Tammy Reed, the 28-year-old mother of a toddler, is not given to belief in conspiracy theories and is not the type to be rattled by the phrase "pandemic flu." The Menifee, Calif., resident is the kind of mom who gathers a good deal of her medical intelligence on government websites, trusts a friend who is a nurse practitioner and is raising her bright, strong-willed daughter with all the confidence of a former nanny and the second-born in a family of six.
She's the kind of mom who thinks that when the vaccine for H1N1 influenza becomes available for her daughter, she may just take a pass on it.
"It's a different brand of flu, but it is still the flu, and I think she's already built a pretty strong immune system," Reed says of her blond, blue-eyed 14-month-old. At the same time, the tests on the vaccine in development against H1N1 aren't even completed yet, and that, to Reed, sounds like a formula for unforeseen problems down the road.
"I'm really more concerned about the long-term effects and lifelong damage it could do to her," Reed says.
So for now, at least, she's made her peace with the prospect that her daughter, Coral, could have a few miserable days and a lifetime immunity from this novel strain of flu.
She'll seek her pediatrician's opinion next month when Coral is due for a checkup, Reed says. "But I don't think it'll sway me at this point."
As the nation braces for a season of pandemic contagion, omnipresent vaccine clinics and debate over healthcare reform, the myriad doubts of parents and citizens like Reed represent a new and potent strain of vaccine ambivalence.
Physicians say they are hearing young parents -- many of whom have neither seen nor suffered any of the once-common diseases of childhood -- express doubts about inoculating their children against the novel strain of influenza.
This new generation of vaccine skeptics has been forged by the stubbornly persistent belief -- discredited by a welter of studies -- in a link between vaccines and autism. And it is further fueled by a combustible mix of distrust of drug manufacturers, media outlets and the federal government.
And although many pediatricians are readying stern lectures in support of vaccinating children, several in Southern California contacted by The Times acknowledged they have doubts about recommending a vaccine that is still in testing for all of their young patients.
"A significant proportion of our population don't want to get it," says Sherman Oaks pediatrician Mikayel Abramyan. "I don't even know whether I will advocate for it right now."
To date, notes Abramyan, who saw a fair amount of novel H1N1 over the summer, the illness has been mild, and many parents of the children he cares for "want them to get their immunity that way instead of a flu shot," he says. While Abramyan says he rarely lets such preferences go unchallenged, "it's a reasonable position, and I understand it on an individual level. . . . I understand where they're coming from."
Americans in their 20s, 30s and 40s have been largely spared the yearly deliberations over seasonal flu vaccine, either for themselves or their kids. School-aged children and their parents are mostly in robust health. Until very recently, they have been an afterthought in vaccination drives, which have focused instead on reaching the very old and very young -- populations considered at highest risk of complications from seasonal flu.
The new H1N1 virus has changed all that. Epidemiologists have found that children, young adults and pregnant women who catch the new flu run a greater risk than the elderly of developing complications; as a result, all three groups top the list of those recommended to get H1N1 vaccine this year. And even before the new strain emerged, many epidemiologists had embraced the view that vaccinating schoolchildren -- the most prolific spreaders of germs -- might be the best way to reduce the seasonal flu's hold on the entire population.
The collective doubts of this generation of parents, say experts in infectious disease control, could stymie the efforts of government officials and the medical establishment to stem the spread of a new contagion, and to ready for other infectious diseases that may emerge down the road.
"Swirling around parents this fall will be a lot of myths, misinformation and legitimate and factual communications," says Sandra Quinn, a University of Pittsburgh public health professor who recently completed a national survey of attitudes about the flu vaccine. Of all the messages parents of young children are receiving, Quinn says, the parents of young children seem to be fixating on the word "uncertainty" -- about the severity and scope of the flu, the status of the vaccine and the need for mass vaccinations.