Should I get vaccinated?

[Eddie Dane]

I'm sure this came up before, but couldn't find the relevant thread.

Aside from all the conspiracies and scaremongering, I wonder about this question.

Swine flu seems no different than any other kind of flu, it just gets more airplay.
I am not impressed with the number of people killed by this virus.

From what I hear, there are some legitimate concerns about the quality of the vaccine. Some in the medical profession seem to think that it was rushed to market and can do damage in small minority of people.

I have two small children, so my question is actually if I should vaccinate them.

[Dymanic]

Originally Posted by Eddie Dane

Swine flu seems no different than any other kind of flu, it just gets more airplay.

There's nothing particularly unique about the virus itself; it's just that no one (with the possible exception of some older people) has encountered it before. The lack of pre-existing immunity means that a great many more people will be affected.

Quote:

I am not impressed with the number of people killed by this virus.

The fun has just begun. Flu season in the northern hemisphere usually has hardly begun by this date, and we're already above the levels of prevalence which represent the peak which typically occurs around February or so.

Quote:

From what I hear, there are some legitimate concerns about the quality of the vaccine.

Perhaps if you could be more specific about those concerns, and reference some of the legitimate sources, we could address them more accuately.

Quote:

Some in the medical profession seem to think that it was rushed to market and can do damage in small minority of people.

There are "some in the medical profession" who think all sorts of weird things -- but it is reasonable to expect that a small minority of people will be damaged by the flu vaccine, just as is the case with aspirin, or, for that matter, peanut butter. It's about striking a balance between risks and benefits.

[technoextreme]

Originally Posted by Eddie Dane

Swine flu seems no different than any other kind of flu, it just gets more airplay.
I am not impressed with the number of people killed by this virus.

Its more than just the people killed by the virus. There is also an abnormally large number of people being put on ventilators and suffering other sever side effects.

[jasonpatterson]

Do you normally get your children vaccinated for the seasonal flu? If not, I'm not sure why your reasoning would be substantially different for this one, except that they are probably going to be exposed to this virus (assuming they interact with other kids, that is.) The only concerns I've heard about with this vaccine have been from anti-vaccination types and not from legitimate medical sources. Occasionally you'll get someone making a very noncommittal statement like, "It's up to every parent to decide what's best for their child," which is entirely true, it's just that that decision is blindingly obvious for the vast majority of children: Get the kid vaccinated.

[MattusMaximus]

It's a no brainer: yes, vaccinate your kids. Then get yourself vaccinated, if possible.

[BenBurch]

Originally Posted by Eddie Dane

I'm sure this came up before, but couldn't find the relevant thread.

Aside from all the conspiracies and scaremongering, I wonder about this question.

Swine flu seems no different than any other kind of flu, it just gets more airplay.
I am not impressed with the number of people killed by this virus.

From what I hear, there are some legitimate concerns about the quality of the vaccine. Some in the medical profession seem to think that it was rushed to market and can do damage in small minority of people.

I have two small children, so my question is actually if I should vaccinate them.

If you are in a risk group, absolutely you should. If you have no chronic medical problems, wait until they say they have served the risk groups and there is vaccine for the general public, and then absolutely you should.

Everybody should get every vaccine possible.

[Dragoonster]

Since you're asking about others that you have responsbility for, it's best to err on the side of caution, I guess.

I have no plans on getting vaccinated. Medical risk alone isn't enough to do anything/everything proactive about health--if it were we'd all wear dust masks and latex gloves everywhere. We all balance risk with convenience or cost, and so far the risk of the virus doesn't seem from my limited knowledge nearly worth the inconvenience (time) and monetary cost of getting a shot. If someone showed up at the door with a free shot I'd get it, but going out of my way does seem an overreaction and somewhat paranoid as it's well beyond my usual risk:cost analysis.

[sackett]

Ask your doctor. Do what he says. Finis.

[skeptigirl]

Originally Posted by Eddie Dane

I'm sure this came up before, but couldn't find the relevant thread.

Aside from all the conspiracies and scaremongering, I wonder about this question.

Swine flu seems no different than any other kind of flu, it just gets more airplay.
I am not impressed with the number of people killed by this virus.

From what I hear, there are some legitimate concerns about the quality of the vaccine. Some in the medical profession seem to think that it was rushed to market and can do damage in small minority of people.

I have two small children, so my question is actually if I should vaccinate them.

Despite what Dymanic posted about the strain not being different, there is indeed something very different about the current pandemic influenza strain. However, he was correct that the claims there are reasons to avoid vaccine are bunk.

One, it is genetically different enough that we are seeing a much higher attack rate than seasonal flu. At a minimum, that threatens to make this a very bad flu year.

And two, the demographics of those suffering severe disease is quite different from seasonal flu. Many more older children and young adults are turning up with severe cases than is typical for a flu season.

Where we typically see a U shaped curve of severe flu in the very young and the very old, with this strain we are seeing the W shaped curve with more fatalities in a broader range of ages.


There is no need to panic, but there is a great need to take the threat seriously. While very few of the total cases of flu are going to be serious cases, many of the few that are have been serious have been difficult to predict. 40% of the serious cases are in previously healthy people including in children.

The vaccine appears to be very safe. YES, when the vaccine is available to you, you should get the kids vaccinated.

[skeptigirl]

Originally Posted by sackett

Ask your doctor. Do what he says. Finis.

Yeah, because they all have perfect knowledge.

I say buyer beware. Do your homework using good scientific sources of information, then ask your provider.

[skeptigirl]

Originally Posted by Dragoonster

Since you're asking about others that you have responsbility for, it's best to err on the side of caution, I guess.

I have no plans on getting vaccinated. Medical risk alone isn't enough to do anything/everything proactive about health--if it were we'd all wear dust masks and latex gloves everywhere. We all balance risk with convenience or cost, and so far the risk of the virus doesn't seem from my limited knowledge nearly worth the inconvenience (time) and monetary cost of getting a shot. If someone showed up at the door with a free shot I'd get it, but going out of my way does seem an overreaction and somewhat paranoid as it's well beyond my usual risk:cost analysis.

Which age group are you in and which country are you in?

May we assume you don't have any of the usual risks for severe influenza disease?

If you are a healthy person younger than 25 yrs old and in the US, you should get the vaccine. It won't cost more than $15. In Canada and much of Europe, it is free isn't it?

[Dragoonster]

Originally Posted by skeptigirl

Which age group are you in and which country are you in?

May we assume you don't have any of the usual risks for severe influenza disease?

If you are a healthy person younger than 25 yrs old and in the US, you should get the vaccine. It won't cost more than $15. In Canada and much of Europe, it is free isn't it?

I'm 37 in California, doubt I have any vulnerabilities atypical of the norm to it. I used to get influenza shots but only when the company I worked for provided them on site and for free. Haven't noticed any correlation between years I got the flu or didn't based on whether I'd gotten the shot or not (have gotten flu after getting the shot sometimes). This strain is different and more virulous (right word?) but so far it doesn't seem much of a threat to me. I'm actually thinking the risk of the extra mile or so I drive to get the shot might be greater than the risk of getting the swine flu with serious complications.

[Dymanic]

Originally Posted by skeptigirl

Despite what Dymanic posted about the strain not being different, there is indeed something very different about the current pandemic influenza strain.

Perhaps you could explain for us just what that difference is (without simply referring to the different way it acts in an immunologically naive population, which is just what we would expect).

[JoeTheJuggler]

Originally Posted by sackett

Ask your doctor. Do what he says. Finis.

Unless your doctor tells you something foolish, such as, "Don't vaccinate your children because the vaccine is too dangerous!"

[JoeTheJuggler]

Originally Posted by Dragoonster

I'm 37 in California, doubt I have any vulnerabilities atypical of the norm to it. I used to get influenza shots but only when the company I worked for provided them on site and for free. Haven't noticed any correlation between years I got the flu or didn't based on whether I'd gotten the shot or not (have gotten flu after getting the shot sometimes). This strain is different and more virulous (right word?) but so far it doesn't seem much of a threat to me. I'm actually thinking the risk of the extra mile or so I drive to get the shot might be greater than the risk of getting the swine flu with serious complications.

It sounds like you're taking a reasonable approach, but I would suggest you think of the benefit of vaccination not just in terms of yourself. Vaccination programs are largely a matter of public health, not just personal health. While you might find your personal risk of getting sick not so big a deal, the spread of an epidemic can be curtailed if a substantial portion of the population gets vaccinated in time.

Just something else to add into your cost/benefit analysis.

[GreNME]

Originally Posted by Dymanic

There are "some in the medical profession" who think all sorts of weird things -- but it is reasonable to expect that a small minority of people will be damaged by the flu vaccine, just as is the case with aspirin, or, for that matter, peanut butter. It's about striking a balance between risks and benefits.

Quoted For Truth.

Another thing to consider is if you have kids, the risk is higher for them so getting them vaccinated is probably worth it. This strain apparently has some resistance to it with people above a certain age, but it's not a silver bullet and it doesn't mean there aren't chances for complications. The main thing to focus on is taking care of yourself health-wise regardless, and making sure to follow common-sense prevention techniques (like hand-washing and the like). The goal of even the vaccinations is to fight the virus spreading, which is what most of the steps taken in most places remain concerned with.

[Dragoonster]

Originally Posted by JoeTheJuggler

It sounds like you're taking a reasonable approach, but I would suggest you think of the benefit of vaccination not just in terms of yourself. Vaccination programs are largely a matter of public health, not just personal health. While you might find your personal risk of getting sick not so big a deal, the spread of an epidemic can be curtailed if a substantial portion of the population gets vaccinated in time.

Just something else to add into your cost/benefit analysis.

Thanks, I'll keep that in mind. I'm a bit of a selfish misanthrope and am not around the elderly or children but if/when it gets worse I'll consider getting it for others' sake.

[skeptigirl]

Originally Posted by Dragoonster

I'm 37 in California, doubt I have any vulnerabilities atypical of the norm to it. I used to get influenza shots but only when the company I worked for provided them on site and for free. Haven't noticed any correlation between years I got the flu or didn't based on whether I'd gotten the shot or not (have gotten flu after getting the shot sometimes). This strain is different and more virulous (right word?) but so far it doesn't seem much of a threat to me. I'm actually thinking the risk of the extra mile or so I drive to get the shot might be greater than the risk of getting the swine flu with serious complications.

Virulent.


I'd get vaccinated at 37. If you are over weight, that adds a risk factor (not saying you are of course... )

The odds are low but the risk is great if your number's up. Those are two different things. So the odds of having severe disease if you do get flu are low, because millions of cases are resulting in thousands of deaths. That would be low odds of getting severe disease.

However, the outcome if you did get severe disease could be death. That is a very high risk.

Yes, driving is risky. But you (hopefully) wear a seatbelt to reduce the chances you will have a serious outcome if you do get in a crash.

A $10 or $15 dollar fee and a short car drive seem to me to be not much more effort than putting a seatbelt on every day of your life as long as you live.

[skeptigirl]

Originally Posted by Dymanic

Perhaps you could explain for us just what that difference is (without simply referring to the different way it acts in an immunologically naive population, which is just what we would expect).

Explain the difference without referring to the difference?

See my post as I did explain the difference.

The demographics of the severe cases is a W curve rather than a U shaped age curve. As many as 40% of the severe cases in children and young adults have no underlying risk factor for severe disease. Obesity is a risk factor for severe disease.

For seasonal flu, the age related severe disease curve is a U shape, young adults and older children who are otherwise healthy only rarely have severe disease. Obesity has not been a particular risk for severe disease in seasonal flu, or if it has, it has gone unrecognized.

[Dragoonster]

Originally Posted by skeptigirl

Virulent.


I'd get vaccinated at 37. If you are over weight, that adds a risk factor (not saying you are of course... )

The odds are low but the risk is great if your number's up. Those are two different things. So the odds of having severe disease if you do get flu are low, because millions of cases are resulting in thousands of deaths. That would be low odds of getting severe disease.

However, the outcome if you did get severe disease could be death. That is a very high risk.

Yes, driving is risky. But you (hopefully) wear a seatbelt to reduce the chances you will have a serious outcome if you do get in a crash.

A $10 or $15 dollar fee and a short car drive seem to me to be not much more effort than putting a seatbelt on every day of your life as long as you live.

Y'all are pretty persuasive in this thread. I'll be up for getting it if there's enough vaccines available now or when they make more. Thanks for the responses!

[Dymanic]

Originally Posted by skeptigirl

Explain the difference without referring to the difference?

I don't disagree that there is indeed something very different about the epidemiology of this virus, but, again, that's just what would be expected. There have been some ambitious attempts to explain this in terms of properties the virus possesses rather than in terms of the immunological profile of the host population. I'm not necessarily saying those explanations are wrong. I'm just saying that it's not enough to assume that the shifted age distribution curves etc are the result of something unique about the virus (other than its antigens) and to then point right back to the epidemiology as support for that.

The claim that the virus is "special" in some other way is rather strong, and therefore requires strong support. Genetic sequencing would be nice, and while the science permits that, it does not yet support definitive conclusions along the lines of "these sequences produce cytokine disregulation", or "these sequences cause infection of the lower lung". (And a lot of the work in genetics has focused on characteristics which might predispose certain individuals to more severe infection, etc, rather than on what it is about the virus that makes it more likely to cause severe infection).

It's entirely possible that we are simply getting our first really good look at a run-of-the-mill influenza having its (typically) spectacular first encounter with the human population.

[Eddie Dane]

I don't know what the supposed problems with the vaccine are.
I'm parroting my wife, who heard it on the radio. I think a child got paralized after a flu shot.

I'm 38, my wife is 35. Wee are both in good health.

[BenBurch]

Originally Posted by Eddie Dane

I don't know what the supposed problems with the vaccine are.
I'm parroting my wife, who heard it on the radio. I think a child got paralized after a flu shot.

I'm 38, my wife is 35. Wee are both in good health.

That is made-up woo, AFAIK.

[Yeggster]

I usually get the flu vaccine .. it's free here ... but I'm not going to get either one this year ... soley because of the hype surrounding H1N1

[fls]

Originally Posted by BenBurch

That is made-up woo, AFAIK.

As opposed to real woo?

Linda

[cafetimes1991]

I read that there is a tiny microchip visible on the end of the the needle of each flu shot. Apparently it can be seen if you magnify the tip of the needle X16.
Uh-huh. Thanks, David Icke. But if he and the others are right, urm...

[Roma]

Originally Posted by cafetimes1991

I read that there is a tiny microchip visible on the end of the the needle of each flu shot. Apparently it can be seen if you magnify the tip of the needle X16.

Does it have the numbers 666 engraved on it ?

Just asking, I'm getting the vaccination this evening and so is my teenager,
I don't really believe in the conspiracies surrounding the H1N1 vaccination but I am very religiously supersticious

[Brian-M]

I've just read a very interesting online article about the evidence for the effectiveness of flu vaccinations on reducing mortality.

http://www.theatlantic.com/doc/200911/brownlee-h1n1

Here are some interesting highlights from the article...

Quote:

study after study has found that people who get a flu shot in the fall are about half as likely to die that winter—from any cause—as people who do not.

Quote:

Majumdar says, “We keep coming up against the belief that we’ve reduced mortality by 50 percent,” and when researchers poke holes in the evidence, “people pound the pulpit.”

Quote:

“For a vaccine to reduce mortality by 50 percent and up to 90 percent in some studies means it has to prevent deaths not just from influenza, but also from falls, fires, heart disease, strokes, and car accidents. That’s not a vaccine, that’s a miracle.”

Quote:

Education, lifestyle, income, and many other “confounding” factors can come into play, and as a result, cohort studies are notoriously prone to bias.

Quote:

Jackson’s findings showed that outside of flu season, the baseline risk of death among people who did not get vaccinated was approximately 60 percent higher than among those who did, lending support to the hypothesis that on average, healthy people chose to get the vaccine, while the “frail elderly” didn’t or couldn’t. In fact, the healthy-user effect explained the entire benefit that other researchers were attributing to flu vaccine, suggesting that the vaccine itself might not reduce mortality at all.

Quote:

In 1989, only 15 percent of people over age 65 in the U.S. and Canada were vaccinated against flu. Today, more than 65 percent are immunized. Yet death rates among the elderly during flu season have increased rather than decreased.

Quote:

People told me, ‘No good can come of [asking] this,’” she says. “‘Potentially a lot of bad could happen’ for me professionally by raising any criticism that might dissuade people from getting vaccinated, because of course, ‘We know that vaccine works.’ This was the prevailing wisdom.”

Quote:

In the flu-vaccine world, Jefferson’s call for placebo-controlled studies is considered so radical that even some of his fellow skeptics oppose it.

So, what do you guys think of all this?

[The Drain]

I got the call from my doctor this evening offering me the swine flu jab later this week (which I've accepted).

But my wife and children (aged 3-8) haven't been offered it yet. We have different doctors, so that might be a factor as in maybe mine has got a delivery in but hers hasn't yet.

Still, I'm intrigued - as a healthy 49-year-old male; am I in a special 'at risk' group? I really wouldn't have thought so.

[fls]

Originally Posted by Brian-M

So, what do you guys think of all this?

I think that you'd be better off not getting information from people who have no expertise and whose motivation is to sensationalize, rather than inform.

http://scienceblogs.com/insolence/20...uenza.php#more
http://www.sciencebasedmedicine.org/?p=2258

Linda

[BenBurch]

Just home from getting vaccinated. We were in line over three hours, mostly outside. Thousands were in line!

[Roma]

Just got back from the university,
45 minutes from start to finish, now I have H1N1 in one arm and the seasonal flu in the other arm.
Free, no line, but plenty of screaming toddlers
(boy you'd think Santa was giving them their shots)

[dudalb]

Get the Vaccination, Eddie, and tell your wife to stop listening to woo sources of information.
If you do get Swine Flu, you probably won't die, but why have a miserable week of feeling like total crap if you can avoid it?

[Brian-M]

Originally Posted by fls

I think that you'd be better off not getting information from people who have no expertise and whose motivation is to sensationalize, rather than inform.

http://scienceblogs.com/insolence/20...uenza.php#more
http://www.sciencebasedmedicine.org/?p=2258

Linda

I usually don't put too much faith in sensationalistic articles I stumble across on the internet, and I'm not against vaccination in general, but this does raise a question in my mind.

How effective are flu shots at reducing the effects of mortality of the seasonal flu? Even the links you provide admit the seasonal flu shots have flaws...

Quote:

In any case, as Mark Crislip pointed out, vaccines for seasonal flu are suboptimal for a variety of reasons.

Quote:

Also, the elderly, the ones most likely to die of complications after the flu, tend not to develop as robust an immune response to the vaccine.

[BenBurch]

Just went past there on an errand and there was still a line outside (and inside they snaked the line up and down each corridor for the school so there was a very long queue inside once you got there.)

[sackett]

Hey, Skept? Joe?

I prefer letting the pros do their job. Over a fairly long life (and it's nowhere near as long as I expect, given my experience with scientific medicine) I've learned to take doctor's orders.

Especially when they make sense that even a halfway intelligent layman can understand.

ETA: Don't take this personally but: Christ how I'm tired of ignorance demanding equal time. It started in the 60s, when all sorts of quackery burgeoned on the climate of "Fug da 'thorities 'n da system, maaaan! Dere's udder waysa knowen! 'N I know what I know!"

[skeptigirl]

Originally Posted by Dymanic

I don't disagree that there is indeed something very different about the epidemiology of this virus, but, again, that's just what would be expected. There have been some ambitious attempts to explain this in terms of properties the virus possesses rather than in terms of the immunological profile of the host population. I'm not necessarily saying those explanations are wrong. I'm just saying that it's not enough to assume that the shifted age distribution curves etc are the result of something unique about the virus (other than its antigens) and to then point right back to the epidemiology as support for that.

The claim that the virus is "special" in some other way is rather strong, and therefore requires strong support. Genetic sequencing would be nice, and while the science permits that, it does not yet support definitive conclusions along the lines of "these sequences produce cytokine disregulation", or "these sequences cause infection of the lower lung". (And a lot of the work in genetics has focused on characteristics which might predispose certain individuals to more severe infection, etc, rather than on what it is about the virus that makes it more likely to cause severe infection).

It's entirely possible that we are simply getting our first really good look at a run-of-the-mill influenza having its (typically) spectacular first encounter with the human population.

It's more than simple amplification due to increased numbers of susceptible people, Dym. You don't get a W age curve by simply increasing the numbers of those infected. You could see a shift to a lopsided U if less older people were getting infected, but you would not see a W.

[skeptigirl]

Originally Posted by The Drain

...
Still, I'm intrigued - as a healthy 49-year-old male; am I in a special 'at risk' group? I really wouldn't have thought so.

Not unless you have some chronic medical problem or are obese.

[skeptigirl]

Quote:

“For a vaccine to reduce mortality by 50 percent and up to 90 percent in some studies means it has to prevent deaths not just from influenza, but also from falls, fires, heart disease, strokes, and car accidents. That’s not a vaccine, that’s a miracle.”

Not necessarily. An elderly person is often confused when they are ill when they are not necessarily confused when they are well. You could easily hypothesize that elderly people with flu do fall, get in auto accidents and do die in accidental fires more often. And influenza is suspected of causing heart attacks. If the mechanism is decreased blood flow from inflammation, or increased clotting that would explain an increase in strokes as well as heart attacks. And then there is the possibility illness increases hypertension and heart rate due to fever. That could also account for increasing strokes and heart attacks.

People should not be so quick to assume something just because the connection is not immediately obvious.

[skeptigirl]

Quote:

In 1989, only 15 percent of people over age 65 in the U.S. and Canada were vaccinated against flu. Today, more than 65 percent are immunized. Yet death rates among the elderly during flu season have increased rather than decreased.

And yet we see that getting a flu shot decreases the chance one will die from flu or pneumonia and heart attacks in that year. Looking for another cause is in order. Concluding flu vaccine has not done anything worthwhile would be premature.

There is in addition, an effort to vaccinate more children to interrupt flu epidemics as well. It may be we are vaccinated the people in whom the vaccine is sub-optimal. Interrupting transmission might be a better strategy.