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Do you get your flu shot?

Discussion in 'Chit Chat' started by Andrew99, Jan 14, 2020.

  1. Mirko

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    @Destin it is the case that the flu shot is not one hundred percent effective and that it does not protect against the flu in future years, and that it is most effective for the most common type. Medical researchers, health professionals know that. However, they still recommend to get it as it still does provide some protection.

    Just because you are accepted into medical school, and your dad works in the field, does not mean that you have expertise in it. Once you have studied medicine, done your examinations, are a licensed medical expert/health professional and worked in the field for a few years, you can revisit that claim. Right now, not so much. :slight_smile:
     
  2. Austin

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    @Destin I’m not sure if it’s your intention, but you’re convincing me the flu shot is worth it. A 40-60% reduction in risk of influenza is actually definitely worth getting your flu shot. The flu is nasty and kills people, unlike the cold.

    Also they don’t just take “random” guesses, they make educated predictions, and the shot is against multiple strains. It does mutate and that’s why people get it yearly.
     
  3. Denial

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    I got one a few years back and I got a welt on my arm afterward that was uncomfortable for a while. I haven't gotten one since.
     
  4. Chip

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    Destin is actually correct both in how the vaccine is developed, and the lack of protection from any strain not contained within the vaccine. What he said lacks nuance, but is substantially correct.

    In the US, for the last available year when I checked a few months ago, the flu shot for that year (2017 or 2018) was only about 37% effective if I remember correctly. Over the past 10 years, the effectiveness of the flu shot has hovered between 35 and 50 percent. There is early development of a new type of vaccine that might be universally effective, but it is years away.

    So 50% effective is better than not effective at all, but hardly conclusive. And there's an insane amount of cash made by Big Pharma in marketing and manufacturing flu shots... all based on very skimpy data. So this is one of those cases where the influence of pharmaceutical money has a considerable impact on how effectively a message is disseminated, even though the value is limited.

    Also, I could be wrong, but it is my understanding that there's a single vaccine variety developed that is distributed nationally, and that it contains only a relatively small number of strains. And the decisions about which strains to include are basically educated guesses on what scientists think will be the most common strains or outbreaks. It's actually impossible to know in part because of how much people travel, and the potential to infect large numbers of people (think 100+ people on a given airplane, someone's coughing, and that air is being recirculated, albeit with filtration, for hours.)

    And as with any injection or medication, there are potential side effects. Not autism, for sure, but reactions, and in some cases, less common reactions that can be serious.

    What it boils down to is risk tolerance. If you take the shot, you're gambling that you're going to be exposed to a variety of virus that the shot protects against, and that it will protect you and be effective. There's also the (likely) side effects, which are mild (rash, flu-like symptoms, tiredness) that last a couple of days for a significant number of people who get the shot, and more severe side effects that are considerably less common. You also might well still get the flu, because you were exposed to one of the majority of varieties that the shot does not protect against.

    If you don't take the shot... you might get the flu if you're exposed to some variety of it, and your immune system isn't strong enough to knock it out by itself.

    So it boils down to risk tolerance, your own personal level of potential exposure, and your own experience with side effects to immunizations and other medications. I work mostly in a field where I don't have a whole lot of contact with different people on a regular basis. So my risk is relatively low. If I worked at Starbucks, for example, where I am coming into relatively close contact with hundreds of people per day, then my risk would be higher... but even then, if it was a Starbucks at, say, the airport, then the vaccine would be less likely to protect me because I'll likely see lots of people from all over the world and be exposed to way more strains that the vaccine does not protect against than those it does.

    It's a personal decision. For me, I've opted against the flu shot because the risk without it is pretty low, and I fairly frequently have side effects from medications. I also have a pretty strong immune system. But if my circumstances were different, I might choose to have it.

    I do think that the influence of Big Pharma has a significant impact on the visibility and perception of effectiveness of the vaccine, and so there's a pretty strong agenda to get people to take it, not just from a public health perspective, but from the financial incentive. The flu shot is a huge cash cow for those who make it, as well as for various treatment centers where one can get the shot (here in the US, Walgreens and Wal-Mart and places like that have somebody that can administer it, and it's a cash cow, plus it gets people into the store, and the value of that cannot be lost when considering their decision to aggressively market it.)

    Similar case in point: 30 minutes of exercise daily has been pretty conclusively shown, in multiple studies, to be substantially more effective than SSRI antidepressants in mild-to-moderate depression. But nobody promotes that, because nobody's putting marketing $ in promoting walking and light exercise. You don't see ads on TV or in print telling you to take a walk daily if you have depression, because there's no one who profits from that.
     
  5. Destin

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    Story of my life haha, A former philosophy professor used those exact words to describe my final essay :/

    I don't know how one acquires nuance, I just bluntly say stuff that's true and throw facts at things expecting others to understand why it's true.
     
  6. Mirko

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    Not to derail this thread however the field you are trying to enter and presumably succeed in, understanding nuances and being able to communicate them is as important as being able to understand facts. It's actually a little scary that you are seemingly starting out your studies with certain expectations of what others are supposed to be understanding.
     
  7. Chizu

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    I get it. It's been working for me. I also got titers done and updated all of the vaccines I got growing up that I lost the immunity to (I lost hep b I think and so I took a fourth boost).
     
    #27 Chizu, Jan 15, 2020
    Last edited: Jan 15, 2020
  8. Destin

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    Yes, I expect a normal person to be able to understand very clearly laid out and well supported facts from official sources when it's laid out directly in front of them. I fail to see how that's scary. It's not like I expect them to already know things off the top of their head, but when I literally just showed them exactly what I was talking about yes I expect them to understand reasonably well.
     
    #28 Destin, Jan 15, 2020
    Last edited: Jan 15, 2020
  9. Austin

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    ...so the substance of the argument is “Big Pharma” is manipulating the data and public health agencies and the flu vaccine isn’t actually useful? ...and the nuance is a bunch of unsubstantiated opinion?
     
  10. Destin

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    Nobody said it's not "useful", even something only 1% effective is technically useful. What we're saying is that it's not useful enough to really mean anything, and certainly not enough to go out of your way to get and pay for it every year based solely on personal benefits. As a healthcare worker getting it is perfectly useful though, since the odds are way higher you'd accidentally give it to someone with a weakened immune system and anything helps at that point.

    As an average person you have a 50/50 chance of getting the flu or not just by walking outside, if you happen to meet someone that has the flu or not. So for the vaccine to be 40% effective (against only the less-dominant half of the strains of it) in reality, that means that overall it gives you maybe 20% more overall protection against all flu strains on something you only had a 50% chance of getting in the first place. Which brings it down to a 10% chance that you'd both get the right strain of flu it actually works on, and that the shot would then prevent it from harming you.

    That's basically nothing.
     
  11. HM03

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    I know it's a lame excuse - but I don't really get seriously sick (literally once in the last 15 years) and I don't like needles....So I never get the flu shot
     
    #31 HM03, Jan 17, 2020
    Last edited: Jan 17, 2020
  12. Chip

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    No, the data isn't being manipulated, at least as far as I know, from anything I've seen. It's the CDC's own data that is presenting the effectiveness of the treatment.

    Is having the shot more valuable than not having the shot? If we're isolating solely on the basis of likelihood of getting the flu, then in many circumstances, yes. But the problem with that isolation is that it does not consider the potential side effects (minimal and more serious), the lack of effectiveness beyond the small number of virii that the vaccine protects against, and the potential exposures a given individual has to a wide variety of virii.

    So while I wouldn't say the vaccine is worthless, it is absolutely true that it will only protect you from getting the flu between 1/3 and 1/2 of the time, assuming you are an average person in an average line of work. If you work at an international airport Starbucks, then it probably only protects you maybe 1/10th or 1/5th of the time because of the wider percentage of virii. And if you work at a typical urban Starbucks, where you are going to constantly be in contact with people who have the flu, then it might have substantial protection if the flu that most of those folks have happens to be one of the strains the shot protects against. If most of the folks have a different strain of the flu that isn't protected by the shot, then it will provide no protection whatsoever.

    Does that clarify and make the nuance more clear? (I'm also curious what is 'unsubstantiated opinion' because most everything I stated above is pretty well documented, which a quick review of either the scientific literature or a company's financial disclosures will reveal.)
     
  13. Austin

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    I feel if you’re going to make an argument that goes against widely accepted recommendations made by public health experts and epidemiologists, it’s incumbent on you to have a strong argument. You’ve essentially said it’s 33-50% effective but since it doesn’t cover all strains, and the numbers are purportedly manipulated by big pharma, the risk of getting the flu shot outweighs the benefits? I can’t follow the logic since the level of effectiveness you quote seems very acceptable. And, based on current evidence, if it were true that the risk outweighed the benefits, we wouldn’t give flu shots...

    Also, the airport/Starbucks worker example, and numbers, are odd (and, I’m guessing, made up?)...
     
  14. Chip

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    The Starbucks numbers are examples, easily extrapolated from epidemiological data on the various diseases and strains of the flu seen in other commonly traveled countries. Obviously these would vary depending on what airport, what routes go through it, and what termina and so forth. So yes, not intended to be precise, hence the "maybe" before the use of those guesses.

    And I'm not sure who has said the numbers are manipulated by big pharma. Not me.

    The statistics are there for absolutely anyone to look up or read for themselves, and Destin posted some of the CDC's data, which is some of the most robust.

    And I did not say the risk outweighs the benefits. If you read my earlier post, I talked about risk tolerance and the factors that go into whether the shot makes sense for everyone.

    I feel like I'm repeating myself, but I'll try once more: For the person who never goes out, rarely interacts with people, the chance of getting the flu with or without the shot is going to be really low. For the person who works the front counter at Starbucks, with or without the shot, the chance will be substantially higher.

    And the chance of mild side effects (feeling a little sickly for a day or three) is pretty high from getting the shot, and the chance of major side effects is extremely low *unless* you have specific risk factors.

    So what each person needs to consider is whether a 33 to 50% chance of having protection from getting the flu *if they are exposed to it* is worth the risk of the minimal side effects and the far more rare but not nonexistent risk of more serious side effects, not to mention the potential but also not nonexistent risk of longer term impact.

    To give you an example of the longer term risk: Decades ago, in the 1940s, when the original polio vaccine was being distributed, it was a live vaccine with an attenuated virus. It was also contaminated with cytomegalovirus, a harmless but pretty contagious virus. However, the public health benefits of protecting people against polio vastly outweighed the then-considered-nonexistent harm that came with getting cytomegalovirus, which was a virtual certainty to anyone who got the shot.

    Fast forward 40 years when people are getting organ transplants, which require extreme immune suppressing drugs. Anyone who had the live polio vaccine and also got an organ transplant discovered that the "harmless" cytomegalovirus wasn't so harmless if you had very suppressed immune function. People died because the CMV started replicating and causing serious problems, and in some cases, the only option was to removed the transplanted organ and aggressively stimulate the immune system to knock out CMV.

    Now of course... immunology has progressed incredibly dramatically since the 1940s, and those sorts of contaminations don't happen any longer because of the way vaccines are now made. But there are still other issues, such as the CMV issue, that pop up years or decades later, that no one anticipated.

    So what it boils down to, again, is risk tolerance.

    If you are in regular contact with lots of different people, and don't want to get the flu, and are willing to accept the potential risks in exchange for a 1/3 to 1/2 likelihood that you won't get the flu if you take the shot, then, by all means, get the shot.

    If those odds don't sound great to you, you rarely have contact with a lot of people, or you aren't interested in the potential risks, and are willing to take the risk of getting the flu as a trade off for the risks of taking the flu shot then, by all means, don't get the shot.

    Finally, unless you are elderly or otherwise have health risks, even if you get the flu, it isn't that big a deal. Flu vaccine wasn't even available at all until the 1970s (if I remember correctly) and very, very few people died from the flu before that.

    Measles, smallpox, whooping cough, diptheria, chicken pox... those are all a lot more serious and can be life threatening. It makes sense to get vaccinated for those. But the downside to not getting a flu shot isn't so significant that it's an absolute "everyone should have it". Unfortunately, nobody bothers to explain this to people who are making this decision, but the information is out there, from the most credible websites (NIH, CDC, peer reviewed medical and scientific journals) and nobody (at least, no one actually familar with the data) actually disputes the factual data above.
     
    #34 Chip, Jan 17, 2020
    Last edited: Jan 17, 2020
  15. Austin

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    If that’s the case, I don’t disagree with what you say. I said in the very beginning I personally don’t love the flu shot. People can make their own decision if they want it. I don’t think it’s successful enough to mandate as they do MMRV, Tdap, HBV, etc. However, it comes off biased and based on conspiracy theory when you discuss “big pharma” and financial disclosures, and report that flu vaccines are being pushed on the public based on “scant evidence.” Maybe you don’t intend it that way but that’s how I interpeted it.
     
    #35 Austin, Jan 17, 2020
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  16. Chip

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    Everything I've said above is well documented.

    And I'm far from a conspiracy theorist.

    But I'm also a realist. The companies that make the flu vaccines make millions, perhaps billions, of dollars off of them every year. However, after a disastrous set of bad vaccines that caused serious problems in the 1980s, the major manufacturers threatened (empty threat) to stop make vaccine because they didn't want to have to defend lawsuits from side effects due to shoddy vaccines. So what happened? They bribed (uh, 'lobbied') congresspeople to get a special exemption passed that essentially made it difficult or impossible to sue the vaccine manufacturers for product liability for their vaccines.

    And so they get to make vaccines, for which they have very limited liability if it is defective and people are injured. That's a pretty much guaranteed way to make a ton of money. And then, if public health policy says everyone should get it, that's 300+ million doses annually. Vaccine companies make bank. Syringe companies make bank. Insurance companies make bank because it's one more reason to have insurance. Wal-Mart and Walgreens make bank by charging $20 for something that costs them maybe $2.

    So there's no conspiracy theory here... but we have to realistically look at the fact that it is, indeed, an industry, a highly profitable one, and one that has some pretty good shielding from any liability for a shitty vaccine. A great place to be if you're a pharmaceutical company.

    None of this says someone should not get a vaccine. But few people would deny that money influences policy, and so policies that are basically OK or have a little bit of benefit can suddenly become a major public health push if the messaging is shaped so that those disseminating the message themselves believe it. And increasingly, that's what seems to happen... nobody goes back and does the primary research, even when it is basically sitting right in front of their eyes. They take the PR spin sent out by the makers of the drugs or vaccines, supported by the politicians who are paid off by the drug companies.

    Again, not saying there isn't benefit. What I'm saying is, the benefits are spun to be more than they really are, because there are quite a few people in the chain who benefit financially from that message being perpetrated.
     
  17. Shorthaul

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    I've never been charged for a flu shot, and I think Walgreens gives them out to seniors for free.

    Now I'm not going to argue that pharmacies don't make ungodly amounts of money, that's a topic for an entirely different thread.

    Truthfully I would rather have the 30% chance of not getting sick compared to 0%. Same reason I wear high visibility vests, its not 100% going to keep me from getting ran over, but it helps.
     
  18. Andrew99

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    Walgreens also gives you free flu shots if you have insurance.
     
  19. alwaysforever

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    The argument that has been presented to me is that while the flu shot won't necessarily prevent the flu, as Chip said, getting the shot lessens the severity of the symptoms if you do get sick. If the sickness is particularly severe, it *might* increase survival chances and recovery over choosing not to take the shot at all. Plus, this year there are two major strains circulating in the U.S. I don't like it, but getting the shot makes sense.
     
  20. Chip

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    So it's not actually free then... they're billing insurance and making a tidy profit off of it. And that was sort of my point, a lot of people profit off of flu vaccine.

    To be clear, I didn't say or intend to imply that.

    What I was saying was that if you happen to be exposed to one of the particular strains of the flu that the shot happens to protect against (which you only have a 30-50% chance of), then the shot will likely prevent you from getting. it. But only if you get one of the small number of strains in the vaccine. If you get a different strain, then the shot provides no protection whatsoever.

    Again, only if the particular strain you are exposed to is one included in the vaccine.

    And I have not read whether either of those strains is covered by the vaccine. That sort of specific information is really difficult to come by, because it runs counter to the narrative they're trying to push that the flu shot protects against "the flu" without mentioning that it's only specific strains.
    @Destin , do you or your dad happen to know the answer to that question?
     
    #40 Chip, Jan 20, 2020
    Last edited: Jan 20, 2020