Fear primarily emanates from two sources: the unknown … and what we don’t understand.
MarySue Grivna was a developmentally typical 9-year-old girl when she experienced a sudden onset of acute disseminated encephalomyelitis, also known as ADEM. She went to bed one night in November of 2013 feeling fine and woke the next morning completely paralyzed, according to ABC Action News in Tampa, Florida. Her parents believe it was the flu shot she had received the week before that triggered this debilitating disease.
ADEM is a disease that is characterized by a short-but-devastating attack on the myelin, which protects nerve fibers in our brain and spinal cord, according to The National Institute of Neurological Disorders. This extremely rare disorder is most typically triggered by an infection of some kind, but in rarer cases, it occurs shortly after a vaccination.
Although doctors are uncertain if Marysue’s condition was caused by her flu vaccination, stories like these inevitably raise questions about vaccine safety. Do stories like these confirm the need to be cautious about vaccines, or are they rare coincidences?
Understand the Fear of Vaccines
Being fearful of vaccinations isn’t widespread, but it is more prevalent than most might assume. Each year, the United States government aims for 95 percent of children enrolled in public school to be up-to-date on their vaccinations. Each year, they fall short of this goal, according to CNN Health.
[Parents believe] flu shots are like rolling a dice.
More specifically, a 2015 survey by NPR found that only 62 percent of 3,000 survey participants reported that they had received their flu vaccine or planned to in the near future. Interestingly enough, this was a trend that was consistent across all income levels and education levels. The only population that really stood out above the rest was those over the age of 65, who had much higher vaccination rates than younger populations.
When it comes to the reasons parents delay or opt out of vaccinations, there a few popular reasons for their concerns, according to John Mayer, PhD, a clinical psychologist at Doctor On Demand.
Parents are concerned about the side effects, he says; they’re concerned that their child may develop autism or actually catch the flu after getting the vaccination. And although there are many proven risks factors for contracting the flu virus, parents tend to be fearful of the flu vaccination because vaccinating their child is a choice they make.
“Parents are actively participating in getting the flu shot for the child,” says Mayer. “Whereas they are innocent bystanders if the child happens to get the flu. It’s out of their control. It creates a parental excuse of, ‘It wasn’t my fault they got the flu.’”
As strange as it might seem, parents generally respond much better to the difficulties children experience when they feel they haven’t played a role in inflicting those difficulties on their child.
Additionally, many parents aren’t convinced that the flu shot does what it promises to do. They either believe the shot is ineffective or that their children’s immune systems are capable of fighting off the virus on their own.
“[Parents believe] flu shots are like rolling a dice,” explains Mayer. “ … Many years ago, there may have been some validity to this fear, but better research and vaccines makes the flu shot [much more] effective.”
The Centers for Disease Control and Prevention wrote that the vaccination “reduces the risk of flu illness by between 40% and 60% among the overall population during seasons when most circulating flu viruses are well-matched to the flu vaccine.”
Social Media and Vaccine Fears
For parents trying to make a decision about the flu vaccine, the internet can be a blessing or a curse. In some cases, parents can use the internet to research vaccines and become well-informed on how safe and effective the shot is for children. On the other hand, social media has presented the opportunity for the spread of information about vaccines that may or may not be accurate.
When there is some dramatic, highly emotional case that may or may not be factually true … it runs through communities kind of like wildfire.
“Social media has greatly affected decisions about vaccines,“ shares Mayer. “The posting and publishing of lay persons speculating about the horrors of vaccines has left scars on the general public. … Before the term ‘fake news’ became so present in our world, these ‘chicken-little’ alarms that celebrities and other non-medical people voices about vaccines were fake news.”
Christine Johns, MD, a pediatric emergency physician who has been practicing for over fifteen years, agrees. Johns says she doesn’t feel that parents have always been as fearful of vaccines as they are today. In fact, she specifically maintains her social media presence as a physician so she can be a voice speaking up for the safety and effectiveness of flu vaccines and call out those who use their platform to spread fear of vaccines without sound, scientific evidence.
“When there is some dramatic, highly emotional case that may or may not be factually true, … parents pick up on that, and it runs through communities kind of like wildfire,” she says. “All of a sudden … people are drawing grossly generalized, inaccurate conclusions rather than taking a look at the science.”
The Facts About the Flu Vaccine
The truth about vaccines, specifically the flu vaccine, is that they are safe and effective, according to Johns. Vaccines are studied thoroughly and have been used on a massive scale effectively and safely for some time.
You may get a little bit of an inflammatory reaction, but you cannot get the flu [from the flu vaccine].
When it comes to popularly held beliefs that the flu vaccine isn’t effective, she explains why people adopt these beliefs even though they’re not factually accurate: The flu does adapt each year, and creating the vaccine requires thorough research and prediction of which strains will be circulating in the upcoming flu season. Johns believes that, because the virus does adapt quicker some years, and some people do get the flu, people begin spreading stories about the flu shot that do not represent its effectiveness as a whole.
“People say, ‘my kid got the vaccine but got the flu,’ and they think it isn’t working [overall],” she says.
When it comes to the risks of the vaccine, people should know that the risks and complications associated with influenza are much more likely than vaccine injury. While vaccine injuries are easily sensationalized on social media, it is the complications associated with the flu that pediatricians and emergency room physicians are seeing day in and day out.
“The risk of complications from the flu, certainly for the person who has a compromised immune system, is much high[er] than the risk of getting the flu vaccine,” she explains. “Really, the risks of the flu vaccine are very minimal.”
Specifically, Johns says the risks associated with the vaccine are minor symptoms for up to 48 hours, including low energy and tenderness at the site of the injection for a couple of days.
“You can’t get the flu from the flu vaccine. This year, it is the injection of the flu vaccine … We’re not using the live nasal spray. You may get a little bit of an inflammatory reaction, but you cannot get the flu,” she explains further.
When it comes to serious complications of the vaccine, they are very few and far between. One specific complication that is a big fear among vaccine recipients is Guillain-Barré Syndrome; however, research has found the the risk for GBS among people who have received a flu vaccine is one or two out of every one million people. Additionally, this rare disease is actually more likely among individuals who have had the flu virus, not the flu vaccine, according to the CDC.
And concerning ADEM, which affects Marysue: the condition only affects 0.000008 percent of people in a year, and only 5 percent of those few cases might be related to a vaccine, according to the National Multiple Sclerosis Society. Although Marysue’s story is heartbreaking, it is only one story among hundreds of millions of safe uses of the flu vaccine.
Addressing Fears of the Flu Vaccine
It is important that parents address their fears of complications and understand how to distinguish between fact and fiction about the flu vaccine. Everyone over the age of 6 months should have a flu vaccine, according to Johns—even those who are pregnant or breastfeeding.
… we need to be good stewards for humanity and get [vaccinated] to protect ourselves, our children, our neighbors, and our community.
“The advice I have for parents is to carefully research their fears about vaccines,” suggests Mayer. “Use multiple authoritative, trusted sources. Fear primarily emanates from two sources: the unknown … and what we don’t understand. Information … eliminates those fears.”
Additionally, Mayer urges parents to make the experience as low-anxiety as possible for their children by remaining positive. Parents can practice role playing with their child before the shot, explaining to them exactly what will happen at the next visit. He warns against pretending it isn’t that big of a deal or suggesting it won’t hurt; instead, he urges parents to explain that it will hurt but only for a short time, and that they won’t get sick because of the shot.
Ultimately, the choice to vaccinate isn’t just about a single family or single child. Parents should consider how their choice will affect those around them, like other students in their child’s school or daycare.
“Even if you or your child could weather the flu without any difficulty … there are a lot of people with chronic medical problems who will not get through it without any trouble,” says Johns. “… we need to be good stewards for humanity and get it to protect ourselves, our children, our neighbors, and our community.”