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Vaccine Is On Its Way, But Public Still Wary

Swine Flu Campaign Faces Key Barriers: Unease, Ambivalence

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Washington Post Staff Writer
Sunday, October 4, 2009

Billions of tax dollars have been paid to giant pharmaceutical companies. Millions of doses of vaccine are on their way to huge warehouses across the country. Thousands of health workers are poised to start injecting into arms and squirting up noses.

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The question is: When the swine flu vaccine finally arrives this week, will Americans line up to get it?

As the federal government launches the most ambitious inoculation campaign in U.S. history, several surveys indicate the public is decidedly ambivalent. A nationally representative poll of 1,042 adults released Friday by the Harvard School of Public Health found that only 40 percent were sure they would receive the vaccine and that about half were certain their children would. Recent research by the University of Michigan and by Consumer Reports yielded similar results.

Although the proportion of Americans who are immunized against the flu in a typical year tends to be even lower than those numbers, health authorities expected and hoped demand would surge for this vaccine, especially for those most at risk.

"We're talking about a campaign where ultimately nearly the whole population is supposed to be vaccinated," said Harvard's Robert J. Blendon, a professor at the School of Public Health, which has been studying attitudes about the swine flu pandemic for the federal Centers for Disease Control and Prevention. "This sends a signal that where we are now, that's not likely to happen."

Part of the reason for the tepid enthusiasm may be that the vaccine campaign is being buffeted by political and social currents: wariness of mainstream medicine combined with suspicion of big government and a general unease and complacency about vaccines. Together, these trends have sparked a flood of misconceptions about the vaccine's safety and effectiveness, as well as about supposed plans to make the vaccine mandatory.

"There's a lot of misinformation out there," said Gregory Poland, a flu vaccine expert at the Mayo Clinic. "Then you mix into that people's concerns about conspiracy theories and government misbehavior and conflicts of interest and all of that, and the average layperson has a difficult time discerning what to do."

Experts stressed that the vaccine was made the same way it is every year and that there is no reason to think it will pose any greater risk. Serious side effects involving the seasonal vaccines are extremely rare.

"Safety is our top priority," said Anne Schuchat, director of the CDC's National Center for Immunization and Respiratory Diseases. "What I want people to know is that no corners were cut at all."

Although the new H1N1 virus generally causes mild illness, most people have no immunity against it, meaning far more people will probably become infected, sick, end up in the hospital and possibly die than during a usual flu season. Most disturbingly, children, young adults and pregnant women appear to be especially vulnerable.

"It's surprising numbers are as low as they are, given that public health authorities have tried to emphasize that H1N1 tends to be at much greater risk to children," said Matthew Davis of the University of Michigan, who led that poll analysis.

The primary reasons people give for their reticence is concern about the vaccine's safety and doubts about the seriousness of the threat.

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