Why Flu Vaccine Rates Lag

A majority of Americans have no intention of getting vaccinated, a survey finds.

September 11, 2008, 9:26 PM

Dec. 10, 2008— -- Less than one-third of Americans have been vaccinated against the flu so far this season, and more than half of Americans don't intend to get shots, according to a survey conducted by the Rand Corp. and released today by the National Foundation for Infectious Diseases.

The report, sponsored by vaccine manufacturer GlaxoSmithKline, surveyed influenza vaccination rates of approximately 4,000 American adults and found that the main reason 54 percent of Americans don't get vaccinated is their belief that they do not need it. Another reason cited is their disbelief that the flu is serious enough to cause adverse effects, according to the survey.

Dr. William Schaffner, president elect of the National Foundation of Infectious Diseases, said motivating people to get a flu shot this year will depend on health care providers explaining the importance of the vaccine and recommending the flu shot to patients.

"People are not aware that even if they have a mild case [of the flu], they are the vehicle of transmission to others," said Schaffner.

While previous surveys have been conducted at the end of the October through February flu season, this is the first interim survey designed to measure vaccination use among U.S. adults. And, according to the CDC, the findings may be consistent with previous annual end-of-season reports.

Using the survey, the Rand Corp. predicted that no region in the United States would be on track to the necessary vaccination rates to prevent the flu this season.

"That is wimpy across the board," Schaffner said.

According to Dr. Litjen Tan, director of infectious diseases and immunology at the American Medical Association, 50 million to 60 million people are expected to get the flu this season. Influenza costs the government around $10 billion a year, he said.

"The consequence to not get immunized is a choice to suffer influenza and the public health and economic consequence of the disease, and infecting those you love," said Tan.

While, according to the survey, nearly 30 percent of people have already been immunized this flu season, some have found alternative and even additional ways to protect themselves from the virus, which kills an estimated 36,000 Americans every year.

Visit the ABCNews.com OnCall+ Cold & Flu Center

The following pages give 10 ways to stay flu-free.

In years past, flu vaccines were hard enough to come by that government agencies asked only those at high risk to get a flu shot.

But now the flu vaccine is abundant enough that some doctors receive their first shipment of it as early as August, giving some the false impression that you can get a flu shot too early.

"The vaccine is really important, and it's actually easier than ever because of the nasal, inhaled version of the vaccine," said Dr. Ken Haller, an associate professor of pediatrics at St. Louis University.

So between the inhaled FluMist and the needle-injected vaccine, you should be able to find a way to protect yourself this flu season.

If you've been using our health information site on Cold and Flu, you're well aware that washing your hands is one of, although not necessarily the best, way to avoid either illness.

Washing your hands with any kind of soap gets rid of germs, as the soap and water washes them off your hands, even if it isn't killing them.

For those without easy access to a sink, Haller recommends using an antibacterial hand gel, which he says is "just as good as hand washing."

"We'll tell people to keep one with you in your pocket or your purse or your car, when you're going from place to place."

Additionally, when sneezing or coughing, covering your nose and mouth with your elbow instead of your hand can help prevent spreading the flu to others -- as can washing your hands after blowing your nose.

This one is especially important if you share a work space with a number of other people -- any of whom could be carrying the flu virus.

"Wipe off before and after. That way you don't inherit someone else's germs, and you don't leave your own," said Dr. Sandra Fryhofer, a general internist in Atlanta and past president of the American College of Physicians.

Some of the germiest surfaces you come in contact with during the day will be in your office.

So keeping your work area clean may be one of the best ways to avoid picking up something that would keep you home from work.

"When the air outside gets colder, it gets a lot drier. It dries out the membranes of the nose," said Haller.

This is bad news for the mucous membranes, which rely on moisture to trap invading microbes and protect us from them.

The mucus is sent to the stomach, where the acids it produces destroy the invaders.

Because of that, keeping nasal passages moist is an important step.

"Humidifiers can be really helpful," said Haller.

Additionally, in dry air, particles like the flu virus can stay airborne longer. By moistening the air, the water droplets will adhere to the particles, sending them downward.

A study done at the Mount Sinai School of Medicine last year showed that, in gerbils at least, relative humidity and temperature had a lot to do with how much the influenza virus spread.

Haller recommends using a saline solution as well to keep the nasal passages moist. (For a video demonstration of how to do this, click here.)

"Since it's just saltwater ? you can do it every couple of hours if you need to," said Haller.

Even ensuring that you're drinking enough water, Haller said, can help keep the body moist enough to protect against the flu.

Almost always a good idea anyhow, exercise can help you avoid the flu as well.

"Exercise can help boost the immune system," said Fryhofer.

The increased circulation from exercise gets white blood cells moving around the body to help fight off infections.

But exercise may not do much once you have the flu. While people who feel up to it can exercise, as Dr. Lisa Bernstein, an assistant professor of medicine at Emory, explains, most are too tired to exercise when they have the flu.

Keeping your immune system in top shape involves eating right, exercising and getting enough shut-eye.

And flu season is no exception. Getting enough sleep not only helps you avoid the flu, but if you do get it, it may not last as long.

"Get plenty of rest, so if you do get sick, you can get over [the flu] more quickly," said Fryhofer.

Because hand-to-hand contact is one of the best ways the flu has of moving from person to person, you may be inclined to avoid shaking hands altogether, especially given the hand hygiene of many people.

If that is your mindset, Fryhofer recommends having something in your hands so that you can greet without offending.

But because that won't always be an option, she advises simply being mindful when you do shake hands that you clean them -- either by washing or with a gel -- shortly afterward.

As many studies have shown, not everyone is going to go through the same effort to keep their hands clean, but while it may mean some extra caution on your part, there's probably little you can do about that.

"The main thing is just making sure your own hands are clean," said Haller.

Rubbing your eyes or nose and chewing your nails are all ways your hands can come in contact with your eyes, nose and mouth -- and all of them should be avoided.

Our hands are constantly picking up germs, and giving those germs a pathway into our body is how they make us sick.

"Generally, at some point, our hand goes to our nose, whether we like it or not, and that can transmit flu viruses from one person to another," said Haller.

Keeping your hands clean is one way to prevent the problem, but keeping them from your face may just be a matter of willpower.

It isn't the food as much as how you're getting it into your mouth.

During flu season, "it's better to use a fork," said Fryhofer.

While this advice may not help much if your food is being handled by someone with the flu, it can be helpful in many of the social situations in which finger food would be served.

If you're shaking hands with many people at a reception, you may not have the time or opportunity to wash up before digging into dinner.

Using utensils can keep any viruses on your hands from traveling to your mouth.

Smoking is known to be detrimental to your health for a number of reasons, but it can also make you more likely to catch the flu.

"If you've thought about quitting smoking, this is a really good time to do it," said Haller.

Cigarette smoke can affect the membranes of the nose, inflaming them. Ultimately, this makes the nose more susceptible to infection.

And this doesn't just affect smokers but the people around them too.

"If you can't quit, at least go outside when you smoke," said Haller.

That way, the risk to others can be reduced.


Cold and flu season is here! Visit the ABCNews.com OnCall+ Cold & Flu Center to get all your questions answered about these nasty viruses.

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