Influenza – We Can Do Better

As I wrote previously, the World Medical Association (WMA) launched its global campaign to promote influenza immunization among physicians (“Influenza – We Can Do Better”) May 21 in Geneva in conjunction with the WHO General Health Assembly (GHA). The good news is that a safe affordable vaccine is available for influenza. The bad news remains that immunization rates among health care workers including physicians is unacceptably low in developed and developing countries.

At the WMA annual luncheon seminar for delegates to the GHA Cornelia Betsch, Psychologist, Erfurt University, Germany, gave a presentation on “A Psychological View on Health Care Workers’ Vaccination Decision”. Dr. Betsch has spoken widely on issues surrounding vaccination, including risks, use of social media in communication and the influence of Internet vaccine criticism on the perception of vaccination risks. She introduced her remarks from the patient perspective asking the audience to:

“Imagine you visit your doctor with your newborn child or grandchild and the doctor can’t stop sneezing and coughing during the whole consultation.

Imagine a friend with cancer who has to go to the hospital to undergo the next chemotherapy. And the nurse, just after she took blood samples, gets diagnosed with influenza.

Imagine that you are unsure if you should get the flu shot and so you ask your doctor if she is vaccinated against influenza. And she says no.”

Dr. Betsch shared data from a 2009 study that reviewed relevant publications from 1980 to 2008 on influenza vaccination among health care workers. The study reported that the most important reason against vaccination was fear of side effects. The others of the top five in descending order were lack of concern, inconvenient delivery, lack of perception of own risk and doubts about vaccine efficacy. The authors conclude that “If health care workers get immunized against influenza, they do so primarily for their own benefit and not for the benefit to their patients. Misconceptions about influenza and influenza vaccine could be improved by education, and organizational barriers could be bridged with sustainable structural changes to allow flexible and workplace vaccine delivery.”

Dr. Betsch described fear of side effects as a very powerful force in human behavior and that decisions about vaccination involve a balancing of fear of risks of infection with risks of side effects. She went on to say “…a second powerful force that motivates human behavior is care for friends and family – to do good for others. Vaccination gives the chance to do good for others because it reduces the transmission of diseases. The more people get immunized in a society, the more difficult it gets for a disease to spread. People who are too young or ill to get vaccinated will be protected by a firewall of immunized individuals around them. With sufficient people immunized, diseases can be eradicated – as it is currently the goal with measles, rubella and polio. Health care workers serve as role models ……and protecting patients and families is not only a human motivation, it is an ethical and moral duty.”

My thanks to Dr. Betsch sharing so clearly not only the scientific evidence related to vaccination motivation, but also the patient’s perspective.

And I agree with Dr. Betsch. We can do better.