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    Flu Shots: Not Just For You
    By Robert Cooper | February 1st 2013 08:00 AM | 14 comments | Print | E-mail | Track Comments
    About Robert

    I have given up on categories. I did a BA in physics, a PhD in molecular biology, and now a postdoc in a bioengineering department. So call that...

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    The influenza virus, ever-wiley, has decided to hit America early and hard this year.  

    The flu season is always full of uncertainty.  How bad will it be?  How well will the annual vaccine work?  What folk remedy will the internets come up with this time?

     For many people, all this uncertainty can make a flu shot not seem worth the effort.  That wouldn't be so bad if flu shots were just about our own personal cost-benefit analysis.  

    But the truth, which gets far too little attention outside epidemiology circles, is that getting your flu shot is about more than just you.


    According to Google flu trends, the flu season has passed "intense" and gone straight to "red arrowhead" levels.

    Flu shots are not magic.  Even if virologists correctly guess what strains to include in the vaccine, the jab won't work 100% of the time.  The shot doesn't directly fight off influenza, it trains your immune system what the virus looks like so your white blood cells will be ready for it.

     If your immune system is a network of guard dogs, a vaccine is a lock of hair clipped from the virus that you wave in front of your white blood cells' noses saying "Smell that boy?  Don't let it in!"



    The flu shot teaches this guy whom not to let past your defenses.

    The problem is, the vaccine's effectiveness relies on the strength of your immune system.  People with weaker immune systems - the elderly, babies, those who are already sick - might not be able to fight off the flu even if their cellular guard dogs see it coming.  But these are exactly the people most likely to get seriously ill, or even to be killed by the flu.  So how do we protect them?

    The answer is something epidemiologists call "herd immunity".  Flu viruses can't reproduce and spread without vulnerable hosts, and each healthy person who gets a flu shot is one less easy target for the flu.  If the density of easy targets drops below some critical threshold, the flu gets stopped in its tracks and can't become an epidemic.

    This is why it's so important to get your flu shot.  Even if you've never gotten the flu before, even if you hate shots and would rather just lie in bed for a week, even if you've gotten sick despite getting a shot in the past (remember, it gives you better odds of fending off the flu, but doesn't guarantee it).  The flu vaccine is least effective for your grandparents, for your cousin's new baby, and for your neighbor just out of the hospital.  Their best protection, then, is for you to get your shot and fight away the flu before it can ever get to them.

    Comments

    Bodewes R, Fraaij PL, Geelhoed-Mieras MM, van Baalen CA, Tiddens HA, van Rossum AM, van der Klis FR, Fouchier RA, Osterhaus AD, Rimmelzwaan GF.
    Annual vaccination against influenza virus hampers development of virus-specific CD8+ T cell immunity in children.
    J Virol. 2011 Nov; 85(22): 1995- 2000.

    I haven't gotten a flu shot for years, but I haven't come down with the flu for years either. I think I have some immunity because of coming down with the flu a few times in my youth. I read that coming down with the flu provides better immunity against varied strains than the flu shot does.

    I'm so sick of this constant barrage of "get your flu shot!" As the number of shots for infants multiplied the rate of autism went up. Now that the elderly are being told to get multiple vaccines - many containing thimerosal - the rates of Alzheimers, Parkinsons, and other forms of senile dementia are going up too.

    The flu shot has only been around for a few years, and the uptake is generally not more than about 40%, yet we have not had the kind of emergency we had in 1918. I think gradual herd immunity has developed because of people coming down with the flu.

    I used to have total faith in the CDC and the vaccine program but I have gradually lost that trust, because I have seen how vaccine injuries are cavalierly dismissed as coincidence without investigation, and how the risks of diseases are exaggerated and the risks of the vaccines denied.

    Personally, I'll take my chances with the flu, and skip the vaccine. That's better for my health, and so far I'm not getting others sick. Individual choice. This is America.

    The Cochrane report says there is little benefit from the flu shot. I have no problem with people choosing to get this shot if they have made a conscious decision, but I do have a problem with govt and employer mandates and propaganda.

    car2nwallaby
    Interesting study by Bodewes et al.  Flu vaccines seem to generate immunity only against specific strains, while flu infection generates flu immunity more broadly.  At least, in children 3-9 years old with the vaccinated group also having cystic fibrosis – not the optimal sampling technique.  But for that to be an argument against flu vaccines, you'd have to tell people that they should catch the flu so they won't catch the flu.  Doesn't quite fly by my logic.
    As for diseases of aging increasing, as always, correlation ≠ causation.  But I would submit that perhaps more diseases of aging could be related to people having more age.

    You claim skipping the vaccine is better for your health, but you offer no possible evidence.  As for not needing a shot because you haven't had the flu in years: I haven't been hit by a car in years (three, to be exact), but I still wear a helmet on my bike.

    Yes, this is America and there is no mandate.  You have the choice not to be vaccinated.  This article was just to make sure you realize the implications for grandparents and anyone who happens to be immune suppressed.
    I'm not telling people not to get the flu shot. I'm saying that people must have the right to make their own decisions, and that those of us who have come down with the flu in the past may have at least as good immunity as those who received the flu shot - or probably even better immunity. I am not a walking disease vector, and I don't have a responsibility to get vaccinated against the flu for the sake of others. It has literally been many years since I have had any form of the flu, although I have children who have attended large public schools and brought home a variety of germs, and I am out and about every day myself, and the flu shot did not even become widely used until a few years ago - and even then the last uptake rate I've read said 40% of people were getting the shot. So it's not that I'm being protected by vaccine-induced "herd immunity". Studies have shown limited effectiveness of the flu shot, even during lucky years when the vaccine strains matched the prevalent strains. And the duration of that imperfect immunity may only be a few months. I know people who came down with the flu even though vaccinated. Go ahead and call that statement "anecdotal" - you don't want to miss a chance for any of the formulaic vaccine-defending responses. Oh, and say, "Well they would have gotten a worse case of the flu if they hadn't been vaccinated," as if we can see into alternate futures.

    Yes, the standard response to any reports of adverse vaccine reactions is "correlation does not mean causation". Our government and mainstream medicine do not even know how to identify vaccine reactions, therefore it is easy to keep claiming "no evidence". We truly do not understand how vaccines affect the immune, neurological, and gastrointestinal systems.

    Still, I do believe in the importance of vaccines as a weapon in the war on infectious diseases. But it is not so simple as "vaccines good, diseases bad". Diseases have risks, and vaccines have risks. In order to weigh these risks, we must have accurate information on the risks on both sides. These days our health authorities exaggerate the risks of diseases and generally deny the risks of vaccines. We do not have unlimited capacity for absorbing multiple vaccines. And unfortunately the CDC, AAP, and AMA seems to be making little if any efforts towards helping to understand susceptibility factors and treatment for adverse reactions. IMO the philosophy of denialism is hurting rather than helping the vaccine program.

    There is a growing number of angry vaccine-injured people and parents of vaccine-injured children. If our medical authorities continue to add more and more vaccines with cavalier disregard of most of the so-called "anecdotal" reports of vaccine injury, the number of angry people will continue to grow, and trust in the vaccine program will continue to erode.

    car2nwallaby
    I'm saying that people must have the right to make their own decisions
    You're also failing to read my response, in which I agreed.  I am not advocating mandatory vaccines, I am advocating that people fully understand the implications before making their decisions.
     those of us who have come down with the flu in the past may have at least as good immunity as those who received the flu shot
    False.  Coming down with the flu may give you a slight advantage in nonspecific immunity against completely new strains, but a flu shot provides far better specific immunity against the strains most likely to be circulating.  People who get a flu shot get the flu less often.  No one serious disagrees with that.


    As for your subsequent claims: I don't know how to respond to vague and unsubstantiated claims, especially if you are unwilling to accept population-wide statistics and probabilities, which consider all personal experiences in addition to just your own.
    Well, I'm glad that you agree that people should have the right to make their own decisions.

    During the recent H1N1 scare I read in credible mainstream sources that people who were over a certain age - about 50 or so - had superior immunity to H1N1 because of a strain of flu that was circulating something like 40 years ago. That is longterm immunity, unlike the current shot which I'm reading may only be effective for a few months.

    Again, I'm not telling people not to get the flu shot - it's up to everyone to make their own decisions and I am no expert. But I'm saying that there are arguments on both sides, and I do not consider it my moral obligation to get that vaccine for the sake of the herd.

    Too bad you don't feel that your article can stand up to debate.

    Oh, I thought my comments had disappeared, but they appeared again. Confusing.

    car2nwallaby
    Yeah, the web hosting here is suboptimal.
    Hank
    Rackspace is the #2 hosting company in America so it isn't a hosting issue. If someone's comment is flagged as spam - by Akismet, owned by Google, the #1 company in the world - it remains unpublished until a moderator or you sees it and publishes it (assuming it was not spam, as in this case).
    Thanks.

    car2nwallaby
    Oops, overheard by the founder.  I was referring more to the text input / word processing.  In my experience cut and paste and undo/redo behave kinda quirky, for example.  This post was actually going to go up a week before it did, but I got a cryptic error message when I tried to publish it.  I have learned, however, not to whine about things that I don't know how to do myself.
    I don't usually get my flu shot for two reasons: one, because I hate needles and two, I rarely ever get sick. But I have never looked at the big picture. Unless we stay confined inside a room and never make contact with the outside world, we are spreading our germs. We should all take the initiative to get our vaccines and prevent the flu from becoming an epidemic. After the creation of the polio vaccine, polio went from being a big problem in the US, to now being something rare that can easily be prevented. The same goes for the flu. Being proactive is the only true way we fight this disease from spreading.

    The google flu trends reports that the flu is over the intense level for this year. This article stresses the point of view that getting a flu shot for yourself is equally important in keeping others around you protected from being infected. This is due the varying immune strength of each persons body. By getting yourself a flu shot you can prevent the flu from spreading to others who have much weaker immune systems such as infants and the elderly.