Tuesday, January 6, 2015

Vaccinate Yourself and Your Children Against the Flu

By Jason V. Terk, MD
President, Texas Pediatric Society
Be Wise — Immunize physician advisory panel member

It happens every year, and it always seems the same. Influenza appears, millions of people get sick, many thousands get hospitalized, and many of those hospitalized die. And yet, influenza vaccination remains one of the most undeservedly controversial interventions in our public health toolbox. There are many reasons why this is the case. It is (like all vaccines) an imperfect preventive measure that one can never be sure did what it was supposed to do. You never get a memorandum from your body letting you know that you were exposed to influenza and did not get sick because of immunity from the vaccine you decided to get. On the other hand, many people get sick in the wintertime with the many viruses that are not influenza and erroneously believe that that the flu vaccine failed to protect them. And, of course, there are the many people who get the flu vaccine too late and get sick from natural infection and believe the vaccine caused their illness. The common thread through all of this is belief.

Belief-based decisions are by their very nature resistant to revision. So, it is very hard to convince people who decide not get a flu vaccine for themselves or their children that their conclusions about this very important public health tool are wrong if their decision is based on belief rather than evidence. In fact, presenting factual information that conflicts with their belief-based decision actually causes a hardening of that belief-based decision.

That is why for me influenza season can be such a heartbreaker. Every year it happens, and every year it is the same. Children (the patients I take of) get sick, and too many children unnecessarily die. The Centers for Disease Control and Prevention already has raised an alarm about the high number of pediatric deaths seen this winter. It is too soon to have 15 children die, with a relatively small part of the country seeing widespread influenza in the early part of the season. Flu is now affecting greater parts of the country, and those pediatric deaths are sure to climb.

This year is worse than others for one major reason. The predominant strain of influenza A is H3N2 rather than the H1N1 strain that usually circulates. And, historically, when H3N2 is the predominant strain, we have more people getting sick with more severe disease. Yes, the vaccine is not well-matched to what is circulating, but it does protect to some degree. It certainly protects better than no vaccine. Anecdotally, it has been my observation this year that kids who have come in with flu who were vaccinated have been less sick than those who did not get the vaccine.

It is the nature of omission bias that we feel less responsible for acts of omission versus acts of commission. In this case, omitting getting a flu vaccine for yourself and your child can be serious and deadly. Once again, please get vaccinated!

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