We could use a few pointers on prudence.
October 15, 2014 7:06 AM   Subscribe

"During the 2013-2014 flu season, according to the Centers for Disease Control and Prevention, only 46 percent of Americans received vaccinations against influenza, even though it kills about 3,000 people in this country in a good year, nearly 50,000 in a bad one."

NYT: Fear of Vaccines Goes Viral: “You look around and most of the deaths in the world are from contagious diseases. Not ISIS.”

NPR: 4 Things We've Learned About Enterovirus D68, And 1 Mystery Cases have been reported in 45 states and the District of Columbia. Though the CDC has confirmed 664 cases as of Wednesday, there are undoubtedly many, many more cases that are causing milder coldlike illnesses. "This is different this year, what we're seeing," Milstone said. "Something is different."

NBC News: Flu Shot Slowdown Peeves Pediatricians Flu vaccine supplies depend on the private market. Vaccines are made by drug companies and they decide how much to make. But the federal government influences this by buying vaccines for use in child vaccination programs. Federal advisers also decide on the formulation.

Previously, recently.
posted by roomthreeseventeen (204 comments total) 18 users marked this as a favorite
 
One nasty thing about the flu are asymptomatic carriers, people who spread the flu but don't get sick from it, so getting a vaccination is really important for everyone.
posted by The Whelk at 7:10 AM on October 15, 2014 [8 favorites]


I got the swine flu last year, and it was one of the worst health/illness experiences I've ever had - so painful, and it was the first time I ever viscerally understood how healthy people can die of the flu.

So yep, I made damned sure I got the flu shot this fall - for the first time ever.
posted by lunasol at 7:16 AM on October 15, 2014 [10 favorites]


So the flu is more of the "ISIS of biological agents," not Ebola, as posited by CNN (a great mockery of the term by Teju Cole for the New Yorker).
posted by filthy light thief at 7:17 AM on October 15, 2014


I usually fail to get a flu vaccine just because I forget, but my pharmacy now has taken a very aggressive stance. Last fall, when I went in to refill a prescription, they were like: "Oh, and have you had a flu shot?" "No." "Sit down and roll up your sleeves, it's free. Any allergies? No? Good." "Um, ok, well, you should know I get nervous when I get OW GEEZ" "Ok, you're done, bye!" It was a veritable ambush. Which was awesome.
posted by showbiz_liz at 7:19 AM on October 15, 2014 [73 favorites]


Now that our resident antivaxxer has moved on, for the first time in 8 years we will have 100% vaccination compliance in my office and I am very interested to see how it will play out.
posted by poffin boffin at 7:19 AM on October 15, 2014 [22 favorites]


I've had the flu twice and the shot most years. Last time I got it earlier than that year's flu shot was available ... if I got that year's flu. It wasn't so bad, but the first time I was close to hospitalization.

Waiting for my "free" one from the office but I may just get it over with.
posted by Buttons Bellbottom at 7:21 AM on October 15, 2014


I've been saying for years, somewhat tongue in cheek, that fear of disease is the new terrorism created in part by the media for slow news days.
posted by ashbury at 7:22 AM on October 15, 2014 [1 favorite]


Where I live you can get a flu shot practically anywhere. This year I got it from Walgreen's 1 block from work. Last year I got it from a grocery store pharmacy 2 blocks from work and got a $10 grocery voucher. Easy peasy ... and if you're nervous about not going to a doctor's office, the providers at those community points generally are giving dozens or hundreds in a week so they get pretty good at it.

I know Ebola is scary, but the flu kills between 3,000 - 49,000 people in the US every year.
posted by freecellwizard at 7:22 AM on October 15, 2014 [3 favorites]


Am I the only weirdo that loves getting their flu vaccine? Not the shot itself, just that I'm doing something for myself and SOCIETY. I feel like I'm doing my part.
posted by joseph conrad is fully awesome at 7:23 AM on October 15, 2014 [57 favorites]


I am not the least tiny bit an anti-vaxxer - but man, getting the shot means taking the next day off from work, no fail. I get sick from it every single time.
posted by Pogo_Fuzzybutt at 7:23 AM on October 15, 2014 [1 favorite]


What strikes me most about the flu vaccine is that, at least among my cohort, people who are otherwise vaccine-positive will, for some reason, loudly tout the fact that they don't get the flu vaccine. What the actual fuck, people?

(It also pisses me off that my insurance won't pay for the flu shot from pharmacies, and if I get it from my GP I wind up having to pay the co-pay, which costs as much as just paying for the damn thing out-of-pocket.)
posted by uncleozzy at 7:23 AM on October 15, 2014 [2 favorites]


I just got my first flu shot this past Monday. The pharmacist asked me if I had ever had a vaccine before. That's what this has come down to, folks.
posted by roomthreeseventeen at 7:24 AM on October 15, 2014 [6 favorites]


(Ah, my mistake, evidently our plan this year doesn't charge a co-pay for immunizations. Guess I ought to make that appointment.)
posted by uncleozzy at 7:28 AM on October 15, 2014 [1 favorite]


Not that we should not be doing more to help contain the disease, but just for some perspective for those afraid of a new plague as fomented by the 24/7 news cycle; the total number of people infected worldwide in the currently ongoing, "worst ever" outbreak of ebola is still less than 9,000.
posted by The 10th Regiment of Foot at 7:28 AM on October 15, 2014 [3 favorites]


But the flu shot isn't like the vaccines for childhood diseases. It's just the CDC'a best guess. It's entirely possible for a different strain of the virus to be the one that causes the epidemic, and for you to still get sick even if you get the shot. That's why I've been a bit lackadaisical about it, really. I'll probably end up getting one this year because I have a doctor's appointment soon anyway, but I don't think not getting a flu shot turns you into Jenny McCarthy. I mean, it's tough to say because it's a case of proving a negative, but for a healthy adult I consider it at worst a venal sin.
posted by Diablevert at 7:29 AM on October 15, 2014 [35 favorites]


A while back, when avian flu was the big fear in Europe, a friend of mine in Switzerland was on a run with a friend. They were running by the river, and there was a lone duck sitting by the path. The friend made a joke about flu, and then the duck looked at them significantly and coughed. They apparently completed the run in somewhat chastened silence.
posted by GenjiandProust at 7:32 AM on October 15, 2014 [96 favorites]


getting the shot means taking the next day off from work, no fail. I get sick from it every single time.

Yeah, our office used to schedule them midweek but has since decided to ruin our weekends by giving them on Friday so if we're all sick the next day it won't matter wrt workflow.

also they better have free donuts this year or I will go on strike.
posted by poffin boffin at 7:34 AM on October 15, 2014 [5 favorites]


Question is what percentage of the population was vaccinated against the current common influenza strains 10 years? Yes, 46% alone looks bad, but if it was 35% a decade ago, then we're actually heading the right way.

(Remember: you need at least two data points to draw a trend line.)

Furthermore, I know the intended vaccination coverage has changed. For most of my life, vaccination against influenza was only strongly recommended for at-risk groups (Elderly, otherwise ill, health care workers, etc. ) It's only recently that we've change to "everybody, every year."

So I'm not going to be up in arms immediately about that datapoint without more evidence -- and some quick searches didn't give me anything, indeed, if anything they suggest we're doing better at covering the entire population.

the flu kills between 3,000 - 49,000 people in the US every year.

Note that a significant portion of that is "people who were likely to die of something soon anyway." In general, Influenza is far more deadly to the weak and elderly. The 1918 pandemic, however, was a huge exception to that, it primarily killed otherwise healthy young adults.

I personally hate the goddamn thing, because I feel like major crap for two days afterwards. Yes, I have multiple data points on this. Note that, since I've actually had influenza* before, I still get the vaccination, because influenza makes you feel like ultra crap for a couple of weeks.


* Influenza A/H3N2, as a matter of fact. H3N2 is originally from 1968 (the Hong Kong pandemic,) but first hit the US in 2003, and our vaccines since then have had a A/H3N2 vaccine as well as a A/H1N1 and a B subtype. This year, the US vaccine will be for an A/California/7/2009 (H1N1)pdm09-like virus, an A/Texas/50/2012 (H3N2)-like virus, a a B/Massachusetts/2/2012-like virus, and some will also have a B/Brisbane/60/2008-like virus component.
posted by eriko at 7:35 AM on October 15, 2014 [8 favorites]


It's entirely possible for a different strain of the virus to be the one that causes the epidemic, and for you to still get sick even if you get the shot.

That's why you have to get the shots that have the most strains of flu stuffed into the one needle, I think? I honestly have no clue how that works, I just let them stab me and then claim my shitty 5 cent lollipop afterwards.
posted by poffin boffin at 7:36 AM on October 15, 2014 [1 favorite]


This seems to be one of those "there are many things worse than the Faux News Headline du jour" articles.

The penultimate paragraph in the NYT column is solid advice. The final paragraph appears to attack the lifestyle norms of those who hold the anti-vax belief system.

I'm not sure the twain shall meet....
posted by CrowGoat at 7:37 AM on October 15, 2014


There's definitely something about the flu vaccine in particular that makes otherwise pro-science people go absolutely bonkers. My last office was very notable for this - coworkers tripped over themselves to share their views on the flu vaccine in particular. In my immediate department there was the man who just flat-out believed it didn't work (not that the CDC wasn't good at predicting the strains, but that the vaccine didn't protect against any viruses whatsoever), another man who thought it gave you the flu, and a woman who thought she didn't need it because she was a recreational swimmer and the chlorine made her immune system stronger. But my absolute favorite was the HR rep who pulled a face when she saw a band-aid on my arm and said, "I don't want to tell you this because you can't take it back now, but mercury is very dangerous to the body. But if you trust the FDA, I guess..."

This was at a biomedical research institution, by the way.

I'm among those who end up feeling sort of shitty and achy after vaccines, and I can barely lift my arm for a week. But I had H1N1 during its 2009 World Tour and I would submit annually to significantly more degrading and painful things for a chance at preventing that kind of misery again.
posted by superfluousm at 7:38 AM on October 15, 2014 [21 favorites]


They will meet when the antivaxxer brings her unvaccinated kid to work because the school sent Kid home for being sick and then the two of them will cough and sneeze all over the place and everyone in the office who is immunocompromised or has someone like that in their life will then have the next month of their life ruined.

5 years ago and im still murder level alpha over that wow
posted by poffin boffin at 7:39 AM on October 15, 2014 [41 favorites]


I have been in the ICU with the flu (1996). I have received a flu shot every year before and since. The flu is deadly. They are not kidding.
posted by Sophie1 at 7:42 AM on October 15, 2014 [5 favorites]


Myself, my husband, and our older daughter just got ours. (The pediatrician was out of the dosage for my younger daughter -- she'll have to get hers later.)

But I agree that it's not like DTaP and MMR and so on. The return on investment for those vaccines is huge -- a very short poke or two and a lifetime of immunity against some REALLY terrible diseases.

For the flu vaccine, it's a poke that always remains sore for a day or two (or a spray that makes your nose runny for a day or two) for less than a year of partial (like 50-75%) immunity to a disease that will probably make you miserable for a week or two, but from which most healthy young people make a full recovery.

I still get the shot, because I figure that the pain of the flu is still at least a hundred times more than the pain of the shot in a given year, even when you weight for the non-100% chance of getting the flu without the shot and the non-zero chance of getting the flu with the shot... But with other diseases I think the cost/benefit ratio is way higher.
posted by OnceUponATime at 7:42 AM on October 15, 2014 [4 favorites]


I would genuinely appreciate clarification of the "sickness" that people are describing the day after a flu vaccine.

My patients often tell me the flushot made them sick because they got a cold within a week of the flu shot, and trying to disabuse them of their voodoo is pointless. The flushot, if it works as indicated, can and should provoke a mild immune reaction which can cause malaise and low grade fever or body aches for a day or so, but it cannot cause a frank illness.

Can anyone here elaborate further?
posted by docpops at 7:43 AM on October 15, 2014 [21 favorites]


also they better have free donuts this year or I will go on strike.

I am now trying to imagine a doughnut vaccine....
posted by GenjiandProust at 7:44 AM on October 15, 2014 [1 favorite]


My uncle infromed us that kids have peanut allergies these days because of "all the damn vaccines they make them get."

Then there was the time my grandfather was in the hospital recovering from gall bladder surgery. Somehow the topic of the flu vaccine came up with the nurse. Grandfather: "I don't get the flu shot." Nurse: "Yeah, I don't either..."

Wait, what the holy living fuck?! Healthcare workers, who are disproportionately around frail elderly and newborns, don't have to get the flu shot?! This fucking country.
posted by dirigibleman at 7:44 AM on October 15, 2014 [7 favorites]


Also, whenever people tell me they had the flu and "it wasn't such a big deal" it's fairly certain they didn't have the flu. Proving influenza requires an fairly painful and difficult to perform test, and health care workers use the term "flu" for everything from a respiratory virus to a common cold to the runs. If you were able to get out of bed and do meaningful work, it probably was not influenza.
posted by docpops at 7:45 AM on October 15, 2014 [25 favorites]


a lifetime of immunity against some REALLY terrible diseases.

They don't actually seem to last forever*, but no doctor will give me a straight answer on whether or not I need to get them again. Presumably insurance won't cover adult doses for people who had them as kids.

*i know this because despite having had every single possible childhood vaccination, i got the mumps when i was 21-22
posted by poffin boffin at 7:46 AM on October 15, 2014 [2 favorites]


THE KEY TO VICTORY
IS SMALLER THAN YOU THINK!
HELP US WIN THIS WAR
DO YOUR PART TODAY!
CONTACT YOUR PHARMACIST!
(source)
posted by blue_beetle at 7:47 AM on October 15, 2014 [1 favorite]


Alas, public health and its persistent PR problem.

Everybody thinks about freedom from things like government intrusion and mandates; fewer people think about freedom to collectively determine and improve our health.
posted by entropone at 7:49 AM on October 15, 2014 [12 favorites]


They were running by the river, and there was a lone duck sitting by the path. The friend made a joke about flu, and then the duck looked at them significantly and coughed.

my new AFLAC commercial is unstoppable
posted by escabeche at 7:49 AM on October 15, 2014 [27 favorites]


The flushot, if it works as indicated, can and should provoke a mild immune reaction which can cause malaise and low grade fever or body aches for a day or so, but it cannot cause a frank illness.

You call it mild. I call it miserable.

Kidding aside, it's basically what you describe. But yeah, it means I'm useless for a day or so - just lay in bed and try to stay comfortable. So.... suboptimal, I guess.
posted by Pogo_Fuzzybutt at 7:50 AM on October 15, 2014 [3 favorites]


...a disease that will probably make you miserable for a week or two, but from which most healthy young people make a full recovery. ... is also a disease that lots of young, healthy but temporarily moderately sick people can pass on to all sorts of people, including the very young, the elderly, the immunocompromised, and those who have legit, serious medical reasons for not getting the shot.

Any specific young, healthy person may not pass on the flu directly to any vulnerable unvaccinated people, but we can act as vectors spreading it to other young, healthy people who are in direct contact with them.

All in all, it's a good idea to get the shot. Consider it Pascal's wager for your immune system.
posted by maudlin at 7:52 AM on October 15, 2014 [22 favorites]


I need to ask my doc if he thinks I should get it this year. Previous years have been eh, NO! and maybe? because of my weird health stuff.

As someone with a messed up immune system, though, THANK YOU to all of you healthy types who do get the flu shot!
posted by misha at 7:54 AM on October 15, 2014 [2 favorites]


That's why you have to get the shots that have the most strains of flu stuffed into the one needle, I think?

The NHS flu shot this year apparently includes:

H1N1 – the strain of flu that caused the swine flu pandemic in 2009
H3N2 – a strain of flu that can infect birds and mammals and was active in 2011
B/Massachusetts/2 – a strain of flu that was active in 2012
and a fourth strain is included in the nasal spray vaccine given to young children.

The information on which strains are predicted to be prevalent comes from the WHO, so presumably the US CDC makes its decision on the same basis. I believe the shot will still offer some mitigation against non-included strains too.

Also, whenever people tell me they had the flu and "it wasn't such a big deal" it's fairly certain they didn't have the flu.

The first time you get the flu you immediately realise that every time you suspected it before it had just been a bit of a cold! It really is a grim time.
posted by sobarel at 7:55 AM on October 15, 2014 [15 favorites]


I wish they would offer a vaccine without adjuvants. I'm one of the people who has a strong reaction to vaccines.* As a child, my DPT vaccine necessitated cutting off my sleeve as my arm had swelled up like a balloon. I got another DT (I think the P was left off) a decade back, again with the swelling. Every time I get a flu vaccine shot, I feel awful starting about a day later. I have to schedule days off if I get one. I am told this has happened since I was an infant, so obviously it is not a mental thing unless I was somehow born with advanced mind-over-body abilities, which I rather doubt. I don't care about mercury (I have a small jar of it not far off) or any of that nonsense.

Feeling like hell for three days with a swollen arm (of variable size, the flu shots are not as bad as the DT shots) and a thermometer-verifiable fever each year, every year just is not worth it to me cumulatively. I have called my local health department to ask about an adjuvant-free vaccine a few times, getting either a "hunh?" or a really tiresome spiel about how I shouldn't worry about mercury (which is stupid, aluminum is the typical metal used an adjuvant).

I've gotten pretty fed-up with the rah-rah vaccine stuff after all of this.

* I get a roaring fever for just a cold. 103 or 104F is pretty much an expected result when I get the sniffles.
posted by adipocere at 7:55 AM on October 15, 2014


malaise and low grade fever or body aches for a day or so

That about sums it up. I get the shot, but it does suck knowing I'm in for a few days of malaise.
posted by diogenes at 7:57 AM on October 15, 2014 [3 favorites]


I've not ever gotten the flu vaccine, and I've also never had the flu. I freely admit that this was irresponsible, and that the big reason I didn't ever do it was a combination of "I've never gotten the flu" and "i am a big enormous chicken about needles".

However, I'm now going to be a little baby's godmother and the baptism is at the end of the month, and I've decided I really need to suck it up and do this. (Fortunately I am up to date with all other vaccinations - I checked with my doctor and everything - so yay.)
posted by EmpressCallipygos at 7:58 AM on October 15, 2014 [5 favorites]


When was the last year we lost 50,000 people to the Flu in america?
posted by rebent at 7:59 AM on October 15, 2014 [1 favorite]


Furthermore, I know the intended vaccination coverage has changed. For most of my life, vaccination against influenza was only strongly recommended for at-risk groups (Elderly, otherwise ill, health care workers, etc. ) It's only recently that we've change to "everybody, every year."

Yeah, I've only had a flu shot for the past couple of years because I had gotten it into my head that young and not-at-risk groups were not supposed to be vaccinated. It took a lot of messaging before I even noticed, sadly.

Here in Minnesota, we had one year where they said there was a vaccine shortage and then they had a vaccine surplus because everyone assumed that other people needed it more and just decided to do without - a failure caused by Minnesota nice.
posted by Frowner at 7:59 AM on October 15, 2014 [10 favorites]


I would genuinely appreciate clarification of the "sickness" that people are describing the day after a flu vaccine.

I don't get this, but my partner does. Every year she suffers from general full-body aches and pains the day or two after her flu shot (no sneezing or coughing, just the aches and pains), and major soreness in the arm in which she received the shot for a week. Once about a decade ago, she seemed to get a full-blown week of flu immediately after being vaccinated. (Note, she doesn't have diagnosed allergies, so it doesn't seem like a reaction to the egg-related medium or anything like that.) Nonetheless she gets the flu vaccine because 1) it's still better than real flu, 2) several of her colleagues have disease vectors children at home and don't get the vaccine for whatever complicated rationalization of their own, so odds are she will be exposed at work, and 3) she's a grown-up who understands she lives in a civilization and we all should pitch in to protect our fellow humans.
posted by aught at 8:02 AM on October 15, 2014 [7 favorites]


Can anyone here elaborate further?

Third hand information, but here goes:

One of my relatives is diabetic, and a couple (3?) years ago she got the flu jab. Within an hour, she was having chest pains so bad she considered calling an ambulance. She called the doctor's surgery that she'd visited for the jab, and was told by the nurse that several other people that day had called with the same problem - chest pains shortly after having the jab. (No further tests were done, relative didn't go to hospital, no scientific evidence, etc).

Other (6+) relatives/friends of varying ages have reported having "flu-like symptoms" shortly after having the jab. Again, no testing, tiny sample size, etc.
posted by Solomon at 8:04 AM on October 15, 2014


When was the last year we lost 50,000 people to the Flu in america?

48,614 in 2003-4 according to table 2 "Estimated number of annual influenza-associated deaths with underlying respiratory and circulatory causes"
posted by ghharr at 8:05 AM on October 15, 2014 [13 favorites]


Oh, and about immunizations lasting a lifetime, not so much for all of them. The thinking is changing on that. For instance, if you haven't had a tetanus shot since you were a kid, you may want to get a booster. I think 12 years is the outside on that one.

And, yeah, I was immunized as a child and also still got the mumps, exactly like Poffinboffin.

I wish I understood the chicken pox vaccine, by the way. I am hopeful maybe some smart person here can explain how it works for me. The thing about that disease is that once you have chicken pox, the herpes zoster (I think?) virus is in your system, dormant, and you are at risk for shingles as an adult. So how does vaccinating work there? Do they use a live or dead form of that virus for the vaccine, and does it protect you from getting chicken pox but will you still get shingles one day?
posted by misha at 8:05 AM on October 15, 2014


48,614 in 2003-4 according to table 2

Yeah, february 2004 was the year I prolly almost died from it. I lost 10lbs in 2-3 weeks and it took me almost 3 months to recover fully. No insurance meant I spent those weeks laying on the floor of my living room next to the heater.
posted by poffin boffin at 8:10 AM on October 15, 2014 [1 favorite]


I get sick every time. I read the literature every time that says that I'm nuts and that it is unrelated, but I do get "flulike symptoms" for a couple of days every time, coincidentally begining the evening after I've had the shot. I still go get the shot every time because it is important and I'll get sick-ish but I'll keep on doing it.
posted by The 10th Regiment of Foot at 8:11 AM on October 15, 2014


I got the swine flu last year, and it was one of the worst health/illness experiences I've ever had - so painful, and it was the first time I ever viscerally understood how healthy people can die of the flu.

Ditto. I had swine flu around the end of 2010. Was living alone, and it overcame me that much, I could have died in that apartment. In fact, for some of the time, it was that fucking awful, I was wishing I would die.

I hate needles, but since then I am the first person in the queue when the flu jabs become available. If you think you'll just take your chance in missing or getting swine flu, and will just ride it out if you get it, then ... well, I can't type what I think else the mods will remove it. Just stay the fuck away from everyone else, and at the very least make sure your will and other provisions for those who depend on you are up to date.
posted by Wordshore at 8:12 AM on October 15, 2014 [2 favorites]


I got the swine flu last year, and it was one of the worst health/illness experiences I've ever had - so painful, and it was the first time I ever viscerally understood how healthy people can die of the flu.

What? Is H1N1 still around? The big swine flu epidemic was in 2009. I remember it well. I went to my doctor for a routine checkup and asked for a flu shot. He said they were in severely short supply, they only had enough to vaccinate the hospital staff. That was pretty irritating, my doctor could get a flu shot and then rubbed it in by telling me I couldn't get one. Sure I can understand the reason for health care workers to be prioritized. But the whole reason flu shots were in short supply was that the CDC and FDA budgets for flu vaccine development were cut by the Bush administration, so they got a late start producing vaccines and were unable to deliver until the epidemic was well underway.

I got the flu, by that point they didn't bother to do tests anymore because everyone who had the flu had swine flu. One day a friend came over to check on me, found me delirious, and took me to the ER, The doctors said I was dehydrated so they pumped me full of IV fluids. I later found out that this was how most people died from H1N1, they got dehydrated and then crashed. Oddly enough, ever since 2009, my body temperature has been consistently 96.8F, it had always been average at 98.6. So now when I get a fever of around 101, it's like I have a fever of 103.

I would genuinely appreciate clarification of the "sickness" that people are describing the day after a flu vaccine.

Yes, I consistently have a noticeable reaction to flu vaccinations. Almost everyone has muscle aches at the injection site, my whole bicep is inflamed. I tend to have what I call a "mini-flu" for 2 or 3 days. It certainly is not anywhere close to having a real flu, but it does show a lot of the flu symptoms: muscle and joint aches, a very slight elevation in body temp, generally feeling unwell, etc. It is definitely preferable to the real flu, and it would not stop me from normal everyday activities, but if I don't have anything else important to do, I'd rather just rest and recuperate as if I did have a real flu.
posted by charlie don't surf at 8:14 AM on October 15, 2014 [4 favorites]


Several people correctly pointed out that the CDC flu-associated death estimates I linked to above include people who were more at-risk because they were already sick with "old people" issues like respiratory and heart problems. So 49,000 young healthy people didn't drop dead in 2003. But still, lots of young healthy people interact with kids and old or sick people.

And my wife who is a nurse can attest that at-risk populations are anti-flu vaccine too. She visited an old man the other day who said "I'm not putting that poison in my body!" I personally haven't ever had the side effects from the vaccine, but if I had I might be more reluctant. My wife's arm gets sore for a couple of days but that's about it.
posted by freecellwizard at 8:19 AM on October 15, 2014 [1 favorite]


The first time you get the flu you immediately realise that every time you suspected it before it had just been a bit of a cold! It really is a grim time.

Ugh, seriously.

It's kind of like breaking a rib: you never really just think you broke a rib. If it's broken, you fucking know because it breaks your previous paradigm.

For me, with the flu, I had grey skin, night sweats with hallucinations, and couldn't move from the couch for a week. I basically felt like a dead body - no way I could power through anything for a couple days like I can with even the worst cold.
posted by entropone at 8:22 AM on October 15, 2014 [17 favorites]


Flu.gov says 69,800 died of the Asian flu in 1957-58, and 33,000 of the Hong Kong flu in 1968-69.
posted by Diablevert at 8:23 AM on October 15, 2014 [2 favorites]


Both my mother and my older son are immunocompromised, and I have a sneaking suspicion that two of the three newest babies in the extended family have not been fully vaccinated (the mother is flaky and prone to spouting woo). I can't fix the broken people in my family, but I can reduce the chances of spreading harm. You do what you can, and you just hope other people do too.
posted by Mary Ellen Carter at 8:25 AM on October 15, 2014 [5 favorites]


When was the last year we lost 50,000 people to the Flu in america?

2003-4 is a good guess given the available data, but when I talk to patients I frame it like this: influenza kills so many people every year that we don't even keep a running tally. Instead, we publish the percentage of deaths each year attributable to Influenza (and the Pneumonia superinfection that ultimately kills most of the people who die of flu).

Estimating the yearly number of people who contract influenza is even tougher, but this 2007 article from The Lancet looked at the morbidity/mortality/economic impact of flu from 1980 to 2001 and gives a pretty good view of the devastation that the disease causes during an average year:
  • 610,660 life-years lost.
  • 3,100,000 days spent in hospital
  • 31,400,000 outpatient visits
  • Direct medical costs between $4.1 billion and $22.2 billion annually.
  • Projected lost earnings between $8.7 and $31 billion annually.

  • posted by The White Hat at 8:30 AM on October 15, 2014 [12 favorites]


    For me, with the flu, I had grey skin, night sweats with hallucinations, and couldn't move from the couch for a week. I basically felt like a dead body - no way I could power through anything for a couple days like I can with even the worst cold.

    A friend of a friend recently qualified as a GP and said the diagnostic test for Flu-like symptoms was to imagine a £50 note fluttering in through the window. If the note dropped near the hand of the patient and they made no effort to grab it they would have Flu, any movement or sign of avaricious interest though and it's just a bad cold.
    posted by sobarel at 8:36 AM on October 15, 2014 [34 favorites]


    Am I the only weirdo that loves getting their flu vaccine?

    I enjoy wearing around the I GOT MY FLU SHOT sticker. It's one of two civic responsibility stickers I get to wear every fall, followed by I VOTED.
    posted by gimonca at 8:37 AM on October 15, 2014 [7 favorites]


    My patients often tell me the flushot made them sick because they got a cold within a week of the flu shot, and trying to disabuse them of their voodoo is pointless. The flushot, if it works as indicated, can and should provoke a mild immune reaction which can cause malaise and low grade fever or body aches for a day or so, but it cannot cause a frank illness.

    See, my doctor says I don't get "sick" from the flu shot, but I consider a fever, body aches, a stuffy nose and itchy eyes to be "sick" enough to interfere with my life. Maybe it's not a "frank illness," but poo-pooing the idea that people are kind of miserable as a direct result of getting the flu shot just makes some of us paranoid that we're crazy for actually feeling like crap after the flu shot.
    posted by xingcat at 8:39 AM on October 15, 2014 [21 favorites]


    If i understand correctly, people who get "sick" after a flu shot are feeling the immune system response without the danger of, for instance, having a virus that will fill your chest with goo for a couple of weeks and possibly lead to Pneumonia.
    posted by Lesser Shrew at 8:40 AM on October 15, 2014 [9 favorites]


    Yes, that's about right, Lesser Shrew. But we're also smart enough to do the math on it.

    So I feel like hell for three days. I don't feel "sick," I feel sick. That's not a dismissable zero. Add that up over a decade, that's a month of feeling like hell. To my knowledge, I've never had the flu. I'm told that if you had it, you'd know it, so I am going with "no flu."

    The payoff matrix for those of us who don't do so hot with the shot says "don't take it" until we're at serious risk: chronic respiratory disorders or just plain age.

    The counter says, "Herd immunity, do it for everyone else!" Sounds great ... but we think that maybe the "everyone else" could meet us in the middle by offering a variant vaccine which does not make us feel like hell. It's a super-reasonable compromise. Meet us in the middle instead of one-size-fits-all.
    posted by adipocere at 8:49 AM on October 15, 2014 [4 favorites]


    The one time I definitely had a bad flu, I was in Shanghai and I was so sick. I picked it up on the train coming back from Beijing at New Year's and I was all alone in the teacher housing. I was in my early twenties and probably healthier than I've ever been - thinner, fitter, better-fed - but there was about 24 hours where I was genuinely scared that I would have to crawl down the corridor and down the stairs and out to the concierge apartment and just hope someone was there who could get me to the hospital...or actually, I was scared that I'd need to crawl but not be strong enough.

    It took about two weeks before I was really better - I remember that it was a huge deal when I was well enough to take the bus (two transfers) downtown to the foreign language bookstore to get something new to read. (A Chinese-published english translation of Story of the Stone which felt like it dated from the 1930s but was really post cultural-revolution.) That was the only time I was ever able to elbow my way through the crowd to get a seat on the bus, too - I knew I couldn't stand up all the way downtown and I made myself do it. (One did not queue for seats on those buses in those days.)
    posted by Frowner at 8:50 AM on October 15, 2014 [3 favorites]


    Many of them are coincidentally getting a cold at about the same time as they got the flu shot, which is given at the beginning of (get this!) cold and flu season. The clustering illusion, confirmation bias, negativity bias, and a few other cognitive biases do the rest.
    posted by jedicus at 8:50 AM on October 15, 2014 [8 favorites]


    When I was in the hospital a month ago after the birth of my son, they not only gave me my flu vaccine, they gave one to my husband as well. I think it's great that they were able to offer the flu vaccine for the 2nd parent.
    posted by ThePinkSuperhero at 8:51 AM on October 15, 2014 [3 favorites]


    I'm embarrassed to say I've never gotten a flu shot. I'm not proud of that. Just lazy, I guess. I actually didn't realize they were free, either. They are free, right?
    posted by Thorzdad at 8:53 AM on October 15, 2014


    To add to adipocere's excellent comment - there are those people who also have difficulty getting sick days off from work, and may wish to take their chances and save them for a day when they actually do get sick as opposed to willingly signing up for sick days, and then not having them later on with an actual illness.

    And then there are also people like me who DON'T get sick days (hi, temp work) and so a day of feeling sick means a day of not getting paid, and I'd just as soon have the money, thanks.

    (No, I'm getting the vaccine this year - I found a pharmacy in my hood that does it and I'll just time it for Friday night so I'm sick over a weekend so it won't matter. But I'm an office temp with a regular schedule; if I were a Starbucks' Barista or something, where my schedule was more unpredictable, I may think otherwise.)
    posted by EmpressCallipygos at 8:54 AM on October 15, 2014 [3 favorites]


    Thorzdad, depends on your insurance. Mine (Cigna) picked it up completely.
    posted by roomthreeseventeen at 8:54 AM on October 15, 2014


    Wait, what the holy living fuck?! Healthcare workers, who are disproportionately around frail elderly and newborns, don't have to get the flu shot?! This fucking country.

    They tried to require it for healthcare workers in NY state (around 2009, I think; I remember the hubbub when I started my job), but there was too much pushback. Now, most large institutions have a mandatory flu shot "program" where you either have to get the shot from them, prove you got it somewhere else, or sign on the dotted line that you're refusing to get one. At my work, before you sign the refusal, they make you watch a webinar about popular myths about the flu shot. Oh, and if you don't get the shot, you have to wear a mask in all public areas during flu season.

    Also, as long as you're wound up, you should know that there are students in my Master of Public Health program who aren't getting flu shots. They don't want to, they don't believe in it, blah blah blah, even if they work directly with sick people. I have put them on my "NEVER PICK FOR GROUP WORK" list, and I hope they can feel my disapproval burning in their bones.
    posted by ThePinkSuperhero at 9:00 AM on October 15, 2014 [24 favorites]


    Thanks for the reminder. I'm terrified of needles but I'll call around and find out who has the nasal spray version of the vaccine this year.
    posted by Jacqueline at 9:02 AM on October 15, 2014


    For all of you with needle phobias: Intranasal delivery is where it's at. My kid got the sniff-delivered vaccine, so I did too. Mrs. Frogs rolled her eyes and called us wimps. (I have no issue with the needle, personally, but the nurse had the intranasal doses ready so what the heck.)
    posted by caution live frogs at 9:04 AM on October 15, 2014 [2 favorites]


    "I don't want to tell you this because you can't take it back now, but mercury is very dangerous to the body. But if you trust the FDA, I guess..."

    Haha, you should've told her it was your AIDS medicine and then projectile vomit blood on her like in 28 Days Later. That woulda been awesome.
    posted by ReeMonster at 9:05 AM on October 15, 2014 [6 favorites]


    It sounds simple to require nurses to get the shot to protect their vulnerable patients. When you have to burn two to three days of PTO (to cover the 8s or 12s you won't be able to do) or just lose that money because your hourly (and need the PTO for something else), its a lot less simple an equation. Doing everything you can to protect the people in the hospital conflicts with the individual need to get by and pay off student loans. Nurses get shit on in this country.

    And the hospital admins will, from the nurse I know, unceasingly push the shot on nurses but god forbid the doctors be pursued with the same vehemence for something as minor and effective in preventing flu transmission as washing one's hands on room entry and exit.

    We need a better flu vaccine.
    posted by Slackermagee at 9:07 AM on October 15, 2014 [3 favorites]


    The real anti-vaxx crowd is just a depressing reminder of the general anti-science idiocy in the U.S. I’ve worked with several. One bragged about never having had the shot or the flu – only to get miserably sick that winter. Another is one of those religious anti-vaxx people. I keep wanting to scream at her, the only reason your kids never got measles/pertussis/smallpox/polio is because so many of the rest of us are immunized.

    But figuring where to get a flu shot is an issue. For various reasons over the years, going to the fam. doc du jour hasn’t been a good option. So two seasons ago I was sure I caught a bad cold waiting in a crowded public health office for my flu shot. Last year I went to a walk-in clinic for an insurance-covered shot, only to end up in a huge fight over a full-office-visit bill they later sent.
    posted by NorthernLite at 9:08 AM on October 15, 2014 [1 favorite]


    I have heard from more than a few people that the flu vaccine kills people. Uh, no, that would be the flu.
    posted by waving at 9:08 AM on October 15, 2014 [2 favorites]


    I feel crappy enough after my flu shot every year that I make a point to get it on a Friday or Saturday, when I can spend the next day in bed if I need to. I get about 24-48 hours of the immune response described above - a low fever, ache-y all over, sometimes a sore throat and general sniffly/stuffiness.

    It's not a big deal for me. My workplace schedules lots of free flu shot clinics, or will reimburse me if I get the flu shot somewhere else, so I can easily get it at a time when I can afford to feel rotten for a day or two. And it's well worth it on both a selfish "better than the flu" level and a "I am doing a good thing for society" level. But it is a thing that happens, reliably enough almost every year that I just go ahead and plan for it even if maybe I'm really just catching a cold at the same time every year.
    posted by Stacey at 9:10 AM on October 15, 2014


    Be aware that internasal vaccines don't work very well for adults. Works great for kids though (assuming you don't have immunocompromised people around).
    posted by RobotVoodooPower at 9:16 AM on October 15, 2014


    They are free, right?

    In the US, almost all post-ACA insurance plans cover the flu vaccine and most pre-ACA plans did as well.

    Some hospitals have been able to make vaccination mandatory for all employees. It's becoming more common in the wake of a large scale 2010 trial at Virginia Mason that showed a dramatic increase in compliance (i.e. a lot of employees weren't getting the shot before and very few went through the religious or health opt-out process, which required lab verification of egg allergy). Subsequent trials and reviews have found a moderate impact on all-cause patient mortality. Evidence of impact on lab-confirmed cases of the flu is lacking, however.
    posted by jedicus at 9:17 AM on October 15, 2014 [3 favorites]


    Be aware that internasal vaccines don't work very well for adults.

    God-dammit why did you have to tell me that
    posted by EmpressCallipygos at 9:24 AM on October 15, 2014 [2 favorites]


    I got the flu shot three weeks ago, and 24 hours after I got it I developed a 103 degree fever and severe body aches, followed by four days of a very severe (like, the pain would wake me up in the middle of the night it hurt so much) sore throat, followed by five more days of painful coughing and sinus issues. Around day 7 I went to the doctor and was told I had an "inflammatory immune response," and to rest. I know that the flu certainly could be worse than that reaction, but it didn't feel very mild to me at the time. The same thing happened to me the last time I got the shot (which was several years ago).

    I work with elderly people now so I basically have to get the flu shot (or wear a mask for 6 months, which is not realistic), but I'm not looking forward to dealing with again next year.
    posted by odayoday at 9:27 AM on October 15, 2014 [2 favorites]


    i have never had the flu. i have never had a flu shot. this thread was very informative and helpful in communicating the importance of getting it. i'll be getting my first one on monday at the in-house company health-fair. thanks all, for the good discussion/context.
    posted by rude.boy at 9:32 AM on October 15, 2014 [27 favorites]


    Am I the only weirdo that loves getting their flu vaccine?

    The first day of flu shots is like Christmas for me. I put it on my calendar and count down the days, and I'm always lined up right at 8 am the first morning with all the octogenarians.
    posted by roger ackroyd at 9:36 AM on October 15, 2014 [10 favorites]


    In the US, almost all post-ACA insurance plans cover the flu vaccine and most pre-ACA plans did as well.

    Provided that your Primary Care Provider has enough of the vaccine in stock, and isn't reserving what it has for the young and at-risk. Mine does not.

    As with practically everything else under the ACA, the rhetoric and the reality have only a nodding acquaintance.
    posted by Shmuel510 at 9:36 AM on October 15, 2014


    Provided that your Primary Care Provider has enough of the vaccine in stock, and isn't reserving what it has for the young and at-risk. Mine does not.

    As with practically everything else under the ACA, the rhetoric and the reality have only a nodding acquaintance.


    I don't think this is good information. As noted elsewhere in this thread, you don't need to go to your PCP. You can get a flu shot at work, at the pharmacy, any number of places.
    posted by roomthreeseventeen at 9:39 AM on October 15, 2014 [13 favorites]


    I'm very pro-vaccination in general, but the last time I looked into this about a decade ago, I felt that for myself, not yet old and with a healthy immune system, the statistics really didn't convince me.

    The fact that the main article doesn't actually present any solid numbers beside X people dead from the flu wasn't at all convincing to me - and as far as I can see, none of the other articles have any solid numbers either.

    Again - BIG fan of vaccines in general - very well aware of the destructive role of the flu in history - not an antivaccer - but skeptical of the flu shot in specific, pending any actual numbers as to its effectiveness on a normal healthy adult. If you have 'em, please pass 'em on to me.
    posted by lupus_yonderboy at 9:41 AM on October 15, 2014 [2 favorites]


    As noted elsewhere in this thread, you don't need to go to your PCP. You can get a flu shot at work,

    I'm a freelancer. Doesn't help.

    at the pharmacy, any number of places.

    If you want to pay for it yourself, yes. That's not the point immediately at hand, which is what insurance covers.
    posted by Shmuel510 at 9:42 AM on October 15, 2014


    what insurance covers.

    Mine doesn't, but many do cover flu shots from, for example, CVS (they've got a big-ass sign outside telling you so; I do believe it's true for many plans).
    posted by uncleozzy at 9:44 AM on October 15, 2014 [1 favorite]


    Huh? My bronze-level insurance plan paid for my vaccine at Target.
    posted by dirigibleman at 9:45 AM on October 15, 2014 [2 favorites]


    Since ACA plan compliance varies state by state I think it's okay and fair to say that some people here may not be receiving the same coverage opportunities as others. It probably shouldn't be a point of contention.
    posted by poffin boffin at 9:47 AM on October 15, 2014 [2 favorites]


    Show me the evidence.

    Please. Show me the same kind of reliable, high-quality evidence we have for other vaccines like DPT, MMR, polio, HepA/B, and bacterial meningitis. Where is it? Flu vaccine formulation is guesswork. This is not a secret. Year-to-year efficacy is highly variable, measuring that efficacy is very difficult to begin with and the published evidence is mixed. That's why there is no international consensus on routine influenza vaccination.

    And now you're telling me you're recommending that not only everybody (as opposed to, say, people at particular risk) get this vaccine, but every year?

    This discussion would be academic if this vaccine had a zero or minimal adverse-effect rate, but it does not. Reactions to flu vaccination are, at the very least, not unusual. Sometimes they are indeed fatal, particularly in the populations that are supposed to benefit most from flu vaccines: the elderly.

    No vaccine is without risk, but we expect a very high benefit-risk ratio from public health interventions, as well we should! Flu vaccines don't meet this high standard. They have huge costs, benefits that have thus far been difficult to demonstrate, and risks which are not negligible. Please don't confuse anti-vaccination hysteria with healthy scientific scepticism about the benefit-risk ratio of routine, annual, mass vaccination for influenza, a virus of many strains and with a high rate of antigenic drift.

    By all means, recommend that health care workers or at-risk populations get it. At least those populations are being closely monitored. And you can formulate vaccines in an epidemic and recommend those; that's an intervention with a clear target. But that's as far as it should go, until the evidence for the rest of it is better.

    Vaccination should not be like playing darts. Nobody should be ostracized for not getting a flu shot; that's unhealthy and it does little to encourage people to get vaccinated. Let evidence speak for itself -- something it does very nicely for a number of other vaccinations we routinely get.
    posted by rhombus at 9:50 AM on October 15, 2014 [21 favorites]


    As mentioned upthread, the UK doesn't recommend the flu jab for everyone. They certainly won't stop you paying £13 to have it privately if you're in the mood (assuming you're not immunocompromised, etc), but it's only free on the NHS if you
    •are 65 years of age or over
    •are pregnant
    •have certain medical conditions (see below)
    •are living in a long-stay residential care home or other long-stay care facility
    •receive a carer's allowance, or you are the main carer for an elderly or disabled person whose welfare may be at risk if you fall ill
    •are a healthcare worker with direct patient contact or a social care worker (see below)
    I strikes me as a bit weird that teachers aren't on that list. I know at least a few teachers who get vaccinated every year, and I'd hate to think that they're paying out of pocket for what's obviously a work expense.

    More surprising to me is that while the NHS encourages its front-line staff to get vaccinated, it doesn't actually seem to be a requirement:
    As you will be aware, the Secretary of State announced this month that any NHS trust eligible for a share of £250m A&E funding for next year will need to ensure that at least 75% of its own staff have been vaccinated against flu this year.
    I keep being assured that we're living in an authoritarian socialist hellhole over here; where's the fun in that if you can't rule with an iron fist syringe?
    posted by metaBugs at 9:54 AM on October 15, 2014 [4 favorites]


    I got enough cases of "martian death flu" as a young adult that I'm religious about getting a flu shot every fall. I remember a horrific new years eve spent with a 102F fever lying half-delirious in a bed in a cabin in the Pennsylvania woods while a rocking party went on in the next room. Fortunately, 3/4 of the other people there were nurses or med students so at least I was under some sort of medical care.
    posted by octothorpe at 9:55 AM on October 15, 2014 [2 favorites]


    I've never gotten a flu shot except for the year H1N1 made an appearance and since Shepherd's then employer was paying for it, why not? I do plan on getting one this year, but mostly because I have moved to somewhere where I am considerably less hermity than my last residence and in a college town, I figure the odds of me encountering someone with the flu is higher. Better safe than miserable and horribly sick.
    posted by Kitteh at 9:57 AM on October 15, 2014


    Meet your new host of Meet The Press!
    posted by robocop is bleeding at 10:00 AM on October 15, 2014


    I can't really afford to miss a week or two of classes (especially when some of them have labs where 'if you miss X labs you auto fail' conditions), so I get a flu shot these days.
    posted by curious nu at 10:02 AM on October 15, 2014


    Please. Show me the same kind of reliable, high-quality evidence we have for other vaccines like DPT, MMR, polio, HepA/B, and bacterial meningitis. Where is it? Flu vaccine formulation is guesswork.

    I found at one point studies comparing Ontario (universal flu vaccine) and the rest of Canada, and there was a significant difference in work absences and hospital admissions -- that people who got sick got a lot less sick, and there were overall savings from giving everyone a shot.
    posted by jeather at 10:03 AM on October 15, 2014 [4 favorites]


    lupus_yonderboy: This metastudy is the one I've seen come up most often. It reaches the same conclusions as the military study I linked above: Internasal is more effective for children, and conventional flu shots are more effective for adults.

    It would be good if our national conversation could handle nuance like this, because we could pressure the industry (and the government who is a huge purchaser) for more effective vaccines.
    posted by RobotVoodooPower at 10:03 AM on October 15, 2014 [6 favorites]


    Not that we should not be doing more to help contain the disease, but just for some perspective for those afraid of a new plague as fomented by the 24/7 news cycle; the total number of people infected worldwide in the currently ongoing, "worst ever" outbreak of ebola is still less than 9,000.

    Except that it's growing exponentially. On average each infected person has been infecting two more. That's exponential growth. You're talking about a 1000% growth rate over the past couple of months. So in a few months, 100,000, a few months later, we're in the millions. With a 70% fatality rate, we're looking at a black death sort of situation, at least in africa, and I doubt it'll be contained there.
    posted by empath at 10:05 AM on October 15, 2014 [5 favorites]


    rhombus: I went off and did some research since I posted a few minutes ago, without great success.

    The one solid thing I did find is that no European country recommends flu vaccinations for healthy adults. That is particularly interesting, as generally preventative care is emphasized more in Europe than in the United States - logical consequence of a not-for-profit healthcare system.

    The fact that the United States, by far the largest for-profit system, is also one of the very few countries to recommend a flu shot for healthy adults, and yet doesn't seem to be able to demonstrate any benefits from that shot...hmm

    On preview: RobotVoodooPower, that's a great link! Money quote:

    Because of flu vaccines' track record of safety and "moderate efficacy," the authors state, "We believe the current influenza vaccines will continue to have a role in reduction of influenza morbidity until more interventions are available. However, evidence for consistent high-level protection is elusive for the present generation of vaccines, especially in individuals at risk of medical complications or those aged 65 years or older."
    posted by lupus_yonderboy at 10:06 AM on October 15, 2014 [3 favorites]


    The one year I had the flu was my freshman year of highschool. I missed the winter dance and was fortunate that my school was running on a trimester schedule, so I did not miss my exams. My temperature went up to 103 for over a day, one of the girls in my class ended up in an ice bath at the hospital because her temperature hit 105. She was ok (she had already been hospitalized)

    That was also the first year I had a flu shot.

    But that's medicine. There is no single thing that works for 100% of human beings, let alone all the time. I haven't gotten the flu since, colds sure, but not the flu. The flu vaccine is tilting the house odds in your favor, which is a good thing.

    Also, as has been said above- get your boosters. An adolescent or adult can get whooping cough if they don't keep up with their vaccines and trust me, it is incredibly unpleasant. I don't like the sensation of the vaccine penetrating the muscle either, but it's better than coughing a lung out (or even the way they test for whooping cough, which is a swab against the back of your nasal cavity).
    posted by Hactar at 10:10 AM on October 15, 2014 [1 favorite]


    As mentioned upthread, the UK doesn't recommend the flu jab for everyone. They certainly won't stop you paying £13 to have it privately if you're in the mood

    Last year I had it done at Boots. Can't remember exactly how much, but think it was 10 or 12 quid. This year I had my flu jab at the pharmacy in Tesco: £9.
    posted by Wordshore at 10:16 AM on October 15, 2014 [1 favorite]


    I've never had a flu shot. When they first started with it, I was told I shouldn't cause I'm allergic to eggs. Now I've heard that's not as much of a concern, but I've still never had one. I love science, but I've also never had flu. So its hard to feel any real urgency to get one.
    posted by agregoli at 10:17 AM on October 15, 2014


    > The flu vaccine is tilting the house odds in your favor, which is a good thing.

    If you want flu vaccines, get them. But do remember that "evidence for consistent high-level protection is elusive for the present generation of vaccines" (and this is from a meta-analysis of over 5000 studies), so it's entirely unclear as to whether it's tilting any odds at all.
    posted by lupus_yonderboy at 10:20 AM on October 15, 2014


    Unsurprisingly, this is a difficult process to analyze, since i) randomized controlled trials are unethical and ii) without full RTPCR or immunochemical workups of everyone presenting flu-like symptoms, and accurate medical history for all of the participants, it is hard to extract data and iii) since doing these kind of trials is hard, all kinds of bias and noise can enter the data pool.

    The gold standard meta-meta reviews in this field are by Cochrane; the ones on adults is here.

    My opinion is that the effect size is large enough to warrant vaccination. Note that half-assed vaccination enterprises are dubious societally because a larger reservoir of flus that can circulate give viruses a greater chance to mutate and give deadlier outbreaks; these effects are not controlled for in the studies that everyone is mentioning. I have no idea as to what would be a sufficient vaccination level before the pool is reduced enough; I would need epidemiology and virology degrees for this; I am pretty sure that the amount of vaccination required would be "more than we do now".

    I am genuinely sorry that people have flulike symptoms for a few days after these injections - however serious* side effects are extremely rare . I have experienced them too...... but after being hospitalized , as an asthmatic, with the flu in my early 20s and almost dying, I have a vested interest in seeing that this doesn't happen to anyone. I would like to be able to quantify my paranoia for the previous paragraph too; if something like the spanish flu was to emerge from large scale recombination of existing flu pools, well, that would be a Very Bad Thing indeed.

    (*as in health threatening - I realize that for wage-earners feeling very sick to the point of not working is a serious side effect, yet another damning systemic effect of not having a sensible sick-day policy for all workers irrespective of the kind of job you have, or being able to support marginally or not-employed people when they are ill too).
    posted by lalochezia at 10:24 AM on October 15, 2014 [14 favorites]


    Also note I am unsure of how much of the "flu virus pool" is in non-human animals. Virologists please hope me!
    posted by lalochezia at 10:26 AM on October 15, 2014


    I was just walking back from lunch, near Huntington Ave in Boston, and there was a vaccine station set up right on the sidewalk. Free flu shots, for anyone who wants them. I'll get one at work next week. Really, there's no excuse to not get one.
    posted by bondcliff at 10:30 AM on October 15, 2014 [2 favorites]


    This is the first workplace I've had with free shots for you and the spouse (sadly not the kid, but probably a liability thing). It's awesome. The lady this year did it so fast I wasn't even sure she had done it at all. No pain.

    I used to be "eh" on the shots, because I didn't take flu very seriously. But then once I got a kid, it was "could not take the guilt of getting him sick/also your child WILL bring home whatever nastiness is going around at school." It seemed dumb not to get it. Maybe it's not got all the most recent flus, but if the older flus are circulating still and I haven't had them, I'm vulnerable.

    I have a non-getting-it coworker, and she says she's never gotten the flu. I say she has no kids and lives alone and so has had an easier time of dodging the bullet. Not the kind of thing you can count on forever.
    posted by emjaybee at 10:36 AM on October 15, 2014 [1 favorite]


    lalochezia:

    Great links. For the healthy adult, it seems like the chances of the vaccine preventing a full-blown case of the flu is a bit over 1% - and, so it seems to claim, the chances of an adverse reaction is basically zero. So, not nothing.

    The worrisome part is this: "Vaccination shows no appreciable effect on working days lost or hospitalisation." So it's not really clear if it would help in the case of an epidemic...
    posted by lupus_yonderboy at 10:37 AM on October 15, 2014


    Huh, this year the CDC is finally recommending intranasal vaccines for ages 2-8.
    posted by RobotVoodooPower at 10:38 AM on October 15, 2014


    This is the first workplace I've had with free shots for you and the spouse (sadly not the kid, but probably a liability thing).

    Might actually be an availability thing. My doctor only had vaccinations for children and the Safeway I got mine at only had them for adults (possibly 12 and up?)
    posted by Margalo Epps at 10:46 AM on October 15, 2014


    The worrisome part is this: "Vaccination shows no appreciable effect on working days lost or hospitalisation." So it's not really clear if it would help in the case of an epidemic...


    a) Note it's not "working days lost to flu" or "hospitalization due to flu", so the effect on flu itself is still not stated in these terms; some of the days lost may be due to those pesky but non-lethal side effects.
    b) Re: epidemic. My significant problem is with future years. What are the morbidity/sickness effects on future flu seasons of less vaccination? Seems to me another game of russian roulettte with very little downside deciding not to play.....
    posted by lalochezia at 10:48 AM on October 15, 2014


    The worst part of this for me is that I cannot receive a flu shot or other flu immunizations. For one, I've got an egg allergy that makes the standard shot impossible, and the nasal spray version is just as bad in terms of aggravating another health issue I have. So, I'm SOL and reliant on herd immunity.

    Luckily I rarely seem to get the flu each year *knock on wood* but I'm always terrified of a very bad flu season.
    posted by strixus at 10:49 AM on October 15, 2014


    The wiki article on flu vaccines suggests that once you are vaccinated against (or inoculated by exposure to, I guess?) a particular strain of the flu that you then have antibodies against it on a long term basis, which is really raising far more questions than it is answering.
    posted by poffin boffin at 10:51 AM on October 15, 2014


    really i just want to know who had live 1918 flu virus and why, presumably a CDC type organization but maybe a supervillain in a volcano lair, who even knows
    posted by poffin boffin at 10:53 AM on October 15, 2014


    fuck i am in the deepest wikihole ever

    avenge my death mefi
    posted by poffin boffin at 10:54 AM on October 15, 2014 [37 favorites]


    > The flu vaccine is tilting the house odds in your favor, which is a good thing.

    If you want flu vaccines, get them. But do remember that "evidence for consistent high-level protection is elusive for the present generation of vaccines" (and this is from a meta-analysis of over 5000 studies), so it's entirely unclear as to whether it's tilting any odds at all.


    No, a proven "consistent high-level protection" would be point-blank cheating the house. Inconsistent high-level protection, or mid-level or even low-level protection is tilting the house odds in your favor, as was described.
    posted by anonymisc at 10:58 AM on October 15, 2014 [1 favorite]


    People at work used to make fun of me because I got the flu shot religiously. They said, you're not in a high risk group. Not too old, not too young, not immuno-compromised. I said, I ride the bus to work, therefore I am immuno-compromised. Now I have a handful of auto-immune disorders and am not infrequently on prednisone, which lowers immunity, so I'm doubly sure to get the shot.

    Malcolm Gladwell had a great talk piece in the New Yorker in 2001 during the Anthrax scare. 13 years later, I still cite it constantly.
    posted by janey47 at 10:58 AM on October 15, 2014 [1 favorite]


    The wiki article on flu vaccines suggests that once you are vaccinated against (or inoculated by exposure to, I guess?) a particular strain of the flu that you then have antibodies against it on a long term basis, which is really raising far more questions than it is answering.

    It's my understanding that the whole reason that they suggest getting a flu shot each year is that that's about how fast the flu virus mutates and new strains crop up. It's not that the vaccine wears out each year, it's more like "shit, there's a new kind of flu and we have to top everyone off". But the old strains might still be out there.

    So say that one year there's strain Alpha, and they develop Vaccine Alpha. There are enough people that get Alpha Flu before the season ends, so it's still out there in the world in time for next year. But the people that got Alpha Flu won't get it, because they're immune; the people that got Alpha Vaccine won't get it either. However, Beta flu is also now out there next season, so all the people who are only immune against Alpha Flu now have to get immunized against Beta Flu. There may also be some people who felll through the cracks and could get Alpha flu still, but most people either already got it or got the vaccine last year. And then next year, Gamma Flu develops, and then you add Delta flu the year after that, and....

    Interestingly, the rapid rate of mutation is kind of behind the SuperFlu in The Stand - that flu virus just mutated WAY faster than usual, fast enough to keep ahead of the body's immune response. So it'd be like, if you get Alpha Flu, you're sick, but right when your body's starting to fight back against Alpha Flu, the Beta flu would have already started developing right in your body, so you never got better.
    posted by EmpressCallipygos at 11:02 AM on October 15, 2014 [1 favorite]


    For all of you with needle phobias: Intranasal delivery is where it's at.

    Last year my daughter (who was 1) got a shot, and I was given a nasal spray because their stocks of the needle vaccine were low. Score! I am really hoping I can get it again because me and needles are not friends. I'm so anxious about needles that the flu shot has me obsessed with the fact I got stuck and something went in my arm and it makes me queasy and I just need to lie down or something. Immediately afterwards I have to run outside and just pace around and catch my breath and get my mind off it until the adrenaline wears off. And over the next couple of days when you get that sore arm thing from it? I'm mentally right back in the doctor's office, smelling the rubbing alcohol, gritting my teeth, trying to not completely flip out and do damage.

    One time I was going to get blood work done and my doctor gave me Ativan and sent me off to the lab. That shit is crazy. I'm not a violent guy but Ativan did funny things to my survival instincts and it went from "fight or flight" to pure "fight" and I had to hold myself back from attacking when the nurse put the rubber tube around my arm and approached with the needle. It was close, I was on my feet with fists balled up before I even realized what I was doing, startled the guy enough he backed the hell out of the room. I apologized and decided I'd go back another time without Ativan. Thankfully a regular old shot is significantly easier for me than having blood taken because that is just not manageable for me.
    posted by Hoopo at 11:04 AM on October 15, 2014


    anonymisc: Please look again at the link - "consistent" does NOT mean 100% or anything like that in that meta-study. No one has ever claimed that this was true, or that less than 100% coverage meant that a flu shot was not effective.
    posted by lupus_yonderboy at 11:04 AM on October 15, 2014 [1 favorite]


    The wiki article on flu vaccines suggests that once you are vaccinated against (or inoculated by exposure to, I guess?) a particular strain of the flu that you then have antibodies against it on a long term basis, which is really raising far more questions than it is answering.

    That conclusion was reached, if I'm reading that correctly, by using samples from individuals who had contracted the 1918 flu on mice infected with 1918 flu. Which would have been great for those folks if they were exposed to that exact strain of flu and not one that was just different enough to dodge the immune system's memory.

    Which is the part I have trouble with, given point mutations tracked in virus passed through cell lines.
    posted by Slackermagee at 11:05 AM on October 15, 2014


    And lalochezia's links DO show a clear effect - basically, if 71 healthy adults get a flu shot, one of them will not get a full blown case of the flu that they would otherwise have had. That's significant, though it probably won't make me personally get a jab...
    posted by lupus_yonderboy at 11:06 AM on October 15, 2014


    lalochezia - Note that half-assed vaccination enterprises are dubious societally because a larger reservoir of flus that can circulate give viruses a greater chance to mutate and give deadlier outbreaks. ... I am pretty sure that the amount of vaccination required would be "more than we do now"

    Massively more. Important caveat: my undergrad course covered a lot of virology, but I haven't thought about flu much in >5 years.

    What you talk about -- the virus sloshing around the unvaccinated (or otherwise naïve) population and slowly evolving -- can be called "genetic drift". It's absolutely relevant, and you'd need to vaccinate a substantial portion of the planet to put a stop to it. Flu mutates pretty fast (as compared to, say, smallpox), so keeping up with the various strains whilst you're doing this would be a tough proposition.

    However, this still wouldn't be enough, because flu has huge animal reservoirs. Generally, when we talk about flu we're talking about Influenza A (B & C are rarer and generally less severe). Influenza A is endemic in birds, and occasionally jumps to pigs and other mammals. Generally, because of differences in the proteins on the surface of cells in the lungs, influenza that can infect birds can't infect humans, and vice versa. However, pigs are a fairly decent halfway house for these viruses. It's thought (with strong evidence and very plausible suggested mechanisms) that pigs act as a sort of mixing vessel for the bird and human viruses.*

    In the pigs, viruses that can infect humans but aren't causing big problems now (because we've had them before and everyone either died or developed immunity) are constantly mixed with bird viruses, which can't infect us but are totally unknown to people's immune systems. People working with the pigs (or other mammals, but I was taught that it's mostly pigs) constantly get exposed to these. Assuming the new viruses can still infect birds, people working with e.g. chickens are also at risk. Mostly they're fine: the new viruses are incapable of getting a foothold in humans before the immune system wipes it out. Very rarely, one of these new viruses can set up a decent infection in a human; rarer still, it also evolves the ability to spread efficiently between humans. Assuming that person has enough time to sneeze on a few people, that's the start of next year's new epidemic strain.

    That's a (crude) explanation of "genetic shift": big, sudden changes in the genetic makeup of flu virus, coming from the animal reservoirs. To completely wipe out flu, we'd also have to vaccinate billions of farmed and wild birds, pigs and other mammals. It's tricky.


    Last year I had it done at Boots. Can't remember exactly how much, but think it was 10 or 12 quid. This year I had my flu jab at the pharmacy in Tesco: £9.

    Nice. I got £13 (well, actually £12.99) from a page on Boots' website, and assumed it'd be representative of the going rate.

    *If you've ever seen Contagion, which has astonishingly good explanations of the relevant epidemiology and virology, this is what the final scene was about: birds, pigs and humans cooped up together in a grubby farm/marketplace. I can't remember whether they ever actually say that the pandemic is flu, but it's obvious that they were thinking about flu when they were writing it.
    posted by metaBugs at 11:18 AM on October 15, 2014 [4 favorites]


    Great links. For the healthy adult, it seems like the chances of the vaccine preventing a full-blown case of the flu is a bit over 1%

    Um, the article says (well, the abstract): "15.6% of unvaccinated participants versus 9.9% of vaccinated participants developed ILI symptoms, whilst only 2.4% and 1.1%, respectively, developed laboratory-confirmed influenza." Unless I'm misunderstanding either the quote, or you, that looks like a >50% reduction of confirmed influenza in vaccine recipients compared to the non-vaccinated population.
    posted by junco at 11:34 AM on October 15, 2014 [3 favorites]


    It's totally unfair to compare flu deaths to Ebola. If you are otherwise healthy, the flu is very unlikely to kill you. Ebola, by contrast, has a 70% mortality rate. Obviously, if you aren't in a western African country, your chance of getting Ebola is almost nil, but if Ebola were as widespread as the flu then the deaths would completely and utterly dwarf it.
    posted by desjardins at 11:34 AM on October 15, 2014


    Ebola, by contrast, has a 70% mortality rate.

    In West Africa. Of the known Ebola cases in the United States, right now, the mortality rate is 12.5%
    posted by roomthreeseventeen at 11:37 AM on October 15, 2014 [3 favorites]


    In 4 decades, I have never had the flu, at least, not the flu described above.
    My theory is, when Captain Trips comes along, I'll either be one of the first to go or on my way to Boulder.

    I did get the vaccine once, in 2009, when H1N1 made its rounds. This mainly because my daughter was about 3 months old at the time, so we lined up with everyone else at the County Health tent and got our shot.

    I am considering it again, mainly because an older relative is undergoing some respiratory related hospital treatments, so it seems to make sense not to be a carrier if if can be avoided.

    Gotta say though, the "mini flu" post-vaccine descriptions don't fill me with a lot of joy.
    posted by madajb at 11:38 AM on October 15, 2014


    In West Africa. Of the known Ebola cases in the United States, right now, the mortality rate is 12.5%.

    This is a bit... wrong. Most of the cases in the US are early. The mortality rate will rise as some of the patients who currently have it die. Or, worse, it will stay low... as more people catch it.
    posted by sonic meat machine at 11:39 AM on October 15, 2014 [1 favorite]


    Um, the article says (well, the abstract): "15.6% of unvaccinated participants versus 9.9% of vaccinated participants developed ILI symptoms, whilst only 2.4% and 1.1%, respectively, developed laboratory-confirmed influenza." Unless I'm misunderstanding either the quote, or you, that looks like a >50% reduction of confirmed influenza in vaccine recipients compared to the non-vaccinated population.

    Yes, lupus_yonderboy is misreading the stats.
    posted by Justinian at 11:39 AM on October 15, 2014 [1 favorite]


    I hope all you folks who have been "lackadaisical" about your flu vaccines in the past will use this thread as a motivating factor to stop being lackadaisical and to be, you know, a good citizen and member of the community. By getting vaccinated.
    posted by Justinian at 11:40 AM on October 15, 2014 [4 favorites]


    sonic meat machine, we just don't KNOW yet. Given that all of the remaining patients being treated were put into isolation and given help almost immediately, there's a lot of reason for hope that our statistics will be better.
    posted by roomthreeseventeen at 11:41 AM on October 15, 2014 [1 favorite]


    Well, roomthreeseventeen, I wish I were so optimistic.

    This is a derail, though. Sorry.
    posted by sonic meat machine at 11:43 AM on October 15, 2014


    Recently a family member of mine went through a long period of being immuno-compromised. And man, nothing focuses the mind on our daily miasma of deadly bugs like knowing that you could bring something home that will kill someone you love.

    My mind goes back to the Scrubs episode where they show germs being spread as a green glow transferring from person to person. If you're in a position to get the flu shot easily, anything we can do to slow it down or prevent our being carriers seems worth it.
    posted by LobsterMitten at 11:43 AM on October 15, 2014 [1 favorite]


    The current death rate outside of Africa (n = 17) is 24%. I certainly don't expect it to reach 70%, in face I think it will decrease as protocols become better developed and enforced, but in any case, it's still a much much much higher death rate than the flu, which was my original point.
    posted by desjardins at 11:44 AM on October 15, 2014 [1 favorite]


    I work for a hospital and the last few years the vaccination has steadily gone from voluntary to encouraged to mandatory for certain employees and highly encouraged for the rest. We have to wear a color coded badge buddy during flu season that immediately identifies whether you got the shot or if you waived it (upon which you are this year subject to filling out more forms than ever before). Those with the waiver badge buddy are required to wear a mask any time they set foot in the hospital proper. The hassle involved basically means the only folks who do waive are those who are anti-vaccination.

    Since I started receiving the shot a few years ago I haven't had a fever since. Sinus colds, sure, but nothing north of 99 degrees. Having lived a life where I typically had a fever once a year from colds and the flu, I kick myself for going so long without the shot.
    posted by linux at 11:48 AM on October 15, 2014


    Sorry for the derail, but I believe that the issue with the people who have been infected because of Mr. Duncan may be because Presbyterian workers wore no CDC-guideline hazmat suits for two days while treating the Ebola patient. They were wearing regular scrubs.
    posted by roomthreeseventeen at 11:49 AM on October 15, 2014 [3 favorites]


    Gotta say though, the "mini flu" post-vaccine descriptions don't fill me with a lot of joy.

    I should probably clarify and say that you are supposed to have an immune response to the flu shot, that's the whole point. If I didn't have a specific incident to associate it with, I'd probably just think I was tired and should take a nap. It is not that severe. Get the shot.
    posted by charlie don't surf at 11:51 AM on October 15, 2014 [3 favorites]


    It is not that severe.

    For you.</baneposting>
    posted by adipocere at 11:53 AM on October 15, 2014


    you lost me at the title.

    i am not anti-vax, or anti-science. my undergraduate degree was in chemistry, and i support the standard childhood vaccines, diphtheria/pertussis/tetanus, etc. i am 59, and i haven't had a flu shot in almost 50 years. i get a cold about once every two years, and it's over in two days. part of the problem, as i see it, is the language of medicine. i've run into some doctors who spoke like arrogant demigods (not entirely without justification, lawyers do it too).

    "we could use a few pointers on prudence"

    just to address me in this fashion is insulting. it posits the existence of some more-prudent entity who is lumping us all together as imprudent. such a statement ought rightfully to have a name signed to it, a name less opaque than "roomthreeseventeen".

    317, i'm not teeing off on you. i know that people who post fpp's frequently summarize the views of the actors on which they're reporting, without necessarily subscribing to those views, in their titles, so you're still good, but this is not the way to talk to people like me. i'm as prudent as i need to be, and excessive prudence is not a virtue. i'm not afraid of the flu, i know that i will eventually die of something, and the something that concerns me the most is other drivers on the road; we need a vaccine for that.

    the palm d'or for orwellian speech in this thread goes to user entropone (7:49) for "fewer people think about freedom to collectively determine and improve our health." i saw what you did there, it made me grin, but it is not a nice grin.

    i have trust issues, so if you want me to do something, you have to be more respectful than this.
    posted by bruce at 11:53 AM on October 15, 2014 [3 favorites]


    i'm as prudent as i need to be, and excessive prudence is not a virtue.

    Well, okay, but the point is not just you getting the flu. The point is that you could carry it, be non-symptomatic, and give it to someone who will get very sick.
    posted by roomthreeseventeen at 11:56 AM on October 15, 2014 [15 favorites]


    I'm an equal opportunity worrier. I worry about the flu and I worry about Ebola. I get my flu shot annually. I wash my hands, sneeze into my elbow, and get every cold variant available every winter. I've had the flu, and it's scary because I usually live alone. I stock up on gingerale and chicken soup, just in case. Not only am I willing to get a flu shot, I am delighted, thankful, to have the opportunity. Every year I get to develop some immunity to some of the strains of influenza. I got a swine flu shot when it was a thing, and I think it helped me survive the swine flu outbreak. Where's common cold vax?

    In West Africa. Of the known Ebola cases in the United States, right now, the mortality rate is 12.5%. Several of those patients got ZMaxx, which is not currently available, and takes time to produce. I truly hope the health care workers in Dallas survive with what I hope will be excellent care.
    posted by theora55 at 11:57 AM on October 15, 2014 [2 favorites]


    so you're still good, but this is not the way to talk to people like me.

    Was the post sending secret messages addressing you personally in some fashion? this is such a weird, personal response.
    posted by empath at 11:59 AM on October 15, 2014 [16 favorites]


    just to address me in this fashion is insulting. it posits the existence of some more-prudent entity who is lumping us all together as imprudent. such a statement ought rightfully to have a name signed to it, a name less opaque than "roomthreeseventeen".

    "We could use a few pointers on prudence" is the second line of the first link in the FPP, not something that roomthreeseventeen said to editorialize, and it absolutely fits the context.
    posted by troika at 12:00 PM on October 15, 2014 [6 favorites]


    I have had the flu shot every year for the past five or six, including just two weeks ago so my memory is fresh. I've never had more reaction than a slightly sore arm that goes away in less than 24 hours. (The soreness. Not the arm.) I certainly believe people who say they have a bigger reaction, but a big reaction is not inevitable.

    I suspect I would survive the flu. I suspect many of the people I interact with on a daily basis -- on public transit, at the supermarket, at the gas station, at work -- may not, or they may have people in their lives who would be enormously affected if I passed the flu to them and they passed the flu to those people. It's not just about one's own immune system or health status.
    posted by jaguar at 12:01 PM on October 15, 2014 [2 favorites]


    I have no major reaction to the flu vaccine, but a horrible sick response that lasts 2 days to the tetanus booster.
    posted by jeather at 12:08 PM on October 15, 2014


    > Um, the article says (well, the abstract):

    > Yes, lupus_yonderboy is misreading the stats.

    "Um", I'm reading the line from that very document that says, "71 people would need vaccination to prevent one case of influenza" so about 1.4%.

    This is quite compatible with the numbers quoted elsewhere in the same document... particularly if you realize that "ILI" does NOT mean getting a full-blown case of the flu.

    There are many numbers here - what are the chances of getting the flu? What are my chances of getting "flu-like symptoms"? There are two different types of vaccine - how does taking either of those affect the chance of getting the flu or ILI? And there are multiple populations...

    My question of this paper was: "if I take the vaccine that's most likely for me to get, what are the chances that I personally won't get a full-blown case of the flu" - and that line seems to imply the result is 1.4% for an "average person". If you have some other interpretation, lay it on me.

    1.4% is not nothing, nor did I imply it is. What would you pay to avoid a 1.4% chance of being shot with a gun?

    Most people won't get the flu either way. 1.4% is significant, particularly considering how nasty the flu is. I probably am not going to do it, because my record not getting the flu is good, and because there's zero evidence that I am somehow "leaching off group immunity" if I do so.

    > be, you know, a good citizen and member of the community. By getting vaccinated.

    Spare me your moralization. There is no evidence the claim my getting a flu shot protects anyone else, and lots of evidence to the contrary. As was argued above, flu is always endemic in humans, but also in animals, and the flu shot cannot possibly push the levels down to the level where individual defectors would have the slightest effect on others. Do remember that flu shots are much rarer in Europe, and yet there's no evidence that flu rates are substantially different from those in the US, nor that the wide-spread introduction of flu shots to the US has changed the relative rates between the US and everywhere else.

    If you aren't vaccinated for, say, measles or mumps, this is bad for society. But you are free to choose personally whether to get flu shots or not, and you should make that choice based on whether you personally want to avoid a small chance of great misery, not because it will make you a good citizen.
    posted by lupus_yonderboy at 12:14 PM on October 15, 2014 [6 favorites]


    empath, all my comments are personal, because they were written by a person. "weird" seems to be a go-to epithet of disparagement on metafilter, so i will accept it stoically, having been called "weird" on one occasion privately by no less than user #1. your suggestion that i am hearing "secret messages" results in me dismissing your public health-oriented concerns with prejudice.

    317's response is valid, yes, i could be an asymptomatic carrier, and if addressed politely, i would do my public-spirited best to mitigate this risk. i will not be hectored into anything.
    posted by bruce at 12:15 PM on October 15, 2014 [1 favorite]


    For what it's worth I, also, think it's weird that the standard you're planting here seems to be basically just making sure we all know you're willing to live in a society, but only if you're asked nicely.
    posted by superfluousm at 12:24 PM on October 15, 2014 [19 favorites]


    I should probably clarify and say that you are supposed to have an immune response to the flu shot, that's the whole point. If I didn't have a specific incident to associate it with, I'd probably just think I was tired and should take a nap. It is not that severe. Get the shot.

    Yeah, I'll probably try to do it on a Friday, just in case I get an adverse reaction.
    posted by madajb at 12:26 PM on October 15, 2014


    Cite for roomthreeseventeen's comment. Sounds like Texas Health Presbyterian Hospital was really unprepared.
    posted by theora55 at 12:28 PM on October 15, 2014


    yes, i could be an asymptomatic carrier, and if addressed politely, i would do my public-spirited best to mitigate this risk.

    Pretty please, with sugar on top, go get a flu shot.
    posted by bondcliff at 12:28 PM on October 15, 2014 [15 favorites]


    So the choice is this:

    Be achy and maybe feverish for a few days

    OR

    Murder people because you don't want to be bothered being a decent citizen

    You can dress that up and make excuses, but I (personally) am not buying it.

    If you've never seen someone drowning in fluid in their own lungs you can pontificate all you want about how much of a PITA it is to get vaccinated for a completely preventable illness. People like me will still judge you and wish that you spent 15 minutes actually educating yourself.

    I sound really harsh and rude, but, for god's sake if you don't believe in science, alright, however trying to explain/make shit up about that is just ridiculous. Human comprehension is relative and nothing is absolute, but dying from something that can be cultured is pretty firm.

    Is your life more important than someone else's you could infect inadvertently? If you think so you need to rethink your life choices.
    posted by syncope at 12:35 PM on October 15, 2014 [7 favorites]


    thank you bondcliff, i will consider it, but i don't think i'm an asymptomatic carrier. if i were, an analogue to typhoid mary, it would stand to reason that i would have left a trail of sickness and occasionally death behind me in my day-to-day interactions. to my knowledge, nobody, from tiny babies to ancient oldsters, has ever gotten sick from talking to me.

    again, the language of medicine. it needs to be changed to assure 100% compliance, and i don't have a sure-fire prescription (heh) right now.
    posted by bruce at 12:38 PM on October 15, 2014


    Now, now, you said you'd do your best if asked politely. No takesies-backsies.
    posted by bondcliff at 12:44 PM on October 15, 2014 [15 favorites]


    Granted my "research" has been hasty and short as I'm on a limited lunch break, but so far (I found discussions about 3 separate studies) there seems to be very limited evidence of a significant amount of people getting flu from asymptomatic carriers.
    posted by Greg_Ace at 12:45 PM on October 15, 2014


    Let's think about that prudence discussed in the fine article. Would it be prudent to ask nicely? Yup.

    Why do we have just the one basic formulation? We have a variety of anti-depressants, an array of birth control pills, and so forth. Somehow, I think there's room for a milder form of the vaccine. Wouldn't it be prudent to have more than one? Yup.

    Would using "murder people" language be prudent? Nope.

    Seriously, as soon as people start using weird scare language as an attempt to wave some kind of boogeyman to influence me, my suspicious ratchets up a couple of notches.

    Murder people. Really.
    posted by adipocere at 12:46 PM on October 15, 2014 [5 favorites]


    I'm getting my flu shot today at a free clinic put on by my city's school district (I throw in that detail to encourage people to see if their schools are doing the same thing). Here's the question: which arm should I get it in?

    I used to always get it in my left arm because I'm right-handed, but two years ago the nurse suggested getting it in my right arm because I'd work the muscle more and the soreness would go away faster. Thoughts?
    posted by The corpse in the library at 12:46 PM on October 15, 2014


    I did my left arm, since I do everything (include sleep on) my right arm.
    posted by roomthreeseventeen at 12:48 PM on October 15, 2014


    to my knowledge, nobody, from tiny babies to ancient oldsters, has ever gotten sick from talking to me.

    To your knowledge! Do you also know how many people you've given colds to? I don't know how many I have, but I'm sure it's quite a number.

    Also, what happened yesterday doesn't dictate what will happen tomorrow. That's also the mistake people are making when they say "Well, I've never gotten the flu before," as though that means they never will.

    Anyway, I won't continue to derail the thread, but I hope you don't just close your ears to the arguments in favor of the vaccine that have been made here just because people use strong language when talking about our collective responsibility to do right by the immuno-compromised.
    posted by superfluousm at 12:54 PM on October 15, 2014 [7 favorites]


    ... a milder form of the vaccine ... It's already dead (if you're getting the injectable form), not sure how you get milder than that. Cover only one strain maybe? I don't get it.
    posted by achrise at 12:57 PM on October 15, 2014


    thank you bondcliff, i will consider it, but i don't think i'm an asymptomatic carrier. if i were, an analogue to typhoid mary, it would stand to reason that i would have left a trail of sickness and occasionally death behind me in my day-to-day interactions. to my knowledge, nobody, from tiny babies to ancient oldsters, has ever gotten sick from talking to me.

    You've personally asked each single individual with whom you've been in the same room on each and every day of your past 50 years?

    That's actually quite impressive. How did you track down the people you shared a bus with briefly?
    posted by EmpressCallipygos at 12:58 PM on October 15, 2014 [3 favorites]


    achrise: Options would include a reduction in dose or preparing it without adjuvants. It's not rocket science.
    posted by adipocere at 12:59 PM on October 15, 2014


    I sound really harsh and rude

    it is true you are history's greatest monster
    posted by poffin boffin at 1:00 PM on October 15, 2014 [1 favorite]


    As a female I don't respond well to people telling me to police my language.

    I understand what you're trying to say, however, as a healthcare professional I think that while we all get to make our choices for our own bodies that we can educate ourselves to make the best choices for ourselves as well as everyone we come into contact with.

    The simple fact is that the current science points to the fact that people declining vaccinations hurts/harms the least well among us. If you pass on a preventable disease out of willfulness or misguideness that lead to death, what would you call that?

    Sometimes being frank is the only way to get through. You seem to have already made up your mind, so don't focus on me and my way of expressing my personal opinion which is backed up by evidence.
    posted by syncope at 1:03 PM on October 15, 2014 [4 favorites]


    lol@bondcliff, one of the smarter people here who has actually made me consider getting a flu shot. the opportunity would have to present itself squarely in front of me, which occasionally happens when i go into a supermarket and there are nurses outside doing it. sometimes i act on these opportunities, like i did 14 months ago when animal shelter volunteers were outside the supermarket exhibiting kittens.

    then there's syncope. "murder people because you don't want to be bothered being a decent citizen." this rhetoric is extremely offputting, it appeals to my contrarian side which wants to know, what is the metric for being a decent citizen, am i a decent citizen, and if not, do i want to fulfill an unknown metric? "is your life more important than someone else's you could infect inadvertently?" syncope, in an alternate universe we are sharing a small desert island for about a month before rescue, and one of us has to kill and eat the other to survive, and if only you were my friend, and i cared for you, i would pursue a collective solution, but in that specific alternate universe, you wouldn't be making any more comments on its metafilter after the episode i described.
    posted by bruce at 1:05 PM on October 15, 2014 [1 favorite]


    she would 100% murder you for jerky.
    posted by poffin boffin at 1:06 PM on October 15, 2014 [1 favorite]


    OR

    Murder people because you don't want to be bothered being a decent citizen



    Wow, you just called people who don't get the flu shot murderers. That's something, right there.
    posted by Hoopo at 1:14 PM on October 15, 2014 [7 favorites]


    I used to always get it in my left arm because I'm right-handed, but two years ago the nurse suggested getting it in my right arm because I'd work the muscle more and the soreness would go away faster. Thoughts?

    I got mine in my right arm this time (because the nurse was standing on that side of me, not due to any forethought). I worked for a few hours afterward then went to the gym, and this year the muscle soreness went away much more quickly than normal. So I think it's not a bad theory.
    posted by jaguar at 1:27 PM on October 15, 2014 [2 favorites]


    I have a Facebook friend who recently posted her theory that vaccinations have caused the enterovirus to spread, and about a dozen other non-vaccinating parents seem to be engaged in a discussion about why that's plausible. I'm having to exercise extreme constraint every time her name pops up in my Friends feed.
    posted by jaguar at 1:31 PM on October 15, 2014


    [Folks maybe just chill a little in general please.]
    posted by cortex (staff) at 1:32 PM on October 15, 2014


    lol@bondcliff, one of the smarter people here

    See, now you've gone and convinced me that you just don't understand the concept of evidence.

    Still though, I hope you get the flu shot. I used to be one of those "feh" people too until I realized there was really no downside to it and a shit-ton of upsides, for me and the rest of the human race.
    posted by bondcliff at 1:33 PM on October 15, 2014 [5 favorites]


    sometimes i act on these opportunities, like i did 14 months ago when animal shelter volunteers were outside the supermarket exhibiting kittens.

    This is a great idea! I bet a lot more people would get flu shots if they could pet kittens while doing so.
    posted by desjardins at 1:41 PM on October 15, 2014 [12 favorites]


    you could convince me to murder immediate members of my family if you held out a wriggly chubby kitten for me to pet
    posted by Kitteh at 1:45 PM on October 15, 2014 [5 favorites]


    She'd have to hold it out, because you'd need to leave one hand free for all the stabbing of family members.
    posted by The corpse in the library at 1:47 PM on October 15, 2014 [6 favorites]


    there was really no downside to it

    Except people have mentioned lots of downsides to it (well, mostly one: they get sick, with further results from that). I'm not saying it isn't worth it, but pretending it's all upside doesn't help.

    you could convince me to murder immediate members of my family if you held out a wriggly chubby kitten for me to pet

    For some family members, I don't even need the kittens.
    posted by jeather at 1:58 PM on October 15, 2014 [5 favorites]


    Ebola, by contrast, has a 70% mortality rate.


    Isn't that rate based on those who show symptoms rather than those who are infected?
    posted by waving at 1:59 PM on October 15, 2014


    Isn't that rate based on those who show symptoms rather than those who are infected?

    As far as anyone knows, everyone who is infected will show symptoms. It would be hugely more terrifying if that were not true.
    posted by empath at 2:57 PM on October 15, 2014 [4 favorites]


    Vaccines, yes! I'm all for them! Got my flu shot just last week, easy peasy, a little sore afterward, a little achy. It's all good.

    My daughter was nine in 2009 and we were in London for most of the summer. Came home in August and school started a few days later. The school was offering the H1N1 vaccine and so both kids got it. She came down with H1N1 the next day, so it turns out the vaccine was too late. She had never been that sick before and has never been that sick since. She was hospitalized and I was out of my mind with terror that this stupid, stupid flu was going to take my sweet girl from us. And then I had the guilt: we were in London during the damned outbreak!

    Anyway. So she's fine now, but had a cough that lingered for years. Literally years. Scar tissue on her lungs, too. She has been diagnosed with asthma, which runs in the family but she had never, ever had even the tiniest of symptoms before H1N1. So is that an after effect? I don't know, the doctors don't know. All I know is that for all our hand washing, and being careful to not touch our faces, and eating right and exercising...we almost lost her. If a vaccine can reduce that chance again, even by the smallest percentage, I'm getting the fucking vaccine, and so is the entire family.

    Sidenote: I started a new job in January of this year, as an administrator in a preschool. Three weeks in, I came down with pneumonia severe enough to land me in the hospital for three days (with seven different antibiotics!). If I had waited another day to go to the ER, the doctors said I might have been too far gone. One of my husband's co-workers lost a family member to pneumonia around the same time. There just wasn't anything they could do for him by the time he went to the hospital. I don't even have direct contact with the children, and yet I got sick. Parents send their sick kids in to school all the god dammed time and there's not a thing I can do about it...except wash my hands, try not to touch my face, and get vaccinated (I will be getting the pneumonia vaccine this year and boosters when I need them).

    Yeah, we're all going to die of something, but I sleep a little better at night knowing that I've done SOMETHING to stay around for a little while longer.
    posted by cooker girl at 3:12 PM on October 15, 2014 [10 favorites]


    I don't want to get my flu shot this year... I don't know why. I don't get the post vaccine malaise (or at least haven't yet), just the sore arm for a week. I've gotten my flu shot religiously since the flu of '06, which was the worstest thing ever. I used to get the right and proper flu every couple years too, and oh my god the horror. So I can't explain why I don't want to get it this year.

    Maybe because I always get the fucking stomach flu. Every year, like clockwork. I know they're different things, and yet it feels so unfair that I make a good faith effort to avoid getting sick and norovirus decides to take a shot anyway. I suppose it's better than getting both, but fuck me, I don't like it.

    Which means I'll probably just suck it up and go tonight or tomorrow. But do I have too? (Yes I do.)
    posted by [insert clever name here] at 4:01 PM on October 15, 2014


    Also, whenever people tell me they had the flu and "it wasn't such a big deal" it's fairly certain they didn't have the flu. Proving influenza requires an fairly painful and difficult to perform test,

    What's the test? A trachea swab?

    For some family members, I don't even need the kittens.

    It occurs to me we could improve vaccine coverage with cats: "Get the shot, you don't want your kitties at home to get sick!"
    posted by sebastienbailard at 6:14 PM on October 15, 2014


    sobarel:
    The NHS flu shot this year apparently includes:

    H1N1 – the strain of flu that caused the swine flu pandemic in 2009
    H3N2 – a strain of flu that can infect birds and mammals and was active in 2011
    B/Massachusetts/2 – a strain of flu that was active in 2012
    and a fourth strain is included in the nasal spray vaccine given to young children.
    I get the flu shot every year. Of course, I also got Swine Flu in 2009 and what my doc guesses was H3N2 last year -- but which he didn't specifically test because he chased me out of the office! I spent a week in a sleeping bag watching "Roadkill" episodes and whimpering.

    Also: The first time you get the flu you immediately realise that every time you suspected it before it had just been a bit of a cold!

    Oh, God, yes, this. *whimper*
    posted by wenestvedt at 6:42 PM on October 15, 2014 [1 favorite]


    Also, I work at a college in New England and we go through the flu shot line on Staff Appreciation Day after we drop off our raffle ticket but before we get our Free Thing Of the Year.

    (This year it was a handsome fleece jacket -- and so of course it's been in the 60s and 70s ever since!)
    posted by wenestvedt at 6:53 PM on October 15, 2014


    I am not especially pro or anti flu shot, I get it most years, but I'm surprised Tamiflu, and the fraudulent efforts by pharmaceutical companies to promote it, had not been brought up. It's not a vaccine no, but I think it clearly demonstrates that Roche and others are very happy to market a product that they know doesn't really work under the guise of public health. I am not saying this is the case with flu vaccines, but rather, that these companies aggressively sell them to doctors, govts, and large organisations with no regard to efficacy. So questions are warranted, and turning it into a morality play does a disservice to everyone
    posted by smoke at 7:30 PM on October 15, 2014 [1 favorite]


    > If you've never seen someone drowning in fluid in their own lungs you can pontificate all you want about how much of a PITA it is to get vaccinated for a completely preventable illness.

    It's one thing to have a rational argument on this subject. It's quite another when people simply make up shit about people not being vaccinated for the flu causing "others to drown in fluid in their own lungs".

    What you are saying is simply not factual. Immunity to the flu would have to be far, far higher than it is before an individual not getting vaccinated would possibly have the slightest effect on the remaining population.

    I could go through the math with you, if don't believe me - or you could simply look at Europe, where almost no one gets vaccinated for the flu.

    This form of argument - and the math - are perfectly applicable to diseases like mumps, measles, polio and the like, where the immunity in the population at large is very high, well over 90%, and there are no other vectors to spread the disease. There, even one person not getting immunized can result in major havoc.

    But even with the prevalence of flu shots, immunity to the flu is less than 50% AND birds and pigs provide a completely separate vector for these diseases.

    I'm sorry if I sound grumpy - but what's the point of having a rational argument with people who simply make shit up?
    posted by lupus_yonderboy at 8:24 PM on October 15, 2014


    The cochrane summaries report on efficacy of flu vaccination is here.
    I don't fully understand it all, so I'd love the take of someone with a science/medical background.

    Re tamiflu controversy: I know at least one evidence based medicine advocate in my area argues that the local health region is making claims they cannot substantiate about the efficacy of the flu vaccine.

    I am not an antivaxer -- my kid has all of his standard vaccines and we parents have ours. However, I am conscious of the fact that Canadian drug advertising regulations do not extend to vaccines, so they can be advertised in a way no other drug in Canada can be advertised.
    posted by chapps at 8:34 PM on October 15, 2014 [1 favorite]


    Similar article to the OP with an emphasis on the media: Ebola vs. Flu
    posted by homunculus at 8:49 PM on October 15, 2014


    I've had my flu vaccination for the year because even though I think it's efficacy against whatever season's flu strain is in some question, having the flu is for sure much worse than the inconvenience and suffering of getting vaccinated.

    That said, I am quite tired of comparisons of the flu to Ebola. The two viruses are not comparable in terms of their effect on otherwise healthy people nor are they comparable in terms of their epidemiology. Comparing influenza deaths and Ebola deaths in terms of raw numbers (as done upthread) has no statistical significance at all.

    Finally, to date there have been fewer than a dozen Ebola infections outside African nations, let alone the US. No statistically meaningful mortality rate can be gleaned from so small a population. Saying things like "the mortality rate for Ebola in the US is currently 12.4%" is pure, unbridled innumeracy.
    posted by mistersquid at 8:52 PM on October 15, 2014 [2 favorites]


    chapps: "The cochrane summaries report on efficacy of flu vaccination is here."

    NNT of between 40 and 70 is good by preventative medicine standards.

    Basic reality--based lack of any of the boogieman outcomes posited by the antivax/anecdata crowd is reassuring.

    I've seen people die right in front of me from flu complications so when I hear people dismiss the need to get a basically harmless shot that could save their own or someone else's life, well, that saddens me.

    I think in the background, one thing that makes flu palatable, is that most of the people who usually die from it are quite old. And as a society, we assume old people must die. There's some undercurrent running there, some buried assumptions of how things are supposed to work. Which is why when a novel immunogenic flu strain comes along that results in *young* people drowning in their own secretions then everyone gets a lot more upset. Because *young* people dying is an abomination, whereas old people dying feels for many people on a gut level like something long expected.
    posted by meehawl at 9:00 PM on October 15, 2014 [3 favorites]


    My grandfather died from the flu. He was only in his 60's.

    I get the flu shot. I wish more people who are able to get vaccinated would do so. Mostly I get it because I work with a bunch of people who get sick but still come to work... the place already sounds like a tuberculosis ward, and last year's cold/flu season was just brutal.
    posted by palomar at 9:12 PM on October 15, 2014 [2 favorites]


    Thanks meehawl.

    I know one thing Alan Cassels (my linked article) has been advocating for is better data collection regarding flu vaccine in BC. We have excellent data in BC but apparemtly flu vaccination is not tracked like prescription meds because... Well it isn't prescription meds, I guess. But BC has on of the highest flu vaccination rates in Canada, so cod be an excellent data source.
    posted by chapps at 10:22 PM on October 15, 2014




    To clear up a bit of miscommunication that was my fault: transmission from animals to humans is very rare. They're the source of new epidemic/pandemic strains (a rare event), but aren't really a factor in transmission within or between human populations. You need long-term, close interaction with infected animals that very few people in the West have, plus a decent dollop of bad luck. I'd cheerfully bet this month's rent that no-one in this thread even knows anyone who got flu from an animal.*

    I was trying to make the point that, even if you could eradicate flu from the human population, it'd come back in a year or two when a new strain made the jump from birds/pigs. But it seems that was a distraction from the conversation; sorry about that.

    It's worth bearing in mind that while it's hard to make a difference at a population level, successful vaccination of key people can make a difference to sub-populations. The tiniest sub-population I can think of is my grandparents: they don't get out much, so successful vaccination of a handful of family members could basically ensure that they're never exposed. That's kind of a reductio ad absurdum, but it's not hard to imagine that there are specific groups that benefit from healthy people getting vaccinated, who're lost in the noise of population-level surveillance programmes. I'm not enough of an epidemiologist to do the risk/benefit analyses for that, though.

    *As you'd imagine, part of the reason I'm happy to bet this is that there's no way that any of us could reasonably test it, without a mol biol lab and more time staring at flu genome sequence data than I care for.
    posted by metaBugs at 2:51 AM on October 16, 2014 [3 favorites]


    I could go through the math with you, if don't believe me - or you could simply look at Europe, where almost no one gets vaccinated for the flu.

    Sorry, what? There was a queue behind me to get the flu jab last week. Here's the figures for partway through last year's UK vaccination program.
    posted by Wordshore at 4:33 AM on October 16, 2014 [1 favorite]


    As far as anyone knows, everyone who is infected will show symptoms. It would be hugely more terrifying if that were not true.

    Yes, it would be, but most infections have asymptomatic carriers.
    posted by waving at 6:24 AM on October 16, 2014 [1 favorite]


    > Here's the figures for partway through last year's UK vaccination program.

    Those figures are only for the following groups:
    • 43.6% in under 65 years in a clinical risk group
    • 34.0% in all pregnant women
    • 67.0% in 65+ year olds
    • 34.1% in all 2 year olds
    • 30.6% in all 3 year olds
    So the targeted groups are the chronically ill, the elderly, pregnant women, and toddlers. That's pretty small compared to the US where the targeted group is “everyone 6 months of age and older.”

    One study found the flu vaccination rate to be less than 25% of the entire UK population, in two consecutive years (from 2002–2004; I haven't seen equivalent data for more recent years). Compare that to the article linked above complaining that “only” 46% of the entire US population was vaccinated last year.

    (Looking at data from other European nations, “almost no one” is an exaggeration, but overall coverage is generally about half of the US rate.)
    posted by mbrubeck at 9:35 AM on October 16, 2014


    In sad news, our pediatrician doesn't have the flu shot for youngsters in stock, so our 2-year old is going to have to wait until November (?!) for his shot. Sadly, you can't just take a kid that young to a pharmacy; they generally only do 12 and up.
    posted by ThePinkSuperhero at 10:21 AM on October 16, 2014


    Am I the only weirdo that loves getting their flu vaccine?

    No! At MIT, they have this incredible and sort of amusing assembly-line process set up where you get handed from one person to the next in a really hilariously efficient way (playing in my head: that Looney Tunes Raymond Scott music), so they get thousands of people through the enormous line in a relatively short time. It was very well engineered, in a way that you might expect MIT to do something. In fact, I am such a weirdo about COMMUNITY-MINDEDNESS and I kind of enjoyed the factory line so much that I showed up very early this year and they let me in early and I avoided the line entirely.

    And I got a bottle of cranberry juice this year.
    posted by theredpen at 9:45 AM on October 17, 2014


    Here's an idea of what the flu is like. Imagine if you had a kid who got sick - and I mean scary sick... but because you are their parents, you still are taking care of them. Now, they don't get sick enough quite to go to the hospital, but - sick enough that you consider it once or twice. More importantly, they are sick enough for both parents to need to take care of them... personal days all around. A few days or so later they start to recover... and suddenly both you and your wife feel like 'uh-oh'.

    And so you call your mother in law 3 hours a way to come and pick up your child while you and your wife convulse on the floor for three days having very lame contests to figure out questions such as 'who is going to the pharmacy?', 'who will open the door for the dog?' and 'who can make it to a different room faster? (fast being 15-20 minutes to crawl 15 feet)'
    posted by Nanukthedog at 10:55 PM on October 18, 2014 [2 favorites]


    I find if I don't swing/move my arm at all for a few hours after the shot, I don't get a sore arm.
    It's the motion essentially causing bruising from the wound.

    So, I might look a bit stupid, but I often pull my arm up sling-style,
    pop my jacket loose to have my elbow wedged in an armhole to keep it immobile, or similarly restrict it using the strap of a bag. Tada!
    No sore arm.


    And yeah - I've had a really BAD flu once or twice. Too sick and feverish to crawl out of bed and tell my housemates I was sick. Luckily there was a water bottle next to my bed, which I managed to get to with the strength of - "I'll end up in hospital or dead otherwise".

    Still, swine flu was luckily only a bit worse than a cold. Contagious as heck though.
    4 out of 5 housemates caught it, by 4 different vectors (they'd been tested and confirmed).
    posted by Elysum at 4:31 PM on October 19, 2014


    I find if I don't swing/move my arm at all for a few hours after the shot, I don't get a sore arm.

    Interesting; that's the opposite of what the nurse told me to do, this year, so I walked out swinging my arm in big circles. I had no pain at all, no stiffness or soreness. I don't know if it was the movement or if I had a particularly good nurse or just dumb luck.
    posted by The corpse in the library at 4:41 PM on October 19, 2014


    So I was a big girl and got my flu shot Friday night!

    I had some muscle achiness Saturday and was pretty fatigued for the last two days, but i was functional. So it wasn't that bad (plus I got to see the back room of my local Walgreens which was funky).

    This "it wasn't that bad" observation is not meant to belittle the claims that it is bad for some. I lucked out. But for those of you who, like me, are kinda wimps about the whole thing, it may not be that bad after all, and if you work regular office hours, get it Friday so then even if you get flulike after effects you can just chill at home on weekend days anyway.
    posted by EmpressCallipygos at 8:12 PM on October 19, 2014


    Quick, we need someone to get an injection in EACH arm, to test our competing theories. Volunteers?

    (And, hmmm, shaking my arm out is what I used to do, but ow, achy arm for a day or two? I generally can't leave achy things alone. Competence at injections is definitely part of it)
    posted by Elysum at 9:48 PM on October 19, 2014


    Got my shot on Friday - no malaise, no fever - felt like someone punched me in the arm for a few hours. Done.

    Also, Kaiser Permanente is genius at preventive medicine. I don't think I was parked all of 10 minutes.
    posted by Sophie1 at 1:17 PM on October 20, 2014


    Interesting article in the BMJ today from Margaret McCartney - very much the doyenne of evidence-based medicine - in which she argues that the best data we have doesn't justify mass flu vaccination programs. As with an alarmingly high number of interventions the message seems to be "higher quality trials are desperately needed"...
    posted by sobarel at 2:02 PM on October 20, 2014 [1 favorite]




    I think I've figured it out - I used to get an overly sore arm from blood tests as well.
    When giving blood etc, obviously don't move the arm at all, as that causes bruising or bleeding.

    For flu shots, you instead have something being injected into the muscle, and shaking it may distribute the fluid better?

    So, I've been doing the same thing for flu shots as for blood tests, despite the different mechanism, but, possibly for me, the pain is more from bruising or something, and keeping my arm relaxed and still definitely hasn't made it worse.
    posted by Elysum at 9:43 PM on November 8, 2014


    I'm a very pro vaccination person in general but I honestly don't see the point in getting a flu vaccine if you aren't at risk. It doesn't even seem to be particularly effective at preventing flu and doesn't really provide herd immunity.
    posted by empath at 11:37 AM on November 9, 2014


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