By Dennis D. McDonald

In Social Media and Preparations For the 2009-H1N1 InfluenzaEpidemic I discussed how a recent high-level policy document issued by the Obama Administration incorporates explicit recommendations for using social media and social networking techniques to communicate with the public about epidemic related topics.

One current example of such a “public dialog” is the CDC’s H1N1 Public Engagement Dialogue which opened up August 31 for registered participants to discuss topics such as:

• Understanding H1N1

  • Understanding the differences between seasonal flu and novel H1N1

  • Assumptions guiding the proposed H1N1 vaccination program approaches

  • Vaccine safety and efficacy

  • Vaccination Program Approaches

    • Pros and cons of a “GO EASY” approach to a vaccination program

    • Pros and cons of a “MODERATE EFFORT” approach to a vaccination program

    • Pros and cons of a “FULL THROTTLE” approach to a vaccination program    

I registered to participate, reviewed the background materials provided on basic topics such as the difference between influenza and the novel H1N1, and today I “dove in” to the moderated discussion stream.

The first thing I noticed was that, as a lay person with no public health or medical training, some of the online discussions were at first difficult to follow. Terms such as “adjuvant,” and issues surrounding the safety of different types of vaccinations (including a discussion of the relationship between mercury and autism), had me stumped. The background materials weren’t sufficient to make me feel comfortable with some of the more technical issues being discussed, especially since many of the registered participants appear to come from a medical or public health background.

Still, I do have some personal experience in evaluating the safety of drugs — I have two grown children, after all — so I was eventually able to follow the different views of what was being expressed.

The user interface of the system supporting the discussion reminded me of a traditional online forum — indentation of statements and responses, the ability to append links or uploaded documents, and the ability to “agree” or reply to a statement. Oddly, there is no “disagree” button. It took some getting used to but that doesn’t take long.

In summary, the back and forth, even though a bit awkward to follow, was quite informative for me. I left a few comments. Overall, I thought the discussion was a positive experience. It certainly made me more sensitive to some of the concerns people might have about mass vaccination with rapidly developed vaccines.

I did come away with one concern for this type of online engagement. I can see how it would be possible for individuals with strong views to dominate the discussion. But that will happen in any forum, and that can — hopefully — serve to bring out different views, especially when professional moderation is in place, as is the case here.

One problem is, given how strong views can be regarding public vaccination programs, there is the possibility that an organized group, if it wanted to, could intentionally derail a public vaccination program. For example, it might be possible to create “pockets of vaccination resistance” that would, in effect, reduce the overall benefits of a general vaccination program.

How concerned should we be about this? As we have seen in the recent healthcare reform debate in the United States, for example, it is possible for statements and views without any basis in fact to take on a life of their own as they are cycled and recycled through mainstream and social media outlets. Loud anti-vaccination media voices could arise.

One could say, “Well, that’s politics,” and let it go at that. But when it comes to matters like a potentially devastating epidemic that  appears to be targeting my kids, I’m hoping that the public discourse can revolve around calmly discussed facts and not the standard back and forth of partisan politics that gets recycled emotionally through a never ending cascade of anonymous online comments.

On balance, I’m pleased that social media and web based techniques are being used to communicate with the public about serious public health issues. They will need to be carefully managed, however, so that facts do not become obscured by emotion and politics, should we experience the drastic increase in H1N1 Influenza that some are predicting.

Copyright (c) 2009 by Dennis D. McDonald