Now that the post-H1N1 "dust" has settled, the influenza vaccination community has been examining the fallout. When H1N1 first roared in like a lion, the public’s consciousness was raised concerning influenza’s severity – particularly for children, and it seemed as if influenza was finally getting the respect it deserved. But when the pandemic’s course took a milder-than-expected turn – and the subsequent seasonal flu (happily) seemed to fizzle as well – public confusion ensued and questions arose. Was H1N1 really that serious or was it overhyped?
Dr. Carol J. Baker
While in reality, last year’s global pandemic caused hundreds of thousands of hospitalizations and deaths, including the deaths of nearly 1,300 children in this country alone, consumer research indicates that it did not create a major change in the public’s "flu complacent" mind-set. In fact, a survey conducted by the National Foundation for Infectious Diseases (NFID) – and mid-season Centers for Disease Control and Prevention (CDC) coverage rates this year – have shown that, despite last year’s unique influenza environment, most people remain unchanged in their vaccine intentions [for this flu season].
Amid the public’s uncertainty over just what to make of influenza post H1N1, one thing seems clear: Pediatricians are undeniably parents’ "go to" source for advice on prevention. NFID data indicate that nearly 7 in 10 mothers would first turn to their child’s pediatrician for influenza information. Given this, it is important that as pediatricians, we leverage the trust parents have placed in us, and become parents’ personal "GPS system," to help answer key questions, help them navigate through the maze of influenza facts versus myths, and point them in the right direction: Vaccination is the best way to prevent the flu.
Prevailing Myths and Misinformation
While a parent’s instinct to protect family is strong, there is ample evidence that many need more guidance when it comes to vaccination. According to NFID findings, many influenza-related myths just won’t go away. "The vaccine can cause influenza," "My child is healthy, he doesn’t need the vaccine," "Hand washing works just as well, or better, to prevent influenza," "The influenza vaccine is effective against only one strain of flu." All these falsehoods are alive and well in the minds of significant numbers of mothers.
So how can we, as health care providers, expect parents to make the proper vaccination decisions for their children on their own, when they may be basing their decisions on a foundation of fiction?
Messages Not Heard
Research also indicates that the pediatrician’s pro-vaccination stance does not always register with parents. More than three-quarters (77%) of mothers who aren’t planning to vaccinate their children against influenza this year reported that their pediatrician or other primary care provider left the decision to vaccinate up to them. But, the same study indicated that a stronger recommendation from a health care professional could motivate more mothers to vaccinate their children against influenza – illustrating the importance of having our voices heard.
What You Can Do
I propose that we as pediatricians adopt a "3-R’s" approach to influenza vaccination. We can aim to:
• Reinterpret influenza as a serious illness. Remind parents of the potentially grave consequences of the disease, including the thousands of children who are hospitalized and the hundreds who die each year from influenza.
• Reeducate parents. Debunk persistent influenza myths, once and for all. Emphasize vaccine safety and testing, and vaccine composition. Clarify the role of hand hygiene and cough etiquette, and the vulnerability of any child to flu – even "healthy" children.
• Recommend annual vaccination. Remind parents this is an important part of a child’s overall health maintenance – alongside vision, hearing, and dental check-ups. Help parents understand that because of the unpredictability of influenza, annual vaccination should be automatic – something that always makes sense – irrespective of the severity of the prior influenza season.
In this new year – and in subsequent years – let’s strive to lead parents to the place where influenza vaccination is considered a "no-brainer" – no yearly reconsideration necessary
Dr. Baker is chair of the National Foundation for Infectious Diseases’ (NFID) Childhood Influenza Immunization Coalition and a past president of NFID. She is professor of pediatrics, molecular virology, and microbiology at Baylor College of Medicine, Houston. Dr. Baker said she had no relevant financial disclosures.