As I’ve discussed from time to time, the three most reviled vaccines among the antivaccine movement are the HPV vaccine (Gardasil and Cervarix), the hepatitis B vaccine, and the influenza vaccine. The first two tend to be demonized because of moralistic associations with sexual activity, given that HPV is most commonly spread by sexual activity and hepatitis is similarly often spread through bodily fluids exchanged during sex. This leads to what I’ve referred to as “slut-shaming” the HPV vaccine, given that it is recommended to be given before girls become sexually active by inferring (and sometimes more than inferring) that the HPV vaccine will encourage promiscuity by removing one of the consequences. As I’ve said before, that is one of the stupidest arguments against the HPV in existence. (Seriously, does anyone think teens worry about maybe getting cancer 20 years down the road when their hormones are raging?) As far as the hepatitis B vaccine, the rants usually come in the form of complaints questioning why it is given right after birth when a major mode of hepatitis B transmission is through sex, even though there are good reasons to administer the first dose of hepatitis B when it is given.
That leaves the flu vaccine.
Pity the poor flu vaccine. Granted, it isn’t the greatest vaccine, largely because the strains of flu virus that circulate each year can vary markedly, which means that the virologists and public health experts charged with formulating the flu vaccine have to make an educated guess each year as to what the predominant strains will be that year, leading to wildly differing efficacy of the vaccine depending on how good their predictions are. When they get the strains right, the flu vaccine is quite effective in preventing the flu. When they get it wrong, not so much, although even a mismatched flu vaccine can provide some protection. Until a universal flu vaccine that doesn’t depend on the highly variable epitopes that are targeted by today’s flu vaccine is developed, the effectiveness of the flu vaccine will vary from year to year for the foreseeable future. This makes the flu vaccine an easier target for the antivaccine movement, which targets because they can use the flu vaccine as an “example” of a vaccine that they can mislabel as “overhyped,” “useless,” and even “dangerous,” the last of which they try to achieve by massively exaggerating the risks of the flu vaccine and appealing to a flu vaccination campaign from nearly 40 years ago, the “swine flu” campaign.
Key to this campaign is the need to portray the flu as not being a serious illness, as a normal part of life, as a disease that doesn’t need to be vaccinated against. This portrayal of the flu is completely disconnected with reality, of course. The flu can kill, and, when it does kill, the people it kills are often young and perfectly healthy. None of this stops one of the more frequent “contributors” to the antivaccine propaganda blog Age of Autism, Cathy Jameson, writing an insufferably self-important account of how she “survived the flu naturally.” She introduces her story thusly:
Before I go into more of the details, let me back up a bit. Not long before I started to feel sluggish I saw another big stink being made about getting the flu shot. Citing the CDC’s over-used scare tactic of “36,000 flu deaths per year” statistic, even though “…[the] CDC does not know exactly how many people die from seasonal flu each year…”, people like me, who hadn’t yet gotten a flu shot, were being told they had just about two more weeks to get one for it to be effective. With how advertising for this particular shot if hyped from September through May, I wasn’t aware that there was an expiration date of sorts for its effectiveness (not that I was going to run out and get “the damn vaccine” mind you).
Ironically, the day I got sick was when the media warmed those two weeks were up. No matter. I was ready.
The funny thing is, from the rest of her report, Jameson wasn’t. Not really. She describes her experience as “feeling like a Mack truck ran me over,” leading her to crawl “under the covers in the fetal position,” and sleeping on and off for 48 hours, apparently rarely getting out of her bed. She described a several day recovery period, during which she slowly started to look and feel human again. Because she apparently never saw a doctor and never got a test for the influenza virus, we have no way of knowing whether what Jameson had was actually the flu, but it sounds like a typical case. Basically, it knocked her on her tuchas for at least a week, making her miserable. All full of pride in herself and, in essence, giving vaccines the finger (as so many antivaccinationists foolishly do), Jameson gloats:
We did it. We survived. I’m sure that isn’t what the media wants to hear. The CDC, all manner of doctors, medical providers and corner store pharmacists are more than ready to pump toxic gunk into us via the “the dreaded flu shot” (which is what one of the nurses at my doctor’s office calls it).
They say that we’re in for a long haul still. They’re still advertising and selling flu shots in full force. They’re trying to win people over with shopping incentives, discounts and store credit in the process. I have to ask, if the flu shot was a guarantee, as society is being lead to believe, why do stores and companies bribe consumers to get it? Gift cards and shopping passes. 20% off here. $15 toward purchases there. It just doesn’t make sense to me.
It isn’t headline news, but with how much the flu shot is pushed, you’d think surviving the flu sans the shot would be.
Yes, because Jameson and her children, who apparently developed milder cases than she after she was sick, survived the flu, it must not be a big deal and you don’t need to be vaccinated. Seriously, this is her rationale. Typical of the antivaccine movement, it is anecdote-driven (hers), rather than data-driven. Also typical of antivaccinationists, her account of the story is all about her, and if she can survive the flu it can’t be that bad. Oh, sure, she acknowledges that she’s grateful that she got through the flu with “relative ease” and even concedes that she understands “some people aren’t so fortunate,” but the entire tone of the post is that the flu is no big deal. I found this rather ironic, given that her account is that the flu basically laid her up for a week or more. Fortunately for her, she didn’t suffer any complications. Others weren’t so lucky.
There are a approximately 30,000 deaths a year from influenza. These numbers fluctuate yearly, of course, but that’s a rough estimate. The numbers also have a fair amount of uncertainty around them for reasons that Mark Crislip explains in detail. Also, most people have never known a person who died of the flu, despite those numbers. Over two million people a year die, around 6,600 per day on average. Crislip estimates that around 360 people a year in his state of Oregon die of the flu, or around 2 deaths a day during the six month flu season. In contrast:
2,400,000 people die every year in the US, about 6,600 a day. In Oregon, that is about 65 deaths a day. No one outside a epidemiologist is going to notice 2 extra deaths a day during flu season. I have seen a lot of people die of influenza, but I have a biased experience: I am an infectious disease doc, so I am likely to see people with influenza, especially patients with disease severe enough to kill them.
Crislip then elaborates:
About the same number of people die from car accidents and die from handguns in the US each year as die from influenza. I have never known a person in my real, as opposed to my professional, life to die from influenza or handguns or a car accident. My personal experience suggests no one dies from these causes, but since I take care of patients at one of the Portland trauma hospitals, I know what cars and guns do to people. My professional life confirms that people do indeed die from being shot or car accidents. I would wager that most people reading this blog have not known anyone who has died from influenza, guns or car accidents. The fact that people do die of influenza seems contradicted by experience. Why get the vaccine? I don’t get the flu and and no one I know has ever died from it.
I can’t say what Crislip says, because I actually have personally known people who died from handguns (a suicide over six years ago) and in an automobile crash (a couple of old high school friends of mine back in the 1980s). However, I’m probably the exception. Most people are probably more like Mark Crislip in that they don’t know people who have died in such a manner. Like Crislip, too, I know what my practice involves (or involved). I know the toll handguns and auto crashes can take because I am a surgeon and my training involved many rotations on the trauma services of various hospitals and because I used to moonlight as a helicopter physician in Cleveland and then later as a trauma attending in the Chicago area. However, because I’m not an infectious disease doctor, internist, or medical intensivist, I’ve never seen anyone I’ve taken care of die of the flu.
Our perceptions of risk are very much colored by our personal experiences. It takes a lot ot step outside of that, look at data that don’t include your own personal experience, and understand that just because you’ve never seen anyone die of the flu or known anyone who died of the flu does not mean that the flu is not a serious disease and just because you’ve never known anyone who died as a result of gun violence doesn’t mean that lots of people don’t die from high velocity lead poisoning. Of course, in the latter two cases, we see the results of gun violence and auto wrecks on the news all the time. We don’t see people dying of the flu. We are told about it on the news, but such reports don’t carry the visceral power of seeing images of gunfire or wrecked cars, not infrequently with blood still at the scene. Just because Cathy Jameson got through a bout of the flu “with relative ease” (other than being laid up and suffering for a week) does not mean the flu isn’t a serious disease.
Not unlike Bill Maher, perhaps the most famous anti-flu vaccine loon, Jameson also has an unjustified faith in “natural” preventatives and remedies:
Now that I’m over it, and as my family and I get back on track boosting our immune systems naturally with some vitamins, supplements and essential oils, I believe we’ll be able to get through the rest of the flu (and flu-shot) season unscathed.
How’d those “natural” remedies to “boost the immune system” work for you, Cathy? I also point out that I survived the flu naturally, too, around six years ago. It was the one year I didn’t get my flu vaccine and before the hospital where I work required the flu vaccine for all health care providers and workers. I suffered pretty much the same way Jameson did, surviving the flu “naturally.” I didn’t like it. I, too, was fortunate enough not to suffer any significant complications, but that week was one of the most miserable weeks of my entire life. I get vaccinated every year now and plan on continuing to do so for the rest of my life unless science comes up with a universal flu vaccine that doesn’t need to be administered every year. That’s my anecdote to put against Cathy Jameson’s anecdote.
The flu vaccine isn’t perfect. There are a lot of problems with it. It’s nowhere near 100% effective, although it is highly effective in years when the match between the strains vaccinated against and those in circulation is good—unlike all of Jameson’s “natural remedies.”