To Get a Flu Shot or Not (Some Reasons)

Michael Specter at The New Yorker rails on a colleague for faulty logic:On Friday, a highly educated, very smart colleague at The New Yorker explained her decision to remain unvaccinated with these words: ‘I never get a flu shot, and I never get the flu.’  >O.K. Let’s play her game. Turn to whomever you are with and say these sentences out loud: ‘I never wear seat belts, and I never get killed in car crashes’; ‘I never use condoms, and I never become infected with sexually transmitted diseases’; ‘I eat red meat seven times a week, only exercise once a year, and I’ve never had a heart attack or a stroke.’

John Treanor, chief of the infectious diseases division at the University of Rochester Medical Center, is quoted in Discovery News speculating (probably rightly!) on human behavior: “You pitch the influenza vaccine as a way to maintain health, that the healthy thing to do is get vaccinated, but if you really wanted people to get it then you should tell them it would make them better looking or have more sexual appeal … Only some people see health as a motivator … It’s not obvious how to get young people to get vaccinated.”

A lot to unpack in this Science Daily report on a Tulane University study that found that people were more likely to get flu shots when they were priced lower because it indicated broader risk. The other part of it is that people only care about their own health, not the larger reason for vaccinations, which is to protect everyone: “Consumers believed they were more likely to get the flu when the vaccine was $25 compared to $125, but only when personal health was emphasized. Consumers saw low prices as indicating a higher need for the vaccine, which caused them to feel they were at greater risk. However, when directed to think about how the flu shot benefited society, consumers did not think about price as an indicator of their own risk.”

For some people, not getting a shot can lead to more than the flu, reports the AP: “Most doctors and nurses do get flu shots. But in the past two months, at least 15 nurses and other hospital staffers in four states have been fired for refusing, and several others have resigned, according to affected workers, hospital authorities and published reports.”

And then also, from the NYT, this: “So far this season, 20 children with confirmed flu tests have died, but that is presumably lower than the actual number of deaths because not all children are tested and not all such deaths are reported.”

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44 Comments / Post A Comment

frenz.lo (#455)

I get smug/angry re flu shots, because I make a point of getting them in October. Herd immunity ain’t no joke, but also, if I miss work, I don’t get paid. It upsets me to hear people’s weak excuses, though. One of my co-workers just finished chemo, and at least a couple clients are undeegoing chemo or are just older or sicker at any given time, and people still won’t get it!

swirrlygrrl (#2,398)

@frenz.lo Yes! I encourage all the people to get flu shots because while most of them are young, healthy and don’t have any obvious underlying conditions that would likely mean the flu is likely to do more than make them yucky for a bit, THERE ARE IMMUNOCOMPROMISED PEOPLE OUT THERE! Some of whom I care about greatly. Let’s not become disease vectors, people.

I also live someplace where flu shots are free and easy to access (now available at most pharmacies). But gah, the number of people who rely on fallacious logic hurts my brain and my heart.

BananaPeel (#1,555)

OK this inspired me to finally call about a flu shot but the only pharmacy in the small town where I am temporarily stationed for work is OUT of flu shots. Great.

OhMarie (#299)

@BananaPeel Yeah I also just got off of the phone with the pharmacy nearest me and they are out. Fortunately I have other options nearby, but I wonder how widespread that is?

OllyOlly (#669)

My company buys them for everyone and basically guilts/threatens us into getting them. (Not exactly a threat but a “Well if you refuse and then get sick there will be problems!!)

I really resented it, but now I have to admit I am glad they essentially made me get one.

Can I just get in here ahead of the crowd and say that the flu shot does not cause the flu?

Thank you.

You may have a mild immunological response–I do, after some vaccinations (let’s not talk about the Hep B series). You will still get colds, the odd respiratory infection that isn’t influenza, or the “stomach flu.” You have a sixty percent chance of not getting the flu at all with this year’s shot, and if you should happen to catch a case, it’ll be milder than it would’ve been without the shot.

I’ve had real, HTG influenza twice. The first time, I realized why people die from it. I’ve been more acutely miserable in my life, but never for as long a time, and never with as long a recovery. The second time I got H1N1 (hooray for front-line work!) and, while it wasn’t as bad in terms of fever and body aches, I thought I might for-real cough up a lung. Both times it took me more than two weeks to recover and return to work, and I was mimsy for a month after that.

So get the fucking shot. I am (relatively) young and healthy, and I’ve still been hit twice in ten years.

Oh, and don’t bother with wearing a surgical mask unless you’re sick. It doesn’t do much good unless you also remember to cover your cough, wash your hands all the time, and refrain from touching your face, eyes, and nose.

And if you’re fool enough to get sick, please don’t show up at my hospital. We’re full already.

swirrlygrrl (#2,398)

@Mingus_Thurber I go a little nutty when people talk about “stomach flu.” There have been numerous beer-fuelled rants about how the flu is a respiratory illness. People may avoid me on ocassion because of it. But I say to you: word.

Also, I got H1N1 (because while I have asthma, it has always been well controlled and I thought I was being a good citizen by not going for the vulnerable populations early vaccination). Bad idea. Weeks to recover from the acute illness, months of lingering lung problems, and now a regular need to use inhalers for my weakened lungs, which still haven’t fully recovered. Getting older (i.e. 33) – it’s been good so far.

selenana (#673)

@Mingus_Thurber I have questions! And you seem like you could maybe answer them. I am genuinely curious and not trying to be combative. I want to understaaaand.
-When you got the flu those two times, had you had the shot?
-If you get the shot, you can’t then be a carrier? (I almost never get sick and would get it for others more than myself – I also try not to take drugs/antibiotics unless absolutely necessary.)

I don’t currently have regular contact with people who might be compromised except on public transportion, which I use regularly. ALso the shot is not as readily available where I live as it is in the States, but I could probably find one at a clinic or hosptial for around $50.

@selenana I have no problem answering questions!

Yes, the two times I got the flu, I had had the shot. The first time was back in. . .oh, 2005 or 2006, whenever it was that the trivalent vaccine didn’t cover one of the strains. That was the strain I got. The second time, I got H1N1, because nothing covered that at the time.

(A long parenthetical digression about the flu vaccine: it’s made fresh every year, and protects against the three strains [hence "trivalent"] that Smart People think will be most prevalent in a given flu season. Some years, it doesn’t work out that way, and there’s a strain of flu that isn’t covered by the vaccine. There’s talk of a new quadrivalent [covering four strains] vaccine coming out this year or next, which would rock.)

As for getting the shot and still maybe being a carrier, I honestly don’t know. I’ve only read some popular science stuff on superinfecters, and as far as I know, the research hasn’t advanced far enough yet to look at vaccines in superinfecters. I’m sure there’s somebody more well-versed in epidemiology than I am who could answer you, though.

Hope that helps. Where are you, if I may ask?

selenana (#673)

@Mingus_Thurber Thanks for answering!
I’m in Japan, and I looked up the gov’t/my local area’s recommendations last night. They recommend that kids and over 65s get vaccinated, but there is no mention of adults being vax’d. I asked around, and nobody I know seems to have gotten it done. It doesn’t seem to be a thing that people generally do here. It is NOT available walk-in at pharmacies or at work. It would be take a half day off work and find an internal medicine clinic thing.

I can’t remember ever getting the flu – maybe when I was a kid? I’m really not very worried about myself. But if my getting the shot would mean there is a significantly reduced risk of my unknowingly infecting someone – because the vaccine would ensure that I was not going to be a carrier – then I would consider going out of my way to get it.

@selenana Unless you’re directly involved with sick or immunocompromised people of any age, you’re probably fine.

I wonder why Japan doesn’t have as big a push to vaccinate as we do? I’d think, given how crowded the cities are, that it would be A Thing.

selenana (#673)

@Mingus_Thurber Maybe because we have national health care, and pretty much everyone has access to preventative care and people go to a clinic, not an emergency room, if they get sick. ?
When I was googling around, I found some studies about how Japan used to have mandatory-ish vax for schoolchildren (boogery little disease vectors), and it reduced the incidence of death by flu in over 65s significantly. But then they discontinued the program. Study.

Thanks for the discussion. I am learning. I am not anti-vaccine at all, I give blood and I don’t mind needles – just wasn’t very informed. If I have a chance to get a vax and definitely the next time I am in the US during winter I will get one.

Genghis Khat (#584)

I got a free flu shot this year through work, but it was a pain in the ass because I had to go out to the burbs to get it, despite not having a car. I did it because I hang out with children and old people, and also because I work in a pharmacy (which annoyingly doesn’t offer flu shots this year) and I touch people who have the flu on the reg, and purell can only do so much.

I think part of the issue is what I’m going to call illness inflation. The actual flu is AWFUL. Like, fever, laid out for two weeks throwing up awful. But so many people call their (admittedly bad!) colds “the flu” and I think this makes people less afraid of getting the flu than they should be. If you don’t have a fever and you don’t want to barf, you don’t have the flu, stop saying you do.

While you’re at it, stop trying to get antibiotics for viruses and if you are prescribed antibiotics for something they treat appropriately, finish your course or you are ruining that antibiotic’s effectiveness for the future. You are truly the reason we can’t have nice things.

TARDIStime (#1,633)

@Genghis Khat thumbs up x1000 on that last paragraph in particular!

josefinastrummer (#1,850)

I don’t agree with Michael Specter’s reasoning at all. Talk about fear tactics. To compare not getting a flu shot to not wearing condoms is just dumb.
I don’t get a flu shot and I don’t get the flu. I honestly don’t think flu shots work, since most of the people I know who get flu shots end up with the flu.

Stina (#686)

@josefinastrummer
1. Tons of people say they have “the flu” when in fact they have a bad cold. The flu shot may actually have helped the people you know. Having the flu shot doesn’t mean that you don’t get sick.
2.The reason that people who have flu shots get the flu is that a) In some people the shot won’t “take” so it’s even more important that other people get them to lessen the spread. b)The shots take time to make. When they come up with the “blend” as it were the flu mix is at a certain state. Then they have to incubate the flus they have in chicken eggs for a while so that when the vaccine is finally produced the flu may have mutated or changed in that time. Year to year it varies how accurately the vaccine matches the current flu.

josefinastrummer (#1,850)

@Stina That’s very interesting and you are probably right that people who say they have flu shots get the flu. But they do get sick more than I do. I never get more than a cold twice a year and personally, I believe, for just me, no one else, that this is because I don’t take a lot of medicine and I have a good immune system. Again, that’s me.

EM (#1,012)

@josefinastrummer Someday maybe you will have someone in your life or family who could die from the flu (in my case, a parent who received an organ transplant) and then you will maybe get it for the sake of other people. If I got the flu it would be NBD, but if I gave the flu to my mom and she died- well, I would feel pretty shitty forever. Especially since (thanks Canada) it’s free for me as someone who has regular contact with a vulnerable person.

Also, your immune system is good for lots of things, but the ability of your body to fight off a virus it’s never encountered- say, if you got dengue fever- has very little to do with how healthy your immune system is. The immune system develops an immune response- creating antibodies to fight things off- by experience. So a vaccine creates an immune response without causing the disease, so when your body encounters measles, your immune system remembers and is able to protect you. If you had a bad immune system, conversely, it wouldn’t make a proper response to the first encounter (the vaccine), and you would get sick. And you could get very sick, and even die- perfectly healthy people have died from chickenpox, and measles, and the flu, because their immune system couldn’t handle a brand new, very aggressive virus.

Also, herd immunity is very important, because some people have weak immune systems (from being treated for cancer, being very old or very young, having an autoimmune disease) and so vaccines can’t protect them. Healthy people getting immunized protects vulnerable people who can’t or for whom vaccines don’t work as well. So even though you’re not afraid of getting the flu, don’t think that healthy people don’t need vaccines- healthy people are the ones who do, for everyone’s sake.

swirrlygrrl (#2,398)

@Michelle Yes, yes and yes.

Heckyes (#1,162)

I get a flu shot every year and have never gotten the flu (take that, “very smart” person at the New Yorker!). I figure that the $25 or hour of my time to go to the doctor is worth not being bed-ridden and in pain for a week or so with the flu.

NoReally (#45)

I have heard some really amazingly dumb rationales for refusing to get a flu shot. Or even take a flu shot, from a person standing there ready to administer it, no charge, no waiting.

It is my secret belief that they are afraid of needles.

josefinastrummer (#1,850)

@NoReally I believe that some people are afraid of needles. But I think a lot of people who don’t get a flu shot (like me!) aren’t afraid of needles but are afraid of putting unnecessary crap into our bodies. I read the comments in that New Yorker article and there was some interesting stuff going on, including a man who became paralyzed from getting a flu shot. I know that won’t happen to everyone but I think a little education is important when it comes to what we put in our bodies.
That’s the nice thing about being an adult in America. You get to choose how you do things, supposedly.

Heckyes (#1,162)

@josefinastrummer Yes, there is a tiny percent of people who get adverse reactions from the vaccine, including paralysis. However, the chance of a person dying from the vaccine are way way way lower than the chance of dying from the flu if you are unvaccinated. The vaccine is most definitely beneficial overall.
There are very thorough tests done on all vaccines before they are released to the public and recommended by the CDC. The flu vaccine is overall very, very safe.

Stina (#686)

@josefinastrummer Here you go josefina get educated http://www.cdc.gov/flu/protect/keyfacts.htm

josefinastrummer (#1,850)

@Stina I never said I was uneducated but thanks for the link. I am sure I could find one to counter what the CDC has to say but I am not interested in changing your mind.

@josefinastrummer Yes, you can get Guillain-Barre from the flu shot. However, the chances of that are *maybe* an extra 2 in 100,000–there’s conflicting data, as only the swine flu shot from 1976 has been implicated in GBS cases.

Yes, some people who get the shot also get the flu. Sometimes, as Stina points out, it doesn’t take, whether because of the individual’s immune response, or because they got it too late in the season, or because the shot doesn’t cover a particular strain.

Most of the time, though, what we call “flu” is actually an upper respiratory infection of viral origin, not related to influenza. “Stomach flu” doesn’t exist, sorry–it’s an entirely different set of nasties that are usually grouped under the name “gastroenteritis.”

As for putting extra crap into your body, it’s your body and I’m not going to argue that point with you. You might think, though, about all the extra crap that enters your body on the regular–like pollution, other viruses, preservatives, hormones–and ask yourself if it’s not a little bit paranoid to single out the flu shot.

The only time I get irritated is when people who have contact with vulnerable populations don’t get vaccinated. If you’re a medical professional, or your work with kids or the elderly, you owe it to them to get vaccinated. Likewise, if you plan to travel to places where other wack respiratory illnesses (bird flu or SARS) are endemic, you need to get vaccinated, just so that if you get sick, shit can be ruled out.

You might check out some of the more recent research on superinfecters, by the way: turns out that there’s a certain percentage of the population who, like Typhoid Mary, can carry huge viral loads without getting symptoms, thus transmitting disease to hundreds or thousands of other people.

sunflowernut (#1,638)

@Mingus_Thurber You go Mingus_Thurber, with your mad science knowledge.

In my experience, the people I know who don’t get flu shot have never had a bad case of the flu. My boyfriend was one of those people, until he got the flu a few weeks ago. It shouldn’t surprise you to know that he’s a flu shot convert now!

NoReally (#45)

@josefinastrummer Yeah, like that

Megoon (#328)

@Mingus_Thurber Ugh my husband’s stepmother works in a hospital and made a STINK about not wanting a flu shot for some trumped up reasons. She took it up the chain of command until they told her she’d have to either get it, or be fired. I had to dig my fingers into my arm as she told the story, expecting pity.

@Megoon Our hospital has a different policy: if you don’t want to get the flu shot, fine, but you have to mask and glove, no matter your job, any time you’re within arm’s length of a patient. Then, if you do get sick, no matter with what, you have to submit a negative flu screening and a doctor’s note before you’re allowed to return to work.

To me, that’s sensible. I work with folks from multiple cultures, and some of ‘em have religious objections to getting the shot. Making the vaccine mandatory without any other options is, to me, a little unreasonable. The places it *is* mandatory, no exceptions, is at the clinics and on the floors where there are more severely-immunosuppressed people. Again, logical: if you’re not willing to get a shot, don’t work on the bone-marrow transplant unit or with neonates in the ICU.

FWIW, I think I have one coworker this year–just one–who didn’t get it. That’s counting housekeeping, dietary, engineering, nursing, physicians, you name it.

swirrlygrrl (#2,398)

@Mingus_Thurber Well stated.

RVA_TXN (#1,461)

I spent 12 years in the Army in a medical unit. I will take any immunization you will give me! Although I only do the flu shot, can’t stand the mist.

I work in a hospital and obviously got the flu shot this year as I have every year I’ve worked here. It is mandatory for employees, but no one is getting fired for not getting it. People can get a religious or medical exemption, but then they have to wear a mask for all patient contact during “official” flu season, which started a month ago. I haven’t see many people around wearing masks though.

km1312 (#213)

Okay, here’s the thing: I totally think that flu shots are good idea and as someone who generally tries to take care of my health, I’d like to get one. BUT I have some pretty serious phobias/panic issues (yes, I’m in therapy), one of which includes needles. Yes, I rationally realize that a tiny pinch of pain is totally worth a year’s worth of immunity to the flu, but panic attacks don’t really work rationally. So, because I refuse to have a complete flip-out in the Duane Reade pharmacy aisle, does anyone know about this FluMist business? Does it work, where is it available?

Heckyes (#1,162)

@km1312 It totally works! If you are a healthy adult (and under 50 or so) it’s just as effective as the shot. It’s not recommended if you’re pregnant or have immune suppression. I don’t think it’s available everywhere that the shot is, but I feel like doctors offices should have it/be able to get it? So call your doctor and ask!

RVA_TXN (#1,461)

@km1312 like Heckyes said, it works the same but I had an allergic reaction to the flu mist but I am perfectly fine with the shot. Also the flu mist is a tiny dose of a live virus and that kinda creeps me out, but probably not nearly as much as needles creep you out!

Heckyes (#1,162)

@RVA_TXN The live virus is inactivated, so it can’t (except in very very rare cases – that’s why they recommend against it if you have a compromised immune system) infect you, it just inspires your immune system to create immunity. But the flu shot is cool, too! However you want to get yourself immune is ok with me.

km1312 (#213)

@Heckyes @RVA_TXN thanks guys! I’m on the hunt for FluMist today, even with the caveats in mind…

Sorbee (#2,256)

I have been beating the flu shot drum since I got it the week before finals my sophomore year of college. It was THE WORST. At the time I lived in the world’s crappiest apartment complex where people constantly pulled the fire alarms, for fun (?) which didn’t help my recovery AT ALL.

But yes. I have limited sympathy for flu shot skeptics. They adminster ‘em in pretty much every drug store or Target, which is probably no more than 5 minutes away from where you’re sitting right now. They make it so easy for you! Be an adult about these things, people!

Like, I’m probably not going to die I skipped it, and neither are the people I see on a regular basis. But missing 5+ days of work for recovery? (Or worse, soldiering through it while working from home while feeling thisclose to death?) No thanks, I’d rather use that PTO for other things.

TARDIStime (#1,633)

I didn’t get a flu shot last year when it was offered by my workplace.
I was wierded out by putting a virus in my veins.
After reading these comments, I think I will get one this year, because I had not considered the risk I was posing to the immunosuppressed/vulnerable around me, and I am horrified about what I might have spread around last year!

I’m going to put it like this, we have no way to know nor verify what is being put in us. Nor do we have a way to tell if it will affect us later in life. These vaccines change every year. As does our immunity to diseases. Future generations will not be immune to the Plague either! These are some of the same reasons Europeans could not go into Africa. The same reasons why most of the North and South American’s died after being discovered.

My uncle developed cancer later in life that stemmed from a mandatory shot he received in the Army during desert storms. My god mother died from heart disease related to the weight loss pill Fin-Fin. So, until there is clear studies on how else these shots can effect us, I’ll continue not to get one. Call me dumb all you want, but I think it’s also healthy to not put things into your body you don’t have a clear understanding of. How could anyone? It changes every year. The vaccine you got last year is not the same you got the year before and so on!

normandarin (#4,583)

I also did not want to get a flu shot but my niece that works as a nurse explained me this is a must if I don`t want to be infected. She knows a lot about medicine and I trust her, she decided she wants to become a medical administrative assistants after reading here that this occupation will remain in demand for many years.

anmanblack (#7,007)

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