Some Americans have given up on flu shots because almost everyone remembers a season when they got one and then got sick anyway. Now the US Centers for Disease Control and Prevention wants to reset expectations about what these annual vaccines can and can’t do.
It’s rolling out new ads it hopes will increase confidence in the vaccines with a clear, straightforward message: The flu vaccine won’t keep a person from getting sick, but it will tame that infection, taking it from “Wild to Mild” — the tagline for the new campaign. Dr. Bill Schaffner, an infectious disease specialist at Vanderbilt University, thinks the CDC is on the right track with these ads. He says people have been confused about what flu shots can do.
Schaffner, who is part of an expert committee that advises the CDC on vaccines, says we have measured the effectiveness of flu vaccine the same way we evaluate the effectiveness of all other vaccines for measles, polio and whooping cough — how well a vaccine completely prevents disease.
For respiratory viruses, that bar is too high, Schaffner said.
“With these respiratory viruses, flu included, the vaccines aren’t very good at preventing milder disease. They’re much better at preventing the serious complications. And I think we have not been very clear in presenting that information,” Schaffner said. “We have to acknowledge that. We we have to say ‘Yep, it won’t prevent that mild disease. But here’s the benefit.’”
The campaign shows a ferocious animal, like a tiger, juxtaposed against something that’s not scary, like a kitten.
Annual flu shots are available now and recommended for everyone 6 months of age and older in September and October. The new ads and radio spots will run on social media channels and social audio starting this week. They are targeted to pregnant women and parents of young children because vaccination rates are down in both of those high-risk groups.
People who are pregnant or immunocompromised, children younger than age 5, and seniors are especially prone to severe outcomes with the flu. But flu vaccination coverage has fallen since the start of the Covid-19 pandemic, especially among vulnerable groups like young children and pregnant women.
“Women who get influenza who are pregnant may have rates of complications that rival that of senior citizens,” Schaffner said. “In other words, flu is more severe in women in pregnancy.” Getting the flu while pregnant increases the odds of preterm birth. Pregnant women are at high risk of hospitalization with the flu, too, compared with the general public.
The latest CDC data show flu vaccination coverage among pregnant women is down more than 16% since 2019. That means more than 3.7 million people were unprotected during pregnancy over the past winter. Among children, flu vaccination coverage for kids younger than 18 was over 62% before the pandemic. This past winter, it was roughly 55%, leaving an estimated 32 million children unprotected last season.
“We had made a lot of progress with pregnant women after the 2009 pandemic, because of so much news coverage of pregnant women who had died during the H1N1 pandemic. That’s been completely wiped out in the years since Covid-19,” said Erin Burns, associate director for communications for the influenza division at the CDC.
While seniors tend to have higher coverage rates and understand they are at high risk from a bout of flu, moms needed more nudging.
“Most of the pregnant women in our focus groups had no intention of getting a flu vaccine and no awareness of the benefits it could bring them or their baby,” Burns said.
In focus groups, pregnant women said they weren’t concerned about the flu. They didn’t know the flu vaccine was recommended during pregnancy (it is), and they didn’t know it could protect a baby after birth (it does.)
Schaffner said he was disturbed to hear that pregnant women hadn’t been made aware of the risk of flu by their doctors. It was clear based on these focus group responses that something was amiss in doctor’s offices, he said.
“They have to get these messages out to women who come to them right now,” Schaffner said.
When health educators explained to expectant mothers that the antibodies they make after getting a flu shot could transfer to their babies and protect them after birth “they found that extremely motivating,” Burns said.
In focus groups, people said they liked the new campaign because it struck them as transparent, Burns said. Burns said experts have long believed flu vaccines could attenuate illness, but the CDC felt cautious about making the claim because they didn’t have data to back it up. Now, she said, they do.
“We started measuring how the vaccine works by measuring against a pretty low bar — does it keep you from going to the doctor? I don’t know that’s so meaningful in the public’s opinion,” she said.
Now, she says, the CDC has deepened its vaccine surveillance network to look at attenuation of illness. There’s a strong and growing evidence base that vaccination does blunt a bout with the flu. The situation is the same for the Covid-19 vaccines: A new batch of shots updated to defend against the XBB.1.5 variant and its descendants is expected to be available in a few weeks.
Schaffner said he liked the catchphrases in the campaign, but hoped there would be more education around them, too.
“This is a great start. I like the catchphrases, as long as we get some information that comes behind it or with it in order to make these catchphrases a little more meaningful,” he said.
— CutC by cnn.com
