Should you get that flu shot?

posted at 9:55 am on September 26, 2009 by Pundette
[ Healthcare ]   

Most of us will get to decide this for ourselves.

The good news is that swine flu does not appear to be any deadlier than other strains:

New estimates suggest that the death rate compares to a moderate year of seasonal influenza, said Dr Marc Lipsitch of Harvard University.”It’s mildest in kids. That’s one of the really good pieces of news in this pandemic,” Lipsitch told a meeting of flu experts being held by the U.S. Institute of Medicine.

“Barring any changes in the virus, I think we can say we are in a category 1 pandemic. This has not become clear until fairly recently.”

The Pandemic Severity Index set by the U.S. government has five categories of pandemic, with a category 1 being comparable to a seasonal flu epidemic.

Sandy Szwarc notes:

Despite perceptions among the public and portrayals in the media of extreme risks, medical professionals recognize that, while the H1N1 flu may spread easily, it causes a relatively mild flu in most people and there is no evidence that is has or is likely to mutate and become deadlier. “If we have to have influenza, I would clearly choose novel H1N1,” Dr. William Schaffner, an infectious disease expert at Vanderbilt University, just told the Wall Street Journal.

A survey says that parents aren’t buying the swine-flu hype:

Only 40% of parents plan to have their children get the H1N1 flu vaccine—much fewer than those who plan to have children get the seasonal flu vaccine.
Hispanic parents are more likely than white or black parents to plan to have their children get the H1N1 flu vaccine.
Nearly one-half of parents who don’t plan to vaccinate their children are not worried about their kids getting the H1N1 flu.
Only about one-third of parents believe that H1N1 flu will be worse for children than seasonal flu. [emphasis added]

As a parent I worry a bit about the haste with which this vaccine has been manufactured. Things go wrong sometimes:

American officials rushed out a vaccine in 1976 following an outbreak of swine flu in military barracks. Around 40million people received the vaccine but doctors reported an increase Guillain-Barre and 25 people had died before the immunisation programme was stopped.

Flu shots can have unpleasant side effects and aren’t nearly as effective as some may believe.

The findings showed that the flu shot was 68 percent successful at preventing the flu compared with the nasal spray, which was 36 percent effective The study was funded by Sanofi, and published in New England’s Journal of Medicine.

No one knows right now just how effective the swine flu vaccine, in either form, will be. The typical claim for flu shot effectiveness is 70%. It can be significantly lower.

And kids with asthma, one of the risk groups being pushed to get the vaccine, may be even worse off if they get vaccinated:

Correction: No, they won’t be worse off. The effectiveness is in question, but the shot hasn’t been proven harmful to kids with asthma. I apologize for that misreading.

The inactivated flu vaccine does not appear to be effective in preventing influenza-related hospitalizations in children, especially the ones with asthma. In fact, children who get the flu vaccine are more at risk for hospitalization than their peers who do not get the vaccine, according to new research that will be presented on Tuesday, May 19, at the 105th International Conference of the American Thoracic Society in San Diego. Flu vaccine (trivalent inactivated flu vaccine—TIV) has unknown effects on asthmatics.

“The concerns that vaccination maybe associated with asthma exacerbations have been disproved with multiple studies in the past, but the vaccine’s effectiveness has not been well-established,” said Avni Joshi, M.D., of the Mayo Clinic in Rochester, MN. “This study was aimed at evaluating the effectiveness of the TIV in children overall, as well as the children with asthma, to prevent influenza-related hospitalization.” [. . .]

They found that children who had received the flu vaccine had three times the risk of hospitalization, as compared to children who had not received the vaccine. In asthmatic children, there was a significantly higher risk of hospitalization in subjects who received the TIV, as compared to those who did not (p= 0.006). But no other measured factors—such as insurance plans or severity of asthma—appeared to affect risk of hospitalization.

“While these findings do raise questions about the efficacy of the vaccine, they do not in fact implicate it as a cause of hospitalizations,” said Dr. Joshi. “More studies are needed to assess not only the immunogenicity, but also the efficacy of different influenza vaccines in asthmatic subjects.”

But in spite of all the negatives and the downgraded status of the H1N1 ‘emergency,’ some healthcare workers are being forced to get the vaccine. The state of New York, MedStar, and HCA are requiring this of healthcare workers. Some have objections:

Critics, however, say the decision to get vaccinated should remain individual, especially for the swine flu vaccine, which was rushed into production to try to blunt the pandemic’s second wave.

“I don’t want to be a guinea pig,” said Orne Banks-Hopkins, 55, a clerical worker at Washington Hospital Center. “I don’t think I should be forced to take something I don’t want to take.”

[. . .]

MedStar, the state of New York, HCA and other entities requiring vaccination are allowing exemptions for employees who have medical reasons for not getting vaccinated, such as egg allergies or risk factors for a rare complication known as Guilliame-Barre syndrome. MedStar and HCA and others also allow workers with religious objections to be exempted.

In New York, however, where the policy affects about 522,000 employees, no religious exemptions are allowed. Workers who refuse would be assigned to duties that do not involve patient contact, and they could face further disciplinary action.

“I have a problem with being mandated to put something in my body,” said Sandra Morales, a labor and delivery nurse at Beth Israel Medical Center in New York City. HCA employees who do not get vaccinated will have to wear surgical masks during the flu season or be dismissed. MedStar workers who refuse would face disciplinary action, including possibly being fired.

The response from workers might be different if this were an actual national health crisis. And mandates from employers and governments might be justified if that’s what we were facing.

So why the heavy-handed response to this non-crisis? Why the push for flu shots at all, when the benefits are not easily demonstrated? The naggers who know what’s best for the rest of us are “frustrated.” From the Post article:

The trend is being fueled by frustration at the stubbornly low proportion of health-care workers who get vaccinated each year despite years of coaxing, urging and incentives to do so voluntarily, combined with trepidation that the swine flu pandemic could overwhelm the health-care system, especially if many caregivers get sick, too. [emphasis added]

Maybe all these stubborn healthcare workers find that the benefits don’t outweigh the risks.

Mandated vaccines would result in windfalls for those with vested interests in the companies that produce them. Somewhere out there is a real journalist willing to follow the money on this.

Meanwhile, parents and other adults ought to do the research, weigh the risks and benefits, and decide for themselves. Some will conclude it’s worth it and others won’t.

I’d be interested to know how many parents are coaching their kids to sneeze, in the new politically correct manner, into their sleeves. I’m not. Coughing, sure. But sneezing on your sleeve? I don’t think so. Get a tissue, and then wash your hands. With soap. And try not to touch your face, especially your mouth and nose. If you’re sick, try to stay home. Hand-sanitizer is okay, I guess, but don’t get carried away with it.

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