The Needs Fewer Stats and More Stories

Two weeks ago, the CDC reported that more Americans were killed by the flu than any other time in the world.

The CDC pinpointed one possible reason for the high death rate: The number of people who got flu shots was unusually low. Only 37 percent of children, the lowest rate in eight years, and only 58 percent of children, 1 percent dip from the previous year. Flu vaccine uptake is never huge; except among the elderly, adult vaccination rates rarely top 50 percent. But the sharp decreases last season may be enough.

It's a persistent mystery why flu vaccines do not find a market, given that flu-meaning influenza, and not one of the garden-variety colds often lumped into the category-is a grueling disease. But it's possible that people are willing to be vaccinated by reports that the vaccine for the 2017-18 season was not effective, only 10 percent of the time in the Southern Hemisphere was 36 percent of the time. the United States.

At first glance, what does it make sense? But the effectiveness of the vaccine is more complex than the binary of Sick or Not Sick. People who get the shot can still be infected with the infection, because they get the shot, they are less likely to experience symptoms, or are admitted to the hospital, or die.

That nuance is mostly missing from the budget of the day. It is difficult to get to know about the possibility that a vaccine will not always prevent illness. Even acknowledging that the flu vaccine is imperfectly felt like a breach of professional standards-an inadvertent signal to the public that it's acceptable to have questions about vaccines as a whole. What they did: A RAND study of people who did not get a flu shot, which was 28 percent did not think they needed it, 16 percent were not motivated to seek it out, and 14 percent said they "do not believe" in it.

No one who has dedicated their career to public health wants to reinforce attitudes like those. But moving the focus may be needed to shift the public mindset. The flu vaccine needs a new story to tell.

Most of the Vaccines we receive in our lives-measles, mumps, rubella, diphtheria-are given ou ou a few times in childhood, and mostly protect for life. (Whooping-cough vaccine needs periodic boosters, because it has been reformulated in the 1990s.

Flu vaccines are fundamentally different. The body that causes childhood illnesses not a lifetime-the measles virus that's circulating in the world today is the same virus as 50 years ago-so it's possible to give a vaccine once. But flu changes the time, it's a new formula, and a fresh shot, every year.

The annual repetition means that people think about vaccines differently, and that they do not know how to do it.

An optimistic view is that the vaccine is only a failure compared to other vaccines. "The expectation that if you get a vaccine, you do not get the disease – that shows how well other vaccines are working," says Joseph Kurland, an infection preventionist at the Children's Hospital and Clinics of Minnesota, who works on increasing vaccine acceptance .

But the flu vaccines are a result of a complicated mix of factors: Flu vaccine formulation is a game of probabilities, linking on educated guesses to six weeks in which direction the virus will drift. Flu vaccine manufacturing is built on the productivity of millions of chickens laying eggs and is growing in the world.

Anyway, the vaccine is a vaccine, and the vaccine has a reputational hit. Selling the public on an imperfect product, it is a difficult task.

One solution might be flipping the public message from the perspective of failures to its success stories. Multiple studies show that people who get the flu vaccine are less likely to become seriously ill; with the flu shot onboard, the risk of being hospitalized goes down by 37 percent. People who have been vaccinated are hospitalized with 82 percent less likely to be admitted to intensive care. If they've been vaccinated and still are ill enough to need an ICU, their stay is likely to be several days shorter. The effects are especially strong for pregnant women, who are 40 percent less likely to be hospitalized for the symptoms, and for children, who are two-thirds less likely to die from flu when they're vaccinated.

These statistics are powerful, but they make it easier to protect. And they illustrate a difficulty inherent in almost all communication: it is easier to scare people with an account of a terrifying disease than it is to entice them with a calm portrayal of nothing gone wrong. That more nuanced storytelling is something public health might be moving towards.

"Says Nicole Alexander-Scott," who is director of the Rhode. " Island Department of Health and President of the Association of State and Territorial Health Officers. "We bring back to personal stories about patients, so it's real and not abstract."

To hear a public health official consider the power of storytelling is a big step. As a field it is suspicious of anecdotes, mistrustful of their data-free power to persuade. It's not unusual, as a journalist, to hear public health scientists of a certain age dismissed a story of a patient's experience as an "of 1" -meaning a numerator of 1 over a denominator of some presumed large, or, translated from jargon, as an anecdote that is not statistically representative. But journalism long ago got that dramatic anecdotes have the power to make people pay attention-stories last season pointed out that flu can cause amputations and sepsis and multi-organ failure. The anti-vaccination movement has long been in the process of being vaccinated.

It would be satisfyingly symmetrical to see public health claim that power back. Deploying storytelling against the underestimated danger of influencing untrustworthy to scientists, less than the numbers and percentages that confer believability. But after last season, it seems to be a motivator for most people. It's possible that stories are.

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