Respectful Insolence

Dammit! Where’s my thimerosal?

As I mentioned earlier this morning, I went to get my annual flu vaccine. It’s the least I can do to protect myself and to protect the immunosuppressed patients around me in a major cancer center. I was looking forward to cheekily asking the nurse administering the vaccine to make sure mine had thimerosal, but when I got to the part of the clinic where the flu vaccines were being administered I was in for a nasty surprise.

The first indication came when I had to fill out a form similar to last year’s form asking me if I had ever had a reaction to egg products or the seasonal influenza vaccine before. I say “similar” because the form was not the same. There was something missing. Last year, I distinctly remember being asked if I had ever had a reaction to thimerosal or mercury and seeing a notice that the flu vaccine I was about to receive contained thimerosal. This year, the question was conspicuously accident, and I began to wonder why.

Then I found out.

I was about to receive Glaxo-Smith-Kline’s Fluarix. I perused the information on one of the prefilled syringes lined up like so many logs at a mill, just waiting to be used. That the particular vaccine being used was distributed in pre-filled syringes made me worry; clearly these were not multi-dose vials. So after I got back to my office after having had the vaccine administered, I promptly went on the Internet and Googled Fluarix. What I found was highly disturbing:

FLUARIX is formulated without preservatives. FLUARIX does not contain thimerosal. Each 0.5-mL dose also contains octoxynol-10 (TRITON® X-100) ≤0.085 mg, α-tocopheryl hydrogen succinate ≤0.1 mg, and polysorbate 80 (Tween 80) ≤0.415 mg. Each dose may also contain residual amounts of hydrocortisone ≤0.0016 mcg, gentamicin sulfate ≤0.15 mcg, ovalbumin ≤0.05 mcg, formaldehyde ≤5 mcg, and sodium deoxycholate ≤50 mcg from the manufacturing process.

Nooooooooooo!

Dammit! Where’s my thimerosal? I want my mercury! Those bastards! They’re actually giving out thimerosal-free influenza vaccine!

Oh, well. At least there’s still formaldehyde, polysorbate 80, and TRITON® X-100. Mmmm. Toxins. My favorite.

Comments

  1. #1 CW
    October 6, 2010

    I got the same vaccine, and was told that there’s no mercury in it – after making a joke about which kind was in it.

    I asked the doctor if still had anti-freeze in it. He looked at me strangely. I found out that he’s not heard that particular anti-vaccine argument. I’m not sure if I’m glad he’s ignorant of that or not. I am glad I got my flu vaccine though – even if it means no left-handed arm-wrestling for a day or so.

  2. #2 Algerine
    October 6, 2010

    Dang it, Orac! You have to just accept facts. No matter how much mercury you ingest and how high you crank the thermostat, you’re simply not going to get taller!

  3. #3 Todd W.
    October 6, 2010

    Oh, well. At least there’s still formaldehyde, polysorbate 80, and TRITON® X-100. Mmmm. Toxins. My favorite.

    I was gonna say, at least you still got some of the biggies. Oh well. Maybe next year.

  4. #4 https://me.yahoo.com/a/Z5ZA2tlvketPsnG3G8EVJbgYwGEUHH4E#13219
    October 6, 2010

    I am glad. You see, some people are actually allergic to thimerosal and I am one of them.
    I learned this back in the days when most contact lens solutions contained thimerosal. I would wear my lenses for a while, get irritated, use the rewetting drops, feel fine for a while and then get worse than before. There was no problem when I was switched to a solution preserved with benzalkonium chloride.
    This will save me a lot of hassle. Last year, I got the “regular” flu vaccine from campus health, which required a special appointment to get the thimerosal-free version, but had to go to the county health center for the H1N1 vaccine. Now it will be one-stop sticking for me.

  5. #5 Todd W.
    October 6, 2010

    @person from yahoo

    As much as we make light of thimerosal in response to the “ZOMG it causes teh autismz!” crowd, you bring up a legitimate reason to avoid vaccines that have thimerosal in it. Valid medical concerns, such as allergies, are good reasons to not get a vaccine. So, when they have vaccines that do not have that ingredient, a greater portion of the populace benefits.

  6. #6 T. Bruce McNeely
    October 6, 2010

    You forgot about the dead babies.

  7. #7 Paul Browne
    October 6, 2010

    Elise Lowerison #3 I think you may have picked the wrong blog for your infomercial!

    Still it could be worse, at least you haven’t posted on Ben Goldacre’s Bad science site…you haven’t have you?

    Does remind me that I was supposed to be in the gym an hour ago:-(

  8. #8 Lambo
    October 6, 2010

    My clinic must have had a bunch of unused signing tags from last year left over, because they had all the questions, but they never asked them. “Just sign and date.”

  9. #9 René Najera
    October 6, 2010

    So no worries about the quality of the posts to decline, huh? Great.

  10. #10 JayK
    October 6, 2010

    Have you started chelation therapy to remove all of those other toxins that have been injected into your bloodstream in doses much higher than human tissue can withstand?

    And have you taken the appropriate amount of Vitamin D today?

  11. #11 Todd W.
    October 6, 2010

    @Orac

    Take solace. As Jake so kindly informed us, pharmaceutical companies lie all the time. Because Merck lied (or at least misled, if you can’t comprehend a press release), then GSK probably is also lying and the vaccine really does contain thimerosal. Better contact the Geiers for your Lupron and chelator cocktail! You can relate your tale on Age of Autism, give a speech at AutismOne, write a book with Blaxill and Olmsted and write a few crappy studies for journals to retract.

    Gotta look for the silver lining.

  12. #12 TheBrummell
    October 6, 2010

    It occurs to me the removal of thimerosol from a vaccine may have an explanation that has nothing to do with anti-vaccination child-haters. It’s a preservative, right? Surely there is a long list of preservatives suitable for vaccines of this type, and some will be less expensive or more readily available in large amounts than others. I’m thinking market forces at the production end, rather than any sort of publicity or response to pressures from members of the public could be the reason. But I have no evidence either way.

    I have never recieved an adult immunization of any kind – I’ve never travelled to those parts of the world where such injections are recommended or required, and I’ve never considered myself to be in a high-risk group for things like influenza or whatnot. The local clinics are offering influenza shots, can somebody provide a good reason why I should take several hours out of my day and go get one? For reference: I’m a 32-year-old white male, living in Saskatoon, Canada. I’m a PhD student at a large university, in an agriculture science department, and I have very little contact with the elderly, small children, or immunocompromised people (as far as I know). I’m mostly curious what the opinions here might be.

  13. #13 JayK
    October 6, 2010

    @TheBrummell: So you’re happy being supported by herd immunity while contributing nothing yourself to it?

    Do what you want, but just be aware of your part in the bigger scheme of things.

  14. #14 James Sweet
    October 6, 2010

    In partial defense of TheBrummell, I have to admit that throughout my 20s, I never got a flu vaccine, mostly because I just spaced on it.

    @TheBrummell: It takes several hours out of your day to go get one? That seems like a problem… I expect it to take about 20 minutes out of my day.

    Also, in regards to market forces and thimerosal — no, it was the bad publicity. That’s been pretty well documented. That said, preservatives are becoming less necessary in vaccines (due to improved shipping and refrigeration technology), and since a small minority of people are legitimately allergic to thimerosal (see comment #4) it’s probably just as well that it’s being removed.

  15. #15 JayK
    October 6, 2010

    @TheBrummell: So you’re happy being supported by herd immunity while contributing nothing yourself to it?

    Do what you want, but just be aware of your part in the bigger scheme of things.

  16. #16 stripey_cat
    October 6, 2010

    TheBrummell: the main reason for a healthy adult to get flu vaccine is so that they won’t spread flu to vulnerable people, as you seem to be aware. If you know anyone with babies or kids at home, who is pregnant, living with elderly relatives, or with assorted serious diseases that affect their lungs (eg asthma!) or their immune systems, then by getting the shot yourself you reduce their risks of flu and its complications. I’d be very surprised if no-one you see on a daily basis fits into at least one of the categories above. Even if they’re vaccinated themselves, vaccinations aren’t perfect (they reduce the risk they’ll get flu, not totally eliminate it), so you still help their chances by not being a disease vector.

  17. #17 Pablo
    October 6, 2010

    As I noted in the other post, MY flu vaccine did have thimerasol in it. So there! Neener, neener, neener!

  18. #18 Calli Arcale
    October 6, 2010

    TheBrummell — because H1N1, which is covered by the shot and expected to be the dominant strain of the season, predominantly afflicted healthy young adults. Exactly your demographic, actually.

    And you may want to reconsider your stance on adult immunizations, especially if you’re studying agriculture. You should at least be getting tetanus boosters every ten years. Tetanus is very hard to treat once it starts to show symptoms, and people who work in agriculture are at greater risk (though realistically pretty much everybody is at risk — the bacterium is ubiquitous in the environment).

  19. #19 Chris
    October 6, 2010

    TheBrummell:

    I’m a PhD student at a large university, in an agriculture science department,

    I can’t believe that your department does not require a tetanus booster. Every decent gardener knows that you will get yourself dirty, get cuts and that tetanus is a actual danger.

  20. #20 Scott
    October 6, 2010

    the main reason for a healthy adult to get flu vaccine is so that they won’t spread flu to vulnerable people, as you seem to be aware.

    Also the fact that the flu is not at all fun even for a healthy adult. Being out of commission for at least a few days is worth avoiding.

  21. #21 Todd W.
    October 6, 2010

    @TheBrummell

    Others have already hit on the main points, but I’ll add my two cents.

    First regarding the removal of thimerosal, it was, indeed, due to the mercury militia raising questions about thimerosal possibly causing autism. At the time, the evidence either for or against the idea was scarce, to say the least. FDA and CDC took a precautionary approach and recommended that manufacturers work to remove thimerosal wherever possible from vaccines. Since then, the evidence has come in that there is no connection. Pretty much all of the manufacturers, though, have already switched over to thimerosal-free production for U.S. vaccines (except multi-dose vials of flu vaccine and one type of meningococcal vaccine). A fuller picture of this can be found on the FDA’s vaccine and thimerosal page.

    As to why you should get vaccinated against the flu, there are some things to consider. You mentioned some of them (coming into contact with high-risk types). The one thing on your list that you cannot be positive about is who is immunocompromised or has some other medical condition putting them at risk. It’s not something you can tell just by looking at a person. This becomes more important if you regularly use public transportation or go to crowded public places (e.g., movie theatre, supermarket, etc.).

    Another thing to consider is this: novel H1N1 influenza inordinately affects younger individuals, including young adults. So, if you have not yet been exposed to it, you are a prime target to be hit harder by it.

    In the end, your personal risks for the flu and its consequences are probably low. Likewise for those around you, though there is greater uncertainty there. For myself, like you, I’m young and healthy. For years I never got the vaccine because I wasn’t particularly concerned about the flu and (sadly) bought into the hype that the vaccine wasn’t particularly good. Then I learned more about vaccines and the anti-vaccine movement, as well as becoming friends with someone who was a multiple transplant recipient. I decided to get vaccinated for those around me, instead of thinking only about myself. I did it for every person I brush past on the subway, for friends, for family, for the cashier at the store and so on.

  22. #22 Vicki
    October 6, 2010

    @TheBrummel:

    The key reason is that “as far as I know.” Would you necessarily know if someone in your department was immuno-compromised? Not everyone who is being treated with chemotherapy advertises that fact to all and sundry. Nor do all transplant recipients, much less HIV-positive people (even those who know their HIV status). The life you save may be your neighbor’s.

    The second reason is that some flu seasons (notoriously the post-World War I Spanish flu, but to some extent last year) are particularly hard on young, healthy people like you.

    The third reason is that you’re at a large university in the largest city in Saskatchewan, not a village of 200 people. You will be interacting with a lot of people: not at length, perhaps, but how long a conversation does it take for someone to sneeze next to you? That said, I’m not especially cautious by a lot of standards: my daily mass transit rides almost certainly expose me to greater risk.

    If you have specific reasons to avoid the flu vaccine, the above arguments may be irrelevant; but there are the reasons why it might make sense for you to be vaccinated, just based on what you said.

  23. #23 Sock Puppet of the Great Satan
    October 6, 2010

    “FLUARIX is formulated without preservatives. FLUARIX does not contain thimerosal. Each 0.5-mL dose also contains octoxynol-10 (TRITON® X-100) ≤0.085 mg, α-tocopheryl hydrogen succinate ≤0.1 mg,”

    alpha-Tocopheryl? Dammit, they’re putting vitamins in the shots! I know its an antioxidant, but how are we furthering our evil plot with it?

    This isn’t the pharma conspiracy I joined up for. What are our lizardoid shareholders and masters thinking?

  24. #24 Sid Offit
    October 6, 2010

    @Brummel

    Seems you’ve created a stamped within the herd. Vaccine groupie after vaccine groupie trampling one another in order to convince you to get a vaccine that will likely provide you no benefit. For god sakes man think about yourself.

  25. #25 DaveH
    October 6, 2010

    @TheBrummell

    On the same track as Vicki, speaking as one grad student to another (Guelph, in ON): the hordes of snot-nosed undergrads. I assume you TA? Occasionally go to the cafeteria? Walk through the halls? Large communal spaces such as universities are ideal spaces to spread airborne diseases. Every person who gets vaccinated helps break that chain of transmission.

    With that as a segue, one of the best arguments for home-based healthcare? If you aren’t sick enough to need to intensive support of a hospital, stay away. I myself have avoided going to the clinic if my symptoms were mild simply because I didn’t want to be around sick people.

  26. #26 KoryO
    October 6, 2010

    My son just got the flu vaccine that is shot up the nose (no injection). Does that stuff have thimerosal in it?

  27. #27 Orange Lantern
    October 6, 2010

    KoryO,
    No. It’s guaranteed not to. Live attenuated vaccines like intranasal influenza vaccine cannot have thimerosal.

  28. #28 Composer99
    October 6, 2010

    @TheBrummell

    I trust you will see how the ‘vaccine groupies’ on this comment threat provide rational justifications for getting vaccinated against influenza whereas Sid Offit has no justification against save an ad hominem fallacy.

    @ Sid:

    Re:

    a vaccine that will likely provide you no benefit

    Citation needed. And please try to do better than your usual quote-mining.

  29. #29 Alan Kellogg
    October 6, 2010

    Poor baby, now you’ll never know the joy of late onset autism. I mean, there has to be something behind all these grown-ups being diagnosed with autism, an ASD, or even Aspergers lately.

    /snark.

  30. #30 Ian
    October 6, 2010

    @Chris – agricultural science is SO NOT THE SAME THING AS GARDENING :P Any more than studying zoology is like working in a pet store.

    @TheBrummel – the inconvenience to you is likely to be minimal, especially if your university has a clinic, or if you live near a walk-in. The benefit is likely not to be to you directly, but you are contagious with flu before you develop symptoms, so even if you stay home sick from work and don’t interact with kids, you might still spread illness when you go to Shopper’s Drug Mart to pick up laundry soap, or when you go to IGA for Nesquik. The whole point is that you can essentially guarantee not to make other people sick, and it will require only a tiny investment from you.

    @Sid Offit – that “think of yourself” argument is much less persuasive among we Canadians than I’m sure you’d like it to be.

  31. #31 jre
    October 6, 2010

    Erasmus: Did you hear they had to recall a whole factory lot of thermometers?

    Aquinas: Why’s that?

    Erasmus: They found tuna in the mercury! [rimshot]

    I tried to find a source for that old chestnut, so as to give credit, but you’d be surprised how many Google hits you get for “tuna in the mercury.”

  32. #32 khan
    October 6, 2010

    I get flu shots because I really don’t like being sick.

  33. #33 Sauceress
    October 6, 2010

    Stop your complaining Orac.
    Octoxynol-10 , α-tocopheryl hydrogen succinate, hydrocortisone ,gentamicin sulfate, ovalbumin, AND sodium deoxycholate sure SOUND LIKE nasty, BRAIN modifying CHEMICALS to ME!!11!

  34. #34 Someone else where the Brumell Works...
    October 6, 2010

    @TheBrummel
    I work at the same institution and in the same building as you, in fact little brother may be watching you right now….

    Just think about the number of students who come into our building for a class every day and touch the doorknob to the bathroom that you also touch…. After you compulsively wash your hands several times consider the shot.

    You would be surprised how efficient the clinics in Saskatoon are. If you go to the main clinic a week or two after it starts you can generally walk right in. It tends to be busy for the first few days when the priority are elderly and other higher risk people.

    I will certainly be getting it as I have a houshold contact (an infant) who is too young to get the vaccine.

  35. #35 Pierre Trudeau
    October 6, 2010

    I go to a supermarket where an immunocompromised elderly small child works and I’ll definitely be getting the flu shot this year

  36. #36 DrWonderful
    October 6, 2010

    I love the burning sarcasm. Really I do. Just wish so many here could handle the snarky stuff when directed at them. But that’s a different issue.

    In all seriousness, not being a medical guy, is this variation of the vaccine any more/less safe or more/less effective than the multi-dose vials that do contain thimerosal? I honestly don’t know and would like to learn a little here in case someone asks me. I’m not being a prick, just asking so please feel no need to attack. Just asking for some info. If you present it in a ball of tightwad snark that’s fine, just really want the info though. Pablo and Bacon likely cannot resist but anyone who answers factually will do.

  37. #37 Lawrence
    October 6, 2010

    DrW – it is my understanding that the only difference is the preservative (or lack of it), so these shots don’t last as long in storage as they did before.

    This isn’t a huge problem here – where we have ready access to modern medical care, but in third world countries, where it is much harder to get the vaccines to the people that need it (in a timely fashion).

  38. #38 Chris
    October 6, 2010

    Ian:

    agricultural science is SO NOT THE SAME THING AS GARDENING :P Any more than studying zoology is like working in a pet store.

    I am well aware of that. I happen to live near a botany lab (it was once torched by the Earth Liberation Front), and know people who have majored in agricultural engr. So at TheBrummel’s program:
    They don’t use any grafting tools?
    Deal in soil samples?
    Have test plots?
    Grow any plants?
    Work with pollinators?
    Hand pollinate plants to create hybrids?

    So the next time I see a bunch of students planting native plants at the local test plot (reclaiming a former garbage dump) with real shovels should I tell them they would not have to do any of that if they transferred up to Canada?

  39. #39 Chris
    October 6, 2010

    Lawrence:

    DrW – it is my understanding that the only difference is the preservative (or lack of it), so these shots don’t last as long in storage as they did before.

    Actually they are provided in pre-packaged single dose pre-filled syringe. The thimerosal allowed the use of a multi-dose bottle with a membrane that a needle could go through to fill up a syringe by preventing bacterial contamination. One is more expensive than the other.

  40. #40 DLC
    October 6, 2010

    So, I can get the flu shot and not immediately turn into Peter Griffin ?

  41. #41 Mandrellian
    October 6, 2010

    “@Brummel

    Seems you’ve created a stamped [pretty sure that word has an “e” on the end – M] within the herd. Vaccine groupie after vaccine groupie trampling one another in order to convince you to get a vaccine that will likely provide you no benefit. For god sakes man think about yourself. ”

    Excellent. It simply isn’t a complete vaccine-related RI thread without a completely ineffectual, unsupported, knee-jerk, hit-and-run, paranoid, attempted (yet failed) troll-ish comment by everyone’s favourite Non-Troll.

    For those not in the know: “Sid” long ago lost the ability to actually irritate people. Thus, Sid’s new designation is Non-Troll, Failed Troll or (if we’re being very charitable) Former Troll as his short, pointless and argument-devoid posts can only elicit sarcasm, smirks, pity and the odd raised eyebrow (or simple ignorance, which isn’t as much fun).

    So go ahead: gaze in wonder upon the most determined Failed Troll on the interwebs!

  42. #42 Denice Walter
    October 6, 2010

    “Shameless flu shot pushers use strip clubs to entice people into medically useless vaccination”….”Virtually all flu vaccination marketting is illegal because it makes false and misleading promises that simply aren’t backed up by the science” (NaturalNews, today. Ah, Mike Adams, the gift that keeps on giving!) Then he continues to carp on about how he and his compadres can’t even talk about vitamin D’s effects.

  43. #43 Matthew Cline
    October 6, 2010

    @Denice Walter:

    Then he continues to carp on about how he and his compadres can’t even talk about vitamin D’s effects.

    There’s a law making it illegal to talk about vitamin D? The English language doesn’t contain the words to adequately describe the wonders of vitamin D? What?

  44. #44 Denice Walter
    October 6, 2010

    @ Matthew Cline : I think that Mikey confuses 1. *not* being able to make claims about supplements as _treatments or cures_ for disease with 2. the *possiblity* of tighter regulations on supplements ( post-DSHEA) and 3.his own fears about censorship and threats to “health freedom” ( as well as free enterprise). Not that that ever stops him from describing the wonders of vitamin D : Elixir of Life Resplendent!

  45. #45 Science Mom
    October 6, 2010

    @ Matthew Cline, Denise speaks the truth (it’s stranger than fiction right?). Here is the excerpt:

    What’s especially interesting about all this is that even while the vaccine industry can get away with the fraudulent marketing of its products, the FTC and FDA actively target natural product companies that tell the truth! So it’s legal in America to lie about the supposed benefits of a vaccine, but it’s illegal to tell the truth about the health benefits of a natural food or nutritional supplement. No wonder we’re all so sick in America…

    So a maker of a vitamin D supplement isn’t allowed to say that vitamin D protects you from the flu far better than vaccines even though it’s absolutely true (http://www.naturalnews.com/029760_v…). But a vaccine manufacturer can claim a vaccine will save your life, even though that’s blatantly false.

    http://www.naturalnews.com/029962_flu_shot_propaganda.html

  46. #46 derelicthat
    October 6, 2010

    @Denice Walter

    “Shameless flu shot pushers use strip clubs to entice people into medically useless vaccination”

    I can go to a strip club AND get a flu shot?! Will wonders never cease?

  47. #47 Orac
    October 6, 2010

    Damn! Now why didn’t I think of that?

  48. #48 Chris
    October 6, 2010

    I wonder if a flu shot offered with a discounted mani-pedi would interest my sisters.

  49. #49 Matthew Cline
    October 7, 2010

    Free toxins with every lap dance!

  50. #50 Drivebyposter
    October 7, 2010

    “Shameless flu shot pushers use strip clubs to entice people into medically useless vaccination”

    Strip clubs have been filled with tiny pricks for years. A few more can’t really hurt. (BAZING!)

    Free toxins with every lap dance!

    By this do you mean syphilis? Or the vaccine toxins?
    Either way, COUNT ME IN!

  51. #51 Kathryn
    October 7, 2010

    I got the flu shot recently, and the pertussis-diptheria-tetanus booster a few weeks earlier, and didn’t get a sore arm for either one. Does that mean I’m lucky, or that it didn’t take since I didn’t show an immune response? Or does it mean that thimerosal-free shots are less irritating at the injection site?

  52. #52 symball
    October 7, 2010

    @ brummel

    In all seriousness you forget that you can easily carry a virus without showing serious symptoms. Maybe you should think of your classmates- do any of them have infant or elderly relatives they could infect with the flu? perhaps an immuno-compromised friend?

    The jab isn’t just for you- No one likes a typhoid Mary.

  53. #53 Dangerous Bacon
    October 7, 2010

    “In all seriousness, not being a medical guy…”
    Posted by: DrWonderful

    Another illusion shattered.

  54. #54 Matthew Cline
    October 7, 2010

    A question about flu vaccines: are safety trials repeated each year for each new flu strain, or are the safety trials only done once?

  55. #55 historygeek
    October 7, 2010

    i got my flu shot last month i went to the store for beer and they are give out flu shots and it had thimerosal i scored on the toxins yippie

  56. #56 jen
    October 7, 2010

    I got the impression from another story somewhere (the person wound up paying for a flu shot because the health insurance covered “the flu shot”, just not the one-and-only-flu-shot-on-the-market) that the single-use flu shot is the only one on the market this year (except, of course, for the kids’ nose swabs).

  57. #57 Scott
    October 7, 2010

    The one I got this year was from a multidose vial. So apparently that story was incorrect.

  58. #58 https://me.yahoo.com/a/Z5ZA2tlvketPsnG3G8EVJbgYwGEUHH4E#13219
    October 7, 2010

    I am the poster way back who is allergic to thimerosal. Last year was the first time in many years that I got a flu shot. Last year, in my mid-fifties, I returned to college. While I don’t live in the dorm, I mingle with all those presumably healthy young people. I have asthma and two prosthetic heart valves and getting influenza could be devastating. I also don’t want to give H1N1 to all those kids.
    I suggest that anyone at increased risk of harm from the flu also get a dose of Pneumovax, the vaccine for Streptococcus pneumoniae, an organism that is a, perhaps the, major cause of community-acquired pneumonias.

  59. #59 Vicki
    October 7, 2010

    Your thimerosal is apparently here in New York City: the FAQ posted for my office’s upcoming free flu shot clinic has “allergic to thimerosal” at the top of the list for “who should not get the flu shot” (with egg allergy right below).

    I’m assuming that this isn’t about geography but about the use of a multi-dose vial. (And I hope people read the poster: at least one coworker last year cheerfully signed the consent form and got the vaccine without actually reading the form. She was fine, but it hadn’t occurred to her that there was information on there, rather than just a promise not to sue their grandmother’s chihuahua or something.)

  60. #60 TheBrummell
    October 7, 2010

    @#34: What, somebody else working in this large building also procrastinates on-line on Scienceblogs? *mind blown* In all seriousness, though, you raise some good points. I’m glad to hear the Saskatoon clinics are pretty good, as that was where my thought about “several hours” came from. I suppose you also saw that email a few days ago stating we should not go to the campus clinic, as they have a limited supply for their own use (high-risk on-campus patients, the medical professionals themselves, etc). Getting to somewhere off-campus would take time, waiting in line would take time, the injection itself should be less than 20 minutes, but all the running around would still probably use up at least an hour or two. I’ll look into the nearest options, and I like your suggestion to go after the initial high-priority rush.

    To all the people who pointed out the various invisible high-risk people around: true. I am well aware that various forms of immunocompromise are not apparent, and unlikely to be advertised (I’ve never seen a t-shirt with “I’ve got a new kidney!” on it, for example). The uncertainty about the risks faced by the people around me is alone a good argument for universal immunization.

    I do indeed work with soil samples, livestock fecal samples, live bacterial cultures (level 2 biohazard lab), et cetera. Tetanus shots are not required by this institution, though I think the people in Animal Science (2 floors below me) are probably all strongly encouraged to get them.

    Frankly, I would much rather spend my time digging in the (high-risk) dirt than here at my computer, trying to make my figures look good and the Methods & Materials section comprehensible, but such is October.

    The sheer volume of hard-edged sarcasm in this thread is pretty impressive. It’s interesting to be the recipient of it, rather than my usual position of spectator. Thanks for maintaining this venue, Orac.

    Also: combined vaccination clinic / strip club is an awesome idea.

  61. #61 Chris
    October 7, 2010

    Why do you think you are immune to tetanus?

  62. #62 Scott
    October 7, 2010

    @ Chris:

    I don’t believe he said he is. Just that his institution doesn’t require the vaccine and that he hasn’t gotten one. Your comment seems like a straw man to me.

  63. #63 TheBrummell
    October 7, 2010

    Wow, that’s quite the leap, Chris.

    I do not think I am immune to tetanus (or influenza, or HIV, or rhinovirus, or… you get the picture). I do not think it impossible I will get infected with influenza in the next few months. I realize getting sick with the flu would be highly unpleasant, at least, and furthermore I would quite likely be passing infectious flu onto other people, including individuals who might die from the infection.

    Let’s a have a quick look at a cost/benefit analysis (this is going to be short and probably inaccurate).

    Getting flu vaccine
    Benefits: reduced probability of getting the flu, reduced probability of passing the flu on to a more vulnerable person.
    Costs: time, a bit of hassle perhaps with the beaurocratic side of the local healthcare system. Possibly a small amount of money for bus fare or something like that.
    Outcome: benefits appear to outweigh costs, assuming the reductions in those probabilities are large. If my probability of getting sick / passing it on are anyways very small, then the costs outweigh the benefits. But we’re talking about flu here, not malaria.

    Tetanus shot
    Benefits: I don’t get tetanus! Yay!
    Costs: probably about the same as for a flu shot.
    Outcome: Costs outweigh benefits, for now, until someone can convince me that my risk of getting tetanus is very high.

    My understanding of tetanus as a disease is the route of infection is by blood contact. If I get bacteria-laden dirt into a wound, it’s very likely I’ll get infected. So, either get vaccinated for tetanus, or reduce the probability of dirt-in-wound to vanishingly small. As far as I can tell, my highest chances of getting tetanus come from my periodic visits to the local junkyards to scavenge parts for my (old and decrepit) car; in the lab, if I’m handling soil there are no sharp objects involved and / or I’m wearing gloves and / or it’s definetaly un-laden soil (autoclaves are wonderful things).

    Besides, tetanus immunization and influenza vaccination provide drastically different effects to “herd immunity” because of the differences in transmission. Honest question that just occurred to me: how often does tetanus pass directly from person to person, rather than from soil/sharp object to person?

  64. #64 Todd W.
    October 7, 2010

    @TheBrummell

    As far as I know, tetanus is the odd-disease out in the vaccine schedule, in that it is not transmitted from person to person. I suppose it could conceivable be passed if someone with an open wound handles an infected individual’s stool and gets it in the wound.

    Regarding getting it in the lab, if the sample you are working with is not treated to eliminate any possible tetanus bacteria, there’s potential for infection. It doesn’t take a whole lot…even a paper cut could probably do it. The worse the wound, though, the more likely infection is to occur. IIRC (don’t have a source to hand at the moment), it is typically small, unnoticed wounds that get gardeners in trouble with tetanus.

    One big problem is that even with treatment, once symptoms show, things get bad really quick. If you develop symptoms of an infection, you will likely be hospitalized and put on paralytics so you don’t aspirate or break bones. Pain meds will also likely be administered, as well as enteral or parenteral nutrition. Even if you get quick treatment, death is still a relatively likely outcome (death rate among those infected is roughly 1 in 20).

    The CDC has a lot of info on it.

  65. #65 Chris
    October 7, 2010

    Scott, he specifically said earlier he had had not vaccines. And as you can see he admits to not getting a tetanus booster.

    And no, tetanus is not just by blood contact. I actually got a booster after stapling my finger, no real blood (offices are also dangerous!). Think about how vaccines are given, into the muscle not the bloodstream. Infections happen to tissue.

    Tetanus does not pass person to person, but it is ubiquitous. There is no such thing as herd immunity from tetanus. And even though it is fairly rare, the activities you describe doing make it more likely, which is why I am surprised that you are avoiding protecting yourself. But I only know because I do garden.

    Plus I have been following the vaccine issue for a while. And not all of the tetanus cases are what you think:

    Among 129 patients with information provided on the condition leading to tetanus, acute trauma was reported for 73% (94/129) of patients; no acute injury (i.e., patients with abscesses, ulcers, or gangrene) was reported for 26% (34/129); and one case (1%, 1/129) was reported in a neonate (Table 2). A puncture wound was the most frequent type of acute trauma (50%), followed by lacerations (33%) and abrasions (9%). Puncture wounds included stepping on a nail (15 cases), splinter (five cases), injury from barbed wire (five cases), a tattoo (one case), and a spider bite (one case).* The acute injury was located on the lower extremity in 48 (51%) patients, the upper extremity in 34 (36%) patients, the head or trunk in nine (10%) patients, and not specified in three patients. The environment in which the acute injury occurred was reported for 83 (88%) patients. Thirty-seven (45%) patients were injured at home or indoors; 26 (31%) were injured while farming or gardening; 19 (23%) were injured while engaging in other outdoor activities; and one (1%) was injured in an automobile accident.

    I am also surprised that it is so expensive to get a Td or Tdap in Canada. I actually thought tetanus boosters would have been covered by Health Canada, and actually encouraged. Thanks for killing that myth.

  66. #66 Scott
    October 7, 2010

    Scott, he specifically said earlier he had had not vaccines. And as you can see he admits to not getting a tetanus booster.

    True, but irrelevant to what I said and not support for what you said earlier. You asked why he thinks he’s immune; saying he hasn’t had the vaccine is NOT a claim to be immune anyway! And in fact he’s now clarified that he specifically does not so claim. In other words, your implication earlier was unfounded and a straw man.

  67. #67 Chris
    October 7, 2010

    The VFC/CDC Vaccine Price List show that the adult influenza vaccine ranges from $10 to $20, and the Td is $14 to $20, and the Tdap is much costlier, being between $27 to $38.

  68. #68 Chris
    October 7, 2010

    Scott, I am guilty as charged. I am still surprised that he is avoiding a tetanus booster, and possibly from my experience in dealing with a household of teenagers I may have been assuming he still has the typical adolescent illusion of immortality. But now I know his understanding of tetanus was just flawed.

  69. #69 https://me.yahoo.com/a/Z5ZA2tlvketPsnG3G8EVJbgYwGEUHH4E#13219
    October 7, 2010

    I am a former physician assistant and I used to work for an immunologist. We couldn’t prove it, but it is possible that one of our immune-globulin-deficient patients may have died from tetanus. A pretty sight it is not. See it once and you will never forget to get your tetanus vaccine.

  70. #70 Militant Agnostic
    October 7, 2010

    I am also surprised that it is so expensive to get a Td or Tdap in Canada.

    I have never had to pay for one in Alberta.

  71. #71 Pompous Latinistic Username
    October 7, 2010

    Wow, the one guy that continually ridicules people for having doubts about thimerasol, gets a flu WITHOUT thimerasol. I would have thought that he would get 20 flu shots in one day all WITH thimerasol to make his point. Perhaps he doesn’t think that’s such a wise idea after all?

  72. #72 Calli Arcale
    October 7, 2010

    Pompous Latinistic Username — he just took whatever the clinic was offering, which happened to be the single-dose unit. Me, I have no preference whatsoever, as I am not allergic to thimerosal. My only requirement is that it be an injectable one; I have asthma and would be contraindicated for the nasal one.

  73. #73 Calli Arcale
    October 7, 2010

    TheBrummell @ 63:

    Besides, tetanus immunization and influenza vaccination provide drastically different effects to “herd immunity” because of the differences in transmission. Honest question that just occurred to me: how often does tetanus pass directly from person to person, rather than from soil/sharp object to person?

    Virtually never — possibly never, period. Tetanus is an oddball for a couple of reasons. First, vaccination has nothing to do with herd immunity, because humans are neither a reservoir nor a vector for the pathogen (Clostridium tetani). Herd immunity cannot be achieved. So the vaccine is given purely to protect the person being vaccinated. Second, it’s not possible to develop immunity from the disease, so even if you survive it once, your risk of subsequent infection is the same as it was before.

    Personally, I’d keep vaccinated. But that’s a personal decision. You don’t have to get vaccinated against tetanus on anybody’s account but your own.

  74. #74 Pompous Latinistic Username
    October 7, 2010

    “he just took whatever the clinic was offering, which happened to be the single-dose unit.”

    Yes how serendipitous. Seems like a perfect opportunity to practise what one preaches was lost however.

  75. #75 Chris
    October 7, 2010

    Yeah, oh reading comprehension impaired one, it isn’t like he was in charge with ordering the supply for the vaccine clinic where he works.

    First sentence in the article before this one is: “My cancer center is finally offering the flu vaccine for its employees, ”

    What part of that did you not understand?

  76. #76 khan
    October 7, 2010

    Question: Is there any problem with getting flu & shingles & TDP shots within a couple days of each other?

  77. #77 kae
    October 7, 2010

    Years ago there was a nail strengthening product called Mavala: Hard As Nails. It contained formaldehyde in some form. It really worked to harden the nails, but there was a caution not to put it on the skin surrounding the nails.

    You can’t buy it any more, and any other products to harden nails which are applied topically are really only nail varnish.

    I had no intention of drinking the Mavala, nor painting anything else except my nails.

    Bastards.

  78. #78 Antaeus Feldspar
    October 7, 2010

    Wow, the one guy that continually ridicules people for having doubts about thimerasol, gets a flu WITHOUT thimerasol. I would have thought that he would get 20 flu shots in one day all WITH thimerasol to make his point.

    Were you unable to read his post?

    Or even the title?

    Probably not.

  79. #79 Antaeus Feldspar
    October 7, 2010

    Thanks everybody, for correcting me on the tetanus vaccine. I should have known that, since I just recently had my annual physical and made sure I was up to date on vaccinations, and one of them was the diptheria/tetanus/pertussis vaccine! But, it’s been worth it, since with your comments I’ve learned even more about the disease and the vaccine than I knew before. Thanks, all!

  80. #80 Composer99
    October 7, 2010

    Antaeus @79:

    One of the things that keeps me coming back here is that I often am as enlightened by the comment section as I am by the original article.

  81. #81 Drivebyposter
    October 8, 2010

    Did Orac get the thimerosal flu vaccine last year?

    And where do jack asses like pompous dumbassicus come from and why do they all think they have a point to make?

    I mean…I feel like they should notice some sort of fundamental flaw in their thinking….

    And on a side note, besides fewer and fewer vaccines, where else would one come across thimerosal.

  82. #82 W. Kevin Vicklund
    October 8, 2010

    Contact lens solution.

  83. #83 Todd W.
    October 8, 2010

    @Drivebyposter

    It was also used to preserve seed grains. The grains were supposed to be washed, IIRC, before being planted and were not to be used directly for food (e.g., for making flour). Not sure if it is still used for that or not.

  84. #84 Pompous Latinistic Username
    October 8, 2010

    “First sentence in the article before this one is: “My cancer center is finally offering the flu vaccine for its employees, ”

    What part of that did you not understand?”

    The part I didn’t understand is why someone who ridicules those for questioning thimerasol would get a thimerasol free vaccine. Seems to me that it would have been more appropriate to get the last dose from a multi-dose vial that perhaps hadn’t been shaken before the previous doses were administered. I mean, there’s nothing to worry about right? In fact, mercury lowers the risk of autism so I would have thought that would be a no-brainer, even if it meant making a special trip to the pharmacy. Why heighten your risk for adverse events by taking the thimerasol free vaccine?

  85. #85 Chris
    October 8, 2010

    You are dense, aren’t you. Let my type it more slowly for you:

    1) The vaccine was offered by his place of work.

    2) He does not order the vaccines used to vaccinate the people at his place of work.

    3) His place of work decided to order the pre-filled single use syringes.

    4) He is a busy person, so getting the vaccine from his place of work was a logical thing to do.

    5) Since vaccine clinics in places where people work are very busy, they often assign a time slot to the employee.

    6) He was not given a choice of the type of vaccine, because there was only one choice.

    Do you understand now? Or do we have to break it down even more?

  86. #86 Composer99
    October 8, 2010

    Pompous Latinistic Username @ 84:

    (1) Orac does not ridicule people who ‘question’ thimerasol (in vaccines). He ridicules people who lie about the effects of thimerasol in vaccines.

    (2) ‘Mercury’ (what mercury compound, exactly, are we talking about?) does not lower the risk of autism. Recent research suggested a correlation between thimerasol-containing vaccines and lower autism risk although if memory serves the researchers put that down to sociological factors (generally, people with children who ended up being diagnosed with autism were less likely to complete their vaccination series or get subsequent children vaccinated – and those subsequent children were more likely to be autistic on account of its hereditary nature).

    (3) Continuing on the vein of #2, how exactly is Orac going to ‘get autism’?

    Your comment smells rather strongly of straw.

  87. #87 Matthew Cline
    October 8, 2010

    7) The flu vaccine is different each year. There isn’t going to be any flu vaccine from last year laying around, only the current vaccine, so Orac couldn’t ask for the older vaccine.

  88. #88 Pompous Latinistic Username
    October 9, 2010

    “Do you understand now? Or do we have to break it down even more?”

    Just to be sure I understand, you are saying “do as we say, not as we do”?

  89. #89 Chris
    October 9, 2010

    No, oh reading comprehension impaired person.

    He tried, idiot. But the preferred vaccine was not available.

  90. #90 Matthew Cline
    October 9, 2010

    So, then, when Orac found out there was no mercury in the flu shot, he should have refused it, then have driven from one clinic to the next until he finally found one that offered a mercury containing shot?

  91. #91 JohnV
    October 9, 2010

    Pompous Latinistic Username are you honestly this stupid?

  92. #92 Vaz Deferenz
    October 10, 2010

    Scented air fresheners are for wankers. If Orac wants thyme aerosol, that’s his choice.

  93. #93 Ender
    October 12, 2010

    Pompous Latinate Username needs a lesson in grammar as well as logic. (OMG! Why did the guy complaining about not getting Thimerosol from the only available assigned-by-someone-else dose not take one of the other doses? Why did he not take 20 of these doses that do not exist and were not available?)

  94. #94 Pompous Latinistic Username
    October 12, 2010

    Where I come from, if you can’t walk the walk, you don’t talk the talk.

  95. #95 Calli Arcale
    October 12, 2010

    Where I come from, we realize that harping on trivialities makes it look like you don’t actually have a decent argument to make and are hoping nobody notices.

    As I mentioned to you before, PLU, but you didn’t respond and so may not have noticed, Orac didn’t even realize he’d had the thimerosal-free version until afterwards. What exactly is your point? That Orac has a life beyond the vaccine manufactroversy? That he thinks there are more important things than satisfying the petty whims of trolls? That he doesn’t take your concerns seriously enough to delay his own influenza vaccination just to prove a point? That he considers the point already pretty damn well proven so why bother going to extra effort to convince the unconvinceable?

    You sound like the people who ask NASA why they don’t refute the moon hoax nonsense. The answer is simple: there’s frankly no point, and they’ve got better things to do than engage in a Sisyphian effort to indulge the whims of crackpots determined to disbelieve them anyway.

  96. #96 Billy
    October 12, 2010

    PLU: if that’s the case, then you better stop talking the talk.

  97. #97 Antaeus Feldspar
    October 12, 2010

    Pompous Latinistic Username are you honestly this stupid?

    No, he isn’t. He’s powerfully stupid, but it’s not in an honest way. His dishonesty starts with the fact that he’s someone who regularly posts here under a different name, adopting a different pseudonym for this harassment. Then his dishonesty and stupidity are furthered by the fact that he doesn’t actually believe that it makes sense to get twenty times the recommended dosage of flu vaccine, and he doesn’t actually believe that those who are unbothered by the low levels of mercury compounds in vaccines actually believe mercury lowers the risk of autism.

    No, he is simply stupid enough to believe that he is actually achieving something of worth merely by harassing people who don’t believe as he does. He knows he can’t defend his own point of view in civilized debate but in his murky mind, he thinks he’s “winning” something if he brings some measure of discomfort to those who have those inconvenient, pesky facts on their side.

    So, yes, PLU is stupid, but not honestly so.

  98. #98 madder
    October 12, 2010

    @Antaeus Feldspar:

    Funny, I always thought “Pompous Latinistic Username” referred to his other handle.

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