Media Advisory. Alameda County Public Health Department. acphd.org (510)

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Media Advisory Alameda County Public Health Department acphd.org (510) 267-8000 Media Contacts: FOR IMMEDIATE RELEASE July 27, 2010 Ms. Vanessa Cordova Alameda County Public Health Department 510/268-2126 Office 510/439-6293 Cell Mr. Ben Tulchin Tulchin Research 415/613-5480 Cell ben@tulchinresearch.com Alameda County Public Health Department Conducts California s First Comprehensive Survey Measuring Attitudes Towards Vaccination, Especially Among Underserved Populations Survey shapes county s current whooping cough vaccination and flu prevention efforts, revealing concern for family wellness may boost vaccination rates, even among those less likely to get the vaccine. Oakland, CA The Alameda County Public Health Department (ACPHD) released public opinion survey results today (detailed results memo follows) identifying possible cultural barriers that hinder flu vaccination among the county s residents, with a particular focus on underserved populations, including African Americans, Asian Americans and Latinos. This first comprehensive survey on flu vaccination in California was conducted by Tulchin Research, a leading polling firm, and made possible by the California Department of Public Health (CDPH) with funding from a Centers for Disease Control and Prevention (CDC) Public Health Emergency Response grant designed to increase the influenza vaccination rates among hard-to-reach populations. The survey measured public opinion about H1N1 and seasonal flu vaccine and has broader implications for conducting outreach to underserved populations for the current whooping cough epidemic. This new data allows us to deliver a more meaningful prevention message to communities countywide, not only for flu, but for whooping cough, as well, said Dr. Muntu Davis, Alameda County Health Officer. Of particular note is the data showing the importance of family in making health decisions related to vaccines. The survey showed that family is a powerful motivator to compel residents to get a vaccine, even among those who initially indicate they are not inclined to get a shot this year. Protecting one s family is the most compelling reason for Alameda County residents to get the flu shot, and four out of ten residents who do not plan on getting a flu shot (40%) report that they will at least encourage their families to obtain the shot. This number is even higher among African-American, Latino and Asian residents, as half of African-American (51%) and Latino (50%) and 46% of Asian adults in Alameda County who do not plan on getting a vaccine would tell their family members to get one. This year, the CDC is recommending flu vaccine for every person 6 months of age and older. - more -

The poll results show that Alameda County can boost its vaccination rate by encouraging all residents to protect their family and loved ones by encouraging them to get a shot, pollster Ben Tulchin observed. This is particularly true among traditionally underserved populations. CDPH has recently expanded outreach to hard-to-reach populations in an effort to increase whooping cough vaccination rates statewide. ACPHD has used the survey to craft culturally competent prevention messages in its ongoing efforts to provide county residents both the H1N1 and whooping cough vaccines free of charge. - more -

July 26, 2010 First Comprehensive Survey in California Assesses Attitudes of Alameda County Residents About Flu Vaccine To: From: Interested Parties Ben Tulchin and Ben Krompak, Tulchin Research In order to assess coverage of the flu vaccine, the Alameda County Public Health Department commissioned a first-of-its-kind comprehensive scientific telephone survey among county residents to determine perceptions of each vaccine. The goal of the survey was to gauge opinions in order to increase the vaccination rate in the county and help prevent a severe outbreak in this coming year s flu season. We present an overview of the key survey takeaways below. Key Findings There were several findings that were particularly noteworthy and we wanted to highlight them before presenting a more detailed discussion of the results. Alameda County residents express more concern for the seasonal flu than the H1N1 flu. o Residents report a higher vaccine rates for seasonal flu than H1N1 flu, and o More would choose the seasonal flu shot over the H1N1 flu shot if forced to decide. Combining the two flu shots into one increases the likelihood of Alameda County residents getting the flu shot. The doctor s office is the preferred location for getting a flu shot. The family is a powerful motivator to compel residents to get a flu shot, even among those who initially indicate they are not inclined to get a flu shot this year. The most persuasive messages for getting a flu shot focus on: o Protect your family and loved ones; o Protect yourself; and o One shot will do it all (seasonal flu and H1N1 vaccine in one).

Summary of Results Based on both past behavior and intended future actions, Alameda County adults express more concern for the seasonal flu vaccine than the H1N1 vaccine. o Nearly half of Alameda County residents (48%) report obtaining the seasonal flu shot in the past year, whereas 30% indicate they received an H1N1 shot. Figure 1: Seasonal Flu and H1N1 Vaccination Rates in Alameda County in 2009 In the past year, did you get a seasonal flu shot or vaccine or an H1N1 flu shot or vaccine? Seasonal Flu H1N1 Yes No 30% 51% 48% No 69% 1% Yes *Data may not add up to 100% due to rounding. o In terms of future behavior, more than half of county residents indicate they plan on getting a seasonal flu shot this year (56%), whereas slightly more than one third (37%) report they will get an H1N1 shot this coming year a 19-point drop-off. o When asked in a forced choice for which vaccine residents would rather obtain, seasonal flu leads H1N1 by a sizable 28-point margin (53% choose seasonal flu compared to 25% choose H1N1).

Figure 2: Residents Pick Seasonal Flu Over H1N1 if Forced to Choose o There were some differences in vaccination rates by ethnicity: Latinos report the highest rates of future vaccine rates among both seasonal flu (65%) and H1N1 (51%); Asians are the second highest, with 65% for seasonal flu and 37% for H1N1 (note the drop-off between the two types of flu that is not present with Latinos); African Americans reported similar numbers as the countywide results (55% for seasonal flu, 38% for H1N1), though we should note that blacks had the lowest rate of past reported vaccination (37% for seasonal flu compared to 48% countywide, only 21% for H1N1 versus 30% countywide); and Caucasians reported slightly lower flu vaccination rates than the countywide average (52% for seasonal flu, 33% for H1N1). With past behavior often serving as an accurate predictor for future behavior, there is a clear preference for the seasonal flu vaccine over H1N1. A 2-in-1 shot that includes both seasonal flu and H1N1 flu is better than each shot on its own. When given information that the flu vaccine would be combined with the H1N1 vaccine into an all-in-one shot this year, nearly two in three voters (63%) indicate they would be more likely to obtain the vaccine.

Figure 3: An All-in-One Shot Makes Residents More Likely to Get a Flu Shot This coming year, the seasonal flu and H1N1 vaccine will be combined in an all-in-one shot. Now that the flu shot will combine these major strains of flu, will you be more or less likely to get the shot? More Likely 63% Less Likely 21% 0% 20% 40% 60% 80% 100% Even more impressively, nearly half of Alameda County residents who say they were not planning on getting a flu shot this year are more likely to get a flu shot if it contains both the seasonal flu vaccine and H1N1 (46%). Thus, H1N1 does play a role in attracting more people to get the flu vaccine that may not have otherwise gotten the shot. In terms of where to get the flu shot, the doctor s office is the location of choice for Alameda County residents. Three quarters (75%) of residents indicate their doctor s office is the most likely location where they would get the flu shot. The local public health clinic (7%), a grocery or drug store (6%), an employer/at work (5%), a neighborhood clinic (3%), or a registered nurse based in a neighborhood fire station (3%) are other alternative sites to get a flu shot that residents would also consider getting a flu shot, but all trail a doctor s office by a significant margin. Figure 4: Location Preference for Getting a Flu Shot

The most compelling reasons Alameda County residents found to get the flu shot were:: o It is important to protect your family and loved ones o It is important to protect yourself; o This year, one shot will do it all by combining seasonal flu with H1N1. The family component is extremely important. o Protecting one s family is the most compelling reason for Alameda County residents to get the flu shot, and o Four out of ten residents who do not plan on getting a flu shot (40%) report that they will at least encourage their families to obtain the shot. Figure 5: Emphasizing Family May Boost Vaccination Rates, Even Among those Less Likely to Get the Vaccine Even if you may not plan on getting the H1N1 or flu shot, are you going to encourage your family to get the vaccine? Yes No

Research Methodology From June 20 July 7, 2010 Tulchin Research conducted a telephone survey among 1250 adults, ages 18 and older, residing in Alameda County. Interviews were conducted in English, Spanish, Chinese, or Vietnamese, according to respondents preferences. In order to accurately reflect the adult population of Alameda County, Tulchin Research employed a random digit dialing methodology that ensures representation of both listed and unlisted landline phone numbers. This method uses random generation of the last two digits of telephone numbers on the basis of the area code, telephone exchange, and bank numbers defined as 100 contiguous telephone numbers in the last three digits of the phone number. The sample of 1250 Alameda County adults contained the following breakdowns: 800 adult sample proportional to the demographic makeup of Alameda County; 150 oversample of African American adults; 150 oversample of Asian Americans adults; and 150 oversample of Latino adults. The margin of error for the entire sample is +/- 2.8%. The margin of error for the ethnic group subsamples is +/- 6.2% The results of the survey were then adjusted to assume a proportional representation of Alameda County based on ethnicity, gender, age, and region information from the U.S. Census Bureau.