More Resources Must Be Focused on Understanding Why Many Americans Avoid Flu Vaccine
November 24, 2010
More research is needed to improve understanding of Americans' reluctance to be vaccinated against the flu to better prepare the nation for a future pandemic flu outbreak, according to researchers from the RAND Corporation.
While the recent H1N1 flu turned out to be less severe than originally feared, the event did provide a full-scale test of the ability of the United States to counter pandemic flu. The lesson learned from the exercise is that public health improvements are needed, according to a perspective article published online today by the New England Journal of Medicine.
"The H1N1 flu pandemic exposed the reluctance on the part of many Americans to be vaccinated against the flu, even during a time of crisis," said Katherine M. Harris, the study's lead author and a senior economist at RAND, a nonprofit research organization. "We need to better understand how to respond to this reluctance before we can be truly prepared for a future flu emergency."
Harris and her colleagues say that the H1N1 experience exposed two major weaknesses in the nation's ability to respond to a pandemic flu outbreak.
The first is a lack of capacity to develop, produce and distribute a new vaccine in time to counter a fast-moving pandemic. By the time adequate stocks of the H1N1 vaccine arrived in late 2009, the pandemic had passed its peak, public demand declined and manufacturers were left with 70 million unused vaccine doses.
The second lesson is that any improvement in supply must be matched by an equally substantial increase in demand.
Despite an unprecedented public education campaign, only about 20 percent of U.S. adults were vaccinated against pandemic influenza. Most striking, researchers say, less than half of health care workers were vaccinated against H1N1, despite the fact they could inadvertently pass the infection to medically vulnerable patients.
Speeding shipments of pandemic flu vaccine would help in the future, but researchers say the evidence suggests that many people still would not become vaccinated.
The science that would clarify the best ways to inform and motivate the public is severely underdeveloped, according to researchers. About 95 percent of the public funding on influenza has been devoted to biomedical topics rather than to social and behavioral science.
RAND researchers say more resources should be channeled into understanding and improving the public's view of flu vaccines before the ongoing biomedical advances can be translated into effective action.
Harris' co-authors are Jürgen Maurer, an associate economist with the RAND Corporation, and Dr. Arthur L. Kellermann, recently appointed vice president and director of RAND Health.
RAND Health, a division of the RAND Corporation, is the nation's largest independent health policy research program, with a broad research portfolio that focuses on quality, costs and health services delivery, among other topics.