At least 179 American children died of influenza last year, the highest since 2004, when doctors began reporting confirmed cases of flu to federal authorities. Despite this record number, about one-third of parents in a new poll at the University of Michigan's C. S. Mott Children's Hospital said they did not intend to vaccinate their children against the flu virus this season.
Parents underestimate the dangers, especially if their children are in good shape, but half of the children who die from the flu are otherwise healthy.
This number is not surprising Sarah Clark, co-director of the poll and associate researcher in the pediatric department of the university hospital. In recent years, the rate of influenza vaccination for American children has stabilized around 60%.
But Clark was hit by what he called "lack of balance of information". Parents planning to ignore the shots reported that they had heard seven times more negative messages about influenza vaccines than those who planned to take the shots, and the captains of the shots did not remind their pediatricians who strongly recommend the vaccine. Parents who have decided not to vaccinate, he said, "are stuck in this situation where they have not got a full picture. It's hard to realize that you're a deficit if you do not have enough information."
One reason for ignorance, Clark says, may be that the flu shot is more confused than most vaccines. Its effectiveness varies greatly, because the wording of each year is based on better speculation by scientists about which of the many influenza strains will be the most common ones and parents may therefore think it is not worthwhile.
Most parents also underestimate the severity of the flu, especially if their children are in good shape – but half of the children who die from the flu are otherwise healthy. Some people also claim that flu can cause the flu. (This is false – mild fever and cold symptoms can the cause is a result of the immune system that creates its defenses by creating flu antibodies.) In addition, people use the word "flu" as a catch-all for all winter illnesses – very few of which are actually serious viruses Influenza shots can prevent.
Because of all these misinterpretations, Clark emphasizes the important role of healthcare providers to explain the benefits of the shot to parents. Pediatricians could point out, for example, that children vaccinated and still receiving flu have milder cases than non-vaccinated children. But only half of respondents stated that their child's doctor proposed the vaccine. "I think if providers are not willing to take some time to work with parents, then we end up in this situation," Clark says.
Parents who miss out on children's flu shots play the odds: "I would not want to risk that."
Part of the problem may be that parents simply forget the pediatrician's recommendation for the flu. This is a well documented phenomenon called confirmation bias, where people tend to remember only information that supports the beliefs they already possess. This is a possible weakness of the poll, he says Flor Muñoz-Rivas, associate professor of pediatric infectious diseases at Texas Hospital and Baylor Medical College, who did not participate in the research. Mr Muñoz-Rivas also notes that the size of the sample, about 2,000 respondents, was relatively small, so it is difficult to say whether factors such as race, ethnicity, socio-economic status and level of education distort the results.
However, Muñoz-Rivas echoes the important role of pediatricians in providing accurate information. "I wonder how many of these parents have answered what it means" efficiency, "he says.
The results of the survey were announced shortly after a North Carolina school that reported a varicella event, a disease for which a vaccine had been available for many years. As with flu, parents often underestimate the severity of varicella – but the Centers for Disease Control and Prevention emphasize that varicella can sometimes be dangerous.
The risks of influenza are also real, Muñoz-Rivas says, and parents who have given up their children's flu must know it. "They will take a risk," he says. "I would not take such a risk."