« Freakonomics Radio

191. Why Doesn’t Everyone Get the Flu Vaccine?

2015-01-08 | 🔗
Influenza kills, but you’d never know it by how few of us get the vaccine.
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When I say the flu, you say you think what so, I think there's a lot of different uses. The word flew, I think, of the virus in the Windsor, but I know that a lot of people confuse it with. You know: respiratory infections, Well, as got infections, everyone thinks the flu is the flew. A cold is a cold really of the reality is that there are so many different viruses that cause these respiratory infections. So in when you know there's a few of them and their just upset of all the different Viruses, that's Jeff clung I mum maybe I'll. Just then, a researcher at the Institute for clinical evocative sciences and also practices of family physician trot
western hospital in Toronto, and we are talking about the flu today. The influenza variety of the flu, because a flu season Bee flew is really worth talking about. Influenza definitely causes many deaths. Every year, U S! It's been estimated set of problems. There is such a wide range. Some years are very mild and some years are very severe. So I think averages something in the order of like ten to twenty thousand deaths each year, but also causes probably ten times more hospitalizations, causes lots of visits to emergency departments into physician offices. That also causes a lot of people. To I take time off from work or school. So it's been estimated about somewhere between five and ten percent of the population, will get infected by influencing each year in terms of when it happens, and
What happened this? Can you talk about that for a minute? Why is influenza seasonal flu seasonal flu season and how does it actually work its way through a population? I think those are very good questions that we don't have all the answers to just yet. Would you know that you know. Generally influenza season falls somewhere between November in March generally, exactly when it's gonna happen is very simple, so some years it starts late in January or February, a some years starts earlier, so as early as sometimes late November, early December and dumb. So what exactly cause it? We don't actually know. We think that it might be related to whether it seems that, especially in countries like Canada, in the U S, when its colder on that seems to promote influenza circulation, so between colder temperatures and Laura Human
he seems to contribute to that, and then why does this? You know, stop all of a sudden. You know when it only infects about five to ten percent of the population. I don't think there is anyone who knows the answer to that. If we look at influenza statistic, in the southern hemisphere or the winners opposite, do we see the same thing there? They get it in their winner, not in their summer, exactly who exactly so that people who are monitoring influent activity they monitor both the northern and southern hemisphere to see what's going on, ok are safe, it is a cold weather phenomenon. Is it actually do you know anything about whether its related to the actual there are more related to the fact that during cold weather there are more people side in cramped spaces, etc, centre yeah. So I don't think we have the answer to that either. That sort of a theory that we have in what we do know is that Europe closer to the creator, its influenza viruses, are circulating around its, not just because a cold weather, because there's a lot of these tropical countries work
circulating all the time. So no offense, but it sounds like you guys, don't really know about much about influenza has great yeah yeah from w, and my see this is free economics, radio, the package that explores the hidden side of everything. Here's your host, Stephen Governor
influenza, one of the many diseases that we lumped together when we say the flu is indeed a bad disease, especially if you're, very old or very young were pregnant poor. If you have a chronic medical condition like diabetes or heart disease influenza is a common cause of pneumonia. The centres for Disease control when cataloguing death by cause groups together influenza and pneumonia. This pairing is perennially in the top ten causes of death in the United States in two thousand and ten, the most recent year, for which there are final data. Influenza pneumonia killed fifty three thousand eight hundred and twenty six Americans, which is more than six times the number of worldwide debts last year from Ebola, and those are just the influenza and ammonia deaths that we know us
that's right. So the biggest problem is that we don't do testing that. Often that's the epidemiologists Jeff clung. So a lot of people come into hospital. They may have a fever, whoever they may be coughing, and you know what you think. Oh maybe this person has pneumonia, so we do the chest x, Ray was the oldest person has pneumonia, and then we need to treat them with antibiotics to me. Leave it at that so often times we don't bother doing the testing for exactly which bug or pathogen is causing the illness and so into the ones it goes undetected and other issue is that of influenza, often triggers other events. So, for instance, you know a lot of people can get in influenza infection. You know they feel sick for a few days, but that's what triggers their heart attack or the other My answer then end up in the hospital, because I am I am here that influence infection may have passed and may not have been detected influenza has been particularly bad. This winter
did. He see, says that influence into mony deaths are an epidemic levels in one week last month, for instance, they accounted for nearly seven per cent of all deaths in United States. One problem is the influenza comes in a variety of strains which change from seeing the season, and so, even though there is a yearly flu vaccine that we all here about, there are a number of actions. Actually, the pharmaceutical scientists and Officials who create these vaccines have to make an educated guess very early in the season as to which strains of influenza they'll be able to protect against this year. For instance, there's one stream doing a lot of damage to those we keeping score home. It is the aged three end. A Switzerland, nine seven one, five to nine three slash. Twenty thirteen strain in that stream was not included in the vaccine, designed for this
here is northern hemisphere influenza season? As result of this and some other factors, the flu vaccine is not one hundred percent effect on average or like sixty or seventy percent effective, but still a fairly effective vaccine against an illness. It can easily kill you or that can kill your more vulnerable loved ones. If you give it to them, who doesn't want Batman, turns out a lot of people. Don't want vaccine. So last year overalls, forty six percent in children is higher if sir about close to sixty percent in adults whose lower at about forty percent, so as a family doctor and as a public health guy in his academic researcher, what would you like the influence of vaccine rate to be you wanted beyond represent, I hope they will ever see it at a hundred percent. There always beat. I mean if, if possible, is oh yeah, I think that would
you know I deal. We want, as many people vaccine is possible. I ain't, I think you know in the more people, get backs needed than the more heard immunity there is so the less chance that you would transmit to somebody else if, if Can't get it so why dont more people get the influence of vaccine every year. We asked a bunch of people. This question got a lot of different answers. Number one: it's a hassle to get the vaccines.
Because you have to get it every year. Did you get to flesh out the same? I did not. Did you get a Felicia this here now I didn't. I didn't I can finish I I have had the chance honestly time thing. It was really a conscious decision. It was more than I was busy the day they are giving them at work. I don't know I just don't really feel like its necessary changes. Have other things to do than Diana just have never face the consequences of the decision. So I thought about going to all green thing. Anyone it's horrible though I don't. I don't think it's the right thing to do. I would tell my children to do I'm doing just long ago, so I think the trickiest the use of influenza. You know how it reproduces. It's very sloppy and so it just makes a lot of imperfect copies of itself, and because of that is constantly what we called drifting is constantly mutating and so that's why, every few years there
these new strains that come out that are different enough from the ones that we have in the vaccine and that's why we have to get back needed every year so that we can keep up with these. You know changing viruses, so that's a real pain prices like other vaccines- and you know yet at once, we get one series and then you're done. For the rest, your life reason number two that only forty percent of adults in the: U S get an annual flu vaccine does it even work songs about how it's not effective this year and I always get sick anyway. Even when I do get it so I have not convinced that they actually quite work. So I just until the need- or I don't know the urgency ticket evolution unless there's someone major epidemic and strongly urge, she has a point. Sixty or seventy percent affected just might not seem like it's worth. It special
you're. Not very old, are very young, you're, pregnant or medically vulnerable. But if you decide to forego the flu vaccine, it's easy to persuade yourself that you're making a logical decision when, in fact your brain may be Can you about its dynasty availability, Heuristic, Frederick Chen is an economist, weak forest and so that the more salient or more vivid something as the easier. As for us to recall, for instance, if we see an earthquake happening and the news and somehow because that's very vivid, we tend to overestimate the probability of an earthquake occurring, she has a particular interest in epidemiology, and so I think the problem with vaccination in the end comes down to does one it's working, it's not very memorable, it's more newsworthy when we see things not work
But when the vaccine is working, nobody wants to talk about it and don't know, nobody's going to go out there and write a newspaper article about a vaccine, all it's working now Here's a third reason about people, don't get the influence of vaccine; they think it actually gives them. Influenza working Health care for seven years, and I always heard they get a flu shot and every time I got shot, I got really bad man but feeling horrible, and when I didn't get one of those fine, I just never got one. I have just Quang about this one reluctance I've heard even from among healthcare workers, is that I dont want get the flu vaccine, because it will give me the flu. I am told that this is a false concern, because this is a dead vaccine, but maybe I'm wrong on that so clear that for us, so the injected vaccines are definitely dead, so those are just. Virus particles have been put in their, so it's impossible to get influence infection from
injected vaccine and so what a lot of people get is they either get another virus? You know they they picked up. Rhino virus are different virus and I think that that was influenza, but also a lot of people, especially the first time they get their influence, a vaccine, their bodies mounting an immune response and they can feel sort of flew like symptoms for the first twenty four hours or so so not full blown influent infection, but it is something of your the kind of person who thinks that the influence of vaccine may give you influenza, then you may also subscribe to the fourth and perhaps most interesting explanation for why our flu vaccine rate the solo,
Ass Jeff clung about this, its natural for you to make the argument that you would like universal back. Nation for something like influenza. On the other hand, there are a lot of people sitter vaccination, even for something potentially a lot more devastating. The average person, then influenza. They don't like that idea at all, so these are about a growing, but a prominent strain of what might be called vaccine paranoia so shocked me about that from it. So the term that we use this vaccine hesitancy. And there's a range as a whole spectrum from the people who are absolutely refuse all vaccines to people who will get them. But they're kind of not sure that they should be getting.
And so I think that's one of the biggest challenges of people who are in a public health fishes and other members of the health care community that I think there's this growing sentiment that you know back scenes are dangerous thing and it's a conspiracy of your government and cynical industry. You know they're just out to make money back, seen hesitancy vexing paranoia, whatever you want to call, it could only gets worse people here, vaccination story, This will, in the end of two thousand and eleven, the CIA asked doctor a freely to launch a hepatitis b vaccination campaign that would focus on a certain neighbourhood of about about in order to get inside these houses, but specifically to get inside. One hat was defined whether Osama Bin Laden was there
That story is coming up and economic freedom, and also now that we know why people don't get the flu vaccine, which was to do about it below people. Go there just more effort for the chocolate bar in mind getting back sitting getting the chopper and one more thing. If you don't already subscribe to this economic trio puck as well, I think you should it is free at Itunes or where your progress. We will not even stick with a needle. Thanks to Pennsylvania, lottery, scratch ass, pennsylvanians or scratching their way to fine and with new, every month, big top rises and second chance, drawings, excitements, always in order.
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from W and Y see. This is for economics, radio, here's your host Stephen Governor Marquisette. He writes about national security of the New York Times. He shared a Pulitzer prize in two thousand nine for the papers coverage of. U S, involvement in places like Pakistan Ghana Stamp and he wrote a book. The book is called the way of the knife. The subtitle is the CIA Secret Army and a war the ends of the earth, it's about the what the shadow war, the war and outside of the declared war zone. Since the September eleventh attacks in places like packets, and in Yemen in Somalia. The CIA has taken on a central role in this.
Worthy nice, decent wages method. He writes about a pakistani doktor named Shaquille a Friday. Well, according to a freebies account, he was first introduced to its first year handler by the country direct. The organization. Save the children now say that show I should add, has vehemently refused it did so, knowing that freedom is start working for the CIA that they had any role in this, but by afraid his account. Met someone from the CIA at a dinner hosted by the Pakistan country, director of savings. The children was doing a lot of work in Pakistan. They were doing broad health work inside of Pakistan, not just explanations but other work to better in a condition to Pakistan, Georgia, according to Ms Eddies reporting, the CIA recruited doktor of freely to do some vaccination that was not connected to save the children. He did Lee
The number of vaccination efforts around Pakistan from around two thousand and nine on he was sort of the perfect spy for the CIA. He could he could move around Pakistan. He had reason to be in places where the Americans couldn't go. He was able to get access by launching these vaccination programmes and she, very willing to take. The CIA is money for his efforts and eventually Miss Eddie says the CIA asked a freely for some help. Locating a certain fugitive. In the year two thousand and eleven, the CIA asked doctor a free to launch a hepatitis b vaccination that would focus on certain neighbourhood of about about in order to get inside these houses, but specifically to get inside one house defined
out of weather or some of the line was there. The CIA suspected in London and his family were living in this house, but they were hoping to confirm the suspicion with dna evidence. Nobody expected then lot and was going to agree to a vaccination, but if they could get possibly relatives children, they could find dna that they can link to download it. So they go about doing this. See. I gives doktor fruity a handsome sum to begin the campaign and they never were successful a Friday and his team? I went to the house that house was one house that refused vaccinations for the people inside of it, and so at the end of the day, a. They were, never able to confirm through this that Bin Laden was hiding in the compound
as we all now know, Osama Bin Laden was living in that about a bed on May second, two thousand eleven. He was killed by. U S forces today at my direction, the United States launched a targeted operation against that compound in a bottle bud Pakistan, small team of Americans carried out the operation with extraordinary courage and capability. No Americans were heart care to avoid civilian casualties after a fire fight, they killed Osama Bin Laden and took custody of his body. The? U S, government had not told the pakistani government, it was show up in the middle of the night and killed in London. This infuriated the pakistani government so after the raid that kills Bin Laden, the pakistani government too is to go, hunt down anyone who might have helped the United States specific.
The CIA working inside Pakistan to have tried to find himself so as a right about in my book. Right The raid Shaquille of freely CIA handler meets him him some money and a bus ticket to Kabul to go over the border into Afghanistan, basically to escape. He doesn't think that he's in any danger and so he does not flee to Afghanistan. He stays, but then he shortly picked up his throne and and then pretty amazingly several months later, the CIA director, the timely and Panada gives an interview that goes public about a free confirming that he had worked for the CIA. And really demanding that he be released by the pakistani government. Its word spread in Pakistan and beyond that, the CIA and enlisted a pakistani doktor, try to gather information under the cover of a vaccine programme well
was very bad news for anybody else out there who is still running vaccine programme. Everyone doing this work was it Lee viewed with suspicion, not only by Pakistan's government, but also by militant groups who were suspecting that Mary was crawling with western spies use. A shut down of the organs patient save the children which was linked to doktor affrati and they had to close down their work. Inside of Pakistan. Save the children had been vaccinating pakistani children against polio. They had to stop eventually. The pakistani tell and banned, polio, vaccinations entirely, and a number of health workers were directly targeted by groups like the pakistani Taliban. That's right! It became very dangerous to be a health care workers. Pakistan administering polio, vaccines since December, two thousand twelve
every sixty five such workers have been killed. As a result, you ve seen an increase in polio in Pakistan. With Ex nation effort shutting down specifically on polio. There's now eyes and polio in Pakistan when health workers had for a time belief that they really eradicated the disease inside of Pakistan in two thousand fourteen there are more than to hunt sixty new reported cases of polio in Pakistan highest number fifteen years for the global public health community. That's a big problem. It's an even bigger problem, since it seems to have been an unintended cons, whence at least in part of the CIA is covert vaccine programme. Now, how of public health officials reacted with great anger,
there are already was concerned anyone working especially for western organizations that they might be under suspicion for being spies. But there is a public health organisation or other Ngos to have this kind of an effort tied directly to the CIA. The anger came from the fact that everyone is really paint with a broad brush as being spied and that these programmes will be shut down and the people who are doing this work would be specifically in January, two thousand thirteen, the deeds of twelve top public health schools. In the? U S sent the White House a letter, it read while political and security again is made by necessity, induce collateral damage. We as an open society, set boundaries on these damages, and we believe- This sham vaccination campaign exceeded those boundaries as an example of the gravity of the situation
today we are on the verge of completely eradicating polio. Now, because of these assassination, vaccination workers, the! U N has been forced to suspend polio eradication efforts. Pakistan. This is only one example and illustrates why, as a general principle, public health programmes should not be used as a cover for cover operations. Were these health school dean's did not say to President Obama? Do they could have? Is this? You ve already got millions of people in this country to paranoid. You can get a flu vaccine, and now you have to go and do this Instead of sending an undercover doktor with vaccines to find Osama Bin Laden, can you send a cable tv guy? Her someone selling encyclopedias here again is Times correspondent Mark Miss Eddie. I should note that the White House earlier this year, sent a letter to a number of health organisations. Saying
the CIA was no longer going to do this activity, So, in addition to all the pragmatic reasons why many people don't get a flu shot, you ve also got vaccine paranoia, although to paraphrase Joseph Heller, because you ve got vaccine paranoia does mean they aren't after you. So what should be done about it? If we agree with medical experts that the flu vaccine is worth getting a big? If for sure, let's make that assumption for now, what's the best way to go, one hundred percent buying here's an idea. Since your listening to this programme. You are presumably a believer in the power of data to inform decision making right. So what are we start by talking straight about the danger of influenza, forcing people to stay at the data providing people with more science or people with more science, with more data as always the answer, and I think we need to be more courageous
that again is Frederick Chen Weak Forest economist. I think what we tell people, what kind of information we provide to people? Probably makes a big difference as to how people are going to behave, but if all governments are doing every season as telling people hate its deficiencies and get a flu shot the flu seas and get a foolish. I think I think people opportune that out fairly quickly. Indeed, there is a lot of evidence that, preaching to people about the science of a gift topic has almost no impact on how they make up their minds about that topic, to political scientists Brendan Ion and Jason Rifle.
Studying what they call vaccine myths. The belief that the influenza vaccine causes influenza, which the science tells us it does not, and the belief that the M M are vaccine. That's measles, Munson Rubella causes autism, which again the science tells us it does not. What these researchers find is that, when people who subscribe to these myths are given scientific information to dispute the myth, they actually become even less likely to get the vaccine or to get their kids vaccinated. Maybe what we need to do is to go targets. The hard core anti vaccine people may be what we should do as go after the people on a meadow who are somewhat ambivalent, Frederick chain, in order to find out how to go after those people in the middle tried something that you might not think an economist would trying? So it's very simple online computer game that I create a too soon.
The spread of disease there, a population can admit, said his virtual epidemic game is no call of duty. I would say it's not superfine, but at least that's quick and fairly penguins for people to play this game. Ten recruited players with on mine adds promised payouts in terms of incentives. We said we would pay for participating in the study and how much you get paid with the pan on how you performed the game. Last forty five days every day at three M eastern time, you would get sent a link that tells you whether your healthy or whether, in fact for that day of your, in fact that there's nothing you can do that day. You just have to wait till you recover, but a few healthy that day than your
to make a choice. Do you want to be safe? You wanna take some safe action today to prevent getting infected, or do you want to be risky once you make that choice, the round ends. You saw the scoring works, So if your healthy, you got more points of your infected, you got fee were points We assume that you take precautionary measures to take their safe action. Is gonna cost you some points. There's, no cause to taking a risky action and so on, happiness at the end of forty five days. We add up border points, you got throughout the game and that's how much we page you for participating in it. Experiment that so what did chins game teach him about the way people think about spreading a disease like influenza. One conclusion not surprising if you're an economist is at the cost of taking precaution, is really important.
So I think, a very and media policy application as that we gotta find ways to make it easier: more convenient, cheaper for people to get vaccinated. We can reduce the costs of vaccination wish. Able to increase vaccination rate. The second conclusion does not very surprising if Europe, a human, is that self interest in fear, pretty good motivators one depend once that the disease is high. One. The people were tall, that many players are in fact that they tend to be safer and one, They were told that not too many people are in fact that they tend not to take decisive action. In other words, most people think about the benefits of immunization for themselves, not for the other people they might. In fact, while people are altruistic down, we would, I think we would seem more vaccinations occurring
This is the part that vaccination, the public doesn't get talked about, and I imagine that you are in the prime of your life perfectly healthy, not vulnerable in the way to dying from influenza, even if you get it, maybe miss a few days of work for the sun epoch, the old. So why do public health officials insist that you should get a flu shop because it's not about it's about the vulnerable people? And about what you can do to help them, and this is what you economists referred to as positive externalities. Our actions benefit, not only ourselves but other people. But if for self interested, we don't take into account that the benefits where, creating for the rest of society, and we tend to do too little relative to.
I'll be back from societies perspective so from societies. Perspective would probably be good for everyone to get the flu vaccine every year. Also, maybe we're mask every day, like a lot of people do in Asia low if everybody Tat, Thou would probably cut down incidents of the flu, but I bet you it's going to be very difficult for us fashion to catch on, because small lino it might be a little troublesome for people to have to put on masks and number two not that good. Looking right, it's on lustres away for people make these masks cool and fashionable. I don't Oh that's going to catch on in this country, but what, if we put our best fashion designers to work, making awesome masks Why not? And you can have logos on these masks people act.
Why not? That might be a good way to advertise until then Frederick ten things that we should put to use the economists favorite tool, granted. That doesn't necessarily mean you need a people to get a vaccine, but would help to lower the cost in any way possible. Let me give you a personal example. My employer offers free food shots every year and it's right here on campus, so it's very easy for me to get a future not now. The thing is: if we didn't have that programme, if I had to go off campus I had to go to some clinic. If I had to go to the hospital to try to get a foolish. I you know that's more trouble song
Jeff clung the canadian epidemiologists. He also lacks incentives idea. So like a lot of healthcare workers, do you know the incentive they have is to get a chocolate bar that seems to work a lot of people. Go there, just more fruitful of chocolate bar mind getting said about getting the trunk the poor and they born of the promises. Influenza is the perception that it's not a big deal. It's true that for most people it isn't, but they are not them. In the ice you seeing this previously healthy person whose ended up I see you now on eventually later dying from influenza, so I think that you know the average person in the street. You know they see what they see, which is their coworker nervously, coughing sneeze,
and then gave them the infection, and you know I got over after just a few days in a. Why do we need a vaccine for that? But then the problem is that they could be giving it to their elderly parent or their young child or the pregnant wife than you know. Their infant is born premature as result of that insolent infection, the pregnant wife, so that sort of thing in a place out and it doesn't make headlines. But that is the reality. The people don't appreciate. So maybe the big problem here is a branding problem, people here, flu vaccine, they think and flew at such a big deal. So what if we started, calling it the Influenza taxi and make some public service announcements it exploit our self interests, their vulnerability to fear and that leave out all this
scientific preaching in public health officials be something like this get an influenza vaccine today. For you, will. You'll kill someone else, you feel like you or the rest of your life If one considers the next economics radio is something I've noticed on the show and elsewhere, and I'm wondering if you ve noticed too. Why do so many people when you ask them a question begin? Their response by saying
This yeah that's a good question. So so that's a good question is a very good question so busy my question: is this a harmless verbal? or a more meaningful linguistic strategy. I would be tempted to say that's a very good question that you just ask me. Because of this conversation another say that a thanks, Charlie, that's next time on friggin, I'm radio Fr Economics radio is produced by W and my c and debonair productions. Our staff includes David Herman Gregg results. Caroline English Susie Electing Burke and Chris Bannon with help from Christopher Worth. If you are more frequent, comics radio, you can subscribe to our pod cast on Itunes or good, a friggin comics, dot com, real fine law
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Transcript generated on 2021-03-12.