Facts and data are not enough to convince people to take action, especially if that action requires getting poked in the arm with a needle to protect themselves from the flu. What does work to change minds is the subject of today’s column.
The 2017-2018 flu season is a bad one. As I write this, 37 children have died, schools across the country have closed, and New York’s Governor Andrew Cuomo signed an executive order to allow pharmacists to administer the flu shot to children. Cuomo also urged all New Yorkers to get vaccinated.
Have you received your flu shot? If not, you’re not alone. Vaccination rates have barely budged for years. The latest numbers available from the Centers from Disease Control (CDC) show that 41.7% of all American adults are vaccinated. Seven years earlier the vaccination rate was 40.4%. That leaves millions of Americans at risk. In the last week, I’ve spoken to several leading experts who study the topic of flu vaccines and I’ve read the latest scientific papers on the subject. Here’s what we know about why people don’t get a flu shot—and how healthcare leaders can persuade them to do so.
Stories Put a Face on the Flu
According to Glen Nowak, a former director for the CDC’s national immunization program and now a professor of health and risk communication at the University of Georgia, a person’s motivation to get a flu shot is contingent up their direct and indirect life experiences. If you know someone who didn’t get a flu shot and that person got horribly ill, you’re much more likely to get vaccinated. According to research, the spread of stories explains why millions of people don’t get a flu shot—and why others do. “The purpose of the stories is to put a face to the disease, to be make it less abstract,” says Nowak.
An organization called Families Fighting Flu uses a combination of facts and stories to spread the message. I recently spoke to the organization’s COO, Serese Marotta, who lost her 5-year-old son to the flu. “Our family stories put a face on the flu and illustrate why we’re so driven in our mission. Our emotional family stories recount how our lives have been permanently altered by the flu,” Marotta says.
Visit the website for Families Fighting Flu and you’ll learn the story of 4-year-old Amanda Kanowitz from Scarsdale, New York. On a Saturday in 2004, she developed a cough and a mild fever. By Sunday, her lips began to turn gray. A doctor recommended that she stay hydrated. The next morning Amanda’s parents found her lifeless in her bed. In a video that accompanies the story, the video ends with Amanda’s mother saying, “The single most important effective thing that parents can do is to have their children vaccinated. Don’t make the mistake we did.”
The Families Fighting Flu website contains more stories—many, many more.
Another important channel for the sharing of stories is through local health departments and the media. This season we’ve learned about a 21-year-old fitness buff who died in Pennsylvania. His family told the local TV station that he had not had a flu shot. We’ve learned about a 10-year-old Connecticut boy who rarely got sick. He was “like an ox,” according to his parents. The boy began to feel ill on a Friday. By Sunday he was dead. We also heard about a San Jose, California, mother of three and a marathon runner. What started as a sore throat led to pneumonia and septic shock. According to California health officials, 70 percent of those flu victims who have died so far this year had not received a flu shot.
“The sharing of stories by families is extremely important because it makes it real for other people,” says Marotta. “These stories illustrate the seriousness of flu and the critical importance of annual flu vaccination for everyone six months and older.”
There’s a growing number of rigorous studies that conclude stories do make an impact. Much of the information we have on the power of story comes from research into another vaccine topic—the movement among some parents who refuse to get their children vaccinated against measles, mumps, and rubella (MMR).
A joint study between the psychology departments of UCLA and the University of Illinois reached a remarkable conclusion: telling a vaccine skeptic that the data proves them wrong is precisely the wrong way to change their minds. Why? “People tend to become more entrenched when you challenge their beliefs,” according to the study.
The study divided 315 American adults into groups made up of vaccine supporters and vaccine skeptics. The group that read information on vaccinations from the CDC (including data that vaccines are safe) “did not change attitudes at all.” Those who read factual information and shown stories and photographs of real children who had died of the disease “substantially increased support for vaccination,” even among those who were “very opposed” to vaccines.
It’s important to note that negative stories also influence decisions, according to the study. If a person hears a story about a friend contracting the flu after receiving a flu shot, that person might be less inclined to get one. Such stories lead to confusion and it’s up to healthcare professionals to clear it up. According to the CDC, it’s impossible to catch the flu from a flu shot. The vaccine is made with an inactivated virus or no virus at all. However, since the vaccine is not 100% effective, it’s possible to catch the flu even if you’ve had a flu shot. Healthcare professionals should use facts and stories to remind patients that even if they should get the flu after getting the shot, the vaccine can still prevent flu-related complications.
According to Glen Nowak, if people don’t think they need a vaccine, it’s difficult to change their “mental models” overnight. “That’s why narratives and personal stories become really important,” Nowak stresses. “You need to serve up examples of people like themselves who were not vaccinated and suffered severe consequences from the flu.”