(Writing this on my mobile phone in the Porter Airlines lounge in Toronto, so please forgive the typos.)
In any given year I receive a handful of emails from random strangers wondering whether they should get vaccinated against certain diseases. With the current H1N1 pandemic, the emails now come weekly.
In the elevator of my spanking new condo last week, I was privy to a conversation between two 30-something construction guys, both of whom had decided to eschew the flu vaccine.
The thrust of their argument was, "I never used to get sick. Last year was the first time I got the flu shot, and I got sick." So, according to this reasoning, it's the flu shot that made them sick.
I kept my mouth shut, but I hope the spuriousness of this logic is clear to most people. Spurious logic was best described in The Simpsons, when Lisa told Homer, "It's like me claiming that holding this rock protects me from polar bear attacks because when I hold it, no polar bears attack me."
"Lisa, I'll give you 20 bucks for that rock!"
The spuriousness here is the association between getting the flu shot and becoming ill. The fellow probably got sick from the common cold and mistook it for the flu. Whatever the reason, there is no mechanism by which one can get the flu from the flu vaccine: the vaccine does not contain live or whole viruses.
The question of risk always arises. The human animal, it seems, is incapable of feeling its way through risk and probability. Decisions are made emotionally rather than logically.
After 9/11, for example, people were afraid of the "risk" of flying, so turned to the "safety" of driving. Driving is actually much more dangerous than flying, so I suspect that the excess deaths due to traffic accidents increased in the post-9/11 period. (I'm writing a paper on this now, so stay tuned.)
The risks of the flu vaccine in general, and the H1N1 vaccine in particular, are, in my opinion, inflated by the media. A small number of people with egg allergies will have serious reactions. Most people with egg allergies know who they are. About 1 in a million may suffer Guillain-Barre syndrome, which is serious indeed. A hefty number will experience soreness and maybe 24 hours worth of flu-like symptoms just after the injection. The overwhelming majority of recipients will experience no effects whatsoever.
Do keep in mind that no vaccine is ever 100% effective. Remarkably, the H1N1 vaccine is proving to be about 90% effective, which is actually better than the regular seasonal vaccine. This means that some people will get the flu despite being vaccinated, and may mistakenly think the vaccine gave them the illness.
The H1N1 vaccine comes with something called an adjuvant, which is just something that boosts the immune response. As far as I can tell, it's just vitamin E, polysorbate (a typical food emulsifier) and even some shark liver oil. Some people have freaked out about the latter, but there's no evidence that it's bad for you.
Perhaps the biggest nonsense surrounding the flu vaccine, and vaccines in general, is their supposed link to autism. I do not see any convincing evidence for this. The one study that drew a connection was poorly done, and has since been debunked many times over. This is the way that real science works. I've talked about this before here, here, here and here.
One commenter put the risk question this way: yes, I suppose the flu vaccine carries some risk. But in terms of severity of that risk and extent of that risk, actually getting the flu is much worse. Conclusion: get the bloody shot.
Keep in mind that every year in Canada, literally thousands of people die from the regular flu. Worldwide, thousands more have died from H1N1. So far in Canada, almost a hundred people have died from H1N1, and hundreds more are seriously ill. I have students who have taken leaves of absence due to serious complications from H1N1.
But how many have died from the vaccine? How many typically die from the vaccine? The number is trivial, if it exists at all. Almost all people who get influenza vaccine have no serious problems from it. Nonsense like this and this don't help anyone.
Let's keep the risk of H1N1 in perspective. Depending on who you are, there's a chance you will not be exposed to the virus. If you are exposed, there's a good chance you won't get the disease. If you get the disease, it is very unlikely you'll get seriously ill. Most likely you'll end up in bed for a few days, miserable but recovering. So not getting the vaccine probably won't be too bad for you.... Mostly due to something called "herd immunity".
Herd immunity is when your unvaccinated ass is protected by everyone else's more responsible behaviour. The logic is that you are less likely to be exposed to the disease because all your friends took the time to get the vaccine. Dumbasses who regularly crow about they don't need to get vaccinated because of their "strong immune systems", evidenced by the fact that they rarely get ill, need to understand herd immunity. Their illness free status may have little to do with their innate superhuman status and more to do with the fact that the rest of society has chosen to be disease resistant.
A small percentage of people who get H1N1 will actually get seriously sick and possibly die. Children are particularly at risk because it seems that we old folks have some sort of partial immunity after having weathered so many flu seasons.
But really, why would you want to be home sick for a week? Why would you want to even risk being home sick for a week? Why not save yourself that little bit of Hell with a simple jab in the arm? More importantly, why risk the lives of the children in your life? If you don't want them to be vaccinated, at least get vaccinated yourself so you don't infect them!
This speaks to a wider societal concern that I hope to write about in the future: society's growing anti-intellectualism and anti-science stance. We flock by the millions to unproven therapies, like reiki or whatever unscientific nonsense Suzanne Summers is selling on TV. But many of us refuse to believe that humans walked on the Moon, despite it having been broadcast on live TV and within living memory. The singular triumph of our technological civilization is denied by a generation tragically divorced from this hard-won heritage of reason's victory over the darkness of brutish ignorance.
Vaccines are the victim of their own success. Their triumph was too easy, too profound to be valued by our generation inured to things "too good to be true". People don't think they need the rubella vaccine, for example, because they've never seen anyone with Rubella. You know why you don't see Rubella? Because people take the Rubella vaccine.
There are those who vocally denounce modern vaccinations as useless and dangerous science propaganda. I'd like to take them in a time machine to Canada 150 years ago, when every neighbourhood had people dead from Measles, Rubella, Smallpox and, yes, the flu. Screw the time machine, how about any number of communities in the global South?
We in Canada are a spoiled lot. We have free, socialized medicine. How incredible is that? We had months of forewarning about the H1N1 pandemic. Our medical infrastructure responsibly kicked into high gear, acquiring for us a sufficient stockpile of high tech vaccination against the pandemic --in mere months! That vaccination is being rolled out all across the country today, absolutely free of charge.
Think about that for a second. In the history of humanity, this is such a rare boon. Pandemics of all stripes have decimated societies and civilizations. Our modern civilization found a solution and implemented it, free of charge and in record time. it's available to us today. What would have shut down society 100 years ago is but an inconvenient trip to the flu clinic today.
And yet there are significant numbers of people today who will not only eschew this boon but will vocally denounce those who accept it and those who provided it.
With every crisis, humanity continues to prove to me that it's too stupid to deserve survival.
I will reiterate that everyone has a choice whether or not to seek vaccination. Your choice is your choice. But, as in all things, you are responsible for the consequences of your choice. I don't need to spell out those consequences, or potential consequences, for you.
The technique of modern vaccination is a veritable gift from science. Like all things, it comes with some risks and with variable effectiveness. But how wonderful is it to have the option? How blessed are we? Never forget that or take it for granted.
And as for those who make the simply retarded argument that the flu vaccine is a ploy by big pharama to make money, I beg you --nay, I implore you-- to stick to your guns when you contract H1N1 and are admitted into the hospital's ICU. Please, refuse to accept those antibiotics, antivirals and steroids that will be needed to save your life since, as you probably know, they too are created by "big pharma to make money".
End of sermon.
Update:
Some have pointed out to me that there is no data about the vaccine's safety in infants or pregnant women. This, to my knowledge, is true. The overwhelming medical opinion appears to be that there is no convincing reason to suspect that it is not safe for these groups. However, I would certainly understand if a pregnant woman, or a parent of a child with a developing brain, was hesitant about exposing the infant/fetus to a potential mutagen. If those individuals choose to not become vaccinated (in the case of the pregnant woman) or to not vaccinate their infant, then I hope they would at least advocate for all adults in the vicinity to get vaccinated. I fail to see a strong argument for a non-pregnant adult to eschew vaccination.
Related:
From today's Globe and Mail:
"Refusing to get vaccinated is selfish" by Juliet Guichon and Ian Mitchell.
"Canadians have a free choice. But they also have responsibilities: not to act as agents of flu dissemination, and to minimize their burden on the health-care system. To perform these obligations, they need to act positively, developing two kinds of literacy.... [scientific literacy and statistical literacy]." -Editorial
Labels: epidemiology
