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Public Remains Wary Of H1N1 Vaccine

Fewer than half of Americans say that they are planning to receive the new H1N1 swine flu vaccine, according to recent polls.

"I'm genuinely baffled," says Arthur Kellermann, an emergency medicine physician at the Emory University School of Medicine who has treated swine flu cases.

The public's skepticism over the vaccine has persisted despite health experts' warning that the H1N1 virus has reached pandemic proportions according to the World Health Organization (WHO).

Public health officials and the medical community are scrambling to figure out how to convince more Americans to get vaccinated when supplies of the vaccine become more widely available, but it won't be easy.

Creating Awareness, Avoiding Panic

For one thing, there are many different reasons why people say they are unlikely to get vaccinated. Nearly a third are worried about side effects, according to a Harvard School of Public Health survey in September. Twenty-eight percent said they don't believe they are at risk for a serious case of the flu, while another quarter say they can get medication to treat the flu if they do get sick.

"They really can lose public credibility for decades if what they do is threaten that thousands are going to die and be hospitalized, and it doesn't occur," says Robert Blendon, a professor of health policy and political analysis at the Harvard University School of Health. "They feel confident there's going to an outbreak, but they don't know how many severe cases there will be."

The swine flu vaccine is now being distributed in some places and is being targeted to those considered at high risk, including health care workers. Pregnant women and children are likely to be next. But the CDC says some deliveries of vaccine will be delayed because production is lower than expected. And officials do not want to create a panic.

"There's too much at risk to try to use scare tactics to try to get people to vaccinate," says Kristine Sheedy, the communications director for the CDC's National Center for Immunization and Respiratory Diseases. "While we don't want to scare people into getting vaccinated, we also want to make the disease real."

High-Profile Skeptics

It is still very early in the fall flu season. As skeptics see more and more people getting vaccinated, experts expect others to change their minds. Reports of swine flu deaths, particularly in people's own communities and schools, could end up being the most powerful motivator.

But this year, officials are also fighting some high-profile counterweights to their message. First, an unusual set of high-profile personalities — including conservative media commentators like Rush Limbaugh and Glenn Beck, and more liberal ones like Bill Maher — is publicly opposing the vaccination effort.

Their opposition appears to be part of the larger anti-government movement that has been vocal during the debate over the Obama administration's efforts to overhaul the nation's health care system. Beck told his viewers on Fox News that he would do "the exact opposite" of whatever the government recommends. Maher echoed that on his HBO talk show, saying, "I don't trust the government, especially with my health."

It's not yet clear how persuasive their opinions will be. "There's no question that the anti-government feeling and fears are playing a role," says Blendon. "We just don't know the magnitude of the impact."

Public opinion surveys show that doctors and nurses are seen as the most credible sources of information on these kinds of medical decisions, but there has also been a flurry of media reports about some health professionals resisting mandatory vaccination campaigns at certain hospitals.

But the CDC's Sheedy says that doctors and nurses have always been tough sells when it comes to the flu. Vaccination rates for the seasonal flu have never topped 50 percent for health professionals — and usually hover barely above 40 percent.

"We hear the same misperceptions among some providers as we do among the general public," she says. "It is quite a challenge for us to ask the public to go out and take this step and get vaccinated to protect themselves, when we have so many health care workers out there who aren't doing the same."

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