Flu Shots Are Nothing To Sneeze At
This flu season is poised to be one of the worst in decades. People are rushing to pharmacies and their doctors to get immunized. A question being asked of us is “Do you believe in the flu shot?” as if we were discussing dragons or the tooth fairy. Yes, we do. Even though we are very hip to natural products for flu season support and look to holistic health management first, we are also trusted, respected, and overly sarcastic healthcare professionals. This topic has reached Rant-level Maximum. This is will be the definitive “Skeptic’s Guide To Flu Shots.” The gloves are coming off, people. Buckle up.
IMPORTANT: The point of this is not to make anyone feel bad about their decisions to date. Please read, then re-read this next sentence: I don’t want this Rant or ANYTHING we write to be an attack on you, the consumer. Consumers, even the extra-aware Woodstock Vitamins customers, are often caught in the middle trying to figure this stuff out.
First, Some Social Commentary
I do want to point out an observation. First, it's insane that American society has split into pro-science and anti-science factions. Science is science and it should be embraced by all. Second, there's a bit of hypocrisy within the pro-science section. The pro-science crowd are the ones who say "no duh, climate change is real" as they look down at those doubting the strength of the evidence. They're quick to reference the overwhelmingly large, almost mountainous piles of research and data we have that shows that our world is undergoing radical climate change at alarming rates AND that humans are a big part of the blame.
The hypocrisy is that some members of that pro-science group are quick to be skeptical of vaccinations despite the data. On top of that, the pro-science folk who know that data matters use so many justifications of the anti-vaccine movement that start with, “I read on Facebook…” It’s troubling. A study actually found that most of the anti-vaccine discussion on Twitter comes from only a few states and are usually perpetrated by more affluent, educated people.
There’s a blog that made a great point I hadn’t considered about this unnecessary battle. They’ve found that the perception of scientific consensus is a gateway belief. If you believe in and trust the experts, you are more likely to believe in the topic, and it will positively affect your attitude towards social policy around the topic. Read what they say about this:
“That’s why those who oppose taking action to curb climate change have engaged in a misinformation campaign to deny the existence of expert consensus.”
If you can convince people the topic is controversial, even when it isn't, you’ll weaken your opposition and even gain supporters. In other words, you are being manipulated away from facts. They've discovered that they can turn out a chunk of the pro-science team and erode their confidence in the experts.
Now we can conclusively say that Russia has played a large part in misinformation campaigns on social media. And not just about politics... They actively insert themselves in the vaccine debate. They sow division and support anti-vaccine messages to further polarize us.
We don’t have the time nor ability to learn it all, so we defer to experts. That’s why the first place you should look for advice regarding vaccines is the CDC and the Immunization Action Coalition, not a blog, an anti-vaccine naturopath, or an editorial book.
I am not an expert in vaccines. I am a healthcare professional trained to look at data with rigor. I trust and defer to the experts. I am here to bridge the gap between the research and you. And because I'm not the CDC, I can be sarcastic while doing so.
You don’t have to believe me. You can stick your fingers in your ears and go “LALALALALA!” If you feel this is a personal attack, you should probably stop reading and just hate me. What the vaccine discussion has become, much like most of the discussions in this country, is an ideological one, not a fact-based discussion. My final bit of social commentary and first bit of advice here is: don't take it personally. If vaccines, to you, are something to "believe in," I suggest you are looking at it all wrong.
You Don't Have To Get A Flu Shot
Like a Planet Fitness gym, this is a judgment-free zone. If you don’t want to get a flu shot - don’t! It really is fine.
All I ask is that when you decide not to, the reason you give is simply “I am an adult and I chose not to.” Don’t justify your decision using the common, now cliche, excuses that are just dripping with falsehoods and misinformation.
I’ll discuss all of the common misconceptions so you are more informed and feel more comfortable about the whole thing. My gut feeling from my 15 years as a pharmacist is that most people who don’t vaccinate will gladly do so if they had all the pieces of the puzzle in front of them. And yes, I do want everyone to be vaccinated, because I care about you, even you out there in the Intra-webs reading this far, far from Woodstock.
But Should I Get A Flu Shot?
Yes. Without hesitation. In fact, it’s ridiculous not to.
Once more, it’s almost criminal to not vaccinate any high-risk patient that can be vaccinated. The high riskers are: kids under 18, adults over 65, pregnant women, and people with heart or lung disease or other serious medical conditions.
They’re not high risk because they have a higher likelihood of catching flu. They’re high risk because they are more likely to DIE from the flu.
“But the flu shot is only 40% effective!” says someone who is just probably afraid of needles. It’s 40% effective (a guess, it seems to be as effective as last year so far) at preventing you from getting sick. The power of a flu shot doesn’t come from making sure you don’t get sick. The flu shot’s real duty is to prevent death and hospitalization. So even if it wasn’t 100% effective, it greatly reduces the severity of a flu infection. There's data proving flu immunization in kids will decrease the risk of death, even if it isn't a perfect match.
An equally important point, you get a shot not just for yourself. You get it to protect all the people you interact with (strangers and loved ones) who are high risk, even if you are not. Here at the pharmacy, we like to say: “The flu ends with you."
If a simple, almost always free, practically painless injection will help save someone’s life, then… why do I even have to finish this sentence?
I know why I have to. I know why the vaccine debate is even a debate at all. I know the reason why people are hesitant to vaccinate. It’s simple...
We Don’t Take Flu Seriously
Again, if you don’t want to get a shot, don’t. Unless you are in one of the high-risk groups, you probably will survive it. I say that as someone whose best friend's marathon-running wife got infected with H1N1 at her wedding and was in a coma in the ICU for 3 days. She's tough and REALLY healthy. Are you? If you are in one of those high-risk groups, you might not survive it.
That sounds a bit sarcastic, even dramatic, but that’s really what this is about. This isn’t about making sure you don’t get sick for a week. Vaccines are used to prevent the serious complications (death being one such "complication") of diseases. Our real goal is to protect people from dying from the flu. A majority of the population doesn’t take vaccination seriously because they judge a vaccination’s worth by the immediate, more common outcomes they are familiar with. The reality of the flu is too far off for most people.
We don’t take the flu seriously, probably because we call everything "the flu." Many people view “the flu” as any sickness in the winter time. We hear it often... “I have a flu,” says the gal who just got done with yoga class in January and has the sniffles.
Look, if you had the flu, you’d know it. The litmus test I use for people is this: If I put $200 cash on your bedroom door and you are too sick to get up and get it, that’s the flu. The reports from my cousin and a buddy, both currently sick with the flu and who were vaccinated, said that it comes on VERY suddenly (within a few hours) and they are so sick they don’t want to leave the bed. After a day or so they feel like they had a really rough workout at the gym.
I’d wager that very few people have actually had legit flu infections. Today, we have the ability to quickly diagnose if someone is truly infected, so it’s much easier than ever before to confirm this.
If someone has had the real flu before, it’s not a big deal in hindsight, right? They’ve had the flu and survived. As one of our customers so wisely put it today, people are very macho about the whole thing. “I’m tough, I survived it! I’m stronger because of it.”
This same mindset is applied to other diseases we don’t take seriously. “Why do we need a chickenpox vaccine? I got chickenpox just like everyone else did and was fine!” says the person who wasn’t aware that over 18,000 kids annually are hospitalized and thousands died from chickenpox. That’s for real. And a simple vaccine has almost eliminated those complications.
It’s only when we hear of young, healthy people dying from flu in the news do many of us leap to action, because sadly, many of us don’t take it seriously.
Not taking the flu seriously is a major problem. Skipping vaccination because of any reason besides being allergic to or had a real, life-threatening reaction to the vaccine is… unwise, to say it nicely.
When we don’t vaccinate ourselves, especially if we are in those high-risk groups, we’re playing Russian Roulette. And the first excuse I hear out of those hesitant to vaccinate is “I haven’t had a problem yet.” Well, keep spinning the barrel then. Personally, I’d like to take the bullet out of the gun.
Flu Shots Don’t Cause Autism
Beyond the basic psychological barriers many have to flu shots, there are a few, common, horribly wrong and inaccurate beliefs about flu shots. The big one is the vaccine-autism lie.
An unethical, greedy, manipulative doctor in the UK wanted to make a few extra bucks, so he ran a fake study that showed a small connection between MMR vaccines and autism. There were like 8 people in this poorly done study, but for some reason, he was published in a respectable journal. His data was proven to be a fraud, his study nullified, he lost his license and was literally thrown out of the country.
Despite this, the idea stuck in everyone’s mind. It didn’t help we had these quacks like Jenny McCarthy get WAY too much airtime by people like Oprah promoting these concepts. (This is Reason 1 she shouldn’t even be considered for President, despite how well she delivers speeches; she is one of the leading promoters of pseudoscience in modern America.)
They believed the link between vaccines and autism was thimerosal, an ingredient used in multi-dose vaccine vials as a preservative. Besides the fact there is conclusive data that there is no way ANY vaccine can cause ANY disease, there’s now lots of information proving pretty definitively there’s no connection between thimerosal in vaccines and autism.
Fun fact: Thimerosal was removed from all children’s vaccines way back in 2001. Yet the number of kids diagnosed with autism has increased. Do we use the "anti-vaxxer” logic against them and claim thimerosal was, in fact, preventing autism? No, of course not. That is RIDICULOUS, of course, and super careless to say. Yet the converse was screamed from the mountain tops and as a result, many kids have not been vaccinated. It’s not just flu, either. Parents are hesitant to vaccinate their kids, causing outbreaks of whooping cough and measles. What the heck?
Sadly, we don’t have a definitive answer on what causes autism. Regardless, it is irresponsible to link it to vaccines.
Aren’t The Ingredients Bad for You Anyway?
Many people don’t want to put harmful chemicals in their bodies, understandably. Let’s address that.
First, thimerosal is avoided because some believe it contains mercury. I’m stealing and paraphrasing something I found on Reddit, because it was masterful in discussing the difference:
Thimerosal is not mercury, it’s ethyl mercury, a compound that doesn’t dissociate in the body (meaning split into two, so we aren’t ever exposed to mercury) and is quickly removed by the kidneys. If you take elemental sodium, it’s explosive. Elemental chlorine is deadly as a gas. Yet when combined, sodium and chloride make popcorn and other foods taste great -- it’s table salt. When elements are combined, you inherently change the properties of the compound. Ethyl mercury, aka thimerosal, is NOT the same as mercury.
Nor does thimerosal increase mercury burden in your body. If you have evidence that it does, submit it for a Nobel Prize because you'll win.
You would need something like 80,000 doses of a vaccine with thimerosal to harm someone. All at once. You’d die from the water first!
Despite all of the information showing how safe it is, manufacturers started making pre-filled vaccine syringes that are 100% sterile without thimerosal. This has made the cost of vaccination skyrocket, but there it is.
Thimerosal doesn’t cause autism or any other harm in humans, especially at the ultra-low doses we get in our rare exposure to them. So what is it in vaccines that’s an issue? The other inert ingredients?
Here’s a list of inert ingredients in the flu vaccine we have (Afluria):
sodium chloride (4.1 mg)
- monobasic sodium phosphate (80 mcg)
- dibasic sodium phosphate (300 mcg)
- monobasic potassium phosphate (20 mcg)
- potassium chloride (20 mcg)
- calcium chloride (1.5 mcg)
If you are checking, that’s 3 types of salt, then 3 salt based pH adjusters (the phosphates). I’ll leave it to you to prove to me those are harmful because they are not. If they are, Jello would be a genocidal weapon of mass destruction.
Formaldehyde is often used as a preservative in some vaccines. People hear that and say "OMG that's what they fill dead bodies with!" and want nothing to do with the vaccine. They may even have a little PTSD from biology lab where formaldehyde rich frogs and other animals were dissected. That stink doesn't go away; I am literally gagging thinking about it! The truth is formaldehyde is mostly removed from vaccines before it goes into the vial. Most importantly, while high dose formaldehyde is good at preserving body tissue, small amounts won't bother us. How do I know? Humans make about 1.5 ounces of formaldehyde a day during normal metabolism. It does not accumulate in the body and is quickly removed.
Anti-Flu Shot Hypocrisy
Being that one of the biggest reasons people don’t want flu shots is because of those ingredients, I thought it would be good to point out something that many people don’t realize.
If you take supplements that aren’t Vitality Approved, there’s a very high chance you are exposing yourself to far worse chemicals, at a higher frequency and larger concentration than any vaccine.
Please re-read that one more time!
Many anti-vaccine people use supplements, and as our readers know, supplements are often contaminated with horrible stuff. Here's a lightning round:
- Many herbal products are extracted using hexane, a carcinogen
- Turmeric is one of the most adulterated products on the market. We ranted about herbal quality here.
- Protein powders and sports supplements are often found contaminated with heavy metals - the same ones or worse that are found in vaccines. We ranted about that here.
- Arsenic is found in many green powders.
- Many B12 supplements are made using mercury.
I appreciate the concern, for sure. It could be said we live in a chemical soup, so we have to minimize our exposure to bad stuff. Vaccines don’t have bad stuff, though. And if we were to be truly honest with ourselves, we aren’t always as vigilant in other aspects of our lives.
"Gotta Build That Immune System"
Another macho notion is the idea that is better to get exposed to the flu and fight it than it is to get a vaccine. Our immune system gets “stronger” this way, says the person with no understanding of how an immune system works. It's as if we want to create muscular, tank-top shirt wearing “bro” immune cells to be alpha to the weak, geeky, normal immune cells. This comes from a very casual understanding of how the immune systems work and what vaccines are.
We recently discussed the immune system and how boosting is a bunch of BS - except in the case of vaccines.
Immune systems work by identifying foreign invaders then attacking and removing them. In order to know what a foreign invader is, we have to be exposed to them. Our immune cells interact with the invader’s cell surfaces to build a description of what the “bad guy” looks like. Sort of like the “Wanted” signs in the Old West. Once we have an accurate description of the “bad guy”, our US Marshals and Sheriffs can lock 'em up in jail rather quickly.
Sure, your immune system gets "stronger" when you are exposed to diseases. But you can get sick. As we stated before, we have to take diseases seriously and look at them from the eyes of the weakest among us. Getting sick is the least worrisome outcome. Some people can get hospitalized. Treatment costs time and money. Some people die.
Wouldn’t it be cool if we could get our immune system to build up its collection of “Wanted” signs and be stronger, without all the risk of getting sick and dying? If only we could give someone a weaker version of a vaccine? Maybe we can just inject fragments of the invader’s cell surface since that’s all our immune system interacts with anyway...?
That’s a vaccine.
Using vaccines is literally how we build our immune systems.
You Can’t Get The Flu From A Flu Shot
Let's use one of my famous analogies that center around junk food. Imagine a virus is a peanut M&M. Whatever color you want. The only way for that virus to replicate is if it has all the parts together; it must be whole. Candy coated shell, chocolate, peanut.
Let’s hit our peanut M&M with a small hammer. We now have crumbs everywhere. Take the pieces of the candy-coated shell out and put them in a pile. Those pieces can’t replicate or reproduce. They’re not starfish; they won’t regenerate back to an M&M (if only!).
Those fragments of a candy-coated shell is the vaccine. Very important parts that will be enough for our immune system to build a description (the “Wanted” sign) and be able to fight off an infection if you ever got exposed to the full M&M.
Why do people say they get sick after a vaccine? Great question with a rather simple answer. Anything in a vaccine that could cause a problem is completely gone within 72 hours. Any symptom or issue that persists beyond that can’t be blamed on the vaccine.
Flu shots are given in public places, typically where there are lots of sick people already. Doctor’s offices. Pharmacies. Hospitals. Common colds - and even the flu - incubate in about 1-4 days. So yes, it’s merely a coincidence. Some people get sick after vaccination because they caught a bug around the time they got the immunization.
Our bodies are weird. One year, you can have a flu shot and not a single ache. Other times, the immune response to the vaccine is more pronounced - you feel a little tired or achy. If any symptom lasts more than 72 hours, you got sick the day of the shot or the day before, not from the shot itself. A flu shot could make you feel achy, tired, feverish, and give you a sore, red arm. That’s it.
Even If All Those “Risks” Were Real, It’s Still Worth It
I've heard people say they don't want a shot because they (or someone they know) had a weird reaction. They believe it was real and related, and therefore don't get a shot.
Again, that’s fine. I’d argue that is a better reason than being concerned about thimerosal. Something bad happened, so they are hesitant.
I’m going to take a controversial approach. Even if there was a risk of vaccines causing a disease, an ingredient could be harmful, you could get sick from a vaccine, or you could have a serious reaction to it, immunization is still worth it.
Everything carries risk. If there TRULY was a small, real risk that a vaccine could cause a problem, WHICH THERE ISN’T, vaccines save millions of lives. As long as the benefit outweighs the risk, a medical intervention is worth it.
Nettles can cause confusion, but some people find it supports their respiratory system. Worth the risk? Aspirin can cause GI bleeds, but it also lowers the risk of death in people with high blood pressure quite dramatically. It’s all a balancing act.
And we are super lucky. With vaccines, it’s almost entirely benefit with little to no real risk.
Here's a dose of the unfortunate reality. There is something in common about the three children that died in Florida:
What To Do To Protect Yourself
Here’s a list. We discussed how to stay healthy during the holidays here, and the advice still holds true.
Here's a quick rundown of what to do:
- Use universal precautions. Pretend everyone has the flu and are trying to kill you.
- Wash your hands frequently, don't touch your face, and keep a hand sanitizer on hand.
- Get vaccinated ASAP this year.
- Get vaccinated earlier next year.
- Stay home. If you are sick, stop spreading the germs. If you were exposed to the flu, stay away for a day or two.
- Eat well and sleep more. These will profoundly impact your immune system.
The High Dose Flu Shot
Many seniors are on the prowl for the "high dose" flu shot, so we might as well address that here...
The idea is that if we give a higher dose of the flu vaccine, we get a stronger immune response, and therefore better protection from the flu. Here's what's real:
- You DO get a higher dose of the flu shot
- This costs 2-3x what a normal flu shot costs
- The side effects are greatly increased
- The benefit isn't great at all - you need to treat about 200 people to improve 1 outcome
So the high dose flu shot is a more costly, side effect version of the flu shot, with little benefit to those who take it.
If your doctor tells you to get it, get it. If you are asking me when you come into the store, I'm going to tell you, simply, that the regular flu shot will do.
Better Late Than Never
I want to rib people a little bit here, despite me just saying I wasn’t going to do that. The media picks up the story and word spreads that the flu is serious. So now we FINALLY decide it’s serious and leap into action. I imagine that this is a fact of human existence in all aspects of life. People buy a house alarm AFTER they get robbed. People start being more empathetic to peanut allergies AFTER their niece has an issue. And people hear “flu outbreak” on the news and rush in to get flu shots WAY later than ideal.
Now, know that you absolutely should get a flu shot ASAP if you haven’t already. If you are now motivated, please follow through. I’m not trying to take that away from you. After all, “the best time to plant a tree is 20 years ago, the second best time is today.” Get the shot!
Know it takes a couple weeks to develop the immune response to fully protect you from the flu. That is why it is always best to get your flu shots as EARLY as possible, which is somewhere between late August and early October.
Some people wait because they “don’t want the shot to wear off.” Protection for almost everyone lasts for about a year, less for some older or sicker adults. Flu seasons only last 6-8 months, so there literally is no point in time that is “too early.”
Your Next Steps
"So you’re saying I don’t have to pay for a flu shot, the worst thing is it could hurt my arm for a couple days, and it could protect me from getting sick or dying? Yeah I’m gonna do that."
"It’s not guaranteed to protect me, but I probably won’t die, but it’s still cheap/free, easy, and convenient? Yeah I’m still gonna do it."
When you strip away the myths and misinformation surrounding the vaccine, there is literally no good reason not to get a flu shot. We’ve said it a bunch, but it bears repeating: You don’t have to get a flu shot. Just don’t get one because you don’t want to. That’s fine, and respectable. You’re an adult and can make that decision.
Here's a conspiracy theory I think we all can believe in. There is a greater than 0% chance that the misinformation surrounding vaccines is literally propaganda to win people over, for whatever reason. The likelihood of that being true is much higher than any of the bad things they say a flu shot can cause.
If you are looking for an opinion and you respect mine, get a flu shot. Vaccinate your family. Do it early. Do it every year. Spread this message. Make the flu end with you.
Just trying to keep it real...
Neal Smoller, PharmD
Owner, Pharmacist, Big Mouth