I Gave My Patients Flu Vaccines. You Won't Believe What Didn't Happen Next!

In this Sept. 17, 2015, file photo, a nurse administers a flu vaccine shot in Washington. (Jacquelyn Martin/AP)
In this Sept. 17, 2015, file photo, a nurse administers a flu vaccine shot in Washington. (Jacquelyn Martin/AP)

Flu season is upon us, and with it a chance to test out my persuasion skills on a deeply skeptical public.

Consider this recent patient of mine, a young man in college who came in for an ankle sprain. “While you’re here, why not get a flu shot?” I asked.

He looked at me as if I were a car mechanic offering a few more add-ons to his maintenance exam.

“Oh, I don’t believe in that stuff,” he told me, waving his hand in front of his face.

“Well, even if you don’t believe in it, the vaccine works,” I responded.

“Yeah, well, you’re a doctor. You have to believe in vaccines,” he said.

Well, I’ve never felt that I “had to” believe in anything other than science, and I've annoyed most of my colleagues at some point with my skepticism about nearly every medical intervention.

But I've checked, and I can tell you the vaccine works. It's not perfect, but it's among the best forms of protection we have.

If you get the flu vaccine, you are between 50 and 70 percent less likely to get the flu, depending on how well the vaccine matches the current strains of the virus. You are slightly more likely to have soreness or a short fever with the flu shot, but you cannot get the flu from the shot, because it does not contain any live virus.

Serious complications may occur in one out of every 500,000 people. Compare that to the hundreds of thousands of Americans hospitalized for flu each year.

These numbers are great, but they don’t make for a very shareable headline. “You will be significantly less likely to get the flu if you get a vaccine, and complications are exceedingly rare!” is probably not going to light up your feed.

The sweet talk I learned about graphs and risk/benefit ratios in medical school seems frankly ineffective in the face of your friend’s Twitter rant. Appointment after appointment, I've had trouble conveying my enthusiasm to the unconverted.

So after looking into tried-and-true techniques, I no longer ask patients whether they want the flu shot, which could imply that the benefit is unproven or the risks are high.

Instead, I tell them they need it. I now simply say, "We have to do the flu shot before you go." And if they say no, I persist. Researchers find almost half of parents who are initially reluctant to vaccinate say yes when a doctor insists. If they have questions, I'm ready to answer them.

I also am more likely to push if patients are high risk for complications from the flu. When an older man with emphysema said no, I told him, "Your lungs aren't great. I really think you need this." He got the shot.

As for the young college student, where the benefit is smaller, I let it go. Though I did ask him to look at some trustworthy resources. Outside the clinic, we need to help patients navigate information, good and bad.

When it comes to shots, fake news is nothing new. I have been dealing with it for as long as I’ve been seeing patients.

One of my first interactions was with a young girl who was afraid of the HPV vaccine because of an article she had read on Wikipedia. Because I was a medical student and had all the time in the world, I spent 20 minutes convincing her that she should trust her doctor over a crowd-sourced internet article.

But as time goes on, I have less and less precious face time with patients, and more responsibilities in each visit.

The internet, meanwhile, doesn’t seem to be similarly constrained.

I would argue there is hope, however, that doctors can overcome some of these hurdles if we stop ignoring the fake news problem and start fighting it head on.

The most trusted articles on the internet are written by health care providers . And if the majority of our patients are going to spend more time on Facebook than in our office, it’s time to meet them there.

This is the reason I share studies on social media, and it’s the reason I write about my work.

I also send patients to well-written websites, especially the Mayo Clinic, so that they can continue to educate themselves using reliable resources.

And for those who want to follow doctors on social media, Dr. Wendy Swanson gives great advice for parents and Vinny Arora curates medical content. For doctors and other science nerds, Kenny Lin brings a skeptical eye to family medicine studies on Twitter.

So here’s my attempt to invade your social media feed. Suggested tweet: “This doctor gave flu vaccines to her patients. You won’t believe what happened next: They were 50 to 70% less likely to get the flu!”

Dr. Elisabeth Poorman is a clinical instructor at Harvard Medical School and Primary Care doctor in Everett. You can follow her on Twitter @drpoorman.



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