To flu-shot or Not to flu-shot. . .

[gmattson]

Sue and I don't get them (and so far, have avoided getting the flu) and all our friends (who do get them) end up with the flu every year. View this clip to find out why!

http://www.youtube.com/watch?v=x5GS7nZi ... angers.htm

[Bill Glasheen]

George

First and foremost, that was a COMEDY skit. I hope folks realized that when they viewed it.

Here is a similar Saturday Night Live skit so the slow-witted can get the idea.

Bassomatic

Flu shots save lives. Shame on you and Susan, George, for not getting the shot. You are in a high risk group. Granted from year to year you are an anecdote so we can't possibly know if "the shot" helped you or not. Most people don't even know what influenza is. They get a drippy nose and aches, and they think they have "the flu."

I walk the talk. I've gotten the shot every single year since 1983. I just got it Wednesday, and dragged my assistant (who has asthma and so is high risk) with me.

More facts in a bit.

- Bill

[Jason Rees]

Active duty military are required to get the Flu Mist every year. Doesn't hurt a bit.

[Topos]

George, I got the first flu shots when I was a teenager [ being 6 months younger than you should tell you when]. In 1972 my wife told me that she never took the shots and never came down with it so I tried. I came down with the most viscous flu and got pnumenitis (sp?). Was on erythromycin for a week and finally recovered.

For me at least I shall be taking the shot next week again.

Caveat emptor.


Best day.

[IJ]

Our vaccine is based on a guess about which strains will circulate in the USA after their annual mixing and reassortment of genes in Asia. Thus, the effectiveness varies from year to year, and the flu, which kills tens of thousands of americans yearly, is gonna get some of us no matter what. Also, when people say they get the flu five times a year, they're talking about bad colds. Actual influenza is a once a year deal. I suspect most people who don't get the "flu" and don't get shots are probably self selected healthy people. Additionally there's no way to go by experience on whether it works or not because the flu shot doesn't stop anything but the real flu and you can still end up with months of nasty colds. Since most people aren't formally tested for flu they don't know if they had it. Thus one should go by what the data shows, and that is a partial protection against influenza and a reduced death rate in vulnerable patients including those with chronic lung and other problems, immunosuppression, and age. I have none of those but it is crucial for me to be vaccinated because I could spread flu to those who do. That's actually a key principle because the elderly don't respond as robustly as the young. So if you want to protect the grandparents it's probably better to make sure junior isn't passing them the virus than it is to hope their vaccine protects them--but the vaccine will reduce their risk either way.

Risks include egg allergy and a very low rate of a paralyzing condition called guillain-barre. One thing that is known for sure: you can't get the flu from a vaccine.

It's a little bit like taking aspirin or lipitor or metoprolol to reduce your risk of recurrent heart attack. You can still have one. You can have one tomorrow. The similar guy who took nothing may not have a heart attack while you do. BUT we know that on average, people who take the treatment are better off than those that do not.

[mhosea]

and a very low rate of a paralyzing condition called guillain-barre.

Does the vaccination actually cause that by virtue of simulating a sudden infection that ends quickly or is the vaccination merely playing exactly the same role as a true infection in triggering this particular autoimmune disease? That is to say, does actually getting the flu put you at a similar risk for Guillaine-Barre?

[Gene DeMambro]

Any immunization can cause, for a few days at least some malaise and fatique. No way that is "the flu". Bill is right. Of the people who got "the flu" from an influenza vaccine, how many spent a night in the emergency room getting IV fluids due to dehydration? Not many. How many were fine in the morning, and were so dizzy and delirius hey had to be driven home 'casue they could drive by work's end? Not many, if any at all. How many had to take a week off of work and couldn't get out of bed, leaving their family or to take to them food and help them to the bathroom? None, I bet.

Twice in the last 10 years I did not get a flu shot due to short supply. Tice in the last 10 years I got the flu, spent time the in hospital, couldn't work and needed help for a week.

Vaccination and immunization are a primo way to prevent spreading and catching diseases. Get your shot!

[Shana Moore]

As a diabetic, it's part of my prevention regimen and STRONGLY encouraged by my doctor. This year, being pregnant, he's advised he wants me to get the shot as soon as I can after delivery.

Generally, I have no symptoms from the shot. Ocassionally a day of being tired/run down. But, being as most folks here are fairly healthy..side effects should be minimal!

[gmattson]

regarding health and fitness recommendations. From what I've read from the two of you, Sue and I have been "lucky".

True. . . what we see our friends getting may not actually be the flue. . . although they believe it is, and perhaps those shots are just allowing nasty colds to invade their systems instead of the specific strain/s the shots are designed to prevent.

Has there actually been any studies performed that show the shots actually prevent people from getting the flu?

How many strains of the "flu" exist "this year" and how many of those strains will be prevented from the shots?

If the vaccine doesn't prevent "all" flu strains, what are the odds of getting "a" flu, even after getting the vaccine?

Are we sure that the long term affects of these shots won't cause problems that are worse than the flu?

What is in these vaccines besides dead flu virus?

Are there any ongoing studies focusing on these questions?

Thanks

[Bill Glasheen]

Lot of questions, and good ones at that.

Has there actually been any studies performed that show the shots actually prevent people from getting the flu?

Lots.

It goes farther than that though. Most preventive treatments - while possibly evidence-based and high quality - do not save money. Researchers in fact often talk about the value (rather than savings) of a treatment in units like Quality-Adjusted Life Years saved (QALY). Immunizations however are the exception. Immunizations sometimes save money. Influenza immunizations I believe fall in that category.

How many strains of the "flu" exist "this year" and how many of those strains will be prevented from the shots?

Generally each year you have 3 strains of influenza in a flu shot. They are the best guess as to what is likely to spread. They often get it right. Every once in a while though a brand new strain will come around, and you aren't going to be protected against that. It happens...

I'm willing to bet (but haven't seen the research) that years and years of getting many different influenza shots from many different strains will begin to give you some general protection. For example we know that old strains sometimes "echo" into new populations, but the older folks who were exposed as kids don't get it as bad (if at all).

If the vaccine doesn't prevent "all" flu strains, what are the odds of getting "a" flu, even after getting the vaccine?

It varies year by year. It's also worth mentioning that you may still catch a flu that exists in the shot you got. But if that happens, chances are you're going to get over it much sooner than if you hadn't gotten the shot at all.

Are we sure that the long term affects of these shots won't cause problems that are worse than the flu?

We now have several generations of experience with the shots. That's a pretty good period of time to see long-term effects.

There was a bit of noise amongst the community of parents whose kids have gotten autism. They've tried to blame it on required childhood immunzations. Thimerisol - a preservative that contains trace amounts of mercury - was the suspect. Well... We now have enough experience with thimerisol-free childhood vaccines to see that the rate of autism has not changed at all without said preservative in it. So as much as you'll see internet campaigns attempting to link immunizations in children with autism, the data don't support it.

Too bad about the autism.

What is in these vaccines besides dead flu virus?

Some of the culture medium used to grow it (egg albumin) and a preservative to keep it from going bad (thimerisol).

Are there any ongoing studies focusing on these questions?

The CDC is constantly monitoring influenza, vaccinations against it, and side effects from the vaccine.

In fact the medical community predicts that a pandemic which kills millions happens every few generations. The H1N1 virus that partially contributed to the end of World War I killed more people than the bubonic plague. It was unique in that the death rate across age was "W" rather than "U" shaped. In other words, the very young and very old are generally the most likely to be killed by influenza and/or infections that follow it. But with the 1918 H1N1 strain, the strong immune systems of the most healthy were attacking the victims' lungs and killing them in a matter of a day or two. The cyanosis was so bad that it was said you couldn't tell what race someone was just before they died. Very strange, and very scary.

It's worth mentioning that NO medical therapy is without risk of side effect. As always, it's a cost/benefit issue.

I'll see if I can dig up a few abstracts.

- Bill

[Bill Glasheen]

If you are one of the folks who constantly gets "flu bugs" during the winter...

One good preventive measure is to get humidification in your home. Assuming you don't humidify so heavily that you cause mold to grow, a more humid environment prevents nasal passages from drying out. Heating air during times of low dew point (e.g. winter) causes the "relative humidity" inside your home to get so low that you get dry sinus passages. You then are inviting influenza or cold viruses to attack you with ease. A little bit of humidification to prevent the sinus drying can make a big difference.

As a side benefit... If you have wood floors, wood furniture, musical instruments made of wood, or nice molding indoors, humidifying your home will prevent damage to that wood.

- Bill

[Bill Glasheen]

Here is another preventive measure. This video is both informative and very entertaining.

Enjoy!

Why Don't We Do It In Our Sleeves?

You may note that your Uechi training will help here!

- Bill

[Bill Glasheen]

Just to give you an idea...

I typed in "influenza vaccine effectiveness" in Pubmed (source of peer-reviewed literature) and found 746 citations.

"Influenza vaccine side effects" got me 2119 citations.

Needless to say, this is a well-studied topic.

- Bill

[Bill Glasheen]

One more thing...

"Flu Mist" - a vaccine given as nasal drops (no needles) is actually weakened live viruses. Because of that, they don't recommend Flu Mist for the very young and folks above age 50.

It also isn't as effective as the injection of killed virus, but some protection is better than none. If enough people get the drops and/or shots, then the phenomenon of "herd immunity" kicks in. In other words, the virus can't spread well when most people are immunized.

- Bill

[Bill Glasheen]

As I scan the literature, George, I see effectiveness rates for vaccines of various types ranging from 60% to well over 90%. To say that a vaccine is 80% effective means that if 100 people were to get influenza without the vaccine, only 20% would with the vaccine.

How a vaccine works depends on your age, your general health, how many times you are exposed, which virus you are talking about, etc.

- Bill