Science may not provide the answers to all questions, but when we ignore science to pursue other policy objectives we undermine our ability to convince the public. Consider how the approach to social marketing in relation to H1N1 used science.
The Public Health Agency of Canada (PHAC) issued two television ads during the flu season. One ad, not surprisingly, focused on getting vaccinated. The second, “Protect Yourself Against the Flu“, was about the ways to protect oneself and began with the image of a person washing their hands.
“No evidence has been found that hand hygiene or other interventions that might prevent contact transmission (e.g., glove use in healthcare facilities) prevent the transmission of influenza.” page 4
This was the 2007 conclusion of the Council of Canadian Academies, a science-based organization, in a study entitled Influenza Transmission and the Role of Personal Protective Respiratory Equipment: An Assessment of the Evidence. Vaccination was the best science-based method of preventing the transmission of influenza.
Throughout the lead up to the flu season the challenge was clearly to convince people to get vaccinated and to manage that process effectively. Would it be easy to convince people to get vaccinated? That was a difficult question to answer. In 2008, 32 per cent of Canadians received an influenza vaccine according to a Statistics Canada report.
In a 2007 survey for PHAC, 34% claimed to have gotten a flu shot while 32% washed their hands frequently as steps they took to reduce their chance of getting the flu in the previous year. More importantly, washing your hands is widely viewed by the public as the most effective precautionary method (95% rate it as effective (5-7 on 7 point scale).
There are three potential reasons for recommending a hand washing course of action:
- There is a belief that it is effective;
- Health officials want to empower people to do other things in addition to getting a vaccine (since people had to wait to get the vaccine)
- Since hand washing likely has other health benefits, the influenza was being used as a “teaching opportunity”.
Since the science told us that hand washing is not effective in preventing the transmission of influenza, the reality is that this recommendation was unnecessary (financially and conceptually).
Throughout the vaccination period, health officials had to battle erroneous claims that the vaccine itself was unsafe. Their response focused on the science and in trying to explain the different types of risk. Once wonders if the unintended consequence of selectively using science — to argue for the safety and effectiveness of vaccines versus ignoring it when it comes to hand washing — is that people might at some point wonder who can be trusted.