Lineups, vaccine shortage latest hurdles in Ottawa's H1N1 marketing challenge

TORONTO - All-day lineups and fresh warnings of a looming shortage of vaccine have suddenly left Canada's public-health watchdogs with a daunting marketing challenge: convincing a skeptical Internet generation of the importance of the H1N1 flu shot.

If that public-relations effort is to successfully target one of the most vulnerable segments of the population, it must be aimed specifically at a younger demographic and make careful and extensive use of modern-day new-media tools, experts say.

Ottawa faces a formidable communications dilemma - balancing the need to raise awareness of the flu vaccine without inciting panic, said Alan Middleton, marketing professor at York University's Schulich School of Business in Toronto.

The current marketing strategy, which is heavily dependent on traditional media like newspapers and television, is working for adults, but not for youth.

"You're dealing with a population that is not good at necessarily cognitively assessing risk," Middleton said in a telephone interview.

A dictatorial message runs the risk of alienating youth either by making them fearful or by raising the spectre of a "Big Brother" figure interfering in their lives, Middleton said.

Canadians under the age of 21 should be told to get informed rather than to get vaccinated, and the message needs to be delivered primarily through modern media tools like Facebook, YouTube and Twitter.

The Public Health Agency of Canada is in the process of compiling a communications strategy for the immunization program, the largest in Canadian history. An agency spokeswoman said officials have not yet decided whether to adopt a uniform approach or target separate segments of the population.

But there are no specific plans in the works to target youth, a perplexing fact considering that younger Canadians are considered especially vulnerable to swine flu.

"This is a younger people's flu," said Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention.

"In a usual flu season, 90 per cent of the deaths are among people over the age of 65. In H1N1, 90 per cent of the deaths are in people under the age of 65."

U.S. statistics indicate that as of Oct. 10, 53 per cent of H1N1-related hospitalizations involved patients under the age of 25, an age group which accounted for 23.6 per cent of total swine flu-related deaths.

In Canada, the crude hospitalization rate among children under 15 was 12.1 per 100,000 people, more than double the national average of 5.3 per 100,000.

Polls had been suggesting the Canadian public was largely ambivalent towards the vaccine until concern seemed to galvanize in the wake of the sudden H1N1-related death last week of an otherwise healthy 13-year-old boy in the Toronto suburb of Mississauga.

Suddenly, people began lining up for hours at a stretch, often waiting the entire day, at vaccination clinics in Toronto and elsewhere in Canada, just as officials in Ottawa reported that what had been billed as a plentiful supply of vaccine was in fact slowing to a trickle.

On Friday, politicians across Canada urged healthy residents to stay away from clinics to allow those who are at greater risk of complications - children under the age of 5, pregnant women and people with health conditions - to get vaccinated early.