STATS ARTICLES 2009
Why you should vaccinate your child against H1N1
By Gary Kreps, Ph.D, and Rebecca Goldin, Ph.D, November 17, 2009
The decision to vaccinate against swine flu is a slam dunk. You just need to get past the vaccine voodoo.
It almost seems as if we need a vaccine for the confusion over the swine flu vaccine. The H1N1 vaccine is either unavailable or not being used; it’s either safe or its side effects are worse than getting the virus; it’s either unnecessary or your child is going to die without it. There are false claims that the vaccine has caused deaths and false alarms over minute amounts of mercury in the vaccine, driven by the false belief that vaccines cause autism.
Meanwhile, health officials worry about the consequences to those in vulnerable groups who are giving up on vaccination altogether. Indeed, when even health care providers are refusing to take the H1N1 vaccine, despite overwhelming evidence that it’s the best preventive measure against this strain of flu, then something has gone wrong with the way sound medical advice is communicated to the public. We fear that the media is not doing enough to inoculate the public against the growing amount of dangerous misinformation over the H1N1 vaccine.
In September, for instance, Fox News hosted Dr. Kent Holtorf, described as “an expert in infectious diseases,” to comment on the safety of the vaccine. “I have more concern about the vaccine than the swine flu,” said Dr. Holtorf, who said he wouldn’t be giving it to his kids. The interview with Dr. Holtorf, who does not, in fact, appear to be an expert in infectious diseases, has been viewed on You Tube over 800,000 times.
Comedian Bill Maher recently told Huffington Post readers that he has talked to doctors who are skeptical of the vaccine but will only say so in private. The Atlantic Monthly published an article in November, written by longstanding journalist critics of the pharmaceutical industry, questioning flu vaccination in general and the H1N1 vaccine in particular as being possibly no better than voodoo science. It would, the authors suggested, be more beneficial to focus public health care efforts on hand washing to combat the spread of H1N1.
While we applaud methodical hand washing, we do not believe it will forestall the current flu or any future pandemic or take the place of vaccination. Nor do we believe that there is a hidden well of private skepticism among doctors about the flu vaccine. The reasons are simple: according to medical experts, the H1N1 vaccine is 70 to 90 percent effective in fending off the H1N1 virus and it is just as safe as the seasonal flu vaccine. Serious allergic reactions are vastly rarer than the deadly consequences of the virus itself.
An even more insidious myth is that while the vaccine may be harmless, it is not worth the effort or the money to get vaccinated. Several conspiracy theories have fed the growth of this perspective. One is that pharmaceutical companies are reaping huge profits by terrifying the public about the virus; another is that the media are hyping the virus for its shock value; another still is that the White House is using the H1N1 outbreak as a Trojan Horse to justify greater government intrusion in health care.
Unfortunately, early reporting on the potential deadly nature of the H1N1 flu, coupled with later backtracking, has hopelessly confused the public. When H1N1 first hit the news, it was compared to the 1918 Spanish Flu pandemic, which killed an estimated 675,000 Americans and 20 to 40 million people worldwide. The death rate among victims of the Spanish flu was somewhere between 2.5 percent and ten percent, an astounding figure. Last spring, scientific uncertainty over H1N1’s lethality combined with the strain having a biological similarity to the 1918 pandemic, led to speculation that it would take an apocalyptic toll.
Thankfully, that has not happened. In October 1918, some 200,000 Americans died due to the flu. According to the Centers for Disease Control, from September 30 to October 24, 2009, fewer than 3,000 deaths were attributed to all strains of flu in a U.S. population that has tripled since 1918. But the good news that H1N1 is much less likely to kill us than the horrific Spanish flu is hardly reason not to protect ourselves against it. Typically, deaths due to pneumonia and flu increase each month from October to February, when they begin slowly decreasing until reaching a low point in July. So we can expect many more deaths in each of the upcoming months than we have seen so far.
Moreover, the public is confused about who is at greatest risk for the H1N1 flu. Currently pregnant women and young children over six months old are the focus of vaccination efforts. Several polls indicate that parents perceive the H1N1 virus as about as dangerous for their children as the seasonal flu. This misconception, combined with fears, sometimes stoked by the media’s waffling, over the safety of the vaccine, make for a dangerous concoction.
Unlike the seasonal flu, H1N1 frequently attacks children. The CDC calculates that 179 flu-related pediatric deaths have occurred in the U.S since last April. Of these, one was due to the seasonal flu and 156 were due to H1N1. (The other 22 were due to a Type A influenza with an unidentified sub-type.) Compare those figures to the 2006-2007 flu season, when only 68 total pediatric deaths were linked to the seasonal flu. Thus, H1N1 has killed almost twice as many kids in the first month of this year’s flu season as the seasonal flu killed in an entire year during 2006-2007. The stakes are high for pregnant women as well, who constitute about one percent of the population but six percent of the deaths attributed to H1N1.
The media could help parents sort this out by framing this story in terms of comparative risk. Some parents may be willing throw the dice, reasoning that the absolute risk to their children is low. Instead they should compare the risk with that of other viruses for which vaccinations are now standard. Chicken pox, which used to take kids out of school for one or two weeks, was widespread until a vaccine became available in 1995. Before the vaccine, 100 to 150 people died each year from the disease, and more than 10,000 were hospitalized. This cost to society was considered high enough that 46 states now require children to get vaccinated in order to attend school.
As this comparison makes clear, the decision to vaccinate against H1N1 should be a slam dunk. The danger may not be apocalyptic, but it is very real. Unless America’s parents get this message, it is their children who will suffer most from confusion and misinformation. In fact, once you get past the conspiracy theories and myths, the development of the H1N1 vaccine is a genuine success story of government and industry working together to serve the public interest. But it’s being undermined by a failure to get the real story out to the very people whose lives may depend upon it.
Gary Kreps, Ph.D, is Eileen and Steve Mandell Chair in Health Communication, George Mason University
Rebecca Goldin, Ph.D, is Director of Research for STATS.org