Fighting flu vaccine misconceptions

Patients are still confused about the flu shot, but vaccination rates seem to be higher for this emerging flu season. 

A new survey from InCrowd found that misconceptions about the flu vaccine are at a three-year high. The microsurvey, conducted for the third year by InCrowd, polls primary care physicians on perceptions about the flu vaccine. 

This year’s report revealed that while most patients are agreeing to the flu shot this year, 51 percent of the physicians polled reported having to clear up patient misconceptions about the flu, up from about 44 percent in previous years. Overall, the survey found that 61 percent patients were agreeing to receive the vaccine this year, up from 57 percent in 2017 and 55 percent in 2016, and 18 percent were vaccinated at a pharmacy or grocery store rather than a physician’s office. 

Margot Savoy, MD, MPH, chair of family and community medicine at the Lewis Katz School of Medicine at Temple University and one of the Center for Disease Control and Prevention’s designated “flu fighters,” said this year’s flu season is off to a slower start than last year, when many deaths and hospitalizations were already being observed by this point a year ago. But as flu cases start to rise, it’s not too late to talk about vaccination.

Savoy was not involved in the creation of the poll, but after reviewing it agreed that there is still a lot of room for educating patients. 

While Savoy said hasn’t seen so much of an increase in misconceptions, there are misconceptions that seem to never go away. Getting young, healthy patients vaccinated remains a challenge, she said, because they don’t see the flu as a big threat, but it’s the friends and family members they could infect that remain at the biggest risk.

“Few elderly ever get back to baseline after admission for flu,” Savoy said. “They often get the shot, but are infected by healthy, young family members.”

Savoy said there are steps clinicians can take to help patients overcome misperceptions about the flu vaccine. This starts with educating patients about the vaccine early on, and being prepared for vaccination season when the time comes.

“Plant seeds! Don’t wait until October to start talking about influenza. During the routine visits in the summer use anticipatory guidance to give patients a heads up that when you see them next it will be time for their flu vaccine,” Savoy said, adding that clinicians should pay special attention to high-risk patients. “Pay attention to the patients with chronic diseases. They often have a lot going on to cover in 15 minutes, but these are the patients who need influenza and other vaccines the most. If they get sick their chance of being hospitalized or dying is significantly higher.”

She said practices should prepare to be stocked with the vaccine when flu season rolls around, and have reminders ready for both staff and patients about administration.

“Use the known best-practices. Stock vaccine. Use standing orders. Offer immunization walk-in clinics. Promote the vaccine on your phone message, website and in the waiting room. Send reminder messages,” Savoy said. 

For patients who still hesitate despite being educated, remain vigilant and don’t give up.

“Respect the patient’s concerns and leave the door open for them to change their minds. Not every patient is going to agree to be immunized. I know that is hard for us to see people taking unnecessary risks for a disease that we know can be devastating,” Savoy said. “Don’t get discouraged or angry. Thank the patient for sharing their concerns with you. Offer information for them to take home. Most importantly, offer them the opportunity to come back. Many patients who initially told me no have returned to be vaccinated once they had time to think about it more.”

Savoy said the end of a visit that doesn’t include a vaccine doesn’t also have to be the end of the conversation.

“I document our conversation in my note so I can pick up where we left off when I see them next,” she said. “There is a reason marketing folks show you the same commercial 10 times in an hour. If at first I don’t succeed I try again next visit.”

It is interesting to note that patients who in the past expressed concerned about getting the flu from the flu shot have now shifted to saying that they will simple get sick, Savoy said.

“I now find myself explaining a lot more about how the immune system works. That you are supposed to feel that way when the body reacts to the vaccine, and that those are signs of the immune system working,” Savoy said. “Actually, it’s not bad if you are sick for a day or two. For some people, I’ve convinced them to come back on a Friday and get it so they feel sick over the weekend instead of during the work week.”

Savoy said also asks patients about big events coming up and work with them to schedule their shot at the most convenient time in order to increase compliance.

“I have had a lot more people who in the past have told me ‘no’ who were able to be persuaded this year,” Savoy said, adding that she believes last year’s severe flu season may have had a positive impact on vaccination rates this year.

“The part people miss is that while the efficacy of the vaccine itself is fairly low, but some protection is still better than no protection, and that’s the message that hasn’t really gotten across,” Savoy said.