SAN BERNARDINO—Willie S. Jones, a 73-year-old African-American, had his last flu shot 32 years ago. “Never again,” he insists “It made me so sick. That shot gave me the flu.” Jones said as he played bingo at a San Bernardino Senior Activity Center.
Since then, Jones has avoided the vaccine, as have many others at the center, even though free shots are offered periodically in the building.
San Bernardino County Health Officer Maxwell Ohikhuare, M.D. confers with staff during the 2009 H1N1 flu epidemic. Ohikhuare says despite risk, Blacks are more likely to avoid flu vaccine.
Decades ago, adverse reactions, like those Jones remembers, were common.
Today's shots are safer, although they can still cause sore arms and rare fevers.
“The myth that you can get flu from the flu vaccine continues to be alive and well,” says Dr. Maxwell Ohikhuare, Public Health Officer for San Bernardino County.
“If they became sick with a virus of one kind or other around the time they had a flu shot, some people draw the erroneous conclusion that the shot made them sick.”
“These are common misperceptions and ones that needs to be corrected,” Ohikhuare adds.
There are other fears as well.
One oft-repeated incident that has fostered suspicion in the Black community is the "Tuskegee Study of Untreated Syphilis in the Negro Male," which from 1932 to 1972 studied 399 poor Blacks in Alabama suffering from the sexually transmitted disease. Many of the men were allowed to suffer and die even after penicillin, which cures syphilis, became available in 1947.
"The sad part is that people are not convinced that it is a thing of the past. Such a practice while tragic cannot happen again because there are too many checks and balances,” said Dr. Ohikhuare.
He explains, "A lot of things that happened to Black people in the past are etched in the folklore. .. . Everybody knows about the syphilis study. Those suspicions continue to foster a systemic lack of trust in government.”
Another reason for the reluctance of African Americans to get flu shots is many do not understand how often they need to be vaccinated. “Some seniors think, like vaccines against common childhood illnesses, the flu vaccine provides lifelong protection against the flu.”
Last year when Ohikhuare looked out at the long line of people waiting to receive the H1N1 vaccine he noted a disturbing absence: African Americans.
“Save a handful, African Americans were not represented in those lines.”
This is of great concern in the medical community, he says because 44,000 Americans 65 and older die from influenza and its complications every year, compared to a total of 7,000 flu related deaths in all other age groups.
As the country enters another flu season--heightened by fears of H1N1 – also known as swine flu -- virus in Latin America, Asia and Europe-- health officials are grappling with a seemingly intractable problem: Many Americans, particularly Blacks, don't trust annual flu shots.
“About 100 million people, or one in three, get vaccinated,” said Dr. Anne Schuchat, director of the Centers for Disease Control's National Center for Immunization and Respiratory Diseases.
“We see lower rates among African- Americans. Among black adults at high-risk for exposure to the flu, only one in four are getting vaccinated. Seniors, pregnant women, infants, and people with respiratory problems or compromised immune systems due to HIV/AIDS, Lupus, Crohn’s disease, and Multiple Sclerosis are at significant risk for influenza.
Last week Ohikhuare reported the county’s second whooping cough death this year and the state’s ninth death – all were infants. An estimated 100 residents in San Bernardino and Riverside Counties died from H1N1 related diseases between April 2009 and March 2010.
Unlike many health care disparities, cost and access is not the main problem. Flu shots run between $15 and $30, but most seniors are covered by Medicare. Most major retail pharmacies offer vaccinations and charge between $20 and $29.99.
Ohikhuare says the problem is educating people about the benefits of flu shots and improving access to them.
That’s why he and county staffers are gearing up to take the department’s annual flu shot campaign “It up to you to Fight the Flu!” to the next level.
“I’m writing an open letter to key health, faith-based and community stakeholders,” said Ohikhuare. We’re asking for the African American community’s help in addressing this. We want to hear from people directly.”
County health officials will begin forming partnerships and holding forums. The department is on Facebook and Twitter and has a website dedicated to fighting flu at www.sbcounty.govdph, or residents can call the Immunization Program at 1800-722-4794, Monday through Friday, from 8 a.m. to 5 p.m. to find a clinic.
“People need to get the facts about the flu vaccine. We know that the Tuskegee experiments have stirred fear and suspicion in the African American community over many health initiatives,” Ohikhuare said.
“As health communicators, in fighting the flu it’s critical that we recognize that such fears exist and address them openly and fairly.”