CAM and low flu vaccine uptake: Fitting together hand in glove

There’s a class of studies that I sometimes refer to as “Well, duh!” studies because their conclusions are so mind-numbingly obvious that one wonders why anyone did the study in the first place. Sometimes that name is meant sarcastically, as in, “Why did these investigators waste the time, effort, and resources to do this study? No, really, why?” Sometimes, though, “Well, duh!” studies are useful and justified because they confirm a conclusion that everyone strongly suspected but for which there wasn’t direct evidence. So it was with a “Well, duh!” study that was published in the October issue of Pediatrics that made the news yesterday in stories with titles like Alternative medicine may be linked to lower vaccination rates and Study: Alternative medicine used to skip flu shots. Those of you who have been reading this blog for any decent length of time probably suspected that this was true, if not outright knew without science that it was.

Now there’s another bit of science to show that it is, in the form of a study that looked at the use of “complementary and alternative medicine” (CAM) among children and correlated it to flu vaccine uptake. The authors note right in the introduction:

Complementary and alternative medicine (CAM), approaches to health that are not considered part of conventional medicine (eg, homeopathy, chiropractic manipulation, chelation therapy),8 have also recently risen in popularity as a form of health care. Estimates from the previous decade (pooled data from 2002, 2007, and 2012) show that one-third of the US population had used at least 1 type of CAM in the previous 12 months.9 The prevalence of CAM is highest among middle-aged, non-Hispanic white women of high socioeconomic status, as well as those with multiple health conditions and who frequently visit medical facilities.8,9 CAM is mostly used in conjunction with conventional medicine10 for prevention of diseases and to improve health and well-being11 and thus should not, in theory, interfere with vaccination uptake. However, CAM has been implicated as lending support to antivaccine/vaccine-hesitant viewpoints via criticism of vaccination, public health, and conventional medicine from adults using CAM,12–14 as well as from CAM practitioners and practitioners-in-training.12,15,16 Even among CAM practitioners who generally support the concept of vaccination, a majority report they recommend a vaccine schedule different from the standard schedule put forth by the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices.17

And it’s true. It’s been studied. Many CAM practitioners, such as chiropractors and naturopaths, tend to be very hostile to vaccines, and the references cited in the passage above definitely show this. None of this is surprising. Some of the most common quackery and tropes adopted by CAM involve antivaccine beliefs or beliefs that feed into antivaccine beliefs, such as the idea that “natural” immunity is better than vaccine-induced immunity, that “detoxification” can treat conditions often blamed on vaccines by antivaccinationists, such as autism. Heck, homeopaths think that their “nosodes” can work as well as vaccines, and, let’s not forget, you can’t have naturopathy without homeopathy because homeopathy is part and parcel of naturopathic education and even a required component of the NPLEX, the naturopathic licensing examination.

So, on to the study.

This study used data from 2012 National Health Interview Survey (NHIS), the most recent NHIS to include the Child Complementary and Alternative Medicine File (CAL). The NHIS annually collects information on the health of the US noninstitutionalized civilian population through household interviews of household adults. The investigators used grouped 37 CAM therapies across 4 domains developed by the National Center for Complementary and Alternative Medicine in 201242–45: (1) alternative medical systems (AMS; eg, acupuncture); (2) biologically based therapies (BBTs; eg, herbal supplements); (3) manipulative and body-based therapies (MBBT; eg, chiropractic manipulation); and (4) mind–body therapies (MBT; eg, yoga). As an aside, I hate the way CAMsters lump yoga into “mind-body” therapies. It’s a form of exercise, people! Nothing more! Calling it a “mind-body” therapy does nothing more than make it seem mystical and magical. End of digression. The authors also separated the use of multivitamins from BBTs because it was by far the largest class. In their analysis, they analyzed the results form 9,000 children and took into account 13 covariates:

Using this model, 13 covariates were selected. At the child level, these covariates were: sex (female/male); age (years); race/ethnicity (non-Hispanic white; non-Hispanic black or African American; non-Hispanic Asian; non-Hispanic other or multiple race; and Hispanic); usual source of care they go to when the child is sick or the parent needs advice about the child’s health (yes/no); well-child checkup in the previous 12 months (yes/no); number of physician visits in the previous 12 months; US-born status (yes/no); presence of at least 1 serious chronic condition or limitation (yes/no [defined as having 1 of the following: Down syndrome, cerebral palsy, muscular dystrophy, cystic fibrosis, sickle cell anemia, autism or autism spectrum disorder, type 1 diabetes mellitus, arthritis, congenital heart disease, or other heart condition]); asthma status (yes/no); and insurance type (private, public, or no coverage). At the family level, these covariates were: highest family education (less than high school, completed high school or the General Educational Development test, associate’s degree or some college [no degree], or bachelor’s degree or higher); family income as a percentage of the federal poverty level (<100%, 100%–199%, or ≥200%); and language of interview (English only or other). These variables come from the NHIS Sample Child, Family, and Person files.

The results were:

Influenza vaccination uptake was lower among children ever (versus never) using AMS (33% vs 43%; P = .008) or MBBT (35% vs 43%; P = .002) but higher by using multivitamins/multiminerals (45% vs 39%; P

One thing that depressed me about the results of this study is just how low flu vaccine uptake is even among children who have never used CAM. 43%? That’s pathetic. We really need to do better. Seriously. How can anyone think that a flu vaccine uptake among children of a mere 43% is anything less than an utter failure? Be that as it may, CAM use is associated with even poorer flu vaccine uptake. Specifically, any children with a history of using anything from an alternative medical system (AMS) or manipulative and body-based therapies (MBBT) Remember, MBBT includes chiropractic. In contrast, mind–body therapies (MBTs) and biologically-based therapies (BBTs) are not associated with decrease flu vaccine uptake, at least not in this study. This makes sense, because taking multivitamins or supplements doesn’t necessarily track with antivaccinationism, given how common the use of such supplements is. Ditto mind–body therapies (MBTs), which under the National Center for Complementary and Integrative Health (NCCIH) classification, include a lot of interventions that are nothing more than various forms of exercise.

It’s not just CAM, though:

Several covariates were also significantly associated with influenza vaccination uptake and warrant further investigation in a future, longitudinal study as potential mediators and/or moderators of influenza vaccine disparities in children. Consistent with other studies, we found higher uptake among the following groups of children: those with a higher number of recent provider visits49–53 (which is conceptually related to having a well-child visit and a usual source of care, all of which are important given that physician recommendation of the vaccine is one of most commonly cited correlates of higher influenza vaccine uptake51,54–65); those without health insurance66; those with asthma or parental worry about asthma51,67; and those of a younger age.50–52,58,68–70 Although we found no disparities between black and white children, we did observe higher uptake in Asian, Hispanic, and other/multiracial children. There were no significant racial/ethnic disparities nationally among children in most recent influenza seasons,69 although higher uptake among Asian children has been observed.70 Generally, higher parental education is associated with higher influenza vaccine uptake in children.56,68,70 However, this scenario is not always the case, and in this study we found the inverse association. Studies (not including influenza vaccination) have documented that parents who delay or refuse vaccinating their children in general tend to be college educated, higher income, white populations, and also tend to have lifestyles that include CAM use and alternative diets.14,71–73 Perhaps not coincidentally, CAM is associated with higher income and higher education,74 which may partially explain the inverse education relationship we observed. Lastly, we found that foreign-born children had higher odds of vaccination compared with US-born children. Although we are unaware of studies examining the relationship of nativity/citizenship and influenza vaccination in US children, a recent study of Mexican adults in California found that higher influenza vaccine uptake diminishes after the first generation postmigration.75 Furthermore, a study of other vaccines found that having a foreign-born or noncitizen mother was associated with reduced odds or vaccination.76 More research is needed in these areas.

I find it particularly interesting that Mexican immigrants want the flu vaccine, so much so that they have a higher flu vaccine uptake than native Americans, but that by the first generation flu vaccine uptake falls to be indistinguishable from that of other native-born Americans.

Of course, one of the problems with this study is the classic “chicken or the egg” question. Is it using alternative medicine that causes parents to refuse to vaccinated or do parents who already have a reluctance to vaccinate tend to gravitate towards alternative therapies? From my perspective, I tend to think it’s more the latter than the former. Parents who are already vaccine-averse like the message promoted by CAM practitioners and their openness to not vaccinating. Of course, then these CAM practitioners themselves promote antivaccine views and “support” not vaccinating, thus creating a negative feedback loop that shuts down any thought of vaccinating. My only surprise from this study is that, if this study is to be believed, the effect is weaker than I would have predicted.

I started this post by referring to this as a “Well, duh!” study, and so it is. That doesn’t mean it’s pointless, worthless, or a waste of verbiage. It’s not. It tells us something important: Namely that CAM and antivaccine beliefs go hand-in-hand. Whether it’s because CAM practitioners’ are antivaccine and influence parents or because parents who are already vaccine-averse or antivaccine seek out CAM practitioners, CAM and vaccines do not go together.

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Influenza vaccination uptake was lower among children ever (versus never) using AMS (33% vs 43%; P = .008) or MBBT (35% vs 43%; P = .002)

Is this saying the actual take-up rate for the influenza vaccine was 33% of children (and so on) or is this a reporting format I am just not familiar with?

By jrkrideau (not verified) on 05 Oct 2016 #permalink

Correct. Among children ever using AMS, flu vaccine uptake was 33% compared to those never using it, which was 43%. That's why I went on my little rant about how flu vaccine uptake in this population was so low, even among the children whose parents never used CAM on them. 43% is pathetic. We clearly have to do better.

In my country, the government made the flu vaccine free for groups deemed at risk: people older than 65, pregnant women, etc. But there's precious little effort to get the families of these people to get a flu shot too! Try to explain afterwards that vaccines are not a magic shield, that herd immunity is a thing, and that maybe if you got the flu despite getting the flu shot, the cause is one of your loved ones...

By irenedelse (not verified) on 05 Oct 2016 #permalink

The flu vaccine was only given to the elderly and medical personnel when I was a kid. I got the flu four times before I was 18. Four times! I have a couple teeth that came in discolored and "chipped" looking from the fevers. As a result, I actually look forward to getting my flu shot every year.

I was pretty casual about the flu shot for many years, even though it was required when I was in the Air Force. So I tended to skip it until I was working in the schools and the H1N1variety hit. I was reading a lot more about it in these blogs and have been more consistent since then. Our grandson just got his 2 month shots, but he's too young for the flu shot yet, so we'll be getting ours soon.

By squirrelelite (not verified) on 05 Oct 2016 #permalink

In Ontario, the government made the flu vaccine free for everybody as part of their 'Universal Influenza Immunization Program'. You can wander into to most drug stores and get a free flu shot. The place where I work gets someone in to give everybody flu shots at work if they want them.

That said, while the UIIP boosted immunization rates in Ontario to start with, it seems to have plateaued out and even declined a bit since then, and based on what I can see from StatsCan, the rate generally still hovers in the 35-38% range.

By Jenora Feuer (not verified) on 05 Oct 2016 #permalink

I had forgotten the sources from which homeopaths' attempts at vaccines, "nosodes," are derived, though I often and understandably read that word as "nodose." Thank Avogadro!

I suspect the low general rate of flu vaccine uptake is at least partly because word isn't getting out. My local pharmacy advertises in-store that they have flu shots available, and my employer sometimes offers clinics (most insurance providers will pay for it, though that fact is not always made clear). But the marketing is not at all aggressive, and certainly not aimed at parents who may or may not get their kids vaccinated. That accounts for the correlation of uptake with well-child visits: these kids see their pediatricians regularly, and their parents are advised to make these arrangements (especially those whose well-child visits fall at the right time of year). But kids who don't get well-child visits, or don't get them at the right time of year, are likely to be missed.

By Eric Lund (not verified) on 05 Oct 2016 #permalink

In other news related to uptake of childhood influenza vaccines, Theresa "MICROBIOME" Conrick shoots herself in the foot at AoA today by trying to make hay out of Mina et al. (2014) today. For example,

"Perhaps the most important finding from our study, with regard to the health of the public and potential concerns regarding vaccination, is that LAIV did not enhance lower respiratory tract infections, morbidity, or mortality following bacterial infections, which are, by most accounts, the most significant issues to be concerned with in terms of respiratory tract bacterial disease."

The hilarity factor only goes up as one reads more.

I had forgotten the sources from which homeopaths’ attempts at vaccines, “nosodes,” are derived

I'm pretty sure that I mentioned the use of putrefactive matter last year when the FDA was putting on the "Homeopathic Product Regulation" production number last year.

" in other news"

Wait, isn't that supposed to be MY line?**
( but you may use it, my child... uh... I mean, brother)

At any rate, Mike Adams also has a scaremongering tract up today about how vaccines cause hypersensitivity of the immune system, autism and IIRC, DEATH!

** They pay us to maintain particular writing styles and use idiosyncratic memes/ nyms so that readers won't realise that we're only repeating what we're told by higher ups.

We have no souls but we love our paymasters.

By Denice Walter (not verified) on 05 Oct 2016 #permalink

and my employer sometimes offers clinics

Yah, back when I had a university employer, they also did. Unfortunately, they didn't get out the message to middle management that taking the time to traipse to the other side of campus should be encouraged. (At least the middle manager was worst afflicted one year.)

Unfortunately, they didn’t get out the message to middle management that taking the time to traipse to the other side of campus should be encouraged.

They actually go to the basement of the Modern Language Building at U of M to administer flu shots for Slavic, German, and Romance.

I'll actually have to get myself to the clinic to get one this year, though. I just got a reminder, in fact.

I am merely here to report the explosion in "Vaxxed" gear to promote the movie (and make a fashion statement about your taste in antivax loonery).

For instance, in addition to the usual t-shirts and caps, you can get Vaxxed rugby socks, Vaxxed kiddie backpacks for ages 1-6, Vaxxed doggy t-shirts, a Vaxxed "chemo bandana" and of course, Vaxxed panties.

https://www.amazon.com/s/ref=nb_sb_ss_i_5_6?url=search-alias%3Daps&fiel…

I am planning to wear a Vaxxed clown outfit on Halloween to try to lure trick or treaters into the woods, so they can be given copies of Andy Wakefield's "Callous Disregard".

Oh, and I finally garnered some shill bucks yesterday. A bulky envelope arrived in the mail containing a $10 check made out to Cash (my favorite kind). All I had to do was read a copy of a glossy monthly professional pathology magazine and rate the articles and ads according to how interesting or crappy they were. Score! Although the advertisers in particular may not be pleased that I mostly rated their ads as 1 on a scale of 1-4 (I am generally unimpressed by full-page ads for lab analyzers that merely tell me they are lots better than the competition, while featuring photos of women that are way too good-looking to be actual lab techs.

By Dangerous Bacon (not verified) on 05 Oct 2016 #permalink

while featuring photos of women that are way too good-looking to be actual lab techs

Just... no.

Just… no.

This.

while featuring photos of women that are way too good-looking to be actual lab techs

I am shocked--shocked!--to find models in an advertising campaign.

Actually, there is no reason an actual lab tech couldn't be beautiful, depending on your standards for "beautiful". But it's probably logistically easier to hire a model to play that role in an advertising shoot.

By Eric Lund (not verified) on 05 Oct 2016 #permalink

I saw this on another site: Publix: One-stop shop for strep throat and flu testing and treatment in Florida pharmacies. Are they shortcutting doctors?

I work in a health center and some of the people will not get flu shots (the nurse will come to you). One person will not get a flu shot because every time she gets one, she develops the flu. Of course her husband under went chelation for lead. As far as I could determine he had no exposure to lead levels of concern.

...“Well, duh!” studies because their conclusions are so mind-numbingly obvious that one wonders why anyone did the study in the first place.

I agree. The study is tantamount to finding a higher amount of Karl Marx books and Che Guevara posters among revolutionary communists.

One thing that depressed me about the results of this study is just how low flu vaccine uptake is even among children who have never used CAM. 43%? That’s pathetic.

Influenza is not a scary disease. Even when a more exotic name is applied, as in the case of Bird or Swine Flu, most people are confident that they can overcome the virus. For a voluntary vaccine, you would need a really terrifying disease to increase the rates over 60%; like Swine Rabies or Bird Ebola.

Of course, one of the problems with this study is the classic “chicken or the egg” question. Is it using alternative medicine that causes parents to refuse to vaccinated or do parents who already have a reluctance to vaccinate tend to gravitate towards alternative therapies?

Probably a little of both IMO. Once you start going down the alt-med rabbit-hole, for say a natural remedy for bacne or something trivial, you are confronted with websites that have other quasi-political leaning as well: like water fasting, electromedicine, anti-dairy, and anti-vaccine as well. It is a slippery slope that leads to the bottom of the alt-med canyon, and once you are down there, you will most likely find a link to naturalnews.com and mercola.com.

It starts with using holy basil and ashwagandha for chronic fatigue:, progresses through the obligatory chorella and diatomaceous earth for heavy metal and parasite detox (rite of passage); and finally leads to rabid anti-vaxx ideals and an alternative theory of oncogenesis (which usually has something to do with O₂ and/or cellular pH).

Certain strains of Avian Flu have extremely high mortality rates - we've just been lucky that those strains haven't been very contagious to people.

SARS was also extremely deadly.

Don't underestimate influenza.

Re: in-office flu shots
For years my company offered in-office flu shots. Then last year I hadn't heard anything by late September, so I kept bugging HR and Safety "hey, when are our flu shots?"
Finally, in *December* they admitted that they weren't going to do them that year, but they are covered by our insurance and we could always go to the super-scary urgent-care clinic.

My doctor was super surprised when I asked for a flu shot in December. "You're always so on top of these things!"

This year I started pestering early, but the soonest we can get the nurse in is early November.

By JustaTech (not verified) on 05 Oct 2016 #permalink

Hey Bacon, I'm going to join Narad, JP and Eric. That's a bit much.

Maybe "featuring photos of women that are way too impractically dressed to be actual lab techs" would still get your point across?

By JustaTech (not verified) on 05 Oct 2016 #permalink

I agree. The study is tantamount to finding a higher amount of Karl Marx books and Che Guevara posters among revolutionary communists.

Yah, as though the Fucklesworth meter needed repeat measurements in the first place.

My doctor was super surprised when I asked for a flu shot in December. “You’re always so on top of these things!”

Weirdly, I've had a number of appointments in the past few weeks in which the intake nurse has asked whether I've had a flu shot this year. My answer has been, "no, not yet" (I've been patronizing my superb independent pharmacist).

The thing is that nobody has offered one. It's a hard damn business to stay afloat in, and I'd as soon direct the reimbursement to the pharmacist, but WTF?

Actually, there is no reason an actual lab tech couldn’t be beautiful

Physicists have lab techs? I mean, back in the day, there were some handsome fellows with long tenure in the instrument and machine shops, but... OK, I'll knock it off.

There's nothing more beautiful than a lab tech who hands you a perfectly differentiated Giemsa stained slide.

Or who can cut a full face intraoperative frozen section without breaking a sweat, with the surgeon and pathologist hovering over their shoulder.

I do the Wayne's World 'we're not worthy' to my techs quite a lot...

By Dr Trousers (not verified) on 05 Oct 2016 #permalink

Narad: "Physicists have lab techs?"

I was a lab tech in a fluid dynamics lab in college. I did have to do things in the machine shop, but also mixed photography chemicals, went to the university supply center to get stuff and was the human graphics device (read tables from computer printout and then draw a graph, back when the input device was a keypunch and the output was a printer).

Just a quick thing regarding fairly slack flu immunisation programs: it does need to be better targeted (there should be good value in getting as many of the high-risk groups done as possible, particularly infants and the elderly, and lots of non-Eurasian indigenous populations, etc), flu vaccination *probably* has rapidly decreasing returns as you get larger proportions of the population. It's utterly crap at replication, right on the edge of viability as a species. So it evolves hella fast, and the more selective pressure you bring, the more likely it'll just squirt sideways in a blerk of mixed-metaphor and mucus.

The other half of the problem is the weird (and to my knowledge largely unexplained) habit of influenza settling on a dominant strain, which can vary region to region and (of course) season to season. Basically: if you get one sub-variation in an area, it'll crowd out the others. But the others do happen (hence the vaccine showing traditionally quite "spotty" coverage - e.g. sometimes you'll get a single community where the vaccine (apparently) did bugger all, because they happened to get hit by one of the lesser strains).

So, in the absence of good research for human populations with very high vaccine uptake, what I'd expect to happen with (for example) 100% vaccination against A/Hong Kong/4801/2014, is that there'd be a really good chance you'd just "discover" A/Brisbane/10/2016, as it'd take over in the absence of dominant competition, and suddenly our vaccine is sitting well below the level we want for the high-risk groups. Now, that might actually delay your flu season by (ballpark) a month or so (something that could make a massive difference in a pandemic, if you could somehow get the vaccine out there in time... which you wouldn't), but for a regular year it could easily be counter productive.

The optimal strategy for flu vaccine at a population level could well be: "half-ass it". We could (and should) target better, but we might not actually *want* full coverage.

...on the other hand, the optimal strategy for an individual (even if not high risk) and the people around them is to get the bloody vaccine, which is what you'd hope medical professionals are actually telling their patients. On the other hand... are we calling CAM folk "medical professionals"?
:/

They actually go to the basement of the Modern Language Building at U of M to administer flu shots for Slavic, German, and Romance.

Trivalent, you say?

I found another coworker who doesn't get the flu vaccine, and again they don't wear the mask like they are supposed to. She walked away the minute I said the flu vaccine was a good thing to have. A different pro-vaccine coworker made some headway with one of the antivaxers by leaving a box of masks on her cart. She thought the supervisor had left them, so she wore them. Thinking about trying that with this lady. Better than nothing I guess.

“Why did these investigators waste the time, effort, and resources to do this study? "
Because they would like us to think: if CAM users are against it, then it should be good.

By Daniel Corcos (not verified) on 05 Oct 2016 #permalink

to administer flu shots for Slavic, German, and Romance.

That still leaves you at risk for Baltic and Celtic languages, not to mention the whole Finno-Ugric complex.

By herr doktor bimler (not verified) on 05 Oct 2016 #permalink

Because they would like us to think: if CAM users are against it, then it should be good.

Actually, if there's a flu outbreak, it's best to figure out where it will hit the hardest.

By Gray Falcon (not verified) on 06 Oct 2016 #permalink

"A statement of fact cannot be insolent."

To be fair, the purported M.D.s, other professionals and patients who appear in ads for medical products and drugs seldom have much in common with reality either.

By Dangerous Bacon (not verified) on 06 Oct 2016 #permalink

DB @34 -- Well, one does occasionally run across exceptions. My wife took me to the ER some while back (like the newt, I got better!) and opined that the resident had missed his calling, since he should have been a model. Didn't seem like a bad doc, though.

By palindrom (not verified) on 06 Oct 2016 #permalink

DB@34: You are violating the First Rule of Holes. If you're in one, stop digging.

By Eric Lund (not verified) on 06 Oct 2016 #permalink

Influenza really is one that even pro-vaccine parents may reject. I think the idea that a low-effectiveness vaccine is important and useful is not an easy one even for them.

By Dorit Reiss (not verified) on 06 Oct 2016 #permalink

Eric @36 -- From Firesign's "Everything You Know is Wrong" --

"As the holy book says in the book of holes, 'For they knew not their holes, from an ass on the ground.' "

OT, but funny.

By palindrom (not verified) on 06 Oct 2016 #permalink

I'll stand up for DB, kinda. I understood "way too good-looking" as a reflection of the simulacral nature of photographic images in ads generally. DB wrote "featuring photos of women that are wtg-l" and whether he meant the women are wtg-l or the photos are wtg-l, it is indeed the photos that dispense with reality in favor of a hyper-real. Forget the lab tech part. The images pof people in this kind of ad are way too good-looking to be actual human beings, including the models who posed for the photos wearing ridiculous facial expressions under glamour lighting amid antiseptic sets before being retouched to the Nth degree in Photoshop to achieve some unreachable ideal of 'perfection' of beauty, credibility, or whatever appeal the doltish creative director has pegged.

DB is obviously old-school and not properly media-saturated, as he still takes this ubiquitous hyper-real imagery to be fake, and fake to be non-normative (which it definitely is not for the perceptions of the masses)...

The television screen is the retina of the mind's eye. Therefore, the television screen is part of the physical structure of the brain. Therefore, whatever appears on the television screen emerges as raw experience for those who watch it. Therefore, television is reality, and reality is less than television.
- - - Dr. Brian O'Blivion in Videodrome

That still leaves you at risk for Baltic and Celtic languages, not to mention the whole Finno-Ugric complex.

Not in our building, it doesn't!

I have always wondered why, say, Chinese and Arabic aren't considered "modern" enough to be in the MLB. Perhaps they are postmodern.

(More likely, it is an issue of space and when the university started offering which languages...)

JP, they provide a vaccine to prevent romance?

I was a lab tech in a fluid dynamics lab in college. I did have to do things in the machine shop, but also mixed photography chemicals, went to the university supply center to get stuff and was the human graphics device (read tables from computer printout and then draw a graph, back when the input device was a keypunch and the output was a printer).

I didn't have such a variety of tasks as a physics work-study lab type, although I did have to talk to the pen plotter and so forth* at the outset. The postdoc who was assigned to me for later stuff was mostly absent, but I should have known when to ask for help. It's a skill that I'm still working on.

David "Sedna" Rabinowitz there was a very cool dude and charitable with his time, though. I've gotten lucky that way. Phil Agre played a similar role years later.

I guess I didn't really think of it as being a "lab tech," though – it was proffered as a learning and training opportunity, sort of grad school lite. So it goes; with a little more support, I might have been able to pull off a then-novel approach to optimizing a sensor matrix.

But I digress. If this annual selection of undergraduates were "lab techs," then, yah, there was no shortage of very attractive ones.

* I think I was the only person who played around with the Tek 4014.

My bad - it's a vaccine against the *roman*. Entirely tooany young people running around tilting at windmills these days.

I have always wondered why, say, Chinese and Arabic aren’t considered “modern” enough to be in the MLB.

Perhaps at the time the Modern Languages department(s) was/were formed, people thought that only Europeans could be modern. China and Saudi Arabia were considered seriously backward countries.

I'm only half joking there. You wouldn't find such extensive and institutionalized ethnocentrism in today's faculty, but fifty years ago was another story. Loving v. Virginia was only decided in 1967.

By Eric Lund (not verified) on 06 Oct 2016 #permalink

Perhaps at the time the Modern Languages department(s) was/were formed, people thought that only Europeans could be modern. China and Saudi Arabia were considered seriously backward countries.

Plausible, except that Russian is under the Slavic umbrella, and is still an astonishingly backward country. (I am mostly not joking here.)

I suspect that, at the time, it was simply a way to distinguish the "modern languages" from the "classical languages." (Greek, Latin, no ancient Chinese.)

I’m only half joking there.

Not all universities ever bothered with the distinction. I need to get a T-shirt with this silkscreened onto it.

I used to work at a clinic that had a high rate of Mexican immigrants, and my experience is that they wanted every vaccine available, as soon as possible, and would return regularly if we were out of stock to inquire. I am not at all surprised by this finding. Then again, I'm pretty positive that our flu vaccine uptake rate was well over 43% in general for our pediatric patients.

On a personal note, I bit the bullet and asked everyone in my family to get a flu shot if they wanted to hold our newest addition to the family. Even my father, who has opined for years about how awful the flu shot made him feel when he used to get it in the military, bucked up and took one for the team. Shockingly (/sarcasm), neither he nor anybody else had any side effects, other than getting a baby to hold when I need a break. I don't know what I'll do next year to motivate though... adding another newborn is out of the question.

My bad – it’s a vaccine against the *roman*

If it can wipe out the plague of Bildungsroman, bring it on.

By herr doktor bimler (not verified) on 06 Oct 2016 #permalink

Like squirrelelite, I was a "shruggie" when it came to the flu vaccine. I, too, was in the Air Force, and we had to stay current on all vaccines because we could find ourselves on an airplane to some far-flung corner of the world, so I was no stranger to being needled. After I re-joined the civilian world, my company provided free flu shots at work, and if I was there, I'd get one. But if I was at a customer's site that day, I didn't worry about it. My HMO provided free vaccines, but still, it wasn't something I would chase down.

What changed my attitude wasn't cost, or science, or anything that anybody could have done or said. It was coming down with the flu.

Most people (including me, at the time) seem to think the flu isn't a real big deal. You hear people talk about the '24 hour flu' or 'stomach flu', and it easy to fall into the trap of thinking that the flu isn't anything to worry about. It is.

I was out of work for a week (and sick on the weekends, too), and none too perky when I returned. I remember sitting on the couch, with the thermostat turned way up, wearing a coat, hat and gloves, shivering like a Chihuahua, and deciding that it was silly, because I could take off the coat, hat, and gloves, and feel just as cold, but slightly more comfortable.

The most interesting part of the experience was that I felt my fever break. I'd been keeping close check on it, as it was staying near 104, then all of a sudden, I felt my whole body relax. For the next few hours, it was a steady drop back to near normal.

It's an experience I do not want again. It hurts.

@ Johnny #49

Took developing asthma as an adult to get me on the regular flu shot routine.

Considering I just started a round of prednisone from a cold, I'd hate to think what influenza would do to my lungs.

Even with enough asthma meds to get all trace of wheeze out of my lungs I had enough inflammation to make me cough loud enough the doc heard me through the closed door and down the hall!

@ KayMarie #50 and @ Johnny #49

I had a similar situation. I would sporadically get the flu vaccine if it was offered (either at work or on campus) but I was never consistent. Then a few years ago I came down with the flu, which wasn't in and of itself too bad. The worst part was the fact the I was unable to recover (as it was almost impossible to take off of work at the time. I had 4 jobs plus school) and I ended up with a nasty, nasty case of pneumonia. I haven't missed a flu vaccine since.

By Missylulu (not verified) on 06 Oct 2016 #permalink