February 2012
(Upcoming) epidemic
In the beginning of February 2012, posts on social networking sites mostly reported that influenza activity was still low and that there was still no epidemic present in the Netherlands. However, it was reported that the south of the country was getting closer to epidemic levels. Several posts on Twitter provided a link to corresponding news site reports.
“The flu epidemic is not yet present in the Netherlands, but it seems to be coming. (link to news site)“ (Twitter)
In February, there were also already posts that an epidemic had arrived in the Netherlands. People who put the posts on Twitter referred to their own experience and news they had read, without providing the corresponding article.
“The flu epidemic is a fact: Half of my floor is ill including myself #stomach flu” (Twitter)
“What is happening to me? My throat aches. I read that there is a flu epidemic in the Netherlands.” (Twitter)
On some social networking sites, information about the virus was concerned with the difference between stomach flu and the seasonal flu, as well as the fact that flu is caused by a virus rather than a bacterial infection.
“Stomach flu, right? A flu shot won’t help with that because it's not really the flu.” (Twitter)
Regarding prevention of the flu, there were several posts containing advice like going outside enough, getting enough rest, eating fruit and taking vitamins. Some Tweets suggested that vitamin D and C are effective in preventing the flu.
“Additional vitamin C! Vitamin C is a real virus killer. It has to be a high dose, a minimum of 3000 mg per day. Can be more during flu.” (Twitter)
There were several posts with links to news sites with prevention tips and information about the flu. Many posts on social networking sites were about the flu shot, of which several expressed belief in the effectiveness of the flu shot in preventing influenza.
“Luckily I got vaccinated and the variant is included (in the flu shot). Luckily, I won’t get the flu!” (Twitter)
People either informed other people about their own positive experience with the flu shot, or reported that the flu shot had at least resulted in weaker flu symptoms.
“No, it’s fine. I think X had a small bout of flu, but thanks to the flu shot it was very weak.” (Twitter)
Several people stated that they were planning to get the flu shot next time in order to prevent illness, which they were currently experiencing.
“I will see whether I can get the flu shot next year!! Again affected by one or another virus.” (Twitter)
Uncertainty and mistrust
There were also several posts expressing uncertainty regarding the flu shot. People who did not take the flu shot themselves wondered whether they should have taken it.
“The doctor also says that I should get the flu shot, but is it true? I strongly doubt it.” (Twitter)
The majority of posts about the flu shot expressed doubt over its effectiveness in preventing the flu, and thought that it might even cause flu.
“Since I had the flu shot in November, I’ve had a double pneumonia and a strong cold. Went through the pain of the flu shot for nothing.” (Twitter)
Others copied a link to a study that concluded that there is no evidence for the effectiveness of influenza vaccination.
“Summarized: 5700 studies about influenza vaccination, 31 were found to be done well and no clear evidence that influenza vaccination makes sense.” (Twitter)
Several people stated that they did not believe in the effectiveness of the flu shot and advised others to not get vaccinated.
“Getting injected with diseases artificially, never start with that. Such a shot makes you ill in order to build up antibodies, but if you have the flu rarely you shouldn’t get such a shot.” (Facebook)
“Flu vaccination? Don’t do it!!!” (Twitter)
Advice to not get vaccinated also seemed to influence uncertainty regarding influenza:
“Get the flu shot this year after everything I’ve heard from others about their experiences?” (Twitter)
March 2012
(Upcoming) epidemic
In March 2012, there were some posts about the late flu epidemic on Twitter and Facebook. Most posts included links to public health websites or news sites. Some posts were written by representatives of the National Institute of Public Health and the Environment (RIVM).
“X@RIVM: two things stand out about the influenza epidemic: it is mainly influenza A H3N2 and it has not been this late in 25 years.” (Twitter)
Several posts, including news site links, indicated that the epidemic was expected to start soon in the Netherlands.
“There is a good chance that a national flu epidemic will strike this week. The north of the Netherlands was almost flu-free the past weeks, however with the end of the Easter vacation in this area, chances of infection will now increase.” (Facebook)
In the beginning of March, there were several posts about the presence of an influenza epidemic, mostly including links to news sites. Furthermore, some people who posted about feeling ill received reactions that there was an epidemic in the Netherlands.
X: “I am feeling ill. Lying in my bed since 9 o’clock, then cold, then again really hot…and I’m complaining. :-p #stomach ache #headache #sigh” – Y: “Influenza virus is going around. Get well soon!” (Twitter)
In March, several posts on Twitter referred to a website with statistics saying that approximately 40% of all Dutch people have the flu each year.
“Flu epidemic close: annually, approximately four out of ten Dutch people get the flu (link to website with statistics).” (Twitter)
Some social media posts informed the reader about the finding that there was less flu-related absenteeism from work, possibly because of the economic crisis.
“Less flu-related absenteeism because of the crisis (link to news site).” (Twitter)
At the same time, a number of Twitter users stated that news reports about the flu epidemic would give employees a reason for absenteeism.
“Employers watch out, the newspapers think it is necessary to give everyone a reason to stay at home. There seems to be a flu epidemic.” (Twitter)
Readers were also presented with links to reports about hospitals, which were said to have had a lot of extra work during the epidemic.
Several posts indicated a possible connection between metabolism of vitamin D and the flu.
X: “There is no causal evidence for influenza virus - > flu. Vitamin D metabolism is […] a far more logical explanation.” – Y: “Vitamin D and influenza – Wikipedia (link) summary: influenza virus is bullshit, flu is a seasonal illness caused by a lack of Vitamin D.” (Twitter)
In addition, people wondered why others worry about the on-going epidemic.
X: “Why the fuck should you be worried about the flu epidemic? It is the FLU! Get over yourself!” – Y: “Sure, in the past 100 years only more than 20 million people died because of it. No big deal.” – X: “That’s what I mean. The flu you are suffering from during an epidemic is the same flu you would get without an epidemic.” (Twitter)
Regarding flu prevention, a number of posts offered links to websites and summarized corresponding tips on how to stay healthy, including eating healthily, exposure to the sun, and wearing functional sportswear. Furthermore, vitamin D as a means of preventing flu infection was discussed again.
“The flu can be shortened or prevented with a high dose of vitamin D, but this is not possible with the flu shot.” (Twitter)
Other posts expressing uncertainty were concerned with the question of whether “a mild epidemic” means that the epidemic is mild or that the flu is mild.
“You are wondering ‘there is a mild flu epidemic in the Netherlands’… is it the flu that is mild or is it the epidemic?!” (Twitter)
Twitter users also asked whether the symptoms they were experiencing were normal for flu.
“I’m worried: does the recent flu have side-effects such as dizziness and prickling in hands and feet? I’ve had it for a week already…” (Twitter)
Some people stated that they were avoiding the flu shot because of its possible long term consequences.
As in February 2012, several posts on Twitter expressed belief in the effectiveness of the flu shot in preventing influenza. Several people stated that they had had good experiences with the flu shot and advised others to get the flu shot as well.
“What about the flu shot? Did you think about that yet? It works really well for me. Since taking the shot I’ve had no cold and wasn’t ill anymore. #tip” (Twitter)
Others stated that they were planning to get the flu shot next time.
“I think I will get a flu shot next year. (Ill again)” (Twitter)
People belonging to the risk groups also posted about their annual flu shot.
Uncertainty & mistrust
In March, uncertainty that was expressed on social media websites dealt with several different topics regarding influenza vaccination. Again, several people expressed uncertainty about the possibility of getting the flu in spite of being vaccinated.
“Oh yes, does a flu shot mean that you indeed can’t get the flu anymore? That is what I’m wondering about.” (Twitter)
Additionally, it was questioned whether it is a good idea to get vaccinated against influenza and if there are economic reasons for being invited to get the flu shot.
“Already flu complaints since 3 weeks; does the flu shot help or is it just an auxiliary income for general practitioners?” (Twitter)
Again, the majority of posts about the flu shot dealt with the ineffectiveness of it in terms of preventing the flu. People posted about their own or about others’ experiences in this regard.
“I only know people who got really ill because of or despite of the flu shot.” (Twitter)
Several posts discussed the harmful effects of the flu shot, including links about the flu shot causing Alzheimers and narcolepsy. Narcolepsy was thought to be caused by the pandemic (H1N1) flu shot from 2009.
“Mysterious sleep disease affects 50.000 Germans! Link to flu shot suggested in Finland. (link to website).” (Twitter)
Another related link was introduced with “All the reasons why you should not get the flu shot this year” on Twitter. Some people expressed that it was more or less a matter of luck whether one is protected by the flu shot or not.
X: “Why do I always get the flu that isn’t included in the flu shot????” – Y: “Because the flu shot only protects you against half of the flu variants. ” (Twitter)
Some posts again indicated that there are economic reasons involved in the vaccination recommendations, which made them question the necessity of vaccination.
“It is getting more obvious that politics regarding vaccination are influenced by the principle ‘the one who pays, decides.’ (link) #flu shot” (Twitter)
Some posts discussed the collaboration between science and the pharmaceutical industry and questioned the reasons for this collaboration.
“The flu is a threat to our health, therefore, every year the flu shot has to be taken. Result: extra millions for the pharmaceutical industry and the state’s finances! Explain to me why we Dutch people have to save millions?????????????????” (Facebook)
April 2012
(End of) epidemic
In April 2012, several Twitter users reported either that they themselves felt ill or that a lot of people around them were ill, and wondered whether a flu epidemic was occurring.
“I have the flu…I guess I’m in good company #epidemic? #at home” (Twitter)
Several posts informed readers that the flu epidemic of 2012 was over again and that it was comparably short.
“Flu News: Flu epidemic finished earlier than in other years: ‘The flu epidemic had a rather short duration.’ (Link to news site)” (Twitter)
Several times, links to websites providing statistics with regard to the flu were posted with information about the number of deaths.
“Two thousand additional deaths during the cold wave in February and the flu in March. (link to website with statistics)” (Twitter)
Furthermore, it was suggested that absenteeism should decrease again as a result of the end of the epidemic. In a number of Twitter-conversations, people advised each other to take time to get better after a flu infection.
X: “Working through it is unreasonable, get well first.” – Y: “You are right X; the flu will always disturb it; better to get additional rest and then hopefully get back into shape afterwards.” (Twitter)
In April, several Twitter posts again expressed the belief that the flu shot is effective in preventing an infection or that it will at least weaken the symptoms of the flu. Furthermore, people informed others via Twitter that they were planning to get the flu shot next time.
“Maybe I have to get the flu shot every year.” (Twitter)
Uncertainty & mistrust
In April 2012, there were again also posts that expressed uncertainty about the possibility of getting the flu despite having had the flu shot.
“Really, are that many people ill?? I actually can’t be ill because of the flu shot, but I am ill anyway, weird.” (Twitter)
Most people that posted something about the flu shot reported being ill because of or despite of the flu shot.
“For the first time in my life I got a flu shot! For the first time in years I have the FLU!!!” (Twitter)
In addition, several posts speculated as to whether the flu shot is effective, or could actually be harmful to one’s health.
“In this article, AGAIN the proof of the fact that vaccines don’t work and are not well studied before they are given to thousands of people.” (Facebook)
Furthermore, one link was posted a number of times that cites a Danish scientist, concluding that employers waste money with paying for the flu shot for their employees.
“Employers could better spend their money on improving hygiene in the workplace instead of on flu shots for their employees. (link to website)” (Twitter)
Moreover, a discussion on social media sites was visible about a news report that an employee of the National vaccine institute in 2009 had forgotten to put pandemic (H1N1) vaccines back in the refrigerator. As a result, 1,2 million vaccines were rendered useless.
“We never should have bought them in the first place. Fear. ‘Millions of flu vaccines made useless through blunder’ (link to news site).” (Twitter)
Views were expressed that a ban on any pay rise for two years was not an appropriate punishment for the mistake made by the employee concerned. Some posts provided links to news sites reporting that the RIVM and the minister of health of the Netherlands did not agree with the information that was given in the original press report. It was said to be exaggerated.
“RIVM: False article about destruction of flu vaccines in “national newspaper” (link to website)” (Twitter)