WHO: Request For Feedback On DONs (Disease Outbreak News)

 

 

 

# 7802

 

 

The World Health Organization releases DONs (Disease Outbreak News) reports via their GAR (Global Alert & Response) page.  Regular readers of this blog know I refer to them often, particularly when confirming MERS-CoV or Avian (H5N1, H7N9) cases. 

 

Today the WHO is asking for feedback on their DON reports, by way of a short user survey which should take less than 5 minutes of your time to complete.

 

 

After answering questions regarding your location, preferred language, and the way you access the DON reports, you’ll have an opportunity to make suggestions on how they might be improved.

For my `wish list’, I pitched the idea of maintaining standardized case line listings’  and some type of patient numbering system, particularly  when dealing with long-term outbreaks, like MERS-CoV and avian flu.

 

I would encourage my readers to take the time to give their feedback as well.

Survey: Gen X & The 2009 Pandemic

 

 

# 6096

 

 

Generation X – that is, the generation born after the post-war baby boom - comprise about 80 million Americans who are now in their 30s and 40s.

 

The University of Michigan’s Institute for Social Research - in conducting their Longitudinal Study of American Youth -  has collected data from roughly 3,000 participants aged 36 to 40 on how they perceived and reacted to the 2009 H1N1 pandemic.

 

While this study reports that Gen X responded reasonably well to the pandemic, only about 20% appear to have availed themselves of the flu shot.

 

And despite believing they were `well informed’ on the subject of pandemic flu, overall they scored only moderately well when tested on 5 areas of general flu knowledge.

 

Gen Xers indicated they trusted their family practitioner, and the NIH the most when it came to flu information, and Youtube videos, drug companies the least.

 

Here is the press release, I don’t find the study available yet on the Lsay.org website.

 

 

Generation X: How young adults deal with influenza

ANN ARBOR, Mich. -- Only about one in five young adults in their late 30s received a flu shot during the 2009-2010 swine flu epidemic, according to a University of Michigan report that details the behavior and attitudes of Generation X.

 

But about 65 percent were at least moderately concerned about the flu, and nearly 60 percent said they were following the issue very or moderately closely.

 

Using survey data collected from approximately 3,000 young adults during the 2009-2010 H1N1 influenza epidemic—the first serious infectious disease this group had ever experienced—The Generation X Report explores how Americans ages 36-39 kept abreast of the issue and what actions they eventually took to protect themselves and their families.

 

"These results suggest that young adults in Generation X did reasonably well in their first encounter with a major epidemic," said Jon D. Miller, author of The Generation X Report. "Those with minor children at home were at the greatest risk, and they responded accordingly, with higher levels of awareness and concern."According to Miller, understanding Gen X reactions to this recent threat may help public health officials deal more effectively with future epidemics.

 

The results show that a majority of Generation X young adults felt that they were "well informed" or "very well informed" about the issue. However, they scored only moderately well, overall, on an Index of Influenza Knowledge, a series of five items designed to test the level of knowledge about viral infections generally and about the swine flu epidemic specifically.

 

Miller directs the Longitudinal Study of American Youth at the U-M Institute for Social Research. The study, funded by the National Science Foundation since 1986, now includes responses from approximately 4,000 Gen Xers—those born between 1961 and 1981.

 

Among the other findings:

• Young adults with minor children at home were most likely to follow the news about influenza closely and were most concerned about the swine flu epidemic.
• Young adults were most likely to report getting information about the epidemic from friends, co-workers and family members. In the month before the survey, they reported having about nine such conversations, compared to getting news about the flu less than three times via print or broadcast media, and about five times from searching the Internet.
• The most trusted sources of information about the influenza epidemic were physicians, followed by the National Institutes of Health, pharmacists at local drug stores and nurses from county health departments. The least trusted sources were YouTube videos, drug company commercials and Wikipedia articles.

(Continue . . . )

National Survey On Pandemic Awareness & Attitudes

 

 

 

# 6009

 

 

A survey out today, conducted by the Ecohealth Alliance, suggests that while many Americans worry about global disease outbreaks, few have good a good understanding about how, or from where, the next global health threat is likely to emerge.

 

 

First a link to the press release, followed by a link to the survey (very much worth reading).

 

EcoHealth Alliance Survey Analyzes Americans' Fear of Global Disease Outbreaks

Survey Respondents Lack Knowledge of How and Why Outbreaks Occur

NEW YORK, Dec. 14, 2011 /PRNewswire-USNewswire/ -- EcoHealth Alliance, a U.S. science-based nonprofit organization, announced the results of a just released survey that polled Americans' knowledge surrounding global disease outbreaks.  Results showed that more than two in three Americans (68%) worry about global disease outbreaks.  When polled about how and why the next big outbreak will happen and what causes them, Americans (88%) receive a failing grade when it comes to their knowledge on the subject.  Survey findings show that less than one in five Americans (17%) know that the next big disease outbreak is most likely to be transmitted from wildlife, according to EcoHealth Alliance.  "Around 75 percent of emerging infectious diseases originate in animals and then can spread to humans," said Dr. Peter Daszak, President of EcoHealth Alliance.  "The key to stopping global disease outbreaks is to protect wildlife and reduce our impact on their habitats.  Until citizens, scientists and governments focus on points of origin, we're at risk for a major outbreak."

 

While most Americans know that overpopulation and air travel contribute to global disease outbreaks, less than half know that contributing factors also include international wildlife trade (40%), climate change (33%), agricultural expansion (30%), deforestation (29%) and hunting (10%).  "Changes to the environment, including deforestation, intensive agricultural practices, bushmeat hunting, illegal wildlife trade, climate change and the encroachment of human populations on formerly untouched wild habitats are all factors contributing to disease spread," said Dr. Daszak.  "Disruptions to an environment from global travel and trade can bring viruses from the other side of the globe right to our very doorstep here in the U.S. within days of an outbreak."

(Continue . . . )

 

 

The 23-page PDF with the full survey results can be downloaded via this Link.

 

Physician Survey: Parental Concerns On Childhood Vaccinations

 

 

# 5503

 

The continuing erosion of the public’s faith in the safety of routine childhood immunizations is dishearteningly displayed today in a new physician survey that appears in the American Journal of Preventive Medicine’s May edition.

 

The study, lead by Allison Kempe, MD, MPH, professor of Pediatrics at the University of Colorado School of Medicine, is based on the results of a nationwide survey of physicians that provide routine childhood immunizations.

 

The major finding is that the majority of surveyed physicians believe that parent’s concerns over vaccine safety have either greatly or moderately increased over the past 5 years.

 

Despite the discrediting of one of their highest profile anti-vaccination advocates; Dr. Andrew Wakefield, and the preponderance of scientific evidence showing excellent safety and efficacy of childhood vaccines,  the anti-immunization rhetoric on the internet and in the media continues to escalate and to take its toll.

 

First, a link to the abstract, followed by a link to the University of Colorado Press release.

 

Prevalence of Parental Concerns About Childhood Vaccines:

The Experience of Primary Care Physicians

Allison Kempe, MD, MPH, Matthew F. Daley, MD, Mary M. McCauley, MSTC , Lori A. Crane, PhD, MPH , Christina A. Suh, MD , Allison M. Kennedy, MPH , Michelle M. Basket, BS , Shannon K. Stokley, MPH , Fran Dong, MS , Christine I. Babbel, MSPH , Laura A. Seewald, BS ,L. Miriam Dickinson, PhD

 

Results on national study of parental concerns about childhood vaccines announced

AURORA (April 13, 2011) – A new study led by Allison Kempe, MD, MPH, professor of Pediatrics at the University of Colorado School of Medicine and director of the Children's Outcomes Research (COR) Program at The Children's Hospital, reports the results of a national survey of primary care physicians who deliver vaccinations to children. Major findings include a majority of physicians think that parents' level of concern about vaccines has either greatly or moderately increased in the past five years and that they are spending a significant amount of time at well child visits discussing vaccine safety with parents. Relying only on discussion of vaccines at visits where vaccines are needed may be too time-consuming and inadequate and may compromise providers' ability to focus on other important health care topics.

 

The study, Prevalence of Parental Concerns about Childhood Vaccines: The Experience of Primary Care Physicians, publishes in the May issue of American Journal of Preventive Medicine and online April 15.

 

According to the study results, in a typical month, 79 percent of physicians report at least one vaccine refusal; 8 percent report refusals for more than 10 percent of children. And, 89 percent report at least one request to spread out vaccines—20 percent report these requests for more than 10 percent of children.

 

Other study findings include the following:

• 40 percent of physicians always or often require parents to sign a form if they refuse a vaccination. Most physicians would agree to spread out vaccines in the primary series at least sometimes. Approximately 10 percent of physicians would often or always dismiss families from their practice if they refuse vaccines in the primary series and another 5 percent would sometimes do so.
• Although few physicians had considered no longer providing vaccines because of the need to discuss vaccine risks and benefits, about one-third of physicians reported that these discussions were negatively impacting their job satisfaction.
• From the physicians' perspective the most successful messages in convincing skeptical parents were personal ones, such as the fact that they vaccinated their own children or grandchildren, discussions of their personal experiences with vaccine safety or with vaccine-preventable diseases, or a statement that they think it is safer to vaccinate than not to vaccinate.

(Continue . . . )

 

The Internet, along with social media, and the hundreds of media outlets that are now available 24/7 are incredibly powerful, but not always accurate, conveyors of information. 

 

The anti-vaccination contingent has become expert in their usage to get their message out.  Today’s study, sadly, gives credence to the idea that they are gaining ground.

 

For more on the anti-vaccination movement, you may wish to revisit:

 

 

Dr. Paul Offit: The Dangers Of The Anti-Vaccine Movement

Referral: TWiV and the `Panic Virus’

NEJM: The Age-Old Struggle against the Antivaccinationists

The Monsters Are Due On Vaccine Street

If You’ve Seen One Pandemic . . .

 

 

# 4583

 

 

Yesterday the NEJM published a review of 20 public opinion polls taken during the pandemic outbreak of 2009.   

 

PERSPECTIVE

The Public’s Response to the 2009 H1N1 Influenza Pandemic
G.K. SteelFisher and Others

 

While I was otherwise occupied, John Solomon wrote about it in New Report Says Most Americans Approve Of Govt. Flu Pandemic Handling, But Many Say They (& Their Kids) Might Not Get H1N1 Vaccine In Future   and Crof covered it in US: The public's response to H1N1.

 

Robert Roos, News Editor for CIDRAP, has a comprehensive review of the findings in:

Polls traced declining interest in H1N1 vaccine

Robert Roos News Editor

May 19, 2010 (CIDRAP News) – If the trajectory of public opinion during the H1N1 influenza pandemic is any guide, safety worries and doubts about the severity of the disease threat may cause a good share of the public to shun vaccination the next time a pandemic emerges, according to a review of 10 months' worth of polls.

 

Surveys taken before the H1N1 vaccine became available showed that about half of the population planned to be vaccinated, but that fraction shrank considerably by the time the vaccine became readily available in December, says the report published online today by the New England Journal of Medicine. The main reasons for not wanting the vaccine were safety worries and a belief that it wasn't needed.

 

(Continue . . . )

 

 

Given that excellent coverage of this story has already appeared, I’ll spare you a lengthy rehash.  

 

Suffice to say that by the end of the fall wave of H1N1, interest in the pandemic vaccine (and it's uptake) had fallen, with many people either unconvinced of its necessity or still concerned over its safety.

 

The concern here is that the impressions left by the experience of 2009 may mean that a lot of people may not be quick to accept a pandemic vaccine in the future.

 

It is the same sort of reaction we see in Florida, and along the Gulf and Atlantic Coastline, after every hurricane season.

 

People who emerged unscathed, or who may have ridden out a weaker storm, come away believing that they’ve seen a hurricane . . . and they weren’t particularly impressed.

 

People who evacuated upon the order (or advice) of local officials, only to return and find their house intact, are less likely to evacuate in the future. 

 

But of course, all hurricanes aren’t created equal.   And basing your future expectations on the last storm can be a fatal error.

The same holds true for pandemics.   

 

As epidemiologists like to say, “If you’ve seen one pandemic . . . you’ve seen one pandemic.”

 

Although there were some missteps along the way (particularly in the overpromising of vaccine supplies in October and November) the HHS and the vaccine manufacturers pulled off a considerable coup by delivering a safe and effective vaccine a month sooner than originally anticipated.

Despite the ominous warnings of the anti-vaccine contingent, we have not seen any spike in Guillain-Barre syndrome, or any other serious vaccine related side effects.

 

The pandemic shot has proven to have roughly the same safety profile as the seasonal flu shot, which is excellent.

 

Unfortunately, the unfounded message that the `vaccine is deadlier than the virus’ continues to persist – particularly online – and that raises doubts in many people’s minds.  

 

While everyone is happy that the pandemic of 2009 proved less deadly than first feared, the public complacency that this has engendered may prove to be a substantial obstacle the next time we face an emerging public health threat.

And The Vaccine Survey Says . . .

 

 

# 4186

 

The CDC has released new data on the uptake of the H1N1 vaccine by Americans as of the second week of December.   Roughly 46 million people had received the vaccine as of that time, or about 15% of the population.

 

These numbers come from household telephone surveys conducted by the NHFS (National 2009 H1N1 Flu Survey).  Ultimately, `nearly half’ of those surveyed `have gotten, will definitely get, or will probably get an H1N1 flu vaccine’.

 

The CDC has more details on their website.

 

 

2009 H1N1 Flu In The News

December 22, 2009 4:00 PM ET

2009 H1N1 Influenza Vaccination Coverage

What is the National H1N1 Flu Survey (NHFS)?

The National 2009 H1N1 Flu Survey (NHFS) is a nationally representative telephone survey that utilizes both land-line and cell phones. It is designed to get completed interviews with 6,000 households per month and to provide vaccine coverage estimates for adults and children. The NHFS data being shared this week were collected the week of December 6-12 with information from 1368 adults and 3,243 children.

 

How many people had received the 2009 H1N1 flu vaccine at the time of the most recent NHFS survey?

 

Results of the December 6-12 NHFS survey showed that an estimated 46 million people (15.3% of the population) had been vaccinated against 2009 H1N1 flu. This represents 28 million adults (13%) and 18 million children (24%) who have received the vaccine. The amount of vaccine that had been shipped to providers at the time the survey was conducted was enough to vaccinate about 21% of the US population. Therefore, almost 3 out of 4 shipped doses had been administered.

How many people were planning to get the 2009 H1N1 flu vaccine?

 

The December 6-12 NHFS showed that nearly half of Americans surveyed through the NHFS report they (or their child) have gotten, will definitely get, or will probably get an H1N1 flu vaccine. Approximately 1 in 3 of these people had already been vaccinated.

 

Who had received the 2009 H1N1 vaccine as of the December 6-12 NHFS?

 

As of the week of December 6-12, 74% of vaccine had gone to people in the initial target groups. This probably reflects efforts by states in recent weeks to expand immunization to people beyond these target groups.

 

Also, as of the week of December 6-12, 42% of all vaccine administered had been given to children.

 

How much nasal spray vaccine has been given so far?
Of the doses of 2009 H1N1 vaccine given so far, 23% were the nasal spray.