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Fear Proves Prime Motivator for Vaccinations

By Dennis Thompson
HealthDay Reporter

FRIDAY, Sept. 16 (HealthDay News) -- Sometimes a little fear might be a good thing.

To run an effective public vaccination program, you've got to make sure that adequate amounts of the vaccine are available and there are enough staff members to administer it, said Dr. Adewale Troutman, director of the public health practice program at the University of South Florida, who, until recently, headed the Department of Public Health and Wellness in Louisville.

You also have to figure out when the public will be available to come get the vaccinations you offer.

And, of course, you need to make sure they are properly frightened.

Fear has proven to be the most potent motivator in getting people to not shrug off important immunizations, like an annual flu shot, Troutman said.

"The influenza vaccine is really an important immunization that people discount because, ehh, it's just the flu," he said. "But tens of thousands of people die every year from the flu."

That changed with the H1N1 scare, when public health officials were concerned that a very potent strain of the flu would combine with scarce amounts of vaccine to create an epidemic. "If it turned out to be a very virulent virus, it could have been disastrous," Troutman said.

The public got the message and flooded locales that were offering flu shots.

"H1N1 resonated because I think people were afraid of it," Troutman said. "Once the fear message got out there, people became concerned about potential shortages of the vaccine. We literally had staff from all over the department doing extra time to make vaccinations available."

Another motivator for some people, mainly senior citizens, can be the cost of the vaccination, he said.

For example, health departments may offer a shingles vaccine at a very low cost, but only as long as supplies last. When they run out, seniors have to go to their doctors to get a more expensive shot.

"So there's a cost motivation for people to come get the shot from the health department," Troutman said.

Once the public is motivated, public health officials then have to make sure they have enough vaccine on hand to treat everyone. "There seem to always be different levels of availability," he said. "It's always a concern: Is there going to be enough vaccine to go around this year?" Then there need to be enough staff members available to apply all the shots.

Once the resources are set and events are timed to the public's convenience, public health directors then start pressing the public to get vaccinated, by writing op-ed articles and doing radio and television interviews -- but knowing all the while that there's a small number of people who don't believe in immunization. Instead, they believe that vaccines are harmful.

"You probably can't change their mind," Troutman said. "They don't accept the science. They don't accept your expertise. The just believe what they believe."

But to reach the majority of adults who accept the concept but don't always act on it, "you talk as much as you can," he said. "You push as hard as you can."

More information

A companion article on adult vaccinations offers details on who should get what, when and why.

SOURCE: Adewale Troutman, M.D., M.P.H., director, public health practice program, University of South Florida, Tampa, Fla.

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