FLU BEAT

We have set up a swine flu page to cover the various issues concrening the flu and the vaccine. At this stage, the only report we have found on the actual effects of the swine flu vaccine is this from the NY Times: "China began its swine flu vaccinations on Sept. 21, the first country to do so. Of the first 39,000 Chinese to get shots, only four had side effects, muscle cramps and headaches, a World Health Organization spokesman said."

NPR - Fewer than half of Americans say that they are planning to receive the new H1N1 swine flu vaccine, according to recent polls - a trend that is leaving many health professionals at a loss.

"I'm genuinely baffled," says Arthur Kellermann, an emergency medicine physician at the Emory University School of Medicine who has treated swine flu cases. "The public has developed this odd sense of complacency. The only thing that comes to my mind is photos of people standing on the seawall of Galveston hours before the hurricane hit."

The public's skepticism over the vaccine has persisted despite health experts' warning that the unpredictable H1N1 virus, which can cause very severe complications even in healthy young adults and children, has reached pandemic proportions.

The Centers for Disease Control and Prevention says an unusually high number of children have died since it first arose last spring. "There are now a total of 86 children under 18 who have died from the 2009 H1N1 influenza virus," the CDC's Dr. Anne Schuchat told reporters in a briefing Friday. Eleven of those deaths were reported in the past week, the CDC says.

Public health officials and the medical community are scrambling to figure out how to convince more Americans to get vaccinated when supplies of the vaccine become more widely available, but it won't be easy.

For one thing, there are many different reasons why people say they are unlikely to get vaccinated. Nearly a third are worried about side effects, according to a Harvard School of Public Health survey in September. Twenty-eight percent said they don't believe they are at risk for a serious case of the flu, while another quarter say they can get medication to treat the flu if they do get sick.

That last statistic is the one that really worries Kellermann, who is also an associate dean for health policy at Emory's medical school. He says that even a mild flu outbreak could overwhelm the nation's emergency rooms, which already have a limited supply of the high-tech equipment that is needed to fight the most virulent cases of the H1N1 virus.

"This flu, seemingly by random, occasionally picks out the healthy child or young adult and puts them in the intensive care unit, hanging on by a thread," he says. "We don't have thousands and thousands of ICU beds and high-frequency jet ventilators standing by to care for those people."
For now, government officials are trying to walk a fine line with their message: They're touting the safety of the vaccine and warning about the risks of swine flu, but stopping well short of creating a panic.

"They really can lose public credibility for decades if what they do is threaten that thousands are going to die and be hospitalized, and it doesn't occur," says Robert Blendon, a professor of health policy and political analysis at the Harvard University School of Health. "They feel confident there's going to an outbreak, but they don't know how many severe cases there will be.". . .

It is still very early in the fall flu season. As skeptics see more and more people getting vaccinated, experts expect others to change their minds. Reports of swine flu deaths, particularly in people's own communities and schools, could end up being the most powerful motivator.

But this year, officials are also fighting some high-profile counterweights to their message. First, an unusual set of high-profile personalities - including conservative media commentators like Rush Limbaugh and Glenn Beck, and more liberal ones like Bill Maher - is publicly opposing the vaccination effort.

Their opposition appears to be part of the larger anti-government movement that has been vocal during the debate over the Obama administration's efforts to overhaul the nation's health care system. Beck told his viewers on Fox News that he would do "the exact opposite" of whatever the government recommends. Maher echoed that on his HBO talk show, saying, "I don't trust the government, especially with my health."
It's not yet clear how persuasive their opinions will be. "There's no question that the anti-government feeling and fears are playing a role," says Blendon. "We just don't know the magnitude of the impact."

Public opinion surveys show that doctors and nurses are seen as the most credible sources of information on these kinds of medical decisions, but there has also been a flurry of media reports about some health professionals resisting mandatory vaccination campaigns at certain hospitals.

Shannon Brownlee and Jeanne Lenzer, Atlantic - All of which leaves open the question of what people should do when faced with a decision about whether to get themselves and their families vaccinated. There is little immediate danger from getting a seasonal flu shot, aside from a sore arm and mild flu-like symptoms. The safety of the swine flu vaccine remains to be seen. In the absence of better evidence, vaccines and antivirals must be viewed as only partial and uncertain defenses against the flu. And they may be mere talismans. By being afraid to do the proper studies now, we may be condemning ourselves to using treatments based on illusion and faith rather than sound science.