Follow Up
My recent article, “Why I’m Not Getting A Flu Shot,” brought the most interest and response of any piece on the website. This follow up article is in response to many of your comments.
There are obviously many concerned people when it comes to the topic of the flu, but unfortunately, anxiety is still too common. One just has to watch or read the media headlines – much of it hype. There are a few good, balanced articles out there, such as the one I referenced from the Atlantic magazine.
A number of people referred to the notion that the flu attacks healthy people more than any group. This is not true. The Center’s for Disease Control (CDC) says that more than half of the people who get sick are elderly with existing medical conditions, while the so-called “healthy” age group (18-49) account for only 7% of the cases.
While I mentioned young children having immune systems not yet fully developed, I was certainly not inferring they should all be vaccinated. Children have significant immunity against many diseases. They develop “passive immunity” before birth, obtaining important antibodies from the mother, and again through breastfeeding.
There are still some who believe everyone should be vaccinated. This notion, of course, is probably not supported by any health care professional or scientist. In fact, the CDC says that some people should not be vaccinated. They include people allergic to chicken eggs (the virus is grown in eggs), people who previously had a severe reaction to the vaccine (especially those who developed Guillian-Barré syndrome), children under six months of age, and people with fever associated with other illness. Most importantly, there are not enough doses of vaccine available for everyone, so those rushing to get the vaccine who may not be at high risk are taking the vaccine from those who may need it most. This information comes from Dr. Coralee Thompson, and her response follows this article.
A problem often not discussed is about spreading the flu. For example, while only 34% of health care workers get a flu shot, over 70% go to work when they have the flu. Instead of forcing health care workers to get the shot, they should not be allowed to work when sick. I discussed other ways to reduce the spread of the flu in my first article. Thank you for reminding me of one I left out: avoid physical contact with people whenever possible – in fact, stay a few feet away from them as you wander through stores and malls and other crowed areas.
On the other extreme of those who believe everyone should be vaccinated, some readers sent me extreme examples of how bad the flu shot can be (YouTube is full of that stuff), or that the whole thing is a government scam. The truth is somewhere in between, but each of us must make our own decision – and it should not be based on hysteria, nor should anyone be forced to be vaccinated.
I left out another issue from my first article. This has to do with the brain, and the mind within it. In there resides some powerful factors such as the placebo effect, our belief systems and issues not well understood but ones that can have significant effects on our immune system and overall health. This is another reason to avoid the media as a source of health care information.
Many people seem to be on one side of the flu shot issue or the other, with the example of a vaccine’s effectiveness being a concern. While the CDC can count the numbers – those who don’t get sick and had the shot versus those who got sick without the shot – it’s not the proper way to do objective research. For example, those who get the shot or more often people of higher-income who are, in general, healthier overall and can afford medical care. Performing quality research, such as double blind studies, would be relatively easy. While these studies are the standard by which all other drugs are evaluated for safety and effectiveness, they are not done on flu vaccines. Some experts have been calling for these studies, but so far the drug makers and government have avoided doing them.
For some reason, many people don’t accept the fact that there are many ways to improve the immune system. Even the CDC recommends the things I suggested in the article: “Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food.” Improving immunity can – and has – helped prevent many diseases. For example, a healthier lifestyle that builds better immune function may have contributed significantly to reducing the incidence of polio long ago. What’s missing most from millions of people is making the choice to be healthy.
Why I’m not getting the flu vaccine
by Coralee Thompson, MD
During my 30 years of working in health care, I chose to have the flu vaccine only once. As far as I know, I’ve never had an influenza infection. Am I concerned about the novel H1N1 virus? Yes, not for my own health, but for those at greatest risk who may get sick and perhaps even die. The CDC gives vaccine priority to children (6 months to 24 years), pregnant women, other adults with underlying diseases, health care workers, and adults who work with infants less than 6 months of age. That list probably includes about 225 million people in the USA (the number of vaccine doses that the US government has ordered). But many healthy, low risk people who can afford it will be lining up for their shot, leaving many unhealthy, high risk, poor people to do without.
For a pandemic (worldwide) influenza such as this, consider a few important numbers regarding the flu vaccine. The world’s capacity for producing flu vaccines is about 750 million at best, yet there are about 6.7 billion people on earth. So who will get the vaccines? First and foremost, the countries that produce them will (the US, Canada, five Western European countries, Australia and Japan). What happens everywhere else? These countries will get only what is left over; too little and too late.
Even in the United States, for example, there are those who need vaccination more than others. Unfortunately, the people who need it most have the hardest time getting it. They are also the ones not getting the basic things that promote health to reduce the risk of infections. And, these are the ones that significantly contribute to the spreading of the virus.
I have great respect for the power of living a healthy life; it’s the first and most important way of preventing almost all diseases. Furthermore, since infectious diseases spread from person to person, it makes great common sense to live healthfully, stay away from sick people and crowds, wash your hands, avoid touching your eyes, nose or mouth, and stay home if you’re sick. I also have a great respect for the power of artificial immunity (vaccination) to prevent infectious diseases as well as their potential to go awry.
To keep some of the preventable diseases in perspective, consider the CDC’s numbers of deaths in the USA per year:
- Heart disease: 631,636
- Cancer: 559,888
- Stroke: 137,119
- Chronic lower respiratory diseases: 124,583
- Accidents: 121,599
- Influenza and pneumonia: 56,326
- Kidney disease: 45,344
But let’s put these numbers in perspective. Consider the worldwide statistics of 10.6 million childhood deaths per year – that’s 30,000 children dying everyday – mostly from malnutrition. According to a Johns Hopkins study in 2005, it would take only $5 billion toward prevention and treatment to save 6 million children a year.
