Flu Shot This Year?

[mr x]

Isn't some precentage of anything always going to have a negative outcome (especially when it comes to medicine)? Does "one guy at work a few years ago" really mean anything to the discussion about flu shots being safe?

Just like the concept "I got the flu shot and still got sick last year" is not really a useful critique of a vaccine.

What's the percentage of negative outcomes? Do you know? Would it be worth the risk if you did know, because nobody ever gets told the whole story with conviction. You always hear 'You have to get the flu shot' on the news, you never hear about the devastating side effects, like drugs ads on US televison. What are the chances of getting violently sick from a flu shot vs getting H1N1? Is there concrete evidence that a flu shot actually works, because people have been prescribed medicines for decades that have proven to be sketchy at best? I've been close to somebody who has gotten very sick from what most people believe to be a reaction to a flu shot. Reality is a legitimate critique.

[chalmers]

Less than 10 cases of anaphylaxis in a million shots administered (http://www.phac-aspc.gc.ca/publicat/cig ... 03-eng.php" onclick="window.open(this.href);return false;).
80% effective against lab-confirmed flu (rather than what people "think" is the flu) (http://www.phac-aspc.gc.ca/publicat/ccd ... p#sec_iv-2" onclick="window.open(this.href);return false;)
5 people ( with maybe two more, if it is confirmed is the lab) have died from the flu in Toronto (sorry, no national data) since September (http://www.citynews.ca/2014/01/08/7-die ... from-h1n1/" onclick="window.open(this.href);return false;)

[mr x]

Also consider, does anaphylaxis cover all possible side effects, and are all cases actually reported. For instance, in the case of my co-worker, I 'm not sure the conclusion on record was that this was caused by a flu shot.

[Juniper Hill]

I've been advocating and prescribing flu shots and other vaccinations for my career (14 yrs, 20 years if you count residency). Serious reactions are exceedingly rare. Reactions to medications, while still rare are much more common.

Having said that, I can understand X's position on flu vaccinations given his negative experience.

[mr x]

Here's one of my pet peeves, from CBC Edmonton:

2) Will the flu shot make me sick?

No, says Dr. Armstrong.

“If you have those sort of mild, flu-like symptoms because you got the shot, it’s generally an indication that your body is really starting to react strongly to the virus – so when the real McCoy comes along later, you’re probably not going to get sick at all.”

“Some people still have the mis-notion that ‘I get the flu vaccine every year and I get really sick‘ – it has no capacity to cause illness, it’s an inactivated virus,” says pharmacist Mo Elsalhy.

[AllanMar]

Reality is a legitimate critique.

The reality using almost any source (anticdotal or published statistic) is a serious reaction like you mentioned is extremly rare.

Any arguement that includes "a guy I know a few years ago", is a pretty weak one IMHO. If that's the standard, FWIW everyone I've known for the last few years has not had any negative reaction.

[mr x]

It's not rare enough that I didn't witness it firsthand. Is that weak? You're hung on semantics instead of the event. How's this - A person I know and work with every day...

And what does 'extremely rare' mean? I am quite sure that you don't know.

[AllanMar]

We're both argueing semantics last I checked.

I guess I'm assuming you know/work with a fair amount of people and 1 in "a few years" is a very small percentage.

I know a guy who's airbag deployed unintentionally on the highway and almost killed him (5+ years ago).... Again, a pretty useless statement in a discussion about airbag safety. I doubt this is going to have any impact next time yourself (or anyone else here) gets in your car is it?

[mr x]

Is one in a few years a small percentage? Who knows? How many people are getting the shot? You are trying to tell me that something I saw was insignificant based on no provided statistical evidence. An outwardly healthy person gets a flu shot for the first time, becomes deathly ill and hospitalized within hours, and nobody can find any reason to say it was not the flu shot. If you can ignore that, more power to you.

At least we know that airbags can cause serious injury. What do you really know about flu shots? I've read reports that strains mutate and by the time they can come around relative to the time you have gotten the shot, there is a chance the shot was worthless anyway....

[AllanMar]

Fine, I'll bite. Even though chalmers already did.

http://novascotia.ca/dhw/populationheal ... 1-2012.pdf" onclick="window.open(this.href);return false;

Looks like ~35% (328,787) of NS got the vaccine in the above (2011-2012).

Adverse Events Following Immunization (AEFI)
During the 2011–2012 influenza seasonal immunization campaign, nineteen adverse events following immunization (AEFI) were reported in Nova Scotia possibly associated with influenza vaccine. Most were moderate in nature (local reaction at injection site and rash), with one being a serious event. No cases were admitted to hospital, and all recovered.

I'm not going to spend a bunch of time producing similar statistics because I know your just going to dismiss them.

[mr x]

I'm through with this thread because you are using statistics to make you believe what you want. See a person near death, and those numbers may look a little less shiny. There is more than enough evidence to question the risk/reward, safety and effectiveness of flu shots.

[GuingesRock]

Grumpy Cat

[AllanMar]

You are trying to tell me that something I saw was insignificant based on no provided statistical evidence.

I'm through with this thread because you are using statistics to make you believe what you want.

Comon now, first the problem is i'm not using statistics and now the problem is that I am.
I'm not saying you don't have a valid reason for being turned off of it, but it's not the case that flu shots are generally a negative thing.

[Jimmy]

I'll jump on with you, Rob

I haven't experienced or know anyone who has experienced reactions to the vaccine (that I know of), though I'm with him on not trusting what's in them...and I especially don't trust the government to ensure that an injection is safe, and doesn't have negative short or long term side effects.

Not saying the vaccine doesn't work, just that I don't trust the government, and that they likely look at it as the lesser of two evils (ie: a bunch of people sick because no flu shots vs the odd reaction here and there, and maybe some unknown side effects that won't be known until 15 years from now)

[chalmers]

This comes to mind:

It is useless to attempt to reason a man out of a thing he was never reasoned into.

[AllanMar]

I especially don't trust the government to ensure that an injection is safe, and doesn't have negative short or long term side effects.

I cant help but wonder who do you trust to determine this?

Not saying the vaccine doesn't work, just that I don't trust the government, and that they likely look at it as the lesser of two evils (ie: a bunch of people sick because no flu shots vs the odd reaction here and there, and maybe some unknown side effects that won't be known until 15 years from now)

Of course they're looking at the lesser of two evils, isnt that pretty much all of life?

I don't have an issue with your logic though, if you just simply don't believe in the flu shot for any reason then there's no critisim there. Everyone gets to decide for themselves after all.

[redoubt]

I'm through with this thread because you are using statistics to make you believe what you want. See a person near death, and those numbers may look a little less shiny. There is more than enough evidence to question the risk/reward, safety and effectiveness of flu shots.

I was going to chime in with something along the lines of "the plural of 'anecdote' isn't 'data'". Which is true, and for good reason. But your coworker actually fits into the stats Allan quoted as one of those who had a serious "adverse event following immunization". Bad shit sometimes follows flu shots and other vaccinations. That's a real risk, you're right.

I completely understand your leeriness of the flu shot, X, which is why I was willing to "roll over" in the first place. Given the same experience, I'd be damn leery of the thing too. I don't think your coworker's experience really challenges the generally accepted conclusions about the safety and efficacy of the flu shot which, after all, allow that at least some people who get the jab are going to have an adverse reaction. But it sure as heck is going to change how those close to him -- like you -- are going to weigh the risks and benefits of getting the flu shot. The risks seem worse than the benefits to you? Fair enough. Carry on.

-Kirsten

[GuingesRock]

I don't trust the government either, and that's because their agendas differ from my own. They aren't concerned about me, but rather the implications of a flu epidemic to the economy (work force and health care costs etc.). That is why I believe they fund the flu vaccine for everyone.

I made my own decision to have the flu shot based on my risk reward assessment. Yes there are unanswered questions. Not everything is known. Medicine is a bit like that. Serious side effects are discovered and drugs withdrawn from the market after years of use. Doesn't happen that often, but it happens.

[Jimmy]

I especially don't trust the government to ensure that an injection is safe, and doesn't have negative short or long term side effects.

I cant help but wonder who do you trust to determine this?

No one

Not saying the vaccine doesn't work, just that I don't trust the government, and that they likely look at it as the lesser of two evils (ie: a bunch of people sick because no flu shots vs the odd reaction here and there, and maybe some unknown side effects that won't be known until 15 years from now)

Of course they're looking at the lesser of two evils, isnt that pretty much all of life?

I don't have an issue with your logic though, if you just simply don't believe in the flu shot for any reason then there's no critisim there. Everyone gets to decide for themselves after all.

Of course they are. As I said previously, I can't remember the last time I had the flu. I also can't remember if I've EVER had a flu shot. So lets pretend the government knows there is known long term side effects but they weigh it out and determine the benefit outweighs the side effects. Does that mean that I'M - me personally better off taking the flu shot?

[jason.loxton]

You can really tell that beer geeks are nearly 100% science geeks from this thread. I have had to play to voice of medical evidence and rational risk assessment in a number of Internet forums regarding the flu shot. Nice to see the discussion move differently here. Oh, and appreciate the shout out to Goldacre. He's my man. Kirsten: Have you read his first book, Bad Science? It's the double bomb!

**Disclaimer: I am not a medical professional. I am a science educator, with a special interest in scientific misconceptions.**

Mr. X: Flu shot effectiveness does radically change from year to year, because the composition of the vaccine is decided, based on models, before flu seasons begins (to allow time for production of the vaccine). Sometimes they guess wrong. In all cases, however, it provides at least partial immunity, and often provides somewhere near the 80% immunity cited here (to a low of around 50%). There's a vast literature on the effectiveness of the vaccine in preventing cases of the flu, both directly in the vaccinated and at the community level. My favourite is this awesome one (having worked with the Hutterites a lot, I have an affinity for anything Hutterite). Because Hutterites are so insular, they were able to mass vaccinate children in some communities and leave other communities unvaccinated as controls, to measure the degree to which vaccinating portions of the population protects high risk members of the population (the elderly): <http://www.nytimes.com/2010/03/10/health/10flu.html>. I love this study!

I get what you're saying about the flu vaccine making not making you sick as a talking point. Read one way it is misleading. But, what they are specifically addressing is the common misconception that you can catch the flu from the vaccine. That is not true of either the live attenuated (rare, nasal form) or inactivated (shots) forms of the vaccine. That is, of course, not to say that the vaccine is zero risk. No responsible medical professional would say that. (The risks are just very small.) The #1 worry is anaphylaxis, as noted above, and that is why they make sure that people do not have egg allergies that they know of. The auto-immune Guillain–Barré syndrome is also a real and serious (although exceedingly rare) complication, however, it is a more common complication from the flu itself.

The reaction you witnessed might have been a coincidence unrelated to vaccine or it might have been one of the rare dangerous reactions. Either way, the statistical risk:benefit ratio from the vaccine, especially if you are high-risk (old, pregnant, etc.) or work with high-risk populations, falls on the side of the vaccine. If you're a healthy adult who does not spend a lot of time around the immunocompromised, you're still better off getting the vaccine, but honestly your risk of serious illness from the flu is low enough that on a person by person basis, your probability of being seriously affected if you choose not to, is really low. (On a societal level it makes a difference.)

Here's a great one stop shopping spot* for answers to common anti-vaccine myths (replete with links to the literature): <http://io9.com/lets-just-debunk-every-f ... 1454237689>

*Note: It is compiled by a science journalist, not a medical professional.

[AllanMar]

I completely understand your leeriness of the flu shot, X, which is why I was willing to "roll over" in the first place. Given the same experience, I'd be damn leery of the thing too. I don't think your coworker's experience really challenges the generally accepted conclusions about the safety and efficacy of the flu shot which, after all, allow that at least some people who get the jab are going to have an adverse reaction. But it sure as heck is going to change how those close to him -- like you -- are going to weigh the risks and benefits of getting the flu shot. The risks seem worse than the benefits to you? Fair enough. Carry on.

More or less what I was trying to say, although better said.

[Jimmy]

With that being said...the reason I don't get the flu shot isn't because I don't trust it - it's because I don't feel like taking the time to get a shot that I don't ever remember getting and haven't been affected by not getting.

[dean2k]

Science!

Keep in mind we're also talking about contagion and disease vectors. Even though you are a relatively healthy adult with a low risk of mortality if you do get Influenza, you are still potentially spreading the virus to X number of people, who are in turn spreading it again to X number of people, etc. etc.

Like Jimmy saying he doesn't trust the government, he's partially right. The government doesn't really give a crap if you personally get Influzenza/H1N1, get sick and maybe even die .... but they do care about Influenza spreading to the larger population and having more people get sick, strain the health care system, take sick days, lower productivity, affect tourism to Canada because of a perceived SARS risk, etc. all in turn affecting the economy.

- just my 2 cents.

[erslar00]

(having worked with the Hutterites a lot, I have an affinity for anything Hutterite)

I'd be leery about anything to do with Hutterites... according to Corb Lund if you're truck get's stuck in the mud they will not help you!!

Well it was truck after truck, we all got stuck
‘cept the big old four by hutterite truck
We all thought “lord are we in luck!”
But he wouldn’t come anywhere near us,
Mighty neighborly, mighty neighborly.

[jason.loxton]

erslar00: I really like Corb Lund, and I expect that that was based on personal experience, but that lyric has always bothered me (in an otherwise great song!). There's a heck of the lot of crazy prejudice and offensive myths about Hutterites in Alberta, but having worked with and stayed over at a dozen colonies, my personal experience tells me they'd be more than helpful if your truck got stuck.