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Why Are So Many of Us Avoiding the Flu Vaccine?

Most people view parents who don't vaccinate their children as kooks who are endangering everyone's health—so why don't more of us get flu shots?
November 20, 2014, 6:07pm

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People who oppose one of the greatest advancements of modern medicine due to half-baked pseudoscience and a reckless disregard for medical expertise are putting all of us at risk. Contempt for the anti-vaccine movement (a.k.a. anti-vaxxers) is both ​passionate and widespread, though a Harris Poll from earlier this year ​found that about one in three American parents still believes the ​widely debunked notion that "vaccines cause autism." But though most of us accept vaccines—that same poll found that nearly 90 percent of Americans agree that they're effective at preventing disease—far too many of us still refuse to get flu shots. Why?

The same medically sound arguments often marshaled against the screeching Jenny McCarthy acolytes—that vaccines protect those who can't get vaccinated themselves via "herd immunity," that vaccines are perfectly safe, and that preventative care is far cheaper than waiting for disaster to strike—can be applied to flu shots as well. Just because I'm a healthy adult with a strong immune system (and an aversion to doctors that borders on neurotic) doesn't mean I'm somehow excused from this lowest common denominator of basic responsibility. But in my reckless avoidance of a simple, easy procedure, I'm not alone. According to the  ​most recent data from the Centers for Disease Control (CDC), less than half of American adults get flu shots each year, despite the fact that around 200,000 people will be hospitalized by the virus (the number of deaths it causes is harder to pinpoint).


So why do so many of us still refuse?

I went looking for fellow travelers, lazy people like myself who support vaccinations in the abstract but haven't gotten a flu shot in the concrete, to see why they're still so reluctant.

Dennis. Photos by the author

"It's not needed," Dennis Dema, a 39-year-old waiter, told me. "I'm young and healthy." Dennis is an Albanian immigrant living in New York City. "We're grown-ups," he said. "We can handle it." Unfortunately, that's not always the case.

The perception among many is that the flu is only a threat to older adults and young children. According to  Kristine Sheedy, a CDC spokesperson, it's true that most of the hospitalizations and deaths occur among the elderly—but anyone can get influenza, and we can't always predict when it's going to turn serious. When you get a new flu virus (like H1N1 in 2009) sometimes those most at risk are younger people haven't been exposed to that sort of strain, whereas senior citizens have.

Gennine Zinner, a nurse practitioner at Boston's Healthcare for the Homeless Program who deals with individuals at high risk from the virus, makes a similar point. " Young people are always like, 'Nah, it's only old people, sick people that die of the flu,'" she said. "Well there are many flu strains, and it changes every year."

Doug Paulson, a 38-year-old speech coach from Manhattan, hasn't been vaccinated. His reason is fairly straightforward: "As far as I know, the flu vaccine doesn't really prevent you from getting the flu." There's some truth to this. According to the ​CDC's fact sheet on flu vaccines, "There is still a possibility you could get the flu even if you got vaccinated. The ability of flu vaccine to protect a person depends on various factors, including the age and health status of the person being vaccinated, and also the similarity or 'match" between the viruses used to make the vaccine and those circulating in the community."

Doug Paulson

Doug went on to explain that part of his indifference to the vaccine comes from the way he thinks the flu compared with the type of diseases we typically associate with vaccinations: polio, measles, mumps, rubella, and other illnesses that threaten one's life, or at least one's long-term health.

"I've never experienced influenza in a way that would make me afraid of it to the point where I would feel the need to inoculate myself against it and protect society from it," he said. Our perception of the flu—and vaccines more generally—is likely informed by our personal experiences, which may explain why each generation of Americans is less convinced by vaccinations than the last. Many older Baby Boomers still remember when pools were closed in the summer to limit the spread of polio, an experience likely to make the importance and necessity of vaccines perfectly clear to them.


So how do we reverse this trend? According to the CDC's Sheedy, research has found that "younger adults don't necessarily feel at risk from influenza personally. But one thing that did resonate with them—and was sort of a motivator for them—was the desire to protect the older adults in their lives, the younger children in their lives, maybe their roommate who has asthma or some other chronic condition that puts them at high risk." Sheedy added, "You don't just get a flu vaccine to protect yourself, you get a flu vaccine to protect the people you care about too."

Adam Tannenbaum

Adam Tannenbaum, a 27-year-old Brooklynite who describes himself as "staunchly" pro-vaccine, still hasn't let his principled position get in the way of his endemic laziness. When we spoke, Adam was rightly worried about herd immunity, and the long, dangerous shadow of preventable diseases cast upon the American populace by an  ​increasingly unvaccinated generation. So I asked him why he hasn't gotten a flu shot. "Because I'm a lazy shit," he told me. "I could totally get it. I'll get it next time I'm at CVS or something. Now I definitely will."

So will I, Adam. So will I.

Follow Tim Donovan on ​Twitter.