Wednesday, December 8, 2010

Should I get the influenza vaccine?

So, apparently nobody cares about getting cancer?  My previous post had the lowest interest yet. Huh. Apparently people worry less about cancer than I thought. 
Ok - how about something more immediately threatening - influenza!  The stuff of swine flu scares, 500,000-1 million deaths per year worldwide, about 41,000 deaths per year in the U.S.A, the possibility of world-wide pandemic super flu mass death - sounds like a Michael Crichton novel, very exciting stuff. By now your local grocery stores and Walgreens are advertising flu shots for everybody - and this year's vaccine includes the infamous H1N1 "swine" flu for your protection. First, read my previous post about how vaccines work.  I won't rehash it all here.
Influenza is a particularly sneaky virus - it jumps around from person to person, and person to animal, swapping genes with other influenza willy-nilly. It is highly contagious and promiscuous with its own DNA - influenza mutates and adapts rapidly.  Remember the Asian bird flu scare from the early 2000's? The big deal about that was that it was very, very deadly, but fortunately not very contagious (it was optimized for infecting birds, not people). The worry was that some poor sap would get infected with bird flu, and another regular human flu at the same time, and the two would combine into a super duper deadly human flu. Fortunately, that didn't really happen and most of the infection was bird-to-human, and not human-to-human. But, had it gone differently, millions of people could have died.
Now, H1N1 "swine" flu from last year - that was an influenza that jumped to people from pigs, and it was very contagious, but not especially deadly. Lucky us!  The thing is, when a flu first surfaces, it is hard to say whether it will mutate rapidly, spread around and kill us all, or do no worse than usual seasonal flu. It is a guessing game.
Flu vaccines are good idea, by all means get one, and it might save you from the misery of the seasonal flu. However, it is not perfect, and is based on an educated guess by health officials on which flus will circulate this year. Flus also change a lot, and the immunity from a flu vaccine does not last a super long time. Small children, the elderly, and those with weakened immune systems or complicating conditions are the biggest risk of death from influenza. The problem is the flu vaccine doesn't work very well in elderly people - their immune systems are not very good at mounting a defense for "new challenges." However, if that same elderly person had a particular flu in younger days, the immune system memory is still sharp and strong. Once you've had a certain flu you're forever resistant, at least a bit. In fact, an H1N1 flu circulated around in the 1960's, and people alive then still showed a better ability to fight last year's H1N1 flu because of prior exposure. Young adulthood and middle age is when we build up all those immune system memories for later years - and you don't get that from vaccines. It is a little bit true: "what doesn't kill you, makes you stronger."
So I've only had one flu vaccine in my life, and that was by accident (at the doctor's for something else, they offered, and I said sure). And - to my knowledge - I've never actually had a full-blown flu *knock on wood*. (Stomach "flu" isn't the real flu). The real flu is fever, sweats, body aches, chills, cough, etc. Sounds awful. But, I plan to optimize my immune system now for future elderly use. If you do have a lot of contact with elderly folks, little kids, hospital patients, etc. the responsible thing is still to get the flu shot so you don't spread it around a vulnerable population.  And live life to the fullest, because you never know when a flu pandemic might kill us all.  :-)    

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