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Swine Flu Vaccine Offers Lessons in Leadership

 |  By HealthLeaders Media Staff  
   November 13, 2009

I was watching "CBS Sunday Morning" last weekend. Call me a fossil, (I'm only 38) but I love the music at the beginning, the sun motif, and Charles Osgood's voice and manner. Never mind that I usually watch it much later courtesy of the DVR.

Anyway, the stories are usually pretty soft—they had one on the 40th anniversary of Sesame Street, for example—and they're often pretty light on details, but a story this week on why people decline the swine flu vaccination was particularly interesting and alarming at the same time.

In the story, the reporter interviewed a couple of doctors who argued that getting a majority of people to get the vaccine is important to "herd immunity." This essentially means that it's more difficult for a disease to maintain a chain of infection when large numbers of a population are immune.

The doctors interviewed in the "Sunday Morning" piece said that irrational fear of the vaccine, thanks primarily to widespread speculation about the role of vaccinations in causing childhood autism (a link that has never been proven, by the way) is getting in the way of herd immunity across the globe.

Meanwhile, the spokesperson for a private group that counsels against getting the vaccine essentially said that people shouldn't be forced to get anything injected in their body. Never mind that no one's arguing that point—at least in this country.

But recent controversy about the safety of the vaccine has spread to people you'd think would know better, including healthcare workers themselves. These are people who are supposedly trained not only in treating patients for diseases and other maladies with which they're already afflicted, but who presumably have a working knowledge of how diseases are transmitted and how people can protect themselves.

Seeing something like this, it's no wonder we have such a problem with getting caregivers to consistently wash their hands. In fact, I'm only vaccinated against H1N1 myself because the initial 3,000 inoculations set aside for healthcare workers here in Nashville were so underutilized that you'd think they were giving away eye pokes and face slaps.

Only about 64 healthcare workers took advantage, so the local health department opened the remaining 2,936 doses to anyone who wanted one—my wife and I among them. One month later, and I'm still here. Not a sniffle.

I'm a big believer in vaccines. Why? My great-grandparents had a big family in rural Mississippi. By the time the so-called Spanish Flu pandemic finished its work between 1918-1920, they were both dead from it, as were three of their eight children. Between 50 million and 100 million people worldwide joined them in death from the disease. Do you think there would have been controversy about a vaccine that would prevent that disease if there had been one available at the time? Me neither.

Recently, a nurses' union in New York threatened to strike over a controversial requirement that said they must be vaccinated for H1N1 or lose their jobs. That requirement was soon rescinded. Nearly concurrently, a union in California threatened to strike because they didn't feel hospitals were doing enough to protect them from swine flu infection. Hello! How about getting the vaccine? I know these are different organizations, but what gives?

Many, many smart people have tried to find ways to convince people that the vaccine is not harmful and is important to protecting against a regional, national or global pandemic. Clearly, they've failed.

So how does a leader convey that getting the vaccine is important enough to overcome these irrational fears? How does a leader get buy-in from caregivers regarding any issue that is controversial? I'm not sure.

But I haven't seen the President or any of his cabinet holding a news conference at which they take the vaccination. In fairness, he's said he and the First Lady will wait until high-risk groups get the vaccine before getting it. I appreciate the gesture, but in this case, wouldn't it be better to go on the offensive against some of this irrational fear by getting the vaccine yourself?

I'd love to hear what great leaders have done to sell unpopular initiatives ranging from the importance of the H1N1 vaccine to the long-term wisdom of aligning with physicians through employment, for example. You can reach me at the email address below.


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