Nearly Half of Americans Believe H1N1 Outbreak is Over

The latest poll from researchers at the Harvard School of Public Health (HSPH) shows that almost half of Americans believe the H1N1 flu outbreak is over (44 percent), and levels of concern about getting sick with the virus continue to decline.

Few (18 percent) think it is "very likely" there will be another widespread outbreak of the H1N1 virus in the U.S. during the next 12 months, although a larger share of the population (43 percent) does say such an outbreak is "somewhat likely." After an initial period of vaccine shortage, 70 percent of adults said there is now enough vaccine in their community for everyone who wants it. The national poll was conducted January 20-24, 2010.

At this point, more than half of parents (53 percent) either got the vaccine for their children (40 percent) or intend to get it before the end of February 2010 (13 percent). The Centers for Disease Control and Prevention (CDC) had identified children as a priority group for the vaccine. Among adults, 37 percent either got the H1N1 vaccine for themselves (21 percent) or intend to do so before February ends (16 percent). If perceptions that the outbreak is over spread, those who now say they intend to get the vaccine may ultimately decide not to. The poll also revealed a substantial share of adults who said they have not gotten the vaccine and do not intend to (61 percent).

"Many parents heeded the public health message to vaccinate their children against this virus, which hit young people unexpectedly hard," said Robert Blendon, director of the Harvard Opinion Research Program and an expert in understanding the public response to emergencies that involve health threats. "But there remains a steady core of adults who, regardless of messaging and other efforts, has chosen not to get the H1N1 vaccine. This group's set of attitudes has proven very difficult for public health officials to change."

The poll, which examines the American public's attitudes and response to distribution of H1N1 vaccine this winter, is the eighth in a series on public views concerning the H1N1 flu outbreak undertaken by the Harvard Opinion Research Program at HSPH.

"Our results show there was broad awareness of public health messages on H1N1; approximately three-fourths of the public reported seeing ads regarding the importance of getting the H1N1 vaccine since December, but many people did not respond to the message," said Gillian K. SteelFisher, research scientist in the HSPH Department of Health Policy and Management and assistant director of the Harvard Opinion Research Program.

When asked if they think there are "still many cases of people getting sick from the H1N1 flu," almost half of adults (44 percent) said that "the outbreak is over," while 39 percent thought there are still many cases of people getting sick. Concern levels are correspondingly down from a peak in September when more than half of adults (52 percent) were concerned that they or someone in their immediate family might get sick from H1N1 during the next 12 months. The latest poll showed only 32 percent still concerned.

After an initial period of vaccine shortage, 70 percent of adults said there is now enough vaccine in their community for everyone who wants it, which is significantly more than in December (48 percent) or November (21 percent). However, 12 percent think there is still a shortage in their community.

Only 5 percent of the public currently believes there is "too much" vaccine in their community, but there may ultimately be more vaccine available than will be immediately used by the public. Findings from this poll suggest that a majority of the public nonetheless believes it is more appropriate for public health officials to purchase "enough vaccine so there is no possibility of a shortage in the long run, even if this decision means that they will spend money on vaccines that are not used" rather than order a more limited supply of vaccine that might mean "there is a shortage if it turns out more people than estimated want the vaccine" (59 percent vs. 38 percent).

Since the beginning of November, according to this latest poll, there has been an increase in the number of adults overall who have gotten the H1N1 vaccine (21 percent in January vs. 14 percent in December vs. 5 percent in November). Of those adults who did get the vaccine, 90 percent received the injectable form, while 10 percent received the nasal spray. However, a significant majority of all adults (61 percent) did not get the vaccine and do not intend to. Most frequently, adults indicated that the "major" reasons for not getting the vaccine for themselves were: They don't think the H1N1 outbreak is as serious now as public officials once thought (37 percent); they are concerned about safety risks from the vaccine (35 percent); they do not think they are at risk of getting a serious case of H1N1 (30 percent); and they believe that they can get medication to treat the illness if they do get sick (27 percent).

"The skepticism of this group indicates that, going forward, it may be difficult to get more movement in the percentage of adults vaccinated for H1N1 or for a similarly behaving new flu virus," said Blendon.

Parents, however, have made more efforts to vaccinate their children. This latest poll found that 53 percent of parents got the vaccine for all or some of their children or intend to get it for them before the end of February 2010. Parents who say they intend to get the vaccine may decide not to if perceptions that the outbreak is over spread.

Among parents who did get their children vaccinated, most got their children vaccinated at traditional sites including a physician's/other health care provider's office (46 percent) or a health clinic (22 percent). However, following significant efforts by public health officials to engage schools in H1N1 vaccination programs, nearly a third (29 percent) say their children were vaccinated at a school. The majority of parents say their children got the injectable vaccine (61 percent) while 35 percent got the nasal spray.

For those parents who did not get the vaccine for their children and do not intend to (44 percent), the most commonly cited "major" reason for this decision was a concern about the safety of the vaccine (56 percent). Secondarily, parents who made this decision explained that they could treat H1N1 with medication if their children got sick with it (33 percent), and they don't think the H1N1 outbreak is as serious now as public officials once thought (32 percent).

A majority of adults (59 percent) rated the overall response of public health officials to the H1N1 outbreak as "excellent" or "good." Conversely, 39 percent rated the overall response as "fair" or "poor." In the view of more than half of adults (54 percent), public health officials spent "the right amount" of attention on the H1N1 flu outbreak, but 26 percent said they spent "too much" attention, and 16 percent said they spent "too little." Intensive public health advertising about the importance of getting the H1N1 flu vaccine, including posters, billboards, web-based ads, television or newspaper ads, was reported as seen by 76 percent of adults since the beginning of December 2009.