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Saturday, September 19, 2015

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Well, I got one this last Monday. As usual, I get a little sick (slight fever, etc.). Unlike other years, I planned for it this time and had scheduled a couple of vacation days to recover. (They were also good mental health days.) I do it for 2 reasons. One, I really don't like getting the flu. And two, I'm not too keen on infecting others with it.

One concern I have, though, is that others might have a similar reaction to mine and don't have sick days or PTO. To take things on a bit of a tangent, I do wonder if some of the resistance to vaccines in general might have to do with these non-severe, but not entirely trivial either, side effects of some vaccines. Poorer people might not have the time to deal with the side effects, and doctors, I imagine, sometimes under-emphasize the possibilities of such effects.

Having said all that, I'm decidedly pro-vaccine and on established schedules. I just wonder if pro-vaccinationists could address those issues better.

Dr X -- there is a flu vaccine that does not use eggs which you might be a candidate for. Of course, since you have at least one allergy, I'm sure you'd want to check this vaccine out to make sure you're not allergic to some other ingredient.

http://www.cdc.gov/flu/protect/vaccine/qa_flublok-vaccine.htm

Gabriel Conroy -- I don't think poor people have less time, although they certainly have fewer resources otherwise. Flu shots are available in so many places. Almost all drug stores have them with no appointment required. (And "free" to lots of people.) As for the side effects, yours would be classified as severe if it makes you that sick and takes that long to recover. In addition, a poor person would suffer much less financial harm from missing 1 or 2 days work from a reaction to the vaccine than they would from missing 1 or 2 weeks from the getting even a mild case of the flu.

I also do not think there is a general resistance to vaccines. For the flu vaccine, there's general forgetfulness and perhaps apathy. The "resistance" to vaccines is organized and is generally among the well-off, well-educated. Fear of autism is a common reason offered. There are some in it for monetary gain (alternative medicine practitioners, for example) and others for social-signaling reasons.

There's a subgroup of the social-signalers who are prone to conspiracy theories. Big Government, Big Pharma, Big Medicine, Evil Corporations, and They are pushing vaccines because... mind control or something.

Donna,

Thanks you! Did some checking and it looks like this is the first year that Flubok is approved for persons above age 49, so I'll call my doc and see if they can get it for me. Their email gave me the impression that they're not offering it, but maybe they recycled a pre-Flubok marketing piece.

If they don't offer it, I'll make some phone calls and travel a bit if necessary to get it this year. It will put my mind at ease. Unfortunately, it isn't approved yet for under 18, so kids can't take it unless the issue is uncertain efficacy (rather than safety).

GC,

The research I've come across (social psychology & Poli Sci) finds it quite difficult to increase compliance substantially without a mandatory component or op-out policies that are deliberately inconvenient. Brendan Nyhan's research on the "Backfire Effect" suggests that many efforts at persuasion, including those that cite evidence, can actually have an effect opposite the intended effect.

Some municipalities are instituting mandates for young children. e.g., NYC for preschool children. The thinking is that vaccinating children would go a long way to reducing the spread of flu,
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Not much about side effect research and absenteeism is available on line, but what I did find indicates that fever/muscle ache post vaccination occurs no more often than it occurs with placebo injection among healthy, working adults. But soreness around the vax injection site is pretty common. So I don't know that physicians are deliberately downplaying side effects rather than simply relying on the evidence at their disposal.

Mild fever and body ache in the two days following vaccination was found to occur more often than it does with placebo injection among young children who hadn't previously contracted the flu or received flu vaccine.

I'm not saying your fever/not feeling well is a placebo effect, but it may be that among health adults, the occurrence is infrequent enough that it doesn't rise to statistical significance.

Donna: Not that I really know one way or the other, but I would want to count apathy and "forgetfulness" instances of "resistance," although certainly not the organized type you mentioned. And by not enough time, I meant "not enough time to deal with potential side effects."

But the rest you say I agree with. One or two days inconvenience is better than 1 or 2 weeks with the flu. But it's partially a gamble, too. It's not as if someone who doesn't get the vaccine is guaranteed to get the flu. For me, the gamble means it's not worth running the risk. Others might assess it differently. My own preference would be for the state not only to subsidize vaccines but to also give a small amount of money to partially make up for lost work time. Maybe not so much for the flu vaccine but for shots for kids that make them cranky for a day or two and that might require the parent to take off work. That wouldn't be without its own problems, of course. (I should add that although I take time off with the shot. I'm probably not so badly affected that I can't function. So I could still theoretically work even with the side effects. But because I have so many sick/vacation days, I have the luxury not to work.)

Dr. X: I know you're not suggesting that my reaction is a placebo effect, but I've actually wondered about it myself, or at least wondered if I've "willed" my reaction in some way. I'd also be lying if I said I didn't like having an excuse to take a few days off, but since I've used my own vacation days and not sick days, I feel like I've "paid" for those days off. (My employer is generous with both sick and vacation days, but much more generous with sick days, so that they're more like "free" days and I feel guilty when I call in sick.) To be clear, I don't think physicians are "deliberately" downplaying any side effects so much as I think sometimes when debunkers debunk anti-vaxxer arguments, they tend to be dismissive of real side effects, however rare. And for those who do experience them, they're not "rare" but things that happen.

(I should probably admit to both of you that while I believe anti-vaxxers are dead wrong and that most vaccines--maybe even the flu vaccine--should be compulsory--I have some sympathy/empathy for them that's hard to explain completely. I don't claim my sympathy/empathy is "justified." I'm just noting that it's there and it colors my attitude toward the subject. I realize this blog isn't the place to explain and argue those views, but that is one of my biases on this subject.)

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