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The media has portrayed a lot of controversy lately about the H1N1 vaccination. On one side of the debate are reputable physicians who feel that the vaccine can prevent serious illness and save lives, especially for those in high-risk populations. On the other side of the spectrum are those who argue against use of the vaccine, claiming that its potential harm is not worth the risk. The reasons for the latter perspective vary widely, but are based on notions such as: the FDA rushed approval of the vaccine too quickly, supposedly higher levels of preservatives in the vaccine, complications of potential side effects, general mistrust of the government and the pharmaceutical industry, and the age-old argument against vaccines themselves--misunderstanding about how vaccines work, and confusion about how introducing a small amount of dead (or inactivated) bacteria or virus into the immune system can actually prevent a disease.
Although I think this debate and the suspicion surrounding the H1N1 vaccine reflect an intriguing distrust of the government agencies responsible for decisions about health policies, a bias that has spread widely in recent months, an issue that hasn't been addressed much if at all, is the even more curious generational difference about the safeness and efficacy of the vaccine.
I, as well my colleagues in the medical profession, have noticed that many older adults have not been suspicious at all about the H1N1 vaccine. One physician told me that when he mentions the need for the vaccination to his patients over the age of 65, they simply and immediately agree.
So why is it that older people would be more trusting of vaccines?
One reason is that people over the age of 65 remember a time when there were no vaccines. Polio, measles, whooping cough, and mumps were all diseases that caused grave illness before there were vaccinations. The polio and whooping cough vaccines were developed in the 1950s, the measles vaccine in 1968. Older generations remember these illnesses and a time when infectious diseases were not only more prevalent, but more deadly.
Those of us who are younger than 60 do not remember these times. Yet, we may recall that in 1976, there was concern that a similar swine flu vaccine was possibly linked to Guillain-Barre syndrome and that more people contracted this illness than the flu, which never really affected the population as was feared. However, the CDC reports that every year an estimated 3,000 to 6,000 Americans develop Guillain-Barre syndrome, whether or not they've received a vaccination.
Since I am not a physician, I am in no position to recommend or discourage the H1N1 vaccine or the standard flu vaccine. As with all issues related to personal health, vaccinations are an individual choice. And as I've discussed before, there are a myriad of reasons that people choose not to follow Western medical advice. I do think however, it's worth bearing in mind what the older generation may be able to teach us: Many people have died of diseases that are prevented today by vaccines. As is often the case with generational differences, older people have lived a history of which younger people have no experience. And although it is a typical human tendency to forget, or deny the lessons to be learned from the past, when it comes to healthcare, many older people remember a time when modern medicine was not an enemy, but a source of protection that prevented death.
I don't know if the U.S. government's health policies are more or less trustworthy today than they were 60 years ago, but perhaps the decision makers in our government do care about our health and well-being, as they too are not immune from diseases like the H1N1 flu.
In any case, the phenomena of generational differences regarding vaccines is worth noting. Older people seem to have higher levels of trust in physicians and modern medicine. History is a great teacher, and one that we can only learn from those who have lived through it.
For further reading on the flu and vaccinations, see these New York Times and CDC articles, as well as Dr. Rob Seigel's PT blog.
