Dr. Carol Baker, Houston, column: Base vaccine decisions on facts, not hopes

By Carol Baker HOUSTON -- Ever since the new H1N1 virus started making people ill last spring, it has become harder for parents in my practice to shrug off influenza as "not much more than a cold." We've seen what flu can do: close schools and ca...

By Carol Baker

HOUSTON -- Ever since the new H1N1 virus started making people ill last spring, it has become harder for parents in my practice to shrug off influenza as "not much more than a cold." We've seen what flu can do: close schools and camps; send sales of surgical masks and antibacterial gels through the roof; over-burden hospital emergency rooms, even in mid-summer; cause death -- not among the elderly, but in children and pregnant women.

While I am noticing more parents bringing their children in for vaccination in this unique flu season, it troubles me to learn from a recent report that 66 percent of the 29,288 North Dakota children younger than 10 who got their first H1N1 influenza dose have not yet received their second and so are not fully protected. Children younger than 10 need two doses of the vaccine.

I am concerned that even in a pandemic season, parents have become complacent.

A recent survey by the National Foundation for Infectious Diseases found that the heightened attention on H1N1 influenza has indeed caused a spike in parents' interest in influenza vaccination for their children.


Sixty-two percent of mothers surveyed said they intended to have their children vaccinated this year for seasonal influenza, H1N1 or both, while only 35 percent said their children previously had received annual influenza vaccination. This certainly is a meaningful increase, but one that still leaves a significant sector of parents not yet sure about influenza vaccination's merits.

This year's unusual influenza situation has convinced me that the time has come to guide patients to make their vaccination decisions based on fact rather than on misperceptions fueled by "magical" or wishful thinking. NFID's study showed just how widespread these misperceptions are among mothers.

For example, nearly two-thirds of respondents who have chosen not to annually vaccinate their children for influenza believe a healthy child doesn't need a flu vaccine. The fact is that influenza is the leading cause of vaccine-preventable death in the U.S.

About 100 pediatric influenza deaths occur each year; and already this year, 1,100 children -- many previously healthy -- have died from H1N1 influenza.

Nearly six in 10 surveyed think other ways to skirt influenza are just as effective as vaccination, swearing by strategies such as staying away from crowds, eating healthier and sleeping longer. The fact is that while secondary prevention measures such as hand and cough hygiene have their place, they cannot prevent inhalation of the flu virus from an errant sneeze encountered just by being in the wrong place at the wrong time.

Historically, influenza vaccination rates begin to drop after November -- not even halfway into what generally is recognized as the annual influenza season. And that may be why children younger than 10 in North Dakota have not received their second dose.

Second doses should be administered within four weeks of the first dose, but even getting the second dose a few weeks late may ensure protection.

In this pandemic year, seven months of uninterrupted media coverage have placed influenza "front and center" in our consciousness. Fortunately, recent news from the CDC and HHS relays flu activity has decreased during the past few weeks, but it is possible more waves of influenza can occur. So, it is best to be prepared and protected.


The time is ripe to discard magical thinking and learn key flu facts. If you have children, understand that in this pandemic year -- and every year -- vaccination is the best, most effective way to prevent against a disease that annually hospitalizes about 20,000 kids.

Realize that it's impossible to predict which healthy child -- or adult -- could become influenza's next victim. Understand that all influenza vaccines -- whether aimed at seasonal or pandemic viruses -- are safely formulated, thoroughly tested and cannot cause the flu.

If your physician gives you the choice, choose wisely, and protect your family's health. View influenza vaccination not as optional but as a means to optimal health.

Dr. Baker, a pediatrician, is immediate past president of the National Foundation for Infectious Diseases, chairman of the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices and executive director of the Center for Vaccine Awareness at Texas Children's Hospital.

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