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H1N1 flu and emotional epidemiology: What if they gave a vaccine and nobody came?

A few weeks ago I posted a link to one of several articles describing the spread of what was rumored to be a particularly virulent form of H1N1 influenza in Ukraine. Was it a mutated form of the H1N1 virus? A recombinant mixture of the H1N1 strain with paramyxovirus? Or an exaggeration?

This recent NPR report suggests it was the latter -- a whipping up of hysteria by Ukrainian prime minister Yulia Tymoshenko, who, the report notes, was now able to ban, at least for a while, all mass gatherings and political rallies (after she'd already had hers). An analysis by the World Health Organization has since calmed the waters (the lethality of the virus in Ukraine is no greater than elsewhere, and the epidemic has already peaked), but the prime minister's swift exploitation of the fears she helped create appear to have boosted her approval ratings substantially.

Mass anxiety may, however, soon spawn suspicious cynicism. In an article in the New England Journal of Medicine, physician Danielle Ofri of Bellevue Hospital in New York remarks on the "emotional epidemiology of H1N1 influenza vaccination." Ofri notes that the same patients who, six months ago, were clamoring for a vaccine that did not yet exist have turned reticent now that it's becoming available. She suggests that practicing clinicians need to be cognizant of the tendency on the part of their patients, faced with a scary new disease, to shift their attitude over time from initial panic to eventual complacency. When the New York City public school system recently offered free vaccinations for students and families, Ofri writes, "less than one-quarter of the consent forms sent home in kids' backpacks were returned."

When it comes to preventing infectious disease, there is safety in numbers. The fewer people get vaccinated, the more vulnerable they, and you, will be -- unless, of course, you've gotten yourself immunized.

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