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Are ‘Vaccine Skeptics’ Responsible for Flu Deaths?

Are ‘Vaccine Skeptics’ Responsible for Flu Deaths?

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For months, speculation swirled around this year’s flu season, and the apparent lack of efficacy of the vaccine in Australia earlier in the year, but did all that skepticism contribute to flu deaths in the U.S.?

The CDC’s most recent flu data indicates that an additional 22 children died from influenza-related causes, and the portion of pneumonia and influenza-associated mortality hovers near 10%, far above the epidemic threshold for this particular week. Recently released flu vaccine efficacy data indicated that only a little over a quarter of pediatric deaths were in vaccinated children.

In commenting on this data, Peter Hotez, MD, PhD, dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston, told MedPage Today that in general, the public health community was not sufficiently visible in the media about the importance of getting vaccinated, and thus allowed anti-vaccine activists to take over the messaging.

“The public health community did not adequately articulate how the current flu vaccine could still save your life,” Hotez said. “This current flu epidemic may turn out to be the first major example of how the antivaccine lobby in America was effective in dissuading people not to get vaccinated, and may be responsible for hundreds or more American deaths.”

Peter Palese, PhD, chair of the Department of Microbiology at Icahn School of Medicine at Mount Sinai in New York City, was unequivocal in his response: “I fully agree with the statement that the antivaxxers are responsible for the needless deaths of many [unvaccinated] people,” he said.

Public health messaging has improved over the years, noted Stephen Morse, PhD, director of the Infectious Disease Epidemiology Certificate Program of Columbia University Mailman School of Public Health in New York City, but is still often ineffectual, because “strong communications are needed to counter” the “overwhelming appeal to emotion” of anti-vaccine advocates, while “still being honest and accurate.”

“For flu, even 20% protection can prevent many cases and save many lives directly and indirectly,” Morse explained. “The dangers of flu and other diseases we try to prevent by vaccines pale by comparison with the risk portrayals by vaccine opponents, but those disease risks and prevention benefits are real and often very meaningful. We often haven’t conveyed that well.”

But not all experts were in agreement. Robert Field, PhD, MPH, JD, professor of health management and policy at Drexel University in Philadelphia, said that the public health community “is only as strong as the tools it has available.

“This year’s epidemic should serve as a reminder of the importance of public health,” he said. “The epidemic might have been even worse if the vaccine had not been available. And vaccines remain our most effective tool in fighting future outbreaks.”

John Sinnott, MD, chair of the Department of Internal Medicine at the Morsani School of Medicine at the University of South Florida in Tampa, said that he did not think that the anti-vaccine lobby did this, or if they did, “it was not very noticeable — I would think they would use the information next year.”

Morse suggested that perhaps there is much that the public health community might learn from the approach of anti-tobacco organizations, such as the Truth Initiative, when talking about the dangers of not getting vaccinated: “We act as if the value of a vaccine, and the dangers of the disease, are generally understood, but they need to be shown clearly and perhaps even dramatically.”


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