Would You Take a Risky Flu Vaccine?
Survey Explores Tough Health Care Decisions
May 31, 2006 -- If a deadly flu outbreak occurred in the U.S. would you
choose to take a risky experimental vaccine that carried a 5% chance of death
or do nothing, knowing that your risk of flu death would be twice as high?
Although the question is academic, fears of a future bird
flu pandemic make it seem all too real. And a new study suggests
that your answer may depend on whether you are making the decision for yourself
or someone else.
Researchers from the University of Michigan Medical School and the VA Ann
Arbor Healthcare System conducted the study, designed to shed light on how
people make the most difficult health care decisions.
They found that those surveyed were more likely to choose immunization for
their children than themselves. They were even more likely to recommend
immunization when asked to take on the role of a physician or public health
policy maker making decisions for the community at large.
"The main message here for the public is that perspective does
matter," decision psychologist and author Brian J. Zikmund-Fisher, PhD,
"The tendency among people facing complex and emotionally charged
medical decisions is to focus only on the decision without necessarily seeing
the big picture. If they are able to consider the situation from a different
perspective their decision may be different."
Weighing the Options
The nearly 2,400 study participants were asked to consider two hypothetical
In one instance, some of the participants were asked if they would take a
risky flu vaccine during a deadly influenza outbreak. In the other scenario, the
same people were asked if they would choose to have chemotherapy or no
treatment when faced with a slow-growing cancer.
The same questions were asked of other study participants, who were told to
assume the roles of either a parent making the decision for a child, a doctor
advising a patient, or a hospital policy maker making decisions to be adopted
In each case, it was also made clear that the active treatment was the
statistically better choice, even though it was associated with a 5% risk of
death. The risk of death with no treatment was 10%.
Experimental bird flu vaccines are in the works, but no single vaccine has
been approved for public use, and there is no suggestion that any of them are
anywhere near as risky as the hypothetical vaccine in this study.
While just under half of the participants making the medical decision for
themselves chose to get the hypothetical vaccine (48%), 57% of those asked to
make the decision for their child said they would choose immunization.
Sixty-three percent of the study participants taking on the role of an advising
physician and 73% of those responding as medical directors said they would
choose the active treatment.
Although more "patient" responders said they would choose
chemotherapy over doing nothing for a slow-growing cancer, a larger percentage
of the other responders said they would choose active treatment for their
children, patients, or the community at large.
The findings are published in the June issue of the Journal of General