Tuesday, May 29, 2007

Maximizing Protection vs. Increasing Rates

It has been about four years now since I have told anyone that our Coalition works to 'increase immunization rates'. In my presentations, on our websites, in our marketing materials, in our meetings and campaigns we talk about maximizing immunization or disease protection not necessarily increasing rates. There are two very important reasons for this.

Reason One: Increasing immunization rates does not sound all that appealing or important to most people. If anything it sounds to people quite robotic and inhuman. For most people with the exception of some public health geeks (no offense here – I have the highest regard for public health geeks as I am one myself) raising immunization rates doesn’t mean anything. It is simply bean counting. In some ways it actually feeds peoples stereotypes that all we want to do is push more vaccines. ‘What do your immunization rates have to do with my life or my children?’ Now if you say you are going to help maximize immunization protection or improve protection from disease that sounds better. If we have learned anything from politics recently it is that words are important. The phrases you use to describe what you do say a lot about you. And it is proven that people react very differently to different words. In a focus group asking people about which was more positive my money would be on protection over rates any day.

The second reason and most importantly for me - as I am a public health/science geek myself - is that raising immunization rates is inaccurate. That is not my job. That is not what I do. Now immunization rates may increase as a result of what I do, but I am not focused on that. My job is to help protect people from disease. If there was no disease I could care less about immunization. So the focus of what we do should be on the diseases and using immunization as a tool that works to protect people from those diseases. Also, simply raising rates is an unrealistic goal.

Why? Because we could spend trillions of dollars and never have 100% of people vaccinated – it’s impossible and a waste of resources. Some people have contraindications, some people are not the right ages for certain vaccines, and some people are not at risk for specific diseases, and some people simply refuse to be vaccinated. Now given that set of cards we can target immunizations to help protect the most people from the most disease.

We are the experts when it comes to what disease are really effecting or would be affecting people’s lives if they didn’t get immunized. And most diseases (not tetanus) have a herd immunity threshold that allow us to protect a group of people even if not everyone in that group is vaccinated. So we are more maximizers and optimizers rather than blind vaccinators.

The moral of this blog is to stop using the words 'increasing immunization rates' and start using the terms maximizing/ optimizing/ improving/ broadening immunization or disease protection. In the end it sounds better and is far more representative of what we do.


Anonymous said...

I like the term"Maximizing Protection" though raising immunization rates has been a mantra for sometime.Yet, as an ole STD worker, Maximizing Protection bring to mind promotion of protection against an STD(not a bad ideal) though the intent here is protection from Disease.

I agree that it's time another term is considered but what can we learn from a focus group on this very timely use of new words.sam

Amy Paulson said...

I totally agree. Coalitions need to be realistic in setting goals that are feasible for coalition work. Creating awareness, advocacy, "maximizing protection" are all ways that coalitions can have an impact. While some coalitions can and DO increase Iz rates, as CINCH has in the past, a lot of it has to do with resources, too. Right what we do best is raise awareness, train providers, and link people with resources.

Thanks for this article...I'm going to forward this to our immunization work group.