Some years ago I read an online essay from a medical doctor about vaccination. It was very eloquently written (wish I could find it again, I think it was on quackwatch.org), and among other things made the following points:
-Vaccines are not absolutely 100% safe. Although the risk is very small, there are indeed some individuals who suffer bad reactions to being vaccinated.
-Vaccines are not absolutely 100% effective. There are some people who will not develop immunity to a disease despite having received the vaccine.
-People who do not respond to the vaccine still benefit from herd immunity, which requires that a very large percentage of a population be immunized.
-Individuals therefore have a social responsibility to accept the non-zero risk of vaccination in order to achieve the greater good of herd immunity.
It all seemed quite reasonable when I read it, as it was in the context of childhood vaccinations against famously deadly diseases like polio, measles, smallpox, and so on.
And now I find myself wondering about the annual flu shots that are so common. I’m currently 41, and the last time I think I might have had the flu was when I was 11. I’ve never had a flu shot; just never seemed worth the trouble to me, probably because I’ve been so healthy for so long. If luck is the only thing protecting me for the past 30 years, well then I can accept the odds for myself, I guess. But taken in the context of the above-described essay, do I have any sort of social obligation to take the flu shot every year? Logically, doing so should contribute to herd immunity, helping to reduce incidence of the flu. Conversely, failing to do so must compromise herd immunity and therefore help foster greater incidence of the disease - which can be fatal in small children and the elderly, and in the remainder of cases costs society a lot of money due to people not coming into work (because they’re sick or caring for a sick family member).
Do you get a flu shot every year? Is it for selfish reasons, or are you motivated to do so by the idea of a greater social good?
I think there’s an obligation to the social contract to help minimize the transmission of diseases, but I don’t think it necessitates getting a vaccine. As pointed out, there are risks involved with having a vaccine and, while they make sense over a large population, the risk changes on an individual basis. For instance, if someone works around kids or the elderly or sick people or otherwise comes in contact with lots of people or have a poor immune system, the risk becomes more worth it. If, however, you have minimal contact with other people and have a good immune system and good hygiene habits, the risk becomes less worth it on an individual level.
At the same time, there’s other things that one can do to help minimize transmission. Like, for instance, if you get sick… stay home. Whenever I see the flu going around the office, it’s because someone just HAD to come into work when they were sick and spread their germs, and eventually it works its way through most of the people in the office. Also, exercise and eat a good diet, keep good hygiene, and otherwise take care of yourself.
So, anyway, in my case, I very seldom get sick and, in fact, and usually among the last to get it when it’s going around, and I do stay home when I get sick and otherwise take care of myself. To that end, I don’t think my risk of spreading the flu is high enough to warrant the cost and potential complications to myself, particularly since there always seems to be a shortage, so those shortages should go to people who need them more.
I get a flu shot every year because I have to, it is a military requirement. My wife and son get one because it’s the right thing to do for everybody involved.
When I used to visit two grandparents in nursing homes every couple of weeks I got the flu shot every year. I also postponed visits if I was sick or felt a bit off. A few years ago there was a shortage or a late delivery of the flu vaccine and those who weren’t exposed to high risk groups were asked to wait for their shots, that year I didn’t end up getting one. Now I wait till the last couple of weeks they are available at the flu clinics that the city sets up and go get mine then since I’m just getting it for myself.
If you regularly expose people who are high risk, the elderly, those too young to be vaccinated themselves, asthmatics, people on immunosuppressive medicines such as for cancer or for a variety of other conditions, diabetics … and so on … then you do.
I think to some extent parents of school aged kids have a bit of an obligation to immunize their kids for that reason as most of the spread of influenza is via that population.
Otherwise less so.
If you do and you are a healthy adult under 50 years of age, you may want to consider the nasal version. It helps prevent both disease and its spread better but most high risk individuals can’t take it.
I think you have a weak obligation to do so. That is, if there is a stronger philosophical reason for you not to get one, I wouldn’t think you’re a bad person.
I also think you’re calculating the value for yourself wrong. I believe that the expected value to myself of getting a flu shot is way into the positive, even if I don’t consider the positive effects for others around me. The minor inconvenience and discomfort of a flu shot every year is worth it to me if it prevents even one case of my getting the flu in my lifetime, which on average I think it will. That’s not really a moral consideration, but a practical one.
I agree that there is an obligation to get the influenza vaccine if you’re putting vulnerable people at risk (see DSeid’s post). This applies especially but not exclusively to health care providers, who increasingly are being required to get the flu vaccine as a condition of employment. These days there are a lot more people with compromised immune systems than there used to be (due in part to HIV and immunosuppressive drugs used to treat cancer and autoimmune disorders), and they are at special risk from communicable infectious diseases, including many that are preventable through vaccination.
On an individual level, having a “good immune system” actually made people more susceptible to severe complications and death during the recent H1N1 influenza outbreak. Fatalities were disproportionately high among the young and healthy.
Please keep in mind that you may not even realize that you are in regular contact with people at increased risk. For example, my office has 70-some people in it; I’m asthmatic, and I’m not the only one, and I probably don’t know about all the people in the office in increased risk categories (there are a number of people over 65, and for all I know, someone on immunosuppressant drugs). A bunch of my colleagues have small children. And then there are the other people in their households: for example, one colleague’s diabetic mother just had her leg amputated.
During the worst of the H1N1, my office actually announced a policy that anyone showing flu symptoms would be sent home from work, period. I really appreciated it. I don’t know that I’ve ever had a proper flu, but my great-grandfather died during the 1918 pandemic, and my grandmother (who was an infant at the time) grew up fatherless and impoverished, so I take this stuff seriously.
The impression I get is that because the flu mutates so quickly, flu vaccines just aren’t as effective as, for example, the measles vaccine. You can’t just vaccinate everyone and let the disease go extinct - all you’d do is eradicate a handful of flu strains and leave the others untouched.
I don’t get a flu shot because I’m allergic to the vaccine - last time, I broke out in hives, started to have trouble breathing, symptoms of shock, etc.
So… I’m very much in favor of herd immunity. If you get a flu shot thank you for not giving me the flu.
On the other hand, it’s not like I can compel people to get vaccinated.
This is why they distribute a new flu vaccine every year. They make predictions as to which strains will be most common for the upcoming flu season, and develop the vaccine to be effective against those particular strains.
Unless you half-ass it like many of the hospitals around here where anyone can use a “religious exemption” to not get vaccinated, and keep on working. It scares and confuses me to see how many of my intelligent coworkers are vehemently against getting a flu shot. We’re not in “direct patient contact” in the lab but we use the hallways and elevators and cafeteria like everyone else. We are the ones testing swabs for flu antigen, for crying out loud - working with tiny swabs at the end of flexible wires, that sproing around when you take them out of their transport tubes. Yeah, I’ll take a shot, please, because a lot of those tests are positive!
One of my friends, a nurse at a different hospital, said that if anyone there directly involved with patient care refused a flu shot, they had to wear a badge that said something to that effect, so patients would be aware.
When I get my flu shot it’s for selfish reasons and to help stop the spread of the flu. I’ve had the flu and it sucks, so** I** certainly don’t want it again. I used to be in contact with my elderly grandmothers a lot and didn’t want to risk bringing the flu home to them, either. Lots of people can’t get the vaccine for health reasons, so I think it makes sense that the rest of us help protect them by getting vaccinated ourselves.
I think Broomstick gives the best reasons for vaccination from an altruistic point of view. A small risk on you part mitigates a much bigger one for them.
On a selfish level. Flu is an utter bitch. I have had it three times in my life and each time it has left me properly bedridden for three or four days, massive fevers, shakes, respiratory and other ENT complications for a month afterwards.
And I know that my experiences are common.
Flu is a killer on a level that would scare us witless were it to evolve for the first time today but because it is so commonplace we tend to treat it as no big deal.
A weak ethical obligation exists if you work with those who are at risk groups. Parents, and school age children should get the vaccine, and anyone who works with public at large, (rather than a closed office or job site) ought to consider it. Though I’m never ill, I’ll probably get one this year since our area is filled with the elderly and kids.
" Historian Alfred W. Crosby, Jr. said of the epidemic, "Influenza and pneumonia, when they kill, usually kill those of two extremes of life, the very young and the old. “The mortality rates for this flu were highest for the 20-29 age group.”
i get vaccinated every year…not out of fear of catching the flu. I am relatively healthy and would most likely survive catching the flu with minor discomfort. But because on average about 36,000 people die every year in the US from the flu.
It’s a wonder that we don’t have a mandatory flu vaccination program in the US with that number of deaths annually. Much greater and costly regulations have been imposed on our society as a result of incidences of fewer deaths than what the flu causes.
I think there is an obligation toward getting vaccinations in general, but it varies according to the vaccine and illness and person. I think it probably weakly favors you getting vaccinated for flu as long as you aren’t depriving somebody else whose priority is higher, but am not sure - I think people should listen to authorities on these questions, and for example during the recent flu vaccine shortage it shifted the level of the obligation.
I get them every year because I have work-induced chronic respiratory disease. My doctors insist I get it, the health authorities categorize me as high risk, and my employer makes getting the shot a condition of my employment.