Hong Kong Health Care Workers Leery of H1N1 Vaccine

From Reuters Health Information

NEW YORK (Reuters Health) Aug 26 - Even though testing has so far raised no "red flags" regarding safety of vaccines against the novel H1N1 influenza virus, surveys and focus groups show that healthcare workers and members of the public may be leery of being inoculated when supplies become available this fall.

Writing in the August 26 issue of BMJ Online First, Dr. Paul K. S. Chan and associates at the Chinese University of Hong Kong note that "in nearly all countries with a (pandemic) preparedness plan, healthcare workers are listed as the priority group for mass vaccination."

In May of this year when the WHO pandemic influenza alert level had been raised to phase 5, the researchers distributed 810 questionnaires to public hospital workers, primarily doctors and nurses.

A tally of the 389 questionnaires that were returned indicated that less than half (48%) intended to accept pre-pandemic H1N1 vaccination. The most common reason for refusal was worry over side effects, follow by questions about the vaccine's efficacy and the conviction that it was "not yet the right time to be vaccinated."

"This is particularly surprising in a city where the SARS outbreak had such a huge impact," Dr. Chan's team points out.

The strongest associations with willingness to be vaccinated, the report indicates, were a history of seasonal flu vaccination and the perception that they were likely to be infected.

In a linked commentary, Dr. Rachel Jordan, from the University of Birmingham, and Dr. Andrew Hayward, from the University College of London, advise that in order to maximize vaccine uptake, "use of convenient mobile systems, monitoring and feedback systems, and 'opt-out' systems (where healthcare workers need to indicate their reasons for not accepting the vaccine) show promise."

In a separate article published online in the Emerging Health Threats Journal, Dr. Natalie Henrich of the University of British Columbia and Dr. Bev J. Holmes at Simon Fraser University, both in Vancouver, describe findings from 11 focus groups conducted with the public in Vancouver, Canada, in 2006 and 2007 to explore their willingness to use novel vaccines in a pandemic.

The researchers asked the 85 participants how willing they would be to accept a new vaccine in the event of a pandemic. Very few people said they or their children would definitely get vaccinated, the authors report. Participants' concerns centered around the risk of infection versus the risks involved in using newly developed vaccines.

"Participants were hesitant to use the novel vaccines (due to) concern that unsafe pharmaceuticals may be rushed to market during the health crisis," the authors said.

Instead, many individuals believed they could protect themselves through their own behavior, including frequent handwashing, staying away from crowded places and sick people, and eating well to maintain their strong immune system.

BMJ 2009;339:b3391.

Emerging Health Threats Journal 2009.