Why Doesn’t Everyone Get the Flu Vaccine? A New Freakonomics Radio Podcast
What if there were a small step you could take that would prevent you from getting sick, stop you from missing work, and help ensure you won’t play a part in killing babies, the sick, and the elderly?
That actually exists: it’s called the flu shot. But a lot of people don’t get it. Why? That’s the question we try to answer in this episode of Freakonomics Radio. (You can subscribe to the podcast at iTunes or elsewhere, get the RSS feed, or listen via the media player above. You can also read the transcript, which includes credits for the music you’ll hear in the episode.)
Influenza and pneumonia, which the Centers for Disease Control groups together, have long been among the top-ten annual killers in the U.S. In 2010 (the most recent year for which there is final data), the count was an estimated 53,826 Americans — more than six times the number of worldwide deaths from Ebola last year.
In the episode, you’ll hear Jeff Kwong, an epidemiologist, family physician, and researcher at the Institute for Clinical Evaluative Sciences, explain the science around influenza and its vaccine. In an ideal world, Kwong says, the vaccination rate would be 100 percent. But in reality, as he tells Stephen Dubner, it’s less than half that in the U.S. Why?
KWONG: I think one of the problems with influenza is the perception that it’s not a big deal. And it’s true that for most people it isn’t. … But then the problem is that they could be giving it to their elderly parent, or their young child, or their pregnant wife. And then their infant is born premature as a result of the influenza infection. … So that sort of thing plays out and it doesn’t make headlines, but that’s the reality people don’t appreciate.
Frederick Chen, an economist at Wake Forest University, designed an online game to try and decipher the incentives people need to get vaccinated. While he admits that the game is not “super fun,” he argues that it provides some evidence for the kind of ideas that policymakers should pursue to boost vaccination rates.
Chen thinks one reason many people fail to get a flu shot is because of a psychological shortcut known as the “availability heuristic”:
CHEN: And so that means, the more salient, or more vivid something is, the easier it is for us to recall. … For instance, if we see an earthquake happening in the news, then somehow, because that’s very vivid, we tend to overestimate the probability of an earthquake occurring. … And so, I think the problem with vaccination in the end comes down to this: When it’s working, it’s not very memorable. … It’s more newsworthy when we see things not working. But when a vaccine is working, nobody wants to talk about it.
There’s also a sizable group of people with “vaccine hesitancy,” who generally dislike the idea of immunization. Some of these skeptics hold beliefs about vaccines that are demonstrably wrong — but they are hard to budge. Research by the political scientists Brendan Nyhan and Jason Reifler, for instance, shows that when such people are given scientific information to dispute vaccine myths, they become less likely to get the vaccine.
Vaccine skeptics will hardly be comforted by the bizarre true story of how the CIA used a Pakistani vaccine campaign as cover during the hunt for Osama Bin Laden. You’ll hear all about it from Mark Mazzetti, a Pulitzer-winning New York Times reporter who chronicles the saga in his book The Way of the Knife: The CIA, a Secret Army, and a War at the Ends of the Earth.