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ENC Regional News
Thu January 18, 2007
UNC-CH study examines low flu vaccination rates
By George Olsen
New Bern, NC – INTRO - The Center for Disease Control estimates that about 36,000 Americans die each year from flu-related symptoms. It's a number which undoubtedly would come down with better targeting of flu vaccine to at-risk groups. But a UNC-Chapel Hill School of Public Health study indicates the first hurdle in achieving that is alerting those at high-risk that they are in fact at high-risk. George Olsen has more.
The CDC identifies three high risk groups those over 65, those under 65 with a chronic health condition and those providing care to the first two groups. But large numbers of those groups aren't getting vaccinated the CDC says only about 26% of 18-49 year olds who had chronic health conditions or were caregivers were vaccinated in 2004. This prompted UNC-Chapel Hill's School of Public Health to study why large numbers of citizens weren't getting immunized against the flu.
01:56 It was really just a matter of whether they thought they were in one of the high priority risk groups that the CDC has established. And what we found was that if you were in one of those high risk groups, 36% of those people went ahead and got vaccinated. However, among the people who believed they were in high risk groups 64% got vaccinated, almost twice as many.
Dr. Noel Brewer, an assistant professor of Health Behavior & Health Education at the School of Public Health at UNC-Chapel Hill who led the study along with a Rutgers University Professor. It's a subtle difference being in a high-risk group compared to knowing you are in one. But it made a large difference in immunization rates. For instance, the vaccination rate for those over 65 years of age was in the 65% range.
11:01 One is that it's easy to know you're over 65. It's also easy for other people to know you're over 65, more or less, so it's easier to place yourself into the risk category to know and understand your health risk factor when you have a simple objective criteria like your age. It's also possible for other people to exert social pressure. They know that you should be getting a flu shot and say, hey, have you had your flu shot yet.
And that's a major point in the study. Dr. Brewer believes the health care community hasn't done an effective job in communicating who is at high-risk of catching the flu. Being older than 65 is a bright defining line you either are or you aren't. But what qualifies as a chronic health condition might be confusing to some.
00:46 For example, women who are pregnant are a very small number of the total population but its considered a group that is at high risk so I'm including those who are in a chronic health condition though its technically not a chronic health condition.
Likewise someone may be asthmatic a chronic health condition but its not instantly obvious to other people, hence no social pressure to get a flu shot whereas someone over 65 is more likely to get the question have you had your flu shot because they're known to be over 65. Clarifying those high-risk categories not so easily defined is something Dr. Brewer would like to see to boost immunization rates. He also believes there is concern among some of the public whether vaccinations of any type are actually necessary or even more harmful than helpful.
17:47 People believe that getting a flu shot will cause them to get the flu or giving their child any number of childhood vaccines could cause autism, for example. This belief in side effects has been widespread for at least 200 years. In some of my other research I've done we looked back at historical documents and found a book from the early 1800s titled along the lines of 150 reasons not to get vaccinated prosecuted under the vaccination law. It included really unsettling stories of someone vaccinating their infant and then the baby dies, and then the grief that the mother experiences. These nightmare scenarios really are very much in the public consciousness.
Dispelling those types of notions on top of better defining those who are at greatest risk from the flu is information that health professionals must communicate better. But in addition to more clearly defining who is at risk, Dr. Brewer thinks advertising a blunt instrument could grab public attention and advance vaccination rates.
15:24 That requires that we communicate that influenza is a killer, that influenza and pneumonia combined are the number 7 killer of Americans, and many people don't realize that flu is that high stakes. They think its something that will be uncomfortable. There'll be long days away from work. They'll feel uncomfortable, achy, they'll feel sick and not great, but there's something that may be at risk and that's the life of a loved one.
Dr. Noel Brewer is an assistant professor of Health Behavior & Health Education at the School of Public Health at UNC-Chapel Hill. His study appeared in last month's issue of Clinical Infectious Diseases. I'm George Olsen.