vaccine, with 20% undecided.   There are more than 60 comments on the thread, which should give the reader some idea of the wide spectrum of concerns held by many HCWs.





And lastly, a series of focus groups held in Vancouver, B.C. in 2007 and 2008 (prior to the outbreak of H1N1) indicated that a large segment of the general public would be reluctant to accept a novel pandemic vaccine.

The full study can be read here, while I’ve reproduced (and reparagraphed) the abstract below.



The public's acceptance of novel vaccines during a pandemic: A focus group study and its application to influenza H1N1

Natalie Henrich and Bev Holmes

As influenza H1N1 spreads around the world, health officials are considering the development and use of a new vaccine to protect the public and help control the outbreak.


Acceptance of novel vaccines during health crises, however, is influenced by perceptions of a range of risks, including risk of infection, risk of becoming severely ill or dying if infected, and risk of serious side- and long-term effects of the vaccine.


Eleven focus groups were conducted with the public in Vancouver, Canada in 2006 and 2007 to explore how people assess these risks and how these assessments relate to willingness to use novel vaccines in a pandemic.


Concerns about using new vaccines during a pandemic differ from concerns about using established products in a non-crisis situation. Participants were hesitant to use the novel vaccines because of a low perception of risk of infection early in a pandemic coupled with the many uncertainties that surround new vaccines and the emerging infectious disease, and concern that unsafe pharmaceuticals may be rushed to market during the health crisis.


Understanding adults' assessment of risks related to, and willingness to use, novel vaccines during a pandemic can help officials promote disease-control measures in ways that improve the likelihood of acceptance by the public and may increase uptake of an H1N1 vaccine.



After a flurry of over-the-top media coverage of the H1N1 virus in April and early May, the mainstream media quickly lost interest when it became apparent that the morgues weren’t filling up with bodies.  By the time the WHO declared a pandemic in June, the media all but yawned in response. 


A great many government officials and editorialists around the world, worried about economic recovery - and wanting to prevent panic – have downplayed the virus at practically every turn.  


It was `mild’ they said, `no worse than seasonal flu’, and the public was reminded at every turn that those who died almost always had `underlying medical conditions.’


And for most people, all of that is absolutely true.   For every 100 people who have caught this virus, 99 appear to recover quickly, and without incident.


When faced with those statistics, the public’s appetite for taking an experimental vaccine is understandably diminished.


Add to that the strident warnings coming from anti-vaccine activists, cautionary stories in the mainstream media about the 1976 swine flu debacle - and the likely need for two shots, a month apart - and our collective willingness to roll up our sleeves drops even more.


Without the full support of the healthcare sector, getting the public to participate in a vaccination program this fall becomes all the more difficult.   If doctors and nurses are reluctant, why should anyone else take the jab?


For most people, getting the flu and taking a few days off from work or school sounds easier than bothering with the shot.


Of course, they aren’t seeing the thousands of young adults and children that have ended up in ICU beds around the country over the past 4 months.   


The odds of that happening to any one individual may be low, but when the population is viewed as a whole, even a virus that severely affects only 1 in 200 can wreck havoc.


While public health officials have urged continual vigilance, and the need for forward looking planning for this fall’s flu season, the public remains largely oblivious to the threat.   


The media’s mantra that this virus is `mild’ has lodged firmly in the public’s consciousness. 


Undoing our collective ambivalence towards this pandemic, and educating the public on the benefits of vaccination, may prove to be public health’s biggest challenge over the next couple of months.

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