Go ahead, vaccinate

Catherine Kudlick is a professor of history at UC Davis, where she specializes in the history of medicine, epidemics and public health. SN&R had a few questions for her about our historical attitudes toward influenza and vaccinations.

Have American attitudes changed toward influenza in recent years, and if so, why?

Today’s responses to H1N1 fall into two extreme camps. Some people dismiss it because basically, since the 1918-1919 pandemic, only milder strains of flu have circulated, so flu has become something mundane, routine.

Another group has gone into panic mode, invoking that earlier experience of 1918-1919 when flu turned deadly.

We need to find a middle ground, somewhere between avoiding irrational panic and being prepared for what many credible epidemiologists predict is the inevitable return of a much worse strain of flu or some other devastating contagious disease. H1N1 hints at a future disaster, much like the 1989 Loma Prieta earthquake sent ominous warnings to Bay Area residents about the possibility of the inevitable future “big one.”

This current experience with H1N1 offers a valuable opportunity to test the weak points in our emergency responses and explore new ways of doing things. It also suggests that individuals can and should be doing more basic things to slow the spread.

What about American attitudes toward vaccines? What accounts for the reluctance, and even the “conspiracy theories,” about influenza vaccine?

These responses are as old as vaccination itself, which dates from around 1800 in response to smallpox. If you think about it, it’s counterintuitive to inject a disease into your body, and it was a hard sell in the 19th century, just as it is today. In 2009, we have more scientific data to show that it works, but we also know that science is imperfect, so we can justify these old fears with a more modern set of excuses.

Americans have an interesting relationship to risk; we know from recent studies that drivers who talk on cell phones or text are four times more likely to get in an accident, and yet we aren’t doing much about it. All present studies indicate that vaccination poses a far smaller danger to our health, and yet it’s much easier to plant that seed of doubt.

Is there a historical precedent for a nationwide pandemic, in which up to 20 percent of the population could be sick in the same season?

I can’t think of one in the U.S., though you’ve got to keep in mind that until the 20th century, it was far more common for people to live with a whole variety of illnesses, and that being “healthy” as we define it today was in some ways a luxury for the majority of the population.