5 Top Reasons For Not Getting A Flu Shot Examined

The excuses people in our nationally representative survey gave for not being vaccinated for seasonal flu were based on a mix of facts and fallacies. Here are the top five reasons people gave in our poll:

1. Excuse: "I want to build natural immunities." (63 percent)

Reality: This was the top reason respondents gave for not getting a seasonal flu vaccine last year. Among those who are unsure if they will have their children vaccinated this season, 69 percent said they wanted to build their children's natural immunities. That's somewhat understandable but misses the most important aspect of immunity—avoiding disease. When your body encounters a virus or a vaccine, it creates antibodies that help fight the disease, and the ability to call on those antibodies provides protection after the flu is gone. Vaccines result in the production of the same antibodies that an infection does without the substantial risks that come with disease.

"I can't imagine anything more tragic than a parent exposing their child to a disease and to subsequently have their child develop a life-threatening infection," says William Schaffner, M.D., chairman of preventative medicine at the Vanderbilt University School of Medicine in Nashville, Tenn., and president-elect of the National Foundation for Infectious Diseases. "Exposing oneself to a 'wild' infectious agent exposes you to a risk of potentially serious consequences. It may be a small chance but believe me, it's real. You don't know that your child, or you, won't be one of the people to develop a grave infection."

Schaffner says that immunity derived from infection might last longer. But influenza viruses change from year to year, so any protection you develop in one flu season may not be helpful in the next. That's why you need a seasonal flu vaccination each year.

2. Excuse: "I don't get the flu." (54 percent)

Reality: More than half of the respondents who skipped getting a flu shot last year said they just don't get the flu. And 62 percent of the parents who said they didn't plan to have their children vaccinated said it was because their kids rarely get sick. But that's largely the result of chance. The Centers for Disease Control estimates that 5 percent to 20 percent of Americans get the flu each year. You can go a number of years without getting the flu—and then you could get a bad one.

It's also important to know that the flu can cause a spectrum of infection. Some people get it without symptoms, while others "don't recognize it because it doesn't put them in bed," Schaffner says. So even if you don't have symptoms, you can spread it to others who may develop a serious illness.

And remember that very few people under 60 have immunity against this year's swine flu. "That's why a pandemic is a big deal," notes John Santa, M.D., director of the Consumer Reports Health Ratings Center. "Many more of us are vulnerable than usual."

3. Excuse: "I'm worried about side effects." (39 percent)

Reality: Side effects of the seasonal flu vaccine are uncommon and usually mild. The most common are pain or soreness at the injection site, aches, and mild fever. A small number of people may have a serious allergic reaction.

A -swine flu vaccine developed in 1976 was associated with a greater—but still rare—risk of Guillain-Barré syndrome (GBS), a serious neurological disorder. An additional case of GBS occurred in 1 of every 100,000 people who were vaccinated against the 1976 swine flu. In comparison, for every 1 million people vaccinated with a typical seasonal flu vaccine, one person might develop GBS. Researchers are unsure why the 1976 swine flu vaccine appeared to have a greater incidence of GBS, but health officials don't expect the same to happen with this year's vaccine. Moreover, Schaffner says the vaccine's protection against illness and complications from the flu, which can also include GBS, far outweigh the risks. People who get an influenza infection are four to seven times more likely to develop GBS than those who are vaccinated.

GBS is more likely to develop in people who have already had the neurological disorder. If that's you, avoid the spray vaccine, which has a weakened live virus, and discuss with your doctor whether to get a shot. Pregnant women, small children, and people with underlying conditions should also avoid the spray vaccine, which can cause minor flu-like symptoms.

Finally, although research has failed to find convincing evidence linking the mercury-containing preservative thimerosal with autism or other health problems, mercury-free vaccines are available, so ask for one if you're concerned.

4. Excuse: "Medicine and other remedies can treat the flu." (34 percent)

Reality: It's true that antiviral drugs, such as (Tamiflu) and zanamivir (Relenza), can be effective in treating the flu. But they're no panacea. If taken within two days of the onset of flu symptoms, they can make them less severe and shorten them by a day or so, but they won't make the flu go away. And like all drugs, they might cause side effects. So far the swine flu virus seems vulnerable to these drugs, though some seasonal flu viruses are resistant to Tamiflu. There's also a risk that relying on the drugs too much can lead to greater resistance.

5. Excuse: "The vaccine is ineffective." (26 percent)

Reality: It's true that influenza vaccines are generally not as effective as some childhood vaccines, like those for measles, mumps and rubella, which are nearly 100 percent effective. But they generally offer 70 percent to 90 percent protection against the disease for children and younger adults, those most at risk from H1N1. They offer less protection for older people, warding off the disease in about 60 percent of the healthy people in their 60s, depending on the match with the season's circulating viruses. The very old and infirm may get less protection, but the vaccine "virtually always provides partial protection," Schaffner says. It reduces hospitalizations from and other complications by 27 percent to 70 percent, and deaths by up to 80 percent. Health officials expect the swine flu vaccine to be as effective.

The most important aspect of immunization is that everyone who gets vaccinated is less likely to spread the disease. "That may not be a benefit to you directly," says Santa from Consumer Reports, "but it is to your family and your community. And if you're a health worker, a teacher, or a child-care worker, your immunity could save children and families a lot of hardship, serious illnesses, and possibly lives."