Rebranding "Get Your Flu Shot": Localities Test New Messages

Foregoing the old-fashioned public service announcement, local health departments are trying new ways to get the word out.

Quick: how many “Get Your Flu Shot” signs have you walked past in the last, say, month and completely ignored? Dozens? Hundreds?

You aren’t alone. And it’s proving to be quite a conundrum for local health departments who are stuck between not wanting to sound like alarmists and wanting to protect the public against a disease that kills as many as 30,000 Americans annually.

It’s the “seasonal” part of the seasonal flu that makes it such a problem. When there’s a unique threat like the H1N1 virus, it’s easy to galvanize public awareness because it’s something exotic and new -- and that’s both interesting and a little frightening. But when it’s something more routine like the seasonal flu (though public health officials are quick to remind you that the actual strain of influenza going around is different every year), it’s a little harder to get the public’s attention. They shrug it off, put off their flu shot and go about their day.

“The idea that this is something we have to respect and something we have to consider a danger to people’s health, that’s a difficult message,” says Paul Etkind, senior director of infectious diseases at the National Association of City and County Health Officials (NACCHO). “People tend to forget or discount that this is something that needs to be taken seriously.”

And then thousands of those people who ignore the warnings get sick. So local officials are trying to think outside the box when they deliver their message.

Sometimes, it means doing something as drastic as declaring a public health emergency to make an impression. That’s what Boston Mayor Tom Menino did this month after his staff realized that the city had seen 700 confirmed flu cases so far this season—10 times the number they saw last year. (Etkind notes that confirmed cases are “just the tip of the iceberg” because many, even most, people stay home and treat themselves or doctors don’t bother or need to confirm a diagnosis through a lab test).

The next day, the city saw a flood of people streaming into pharmacies and community health clinics to get their flu shot, says Etkind, who consulted with Anita Berry, director of the Boston Public Health Commission's infectious disease bureau. That weekend, city officials organized a flu shot drive and saw record numbers of people taking the one basic precaution that doctors say is the best defense against the flu.

So the emergency declaration worked. But, Etkind stresses, it needs to be a last resort. Yes, using heightened wording like “emergency” motivated people to get their shot, but city officials also had the data to demonstrate that they really did have a serious situation on their hands.

“This wasn’t just a communications ploy. They had the data to substantiate it,” he says. “Otherwise, it’s just a child crying wolf.”

Assuming the situation isn’t so dire that an emergency declaration is warranted, local health departments are still finding ways to change up the old program of public service announcements, radio interviews and the like.

In St. Louis County, Mo., the county health department worked with Saint Louis University to debut a whole new branding campaign. Taking their lead from the infamous Soup Nazi from the 90’s television hit “Seinfeld”, they called it: No Flu For You. It’s included a website, social media and the more traditional outlets to get the word out and not only inform people about the benefits of getting a flu shot, but offer resources so those interested could organize even more localized efforts.

The county also teamed up with a local hard rock radio station,105.7 The Point, and the Gateway Immunization Coalition, an advocacy group, for another unique outreach campaign. Called “Kids that Rock”, parents of toddlers were asking to submit a picture of their young ones “rocking out” and then take a short survey about their immunization history. Participants were then entered into a contest for a donated vacation to Cancun, Mexico. The promotion not only raised more awareness about the need for children to get a flu shot, but also gave local officials some hard data about how many of their constituents were following that advice.

“We’ve just tried to be a little bit irreverent,” says Eleanor Peters, epidemiology specialist for the St. Louis County Health Department. “Since it’s become so routine, it’s difficult to get people’s attention when there’s so much coming at them.”

That’s a reality that’s starting to sink in at health departments nationwide. You could say it started with the Centers for Disease Control and Prevention (CDC), which set the standard for out-of-the-box public health marketing with its zombie apocalypse campaign that drew attention to emergency preparedness. This year, the CDC got Matt Birk, center for the Baltimore Ravens who will be playing for a Super Bowl ring next week, to become an unofficial spokesperson for flu vaccination. The Florida Department of Health has launched a series of (if we dare say) hilarious television, radio and billboard ads called “The Fifth Guy” -- meaning one in five people don’t wash their hands, which is one of the best defenses against spreading diseases like the flu.

Local health departments have been slow to learn, Peters admits, but as some of these examples show, they seem to be getting the message.

“We need to innovate,” she says. “We need to realize the dynamic media market that we’re in.”

Dylan Scott is a GOVERNING staff writer.