Q&A: Immune system ‘strength’ & influenza

Posted by ERV on August 8, 2011
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EMAIL! (technically, a paraphrased really great question from someone at FreeOK!)


Dear ERV–



Is there any reason why I, a young healthy adult, really *need* to get the flu shot every year? Even if I do get the flu, wont that just make my immune system stronger?









Blech. Flu shots. Every damn year people are bugging us to get the flu shot. But no one likes shots. They cost like $10-$20. Have to take off work or run to get one in between classes. And then your arm hurts allllll daaaaay and you might get a headache or a little fever. UUUUUUUGH WHYYYYY????? WHYYYY????

“Do I *have* to get the flu shot every year?” I totally understand where you are coming from.

The answer isnt an easy yes/no.


First, the basic ‘WHY??????’ behind the flu-shot-every-year thing.

Heres the deal, influenza has a couple different ways of changing. The one that probably jumps into your head immediately was ‘Oh, yeah they mutate’. Yup! Influenza is an RNA virus. The enzyme that makes RNA from RNA makes a lot of mistakes. Those mistakes in the RNA genome/messages translates (heh) into variation in amino acid sequences, thus variations in protein structure, ‘antigenic drift‘. Start with Protein A and then you get ‘Kinda Protein A’ and then ‘Kinda Sorta Protein A’.

But influenza is a segmented RNA virus. So if something is infected with +2 different ‘kinds’ of influenza, the viruses can shuffle their genomes. Thats called ‘antigenic shift‘. Start with Protein A and then you get ‘Protein Not-A’.

While influenza has these different sources of genetic diversity, that diversity is under selective pressure from *us*. The human population is generating antibodies to variants of influenza, either from getting sick or by getting vaccinated. This selects out the influenza variants the human population doesnt have good immunity to, so those variants are the ones that infect us the next year, and so on and so on.

We are caught in this evolutionary treadmill because 1) influenza can change a lot, and 2) we cant make antibodies to *one* influenza infection or *one* influenza vaccine that protects us from *all* kinds of influenza.

Thats why scientists were super pumped about identifying antibodies that *could* work on lots of different kinds of influenza.

So, thats why we have to get new shots every year to ‘influenza’– usually every year, the shot is slightly different mix of three influenza variants than it was the years before (sometimes there are duplicates).

To answer the second part of that question first “Wont getting sick rather than getting the shot make my immune system stronger?” The answer is ‘Yes, kind of, but it doesnt matter.”

When you get sick, you make antibodies that are really, REALLY good at attacking the virus you were infected with.

When you get a vaccine, you make antibodies that are pretty good at attacking a virus you might be infected with. Vaccines are composed of crippled/dead viruses or just chunks of viruses– while they train your immune system to fight off a pathogen, its not as ‘robust’ of a training as you get from actually getting sick. So if you compared the antibodies from a person who got sick and a person who got the shot, the person who got sick would have ‘better’ antibodies for that variant of influenza.

But since influenza changes all the time, theres not really much of a point to getting a ‘stronger’ immune response from getting sick. The influenza circulating this year is going to be different from last years– who cares if you got sick last year? The flu vaccine is trying to train your immune system for the *modern* virus, not the one that was hanging around last year.

On to the first part of the question– “Do I need to get the shot every year?” Well, it depends on who you are and who you are around.

In these cases, your decision to not get a vaccine could kill or seriously harm someone else (I might be forgetting some):

  • Did you/a relative just have a baby? You better get the shot to keep you from infecting baby.
  • Do you hang out with your grandparents a lot? You better get the shot to keep you from infecting Grandma and Grandpa.
  • Do you hang out with someone who is immuno-compromised? If you are around anyone who has to be on immuno-suppressive therapy for a medical condition or is otherwise immuno-compromised, you better get the shot to keep you from infecting them.
  • Are there extenuating circumstances? Sometimes something non-normal happens, eg Swine Flu. If something weird pops up like Swine Flu, or a flu that is differentially affecting ‘young healthy’ people as opposed to the normal ‘very young’/'very old’ groups, then you better get the shot.

In these cases, your decision not to get a vaccine might not be so dramatic:

  • Are you a student? Schools, gyms, and dorms are warm, moist petri dishes. If one person gets sick, EVERYONE gets sick. If you dont want to be part of that, if you *cant* miss class or the district basketball finals, you better get the shot.
  • Can you afford to get sick? Can you afford to miss work/household duties for a week? Can your business/household afford for you to be out of commission for a week? Can you afford the potential medical complications that could arise from ‘only the flu’? This might be something those of us in work-a-holic-no-healthcare US people think about, but it *is* something that I weigh when I am debating ‘do I need to get the shot this year?’

These lists are non-exhaustive– People might bring up more situations in the comments.

But my point is, there is no inherent ‘benefit’ to getting sick from influenza. There is no reason to get sick from influenza. We have a vaccine. Yeah, sometimes we gamble wrong when guessing what strains to put in the influenza vaccine, and you might get sick anyway, but any way I can stack the deck in my favor, towards ‘not getting sick’, Im going to do it.

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Comments

  1. #1 Miss MSE (@MissMSE)
    August 8, 2011

    As annoyingly anecdotal as it is, the only years I’ve contracted true influenza (as opposed to some other nasty little virus) have been the years when I’ve gotten the flu shot. My doctor is a bit baffled by this, but she backs me up, and doesn’t push the issue. However, I can also generally afford to isolate myself the minute I’m sick, so I generally opt out of the flu vaccine and try and sleep enough instead.

  2. #2 Woden
    August 8, 2011

    Also, just to point out, if you are in (or are considering going into) the healthcare field, a lot of states now require you to get your yearly flu vaccine if you will be interacting with patients. That means doctors, nurses, pharmacists, and pharmacy technicians, you’ll generally have to get your flu shots whether you like it or not.

    Personally, I think this is a good thing. First of all, during cold and flu season, doctor’s offices and pharmacies usually have enough volume that it hurts when somebody is out on sick leave. But even more importantly, if even one employee at a doctor’s office or pharmacy gets sick, they could potentially be infecting dozens or even hundreds of patients before you even start showing symptoms; I know that the pharmacy I work at often has upwards of two hundred patients in a day, and we’re not even an exceptionally busy pharmacy. Given that influenza usually takes three to four days before symptoms appear, but can be infectious in as little as a day, that is a huge number of people being exposed, especially since there is an above-average chance that those people will immuno-compromised or living with immuno-compromised individuals. The risk just isn’t worth it.

  3. #3 Kevin
    August 8, 2011

    Do you work in a children’s hospital? Yes :-/

    I’d never gotten the flu shot before moving to Boston, but now I get it every year. I’m kinda shocked it’s not mandatory considering there are kids with leukemia all over the place.

  4. #4 ERV
    August 8, 2011

    DANG IT!

    I knew I was missing something obvious– If you work in any kind of health care setting, you should get the vaccine.

  5. #5 Stephen Bahl
    August 8, 2011

    I never get flu for some reason. I get colds every once in a while (they go away after like one day and aren’t really that debilitating) and if I get gastroenteritis I’m in intense agony, but I never seem to get flu at all. Maybe I’m just lucky. At my last job they had a free vaccine program and I thought about signing up because yay, herd immunity. But I didn’t end up actually doing it even though I probably should have.

  6. #6 JohnV
    August 8, 2011

    My current lab is in a hospital and the policy is if you don’t get a flu shot (they offer them for free) you get a stick put on your name tag and that restricts your access to areas of the facility.

  7. #7 JohnV
    August 8, 2011

    That would be a “sticker” on your name tag. And the hospital is part of a university and has a bunch of research labs in it. We’re sequestered to our own area anyway and it is plausible that someone could function without access to the rest of the hospital.

  8. #8 dustbubble
    August 8, 2011

    Oooer. Virocrim ‘ere.
    We hassle like the blazes to get winter ‘flu jabs from the GP, or used to, as both kids had monster childhood asthma, and the DoH recommended/ordained (hard to tell the difference) that as such they should.

    GPs tended to pooh-pooh our helicopter parent fussing, the attitude is very much “everyone gets it, only special high-risk categories can be covered, just make sure you tuck up warm and drink plenty, cheery-bye” as it costs Big Brother money, as it’s all “free”.

    Our former ancient neighbour got it, despite her irritation about “bothering the doctor”.
    Can’t think who else, mums-to-be? Although that runs up against the “eebil vaxinz iz kill babby” shite among the “intelligentsia”. Thanks, Wakefield.
    People just expect to get the ‘flu, year in, year out.

    Keep Calm
    and
    Carry On

    That’s the ticket (or so they’d prefer us to think). Lot cheaper.

  9. #9 JusaTech
    August 8, 2011

    Here’s another group to consider getting the flu shot: Are you a grad student/post doc? Can you afford to miss/totally mess up a big experiment because you are sick? Can you depend on your lab-mates to pick up the slack and do it right? No? Get the shot. (If you’re the kind of grad student who takes off to ski all the time, feel free to skip the shot, but please do the decent thing and not share your sickness with the rest of the lab.)

  10. #10 Atif
    August 8, 2011

    I don’t know about other workplaces, but in the hospitals that I have worked in, the flu shot has been strongly advocated. While they have flu shot clinics, they’ll also give it to you if you go by Occupational Health. They’ve been very supportive of different schedules, and encourage everyone to get it.

    And students are a breeding ground. Between dorms, classes, clubs and restaurants, combined with lack of sleep and (generally) poor diets, we definitely need the shot.

  11. #11 D. C. Sessions
    August 8, 2011

    Can’t think who else, mums-to-be? Although that runs up against the “eebil vaxinz iz kill babby” shite among the “intelligentsia”. Thanks, Wakefield.

    At least some flu variants (the most recent pandemic strain being one) are much more dangerous (as in, lethal) to pregnant women than to other healthy adults. Wankfield (and even more the Mercury Militia), thanks so much.

    So, another quick summary:
    * You have (or are around) kids,
    * You are a kid,
    * You are around geezers,
    * You are a geezer (/me raises hand),
    * You are around the immunocompromised (/me raises hand),
    * You are immunocompromised (controversial),
    * You are at least some of the time a health-care worker (/me raises hand),
    * You’re preggers,
    * You’re around people with asthma,
    * You’re have asthma,
    * …

    I’m pretty sure I missed some.

  12. #12 sasqwatch
    August 8, 2011

    Another thing to clear up is the use of the word “flu” as shorthand for influenza. To some people, you say “flu” and they think of a tummy bug that makes you sick for a day or two. (the stomach flu). Others think of the “flu” as a nasty cold.

    Influenza kills a quarter to a half million people every year worldwide, and getting a case of it will usually only result in you *wanting* to die for about a week or two, due to the severe aches, chills and fever you’d be experiencing. If you’re old, young, infirm, or otherwise immunocompromised, you have a much better chance of joining the choir invisible because of it.

    It also might be a good time to mention that the flu pandemic of 1917-1918 took out an estimated 10-million people (world population then was about 1.8 billion), preferentially attacking people in their prime. That’s a mortality rate of a bit over 0.5 % (of every living human) — simply staggering. 1 out of every 180 humans deaded, in addition to the “war to end all wars” that was going on at the same time.

    There’s good reason to believe, esp in todays crowded world, that we are overdue for another pandemic like the one (two actually) that swept the planet in the early 20th century. Gina Kolata has written a harrowing book on the topic. Great read.

  13. #13 sasqwatch
    August 8, 2011

    I oopsied on some numbers. The 2nd wave of the pandemic took out 40-million people through 1918. That a little over 2% of all humans living at the time. If you count the problem years as going through Dec 1920, the estimates are between 50 and 100-million people dead (with about a third of all humans infected), making it one of the deadliest disasters in human history.

  14. #14 Slugsie
    August 8, 2011

    I have never had a flu shot, despite living in the UK where it would be free if I wanted it, and an employer who happily grants paid leave time for medical appointments. I have also never had the flu.

    Am I lucky? Maybe. Do I have a good immune system? Possibly. Does it prove anything? Not really.

  15. #15 stripey_cat
    August 8, 2011

    I’d say that if you work in a childcare or education setting, or if you have contact with children, you ought to get the vaccine. More children than you’d think are immunocompromised, asthmatic, or otherwise vulnerable: even if the kids you deal with are healthy, their friends and classmates will most likely include several who aren’t.

    Also, most large workplaces will have at least one pregnant woman about the place. And asthmatics, cancer patients, etc. So will shops, public transport, and other public places. Unless you expect anyone who’s vulnerable to seclude themselves in their houses for six months of each year (and are willing to support maternity and sickness payments to allow them to do so), it’s only decent to not be a plague-rat.

  16. #16 D. C. Sessions
    August 8, 2011

    It also might be a good time to mention that the flu pandemic of 1917-1918 took out an estimated 10-million people (world population then was about 1.8 billion), preferentially attacking people in their prime.

    If you ever get the chance, wander through the graveyard of a small town that’s been around for at least a century. $HERSELF and I did that in Quemado NM — it’s had a fairly stable population for over 150 years, no industry, no mining, no pollution to speak of, fresh air, fresh food, all that. Not a lot of people, though — mostly ranching in the area.

    Deaths scattered about, with a few peaks for WWI and WWII. And a big peak in the autumn of 1918, with multiple sites having several family members buried together. One memorable group composed a young woman, her 8yo child, and her toddler. All dead within weeks of each other. This in a graveyard that often skipped half a dozen years with no graves.

    I’ve always found graveyards interesting. Check them out some time.

  17. #17 sasqwatch
    August 8, 2011

    Strange — I’ve toured one of the largest cemeteries in Southern Colorado (a two minute walk from my house) many times. They fascinate me, too. I completely forgot to keep an eye out for the fall of 1918.

  18. #18 D. C. Sessions
    August 8, 2011

    sasqwatch — if you get a chance, scan the registry there. We were visiting on weekends when there was nobody in attendance so we couldn’t, but I’d love to have one of those registries to scan and summarize for the “it’s only the flu” crowd.

  19. #19 Vince whirlwind
    August 8, 2011

    The flu vaccine is rubbish – your point about it being a good idea in case something special (eg swine flu) comes around is contradicted by your admission that it won’t protect you from the hundreds of variants that are around anyway.

    So,
    – the flu shot makes you sick
    – the flu shot is unlikely to prevent you from getting sick in the short term
    – the flu shot will almost certainly not protect you from anything in the long term
    – getting the flu is extremely unlikely to create any problems

    And bearing in mind the high risks associated with submitting to any kind of medical procedure (doctors clinics, surgeries and hospitals are hotbeds of infection, medical personnel still don’t know how to wash their hands and often forget other important sterile procedures), you only go near doctors when there is a very clear benefit in doing so.

    I should point out that I and my children are fully vaccinated with the proper vaccines that do something useful, just not this revenue-raising flu-vaccine nonsense.

  20. #20 Justicar
    August 8, 2011

    Great for your kids. Let’s hope the parents and children you and your flu carrying kids choose to infect with a potentially fatal disease are not a large number.

    If you let a nurse stick you without his/her following sterile procedures, you’re not being very proactive in your medical care.

    Nothing goes inside me until I read the label and watch them wash, glove up, and sterilize the area. Same with my kids.

    There’s a difference between whining about things, and doing something about things. And a difference between diligence and paranoia. I’m diligent in my medical treatment; I understand the risks associated. I’m not some paranoid dude running around screaming the whole of the medical community is out to infect me and mine because I close my eyes and let them do whatever.

    Incidentally, I’ve never had to remind a doctor or nurse to wash their hands or sterilize the injection site. I do, each time, politely ask to see the label of the thing before they stick it in me.

  21. #21 D. C. Sessions
    August 8, 2011

    Incidentally, I’ve never had to remind a doctor or nurse to wash their hands or sterilize the injection site. I do, each time, politely ask to see the label of the thing before they stick it in me.

    I have, but it was fun. As I was preparing to leave hospital following surgery, a group of student nurses came around and I volunteered to let them change my dressings. And then I played Patient From Hell — wash, gloves, hands never go anywhere blind without protection, don’t attempt to lift more than you safely can, you name it.

    It was a blast — and from the grins on the students, they were with the game.

  22. #22 Bayesian Bouffant, FCD
    August 8, 2011

    Even if I do get the flu, wont that just make my immune system stronger?

    Oh, you mean like the old saying, “what doesn’t kill you makes you stronger”? Think seriously about the first half of that.

  23. #23 sasqwatch
    August 8, 2011

    D.C. Sessions: I will do that soon. The earliest graves here (Colorado Springs) that are well-marked hail from the 1880′s, and it was a fairly bustling town by the late teens. There’s sure to be a sizable spike.

    Regarding the original part of the question that states: “Even if I do get the flu, won’t that just make my immune system stronger?”

    One hypothesis that cannot be dismissed out of hand is that a flu around 1890 had similar proteins in the coat. Young children would have been primed for that virus, and if the 1918 virus was similar enough, it could have caused an immune overreaction, causing a flood of white blood cells and fluids rushing to the lungs. It could have been people’s really, really healthy immune systems that killed them, in other words. (speculations from Gina Kolata’s 1998-99 interviews with Jeffrey K. Taubenberger, pg 305 of “Flu”, linked to above).

  24. #24 Andy
    August 8, 2011

    Thanks for this post.

    I suspect that there are a lot of people (including me) who generally know that getting a flu shot is a good idea, but who don’t spend any time thinking about it and who are kind of fuzzy on the details. Without a reminder, it’s easy to let getting a flu shot be put on the back burner because of all of the other things that we also need to be doing.

    So I think that this is a really helpful post.

    (I tend to get a flu shot every year, but my employer makes it extremely easy: the shot is free and they arrange for nurses to come to our workplace on a couple of different days and give the shots on site.)

  25. #25 Thanny
    August 8, 2011

    I never get the flu. Just this past year was the first time in about 20 years that I got the common cold. When I get sick, it’s tonsillitis – usually strep, for which I take amoxicillin.

    Could I still be a carrier for others after being exposed? Would getting a flu shot do anyone around me any good?

  26. #26 Vince whirlwind
    August 8, 2011

    @20, is there any evidence base for your assertion that my flu-unvaccinated children are more likely to infect anybody with a potentially fatal disease than their flu-vaccinated peers? I’d love to see it, if there is.

    We’ve had years of fear-mongering about flu pandemics, each episode resulting in governments purchasing and then throwing away vast volumes of vaccine all to the benefit of the shareholders of the pharmaceutical companies. The drive by these same money-grubbers to convince the gullible that flu vaccine is necessary or even effective has hoodwinked many, it seems. They’ve even gotten away with premature release of unsafe vaccines as a result of these scares.

  27. #27 R2
    August 9, 2011

    @26: Which vaccine was prematurely released and unsafe?

    If you are talking about the one I think I’m talking about, I think there has already been a post on ERV about it.

    http://scienceblogs.com/erv/2011/07/swine_flu_vax_didnt_cause_guil.php

  28. #28 sasqwatch
    August 9, 2011

    Vince: if vaccine production is such a gravy train, could you please explain to me why pharmaceutical companies have been getting out of that business for as long as I’ve been alive? When I was a young boy (early 70s) we had 25 producers of vaccines. We now have 5 – perhaps four; it’s been a while since I last looked. Whoopsie. perhaps we’re down to two.

    When supply exceeds demand and doses are thrown away, that costs millions. Shareholders don’t cackle with glee; instead companies downsize, lay off workers, and get out of the business. Drugs are more profitable. Do you even read the news? (I mean, real news.)

  29. #29 Dubliner
    August 9, 2011

    I’ve got a really crappy immune system and catch every virus doing the rounds. I used to get the flu every bloody year until I started to get annual flu’ shots 12 years ago. I haven’t had it since. Plenty of other stuff :( but no flu. So at least that is one week less stuck in bed each year.

  30. #30 Caudoviral
    August 9, 2011

    The thing about most anecdotes of “I always get the flu even if (only when) I get the flu shot”, is that people really suck in self diagnosing the flu. Influenza is a specific thing, and the vaccine protects you against it. It doesn’t protect against a bad rhinovirus or adenovirus that comes along and give you numerous flu-like symptoms. This is especially true since the term ‘flu’ gets bandied around for any bad viral infection (e.g. the moronic term ‘stomach flu’). If you get your shot and still wind up really sick there is a chance that the shot didn’t work. Far more likely you just have one of the untold other number of viruses that like to have reproduction parties in squishy human cells.

  31. #31 ErkLR
    August 9, 2011

    I demand evidence that my unvaccinated children are dangerous. Now I will make several batshit insane conspiracy-theory assertions and provide no evidence at all! I get special rules, heads I win, tails you lose fuckers!

  32. #32 Richard Hendricks
    August 9, 2011

    All right Vince, what’s the difference between a disaster averted due to hard work, dedication, and a little luck, and false alarm?

    Oh really, you can’t tell? Nooooo shit.

  33. #33 Vince whirlwind
    August 9, 2011

    So, no evidence-base for how the flu vaccine would make my children less likely to pass on a “potentially lethal disease”? Just insults.

    @sasqwatch thinks that a reduction in the numbers of corporations involved in an industry equates with that industry failing to generate an income. Utter rubbish. Every industry has seen similar loss of diversity, as it is standard business to buy out competitors in order to increase margins and revenue.
    And millions of doses thrown away was a win for the pharmaceutical companies (who had whipped up the scare with a few judicious press releases to a few tame journalists), because they already *sold* those doses to the government.

    And Robert Hendricks,
    a/ what disaster? You mean the “[insert-animal]-flu” scares whipped up each northern-hemisphere Autumn in the media? I believe a detailed study was made in New Zealand of the (negligeable) effects noticed by healthcare providers when the “[insert-animal]-flu” hit them first, prior to any vaccine being available.
    b/ how will the highly ineffective flu vaccine avert it?
    c/ what kind of idiotic risk analysis would result in the decision to submit millions to the cost and risk of flu-vaccination for virtually no gain?

    And ErkLR, evidence is how knowledge works. Simply asserting that a highly ineffective vaccine against a non-dangerous virus somehow helps is not enough. Where’s the evidence-base? Same place as “burnt toast gives you cancer”, as far as I can see.

    On the other hand, pointing out that corporations make money by convincing people to spend money on unnecessary products should be an entirely uncontroversial statement of fact.
    But you characterise it as “batshit insane”. That’s not rational analysis.

  34. #34 PumaJ
    August 10, 2011

    I’ve had influenza about 4 times in my life (I’m 60). Influenza is a miserable illness in & of itself. Twice my course of illness was complicated by pneumonia. After the second bout of pneumonia, I decided that I would get the flu vaccine every year. For years I did just that. Then one year I skipped the vaccine. I caught influenza & then developed pneumonia. I missed a month of work. I haven’t missed a flu vaccine since then & I’ve not become ill with influenza as a result. I work in a middle school. When the new H1N1 went around, my students dropped like flies, so did most of the teachers. Very limited vaccine was available in the USA when the pandemic hit here. I did become ill, but not very. I had some immunity to part of the virus due to having been ill in 1957 with an influenza virus that was very similar to part of the virus in H1N1.

    I’m a nurse. I encourage my students & every I know to get a yearly “flu shot”. It is impossible to get ill with influenza from the vaccine, though some folks may experience a day or two of slight aches & pain & perhaps headache. Those who claim to have become ill with influenza as a result of the vaccine have either become ill with some other virus, or were exposed to the influenza virus shortly before or immediately after getting the vaccine. It takes about 1-2 weeks for one’s body to make enough antibodies in response to the vaccine for one to be protected from influenza viruses. Thus, if one is exposed to the virus shortly before or after being vaccinated, one can become ill, but the illness isn’t because of the vaccine. That being said, it is still possible to contract influenza even after being vaccinated. However, in such cases, the course of illness is much shorter & much less severe.

    There are many other respiratory viruses in addition to influenza that circulate during the winter months. Some of those viruses can cause fever, cough, and muscle aches/pains. Yet, however similar to influenza symptoms some of those viral infections may be, they are not as severe. Generally other respiratory viral illnesses do not carry the same risk of secondary infections such as pneumonia that influenza has. Some respiratory viruses can lead to bronchitis in some folks, but that isn’t the same as pneumonia.

  35. #35 R2
    August 10, 2011

    Vince… if you are going to try to get involved in scientific discussions, you must be willing to do the research. We are not here to do the work for you. I’m going to assume you are not lazy or intentionally ignoring evidence, so here’s a quick little tool that will help you if you do not want to put in too much effort: Google Scholar.

    And, look at what I found in less than 5 minutes of searching!

    “Vaccination of approximately 20–25% of children, 1.5–18 years of age in the intervention communities resulted in an indirect protection of 8–18% against MAARI (medically attended acute respiratory illness) in adults ≥35 years of age.” From the journal Vaccine, in 2005, http://www.sciencedirect.com/science/article/pii/S0264410X04007297

    From NEJM in 2001, (http://origem.info/FIC/pdf/Reichert_et_al_Japanese_Exp_NEJM01.pdf), we can get this: “Vaccinating schoolchildren against influenza
    provides protection and reduces mortality from
    influenza among older persons.”

    And, finally, all the way from 1972, the Medical Journal of Australia examined many communities with different levels of immunization and found that “widespread, but not necesarilly total, immunization limited the spread of clinical disease” and “partial immunization of a community appears to have checked the spread of influenza”. Also interesting is this: “the favourable result may have been influenced by the decision to try to immunize groups considered to be most at risk, including, of course, the children.” (http://compepi.cs.uiowa.edu/uploads/Readings/Warburton72/warburton72.pdf)

    In summary, vaccinating your children against influenza will save someone’s life… if we all work together! Freeloaders kill if their numbers get too high. They’ll appreciate it once they are older and future children vaccinate.

    We’ve known this from 1972 and recent studies keep on showing evidence in favour. Is there any excuse for you to claim there is no evidence? I mean, other than negligence?

  36. #36 R2
    August 10, 2011

    My comment was held up in moderation. But Vincent@33, I can assure you there is plenty of evidence. Wait until ERV can approve the comment to get the links to studies (one from 1972!)

  37. #37 R2
    August 10, 2011

    Sorry for so many posts one after the other, but I found another study in favour of herd immunity for the influenza vaccine!

    http://www.ncbi.nlm.nih.gov/pubmed/17167135

    Full text here: http://journal.9med.net/qikan/article.php?id=224815

  38. #38 WLU
    August 10, 2011

    Very interesting (and LOOOOONG) book on the 1918 pandemic is The Great Influenza by John M. Barry. Has sections on how medicine in the United States (and the world) changed around the turn of the century, some basics on how the flu works, and a whole lot of biography of the researchers of the time. One neat thing about the killer strain from WWI was that it actually preferentially killed healthy young adults because the immune system essentially employed scorched earth tactics on your lungs. The healthiest ones with the strongest immune systems ended up dying the fastest (on the order of hours between initial symptoms and death!) simply because their immune systems had the strength to ravage their lungs the hardest. Barry repeats “But it was influenza. Only influenza.” dozens of times as a litany or mantra, as if to recognize the disbelief everyone feels when hearing how horrible it truly was. Great book.

    I get my flu shot every year to break the transmission chain – so I can’t pass it along to my grandmother (and others) when I visit her at Christmas. I’m unlikely to benefit, but I’m satisfied at helping a couple strangers (and Grandma) not die.

  39. #39 ErkLR
    August 10, 2011

    I’m sorry Vince, perhaps I wasn’t clear. I was mocking you because you demanded evidence for statements other people made then followed that demand with your own ridiculous statements without a shred of evidence. Even if they weren’t ridiculous, you made assertions without a bit of the evidence you demanded of others. So yeah, special pleading for yourself. When you are ridiculous, you will likely be ridiculed.

    R2 is a far better person than I to attempt to engage you seriously, but I think his/her effort is futile. I doubt you really want evidence, I think you want to spread what you think is the truth and can not be convinced otherwise. So I mock you.

  40. #40 sasqwatch
    August 10, 2011

    Vince: And millions of doses thrown away was a win for the pharmaceutical companies (who had whipped up the scare with a few judicious press releases to a few tame journalists), because they already *sold* those doses to the government.

    You seem to think that “government” is one giant nameless, faceless entity that buys up all the stock with its infinitely deep pockets? Wow. You simply deny that vaccines have extremely low profit margins, esp. when compared to other sectors within pharmaceutical production? Wow. You must be a self-styled genius.

  41. #41 R2
    August 10, 2011

    ErkLR:

    In my defense, I did realize how futile it was. I just find the topic interesting and thought it would be useful for other people. The fact that it demolishes his claim that there is no scientific evidence for the indirect protection of the flu vaccine, while the inspiration, is just a side benefit.

  42. #42 Vince whirlwind
    August 15, 2011

    I’ve read your links.

    1/ Not very convincing. This isn’t a proper randomised trial and the conclusion drawn (which isn’t particulary interesting anyway) skates over the obvious problems when different groups are aware they are getting different attention.

    2/ Claims 1 death prevented by 420 vaccinations, but only if the vaccinations are repeated every single year. This is data for Japan and the article clearly shows you don’t get anywhere near that result in the US anyway. Even there, the Japan conclusion is obviously confounded by the preexisting downward trend and the rapid increase in average age in Japan. So how many vaccinations are required in the US to save one life? Who knows. The graph in this article for the US shows a lot of vaccination activity with no clear benefit.

    3/ etc…

    Vaccination against flu is based on belief, encouraged by private enterprise whose modus operandi, yes Sasqwatch, is to make money selling unnecessary products. Medical over-servicing is a classic money-maker.
    Smallpox and polio were eliminated (or should have been) because vaccination against those actually works. Against flu, it’s a waste of time.

  43. #43 speedwell
    August 15, 2011

    Question about the flu shot:

    In about a month, I will be going to South Africa for a business trip, where it is winter. I am a diabetic and I get my flu shot every year. Should I get another one before I travel?

    Thanks!

  44. #44 R2
    August 16, 2011

    1/ Randomisation, double-blind, etc… are not ethical when there is a proven treatment/prevention strategy in this case.

    2/ 420:1 is quite good when you consider that the rate of complications for the flu vaccine is so low. Also, why must studies be from the US? Stop oppressing me you ethno-centric bitch! (http://www.giantitp.com/comics/oots0202.html). But seriously, unless you have evidence that Japanese and US reactions to the flu vaccine are different, it’s not valid.

    3/ ‘etc’, really?

    Anyway, I can see there is really no point in discussing it with you until you do some research yourself. Why don’t you write a proper literature review on the topic and then we can discuss it? (And this means that you have to look for papers for and against what you think and view them without bias!)

  45. #45 rork
    August 25, 2011

    I always get the jab, but figure I might get exposed to the virus later anyway, perhaps many times (I’m in a medical center). I was never sure whether this exposure improves my immunity above just the jab (it’s “a booster”), but figure it does. Goes to the original question about getting exposed to the real thing – you can still do that.

    As far as which people might kill or harm someone by not getting vaxed, I think your list is far too conservative – I think it’s just about everyone. Assuming the benefit/cost is somewhat known, you do it for your fellow human beings – if you care at all about them (some folks appear not to). I’m a statistician and will use the technical meaning of “expect”: not getting vaxed means you can expect to assist in the sickness and death of other people. In my world that’s immoral, maybe wicked is the word I want.