Parental Concerns Hinder National H1N1 Immunization Efforts

Ask any health professional who cares for children and they will tell you: When H1N1 flu hits, it can be very severe. In the last four months of 2009, nearly 240 children died in the United States from H1N1 flu—more than three times as many child deaths as in a typical non-H1N1 flu season. Meanwhile, the H1N1 vaccine given to more than 60 million individuals since October, has had a track record of safety in children comparable to the widely used and similarly manufactured seasonal flu vaccine.

But many parents’ views of H1N1 illness and vaccine safety may not match these national data. Results from the latest C.S. Mott Children’s Hospital National Poll on Children’s Health indicate that, while 55 percent of parents worry about the H1N1 illness for their children, 66 percent of parents worry about the safety of the H1N1 vaccine.

“Parents’ worries about H1N1 vaccination are natural for any new vaccine,” says Matthew Davis, MD, director of the poll and associate professor of pediatrics and internal medicine in the Child Health Evaluation and Research Unit at the U-M Medical School. “But in this case, what I have emphasized to my patients is that we are facing a type of flu that is much worse than usual for kids who get sick. The vaccine is made so similarly to seasonal flu vaccine that it’s not really unknown to us. The track record in the first 60 million people looks reassuring to me. So, in weighing the benefits and risks, it seems clear to me for kids that the benefits of H1N1 vaccination outweigh the risks.”

The poll found that 28 percent of parents worry more about H1N1 vaccine safety than about H1N1 illness. Among these parents, only 10 percent have had their children vaccinated against H1N1.

Meanwhile, 16 percent of parents worry about H1N1 illness more than the vaccine, and 58 percent of these parents have had their children vaccinated against H1N1. Among the remaining parents (56 percent) whose worries about vaccine safety and H1N1 illness were equal, 30 percent had their children vaccinated.

“Our study indicates that parental worries about H1N1 vaccine safety have limited national efforts to vaccinate kids against H1N1 disease,” says Davis. “Of course, we expect parents to act on behalf of their kids in ways that fit what they believe. The question is, have medical and public health professionals communicated clearly enough about the benefits and risks of vaccination, and about the risks of H1N1 illness for children? We owe it to our patients and families to make sure that the best data are available, and that we’ve answered questions in our communities about what to do for kids.”

“If a substantial number of parents with concerns were reassured about the vaccine, or were persuaded of the risks of H1N1 illness, then we might see greater interest in H1N1 vaccination for children,” says Davis, who is a primary care pediatrician and internist and also associate professor of public policy at the U-M Gerald R. Ford School of Public Policy. “With increasing vaccination rates, there might be additional protection not just for kids who get vaccinated but also for members of their communities who are not, or cannot be, vaccinated.”