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To boost vaccination rates, the flu shot needs a PR makeover

Greg Black/Flickr Creative Commons

Each fall, as pumpkin-flavored items start hitting store shelves, doctors implore people to get a flu shot.

This has been a major public health push since 2010, when the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices updated its flu vaccination recommendation to recommend that everyone 6 months and older should get the shot each year.

(Previously, the agency recommended the shot for a more limited group, including health care workers, pregnant women, people over 50, and those coming in contact with kids under 5.)

Since then, CDC data show that flu vaccination rates among adults have slowly ticked up a percentage point or so each year, from 40.5 percent during the 2010-2011 season, the year the universal recommendation took effect, to 43.6 percent in the 2014-2015 season.

Graphic courtesy of the Centers for Disease Control and Prevention/cdc.gov

That's slow and steady progress, but it's not anywhere close to where we should be, according to the federal government. The feds have set a goal of having 80 percent of adults vaccinated for the flu by 2020. At the current rate of increase, we won't hit that target until somewhere around 2075!

Confounding the effort to boost vaccination rates, last year's flu shot was pretty darn weak: It only reduced the chances that someone would get sick with the flu by 23 percent, according to this NPR story.

What went wrong? International public health experts gathered in February 2014, as they do every year, and studied data from thousands of patients with the flu that season to select which flu virus strains should be included in the vaccine. By the time the flu season arrived, one of the flu viruses had mutated.  The seasonal vaccination no longer protected against the predominant strain that was circulating.

All of this brings me to my question: How can we rebound from last year's less-than-stellar flu shot and convince people that the vaccination is worthwhile, even critical?

Put another way: Does the seasonal flu shot need a makeover?

"I do think public health officials have extra work to do this year to make sure that flu vaccination rates don't decrease," says Lori Uscher-Pines, a policy researcher at the RAND Corporation. "We're following a year when there was a lot of negative PR about it."

The flu shot gets a makeover

 I reached out to several public health experts to find out how we could makeover the flu shot's image.

First, we need to convince people to take the flu seriously.

People tend to think of the flu as a nuisance – as a bug that will leave them bed-ridden for a couple of miserable days, says Dr. Robert Schechter, with the California Department of Public Health's immunization branch.

But in reality, he says, "the flu is a nasty disease every year." He says that even in so-called mild flu seasons, the disease leads to lots of hospitalizations and contributes to thousands of deaths nationwide (often because it aggravates an existing chronic illness).

Next, we have to do some damage control to address last year's weak vaccine.

Typically, the seasonal flu vaccine's effectiveness ranges from 25 to 60 percent, putting last year's shot on the low end of the spectrum. Those aren't the best odds, but experts say the shot is still the best defense against the flu.

"Better than nothing" isn’t great branding for this year's shot, though. Instead, let's try appealing to our American love for a comeback story.

Schechter explains that flu season is just ending in the Southern Hemisphere, and the strains that were circulating there are similar to the strains covered by this year's vaccine. That, he says, "is a promising early sign that this year’s match will be better."

Or, let's try celebrating the vaccine for what it does when we're not looking. Its superpowers, if you will.

The flu shot protects against several virus strains, so even if the shot doesn't protect well against the dominant flu strain, it can protect you against the other strains in the vaccine, says Dr. Shruti Gohil, associate medical director for epidemiology and infection prevention at UC Irvine.

Also, for people who are vaccinated and still get sick, the shot tends to make symptoms milder and reduces the risk of hospitalization from flu, Gohil says. And less people with flu or flu-like symptoms means less people to transmit the disease to others who are at higher risk for complications, she says.

"It's a real clear public health priority to have people vaccinated," Gohil says.

The shot-getting experience

Finally, experts say, we need to address the experience of getting the shot. We've actually made a lot of strides in this area, says RAND's Uscher-Pines.

The shots are now at locations beyond the doctor's office, including pharmacies, retail stores like Target, and workplaces. Not only does this up the convenience factor, but these locations also help spread the word about the vaccine, Uscher-Pines says.

Now, "it's not just the business of your primary care provider to educate you about the need for flu vaccine," she says. "You hear about that when you go the drug store to pick up a prescription or toothpaste."

Also, fewer people now have to pay out of pocket for the flu shot. The Affordable Care Act requires health plans to cover certain preventive services without charging a copayment or coinsurance, even if you haven't met your yearly deductible. This includes certain adult immunizations, like the flu shot.

What will convince you to get a flu shot this year? Tell us about it in the comments section below or e-mail us at Impatient@scpr.org.