Flu fighters seek to dispel vaccination myths

Oct 4, 2006 (CIDRAP News) – A powerful motivator for getting a seasonal influenza vaccine is having suffered through the misery of the disease.

However, factors that sway people away from vaccination are a lack of information and outright misconceptions, the National Foundation for Infectious Diseases (NFID) found in a consumer survey released at a press conference today. The conference, with some of the nation's top health experts in attendance, marked the start of the flu immunization season.

Julie Gerberding, MD, MPH, director of the Centers for Disease Control and Prevention (CDC), said there will be 100 million seasonal influenza vaccine doses available this year, 17 million more than last year. However, Gerberding and other experts worry that Americans, particularly those with health risks, won't take full advantage of the increased supply.

"We'd like to see the highest-ever rates, especially among seniors," she said. "The vaccine is here, and the time is now. Let's make this our best flu season."

The study found that less than half of respondents (48%) planned to get a flu shot this year. The study, a random-dial telephone sample of 1,014 adults (503 men and 511 women) aged 18 and older, found that of the 52% who said they wouldn't get a flu shot, 43% didn't think influenza was serious enough to warrant vaccination.

More than half of the respondents said they regarded a cold and influenza as similar health problems and would treat them similarly. Close to half—46%—of respondents incorrectly thought that flu vaccine could cause the illness itself.

Better than half of those who planned to be immunized this year said they made vaccination a priority after suffering a bout of flu in a previous season, according to the survey.

Study respondents knew that the period of September through November is the best time to be immunized—but they erroneously believed that December is too late to benefit from the vaccine.

"We'd like to correct that perception," said Susan J. Rehm, MD, NFID medical director and vice chair of the Department of Infectious Diseases at the Cleveland Clinic. The flu season peaks in December, January, and February, sometime even in March, she said.  "The medical community must reinforce that later-season vaccination is useful, even if the disease has already begun in your area."

Mark McClellan, MD, PhD, administrator of the Centers for Medicare and 

Medicaid Services, said about a third of seniors don't get annual flu shots, even though vaccination is free through Medicare part B. He noted that each year, 200,000 people are hospitalized with influenza, and 36,000 die of the disease.

"There's a prevention gap here that we see too often, and we're working very hard to close it," he said.

Medicare officials are hoping to increase flu vaccination rates among seniors with a personalized, grassroots approach that focuses on preventive care, including vaccination and screening, McClellan said. Preventive services are now being promoted and delivered with the same system that administers the new Medicare prescription drug benefit, he said.

Another group on which health experts are focusing their flu vaccine message is parents of children aged 6 months to 5 years. Earlier this year, the CDC added 2-, 3-, and 4-year-olds (and their household contacts) to its recommendations about who should receive the flu vaccine.

Julia McMillan, MD, a member of the American Academy of Pediatrics committee on infectious diseases and vice chair for pediatric education at Johns Hopkins University School of Medicine, said now is the time for parents to call their children's pediatrician to schedule an appointment for vaccination. Children in the recommended age-group who have not been immunized before will need two doses, 1 month apart.

"Rates aren't what they should be, especially in kids who have chronic conditions such as asthma," she said, noting that children who have chronic conditions are five times as likely as healthy children to be hospitalized with influenza.

Health officials also said they'd like to make people more aware of the CDC recommendation that pregnant women should receive flu shots. In the NFID survey, less than half (49%) thought that pregnant women should be vaccinated.

Healthcare workers are another group with relatively low vaccination rates, despite the CDC's longstanding recommendation that they get annual flu shots. Only 36% of healthcare workers are vaccinated each year; unvaccinated workers contribute to flu outbreaks and staffing shortages in health care facilities.

The CDC has issued stronger, earlier recommendations for healthcare workers, and in June the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) issued a new infection control standard that requires accredited organizations to offer flu immunizations to staff, volunteers, and others who have close contact with patients. The requirement takes effect Jan 1, 2007.

Gerberding said vaccine manufacturers will deliver 75 million doses of vaccine by the end of October, and she hopes there will be fewer problems with uneven distribution of the vaccines this year. Because vaccine distribution is handled by the private sector, coordination can be difficult, she said. However, she added that the National Influenza Vaccine Summit, made up of 130 industry groups, has been working to resolve problems with supply and distribution.

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