This fall, vaccine makers are starting ahead of the H1N1 (swine) flu virus that caused the 2009 pandemic. But public sentiment for this season's flu vaccine may be lagging behind.
Drugmakers have promised a record supply—about 160 million doses—and the vaccines are arriving at stores and doctors' offices earlier than usual. But some Americans, perhaps reacting to the confusion and fear spawned by last year's dramatic flu season, have lingering concerns about the seasonal flu vaccine, according to a new, nationally representative poll of 1,500 adults from the Consumer Reports National Research Center.
This year's vaccine protects against three viruses: the 2009 H1N1 (swine) flu virus, the H3N2 virus, which frequently causes high rates of pneumonia and death in years that it circulates, and an influenza B virus. "Already in this early fall there have been infections in people in the U.S. with each of these three viruses," says Tim Uyeki, a medical epidemiologist in the Centers for Disease Control and Prevention's influenza division. While it's too early to predict how the flu season will unfold, Uyeki says that early monitoring suggests that the seasonal flu vaccine will be a good match.
The truth about last year. The 2009 flu pandemic spurred 45 percent of American adults to get a seasonal flu vaccine, a 4 percent increase over 2008, our poll found. And 15 percent of those who don't usually get the vaccine did so last year, a 5 percent jump. But only 37 percent of the respondents said they would definitely get this season's vaccine. Of those who plan to avoid this year's vaccine, one of the top reasons given was that they thought last year's epidemic was overblown.
It appears that many Americans see last year's swine flu scare as a barking dog that didn't bite. And indeed, recent analysis has found that last year's estimated death toll was about half that of an average seasonal flu season between 1976 and 2006. But "looking at the numbers of deaths does not reflect the severity of this pandemic," Uyeki says. "It had a disproportionate impact on younger adults." About 270,000 people in the U.S. were hospitalized and 12,470 died, according to estimates from the Centers for Disease Control and Prevention. In most years, about 90 percent of the deaths from seasonal flu are among those over 65. But last year 87 percent of the deaths during the pandemic were among those under age 65.
That message seems to have resonated somewhat; 58 percent of parents in this year's poll had their children vaccinated for seasonal flu in 2009, a big jump from last year's poll. Only 41 percent of parents had their children vaccinated in 2008. Fifty percent of the parents of children ages 6 months to 17 years definitely plan to get their children vaccinated this year.
As government and media campaigns publicize the risks of the flu, the benefits of vaccination, and the dangers of common misconceptions, more Americans might be convinced. Our poll shows that 31 percent are still undecided about what to do this year. Last year's media blitz on the flu was influential, according to the CR poll. The number of people who said the media played a role in persuading them to get vaccinated for the seasonal flu doubled last year, from 16 percent in 2008 to 35 percent in 2009. And more than half of the 22 percent of Americans who got the H1N1 vaccine last year cited the media as a factor.
This year, when we asked those who were undecided about their flu-vaccine plans, 57 percent said government guidelines might influence whether they get a vaccine. But, as in the past, health-care providers will have the largest influence on people's decisions: 73 percent cited them as a factor in decision-making.
New guidelines. To increase vaccination rates, the CDC has simplified its guidelines this year. It now recommends that all Americans older than 6 months get vaccinated. The agency continues to stress the importance of getting the vaccine for people at high risk, including pregnant women, young children, adults over 65, and anyone with an underlying chronic disorder, such as asthma, heart disease, or immune suppression.
Last year's pandemic brought new evidence that being very obese might also be a risk factor for flu complications. Other recent research has found that vaccinating pregnant women can also provide some immunity to their children through the sixth month, and that a high vaccination rate among children can lead to lower rates of infection throughout communities.
Just half of health-care workers got the shot. Despite the importance of vaccination for people in high-risk groups, our poll found that many Americans don't know they're at increased risk. Only 42 percent of people with a medical condition that puts them at risk of flu complications considered themselves to be at increased risk. And just 33 percent of those over age 65 considered themselves at higher risk due to their age. Even among those who consider themselves at risk for complications, only 56 percent said they'd definitely get vaccinated this year.
Perhaps even more alarming is that only 52 percent of health-care workers and those who work in residential nursing homes were immunized for seasonal flu last year, and just 34 percent for H1N1. That's surprising considering that they're among the most likely to catch the flu and spread it to patients at high risk for complications and death.
Reasons for skipping the flu vaccine. Of the 30 percent of respondents who said they would definitely not get vaccinated this year, 44 percent said they were concerned about side effects and 41 percent about the safety of this year's vaccine. Forty-five percent said last year's epidemic was overblown.
Among those who didn't get a seasonal flu vaccine last year, most (60 percent) said they wanted to build natural immunities. And 41 percent said they just didn't get the flu, a finding that was more pronounced among men. That's a significant drop from the 54 percent who provided the same rationale in 2008, which suggests that more Americans are getting the message that they can't count on being immune to the flu.
Other reasons for skipping a flu vaccine include "medicine and other remedies can treat the flu" (38 percent), and "worry about side effects or getting the flu from the vaccine" (36 percent). We've examined these flu-shot excuses, and found them lacking.
Bottom line. There is no reason to fear this year's vaccine, according to our medical advisers and consultants. The flu vaccine has proved to be safe over many decades. While estimates vary, in general it has been found to reduce the risk of catching the flu by about 70 to 90 percent in healthy adults. It's less effective in older people and those with compromised immune systems, but it can lessen the severity of the flu, limiting serious complications and deaths.