I don’t (yet) consider it a national disaster that there is inadequate vaccine. But I know that there will be a number of otherwise healthy people who will die this year from the flu that would not have, if there had been sufficient vaccine.
How big a number? We’ll see.
I was running our inpatient service last December, which was the worst month for respiratory infections, mostly related to or exacerbated by the flu, in our area in anyone’s memory. (It was not so bad nationally, but locally we got hit hard.)
I had two patients who were about 40 years old and healthy as horses. They both started with the flu, developed a post-flu pneumonia, and then became septic from that and went into respiratory failure. Both were on ventilators for three weeks and very nearly died. (Both recovered fully, after quite a bit of rehabilitation and such.) The old people with flu complications came in so fast that we could hardly keep up.
I’ve had one real bout of the flu in my lifetime. The difference between the flu and a “cold” is that with the flu, you think you might die, and you really wish you’d just get on with it.
I got a flu shot this year. I was willing to give mine up from a personal standpoint, but our infectious disease team (many of whom are my attendings) insisted that those of us with direct patient contact be near the top of the list due to our potential as vectors and our necessity should things go to hell.
Our clinic’s policy is that shots will go only to those over 65 or with a fairly specific list of conditions. (We don’t see kids or many pregnant women.) The odd thing is that the shortage has increased demand–lots of people who we couldn’t beg to come in and get shots last year are pissed about not getting them this year. Maybe we should declare a shortage every year.
I normally refuse antibiotics, yes. I’d have to be half fucking dead before I request antibiotics. I figure it makes up some for those who go and take antibiotics for the fucking sniffles.
Tell me about it.
Ok, so, if I may make sure I’m understanding this:
-The flu sucks. Yes, I’ve never said otherwise.
-People do die from the flu. Yes, I never denied that this happens; I sincerely doubt that a healthy young person in an environment where they have access to health care and people will notice if they, say, stop breathing, is going to die from the flu.
I’m sensing a certain amount of animosity towards those who aren’t terrified of the flu. Fine; if you think it’s a big deal, that’s fine. If someone doesn’t, that’s fine, too. I personally am not worried about it. No one’s going to get sick/die/suffer horribly because I don’t think that the flu is a big deal.
While I appreciate the willingness to err on that side, if what you have really does look like a bacterial pneumonia–usually pretty easily distinguishable from bronchitis or “the sniffles”–you would not only be doing yourself a favor by taking the antibiotics, but supporting the fight against antibiotic resistance by heading it off at a reasonable stage rather than 1.) spreading it to other people who will then also require antibiotics, or 2.) letting it progress to sepsis and then requiring the big dog IV antibiotics rather than a few days of azithromycin.
I really didn’t mean to make it sound that way. I don’t disagree with anything you said; the chances of young healthy people developing the complications I described above are extremely slim, and such people should not be freaking out about not getting a flu shot. If I did not have direct patient contact, I probably wouldn’t get one (especially with the shortage).
However, it is something that is frequently misunderstood and inappropriately minimized. There is no doubt that flu shots prevent mortality and morbidity in the appropriate populations.
Rather than animosity, I see in some of the posts a healthy respect for infuenza and its sequelae. I have had many colds, even some which included bronchitis and felt like crap for a couple of weeks. But overall I don’t remember those illnesses. I had the flu about 10 years ago and I still remember how sick it made me. There were huge gaps of time that I lost. I recovered withour major complications.
However, I have evaluated people in other hospitals for their readiness for rehab. Some had developed a critical illness polyneuropathy following a flu-like illness and their functional ability was essentially vent dependent quad. Many improved but it was a long and costly (financially and emotionally) illness.
I don’t exactly run scared of the flu and I don’t expect people who have not had contact with it firsthand to have the same concerns. But I would be negligent to treat it lightly. I cannot speak for any other poster, but that was my interpretation of other posts as well.
I am a 50-yr-old asthmatic. Before I started getting yearly flu shots and the every-few-years pneumonia shot I’d catch a flu once or twice a year that would leave me sickly (as in barely able to walk) for a month afterwards. One year that month stretched into two and then I was hit with the next variety to come down Qadgop’s railroad track so that was three months of being sick in a row and the next fall I caught it again. That’s when tough ol’ “but it’s only the flu!” drop started getting vaccinated.
This year I’ll probably skip it so somebody who REALLY needs it can have it (“Oh, isn’t he noble?” :rolleyes: ) but I’m getting mightily pissed that perfectly healthy people are going to bizarre ends to get the shots they never bothered with in previous years just because it’s on the news. But I remember 1918-19 (not literally but you know what I mean) and I’m as scared as hell of the flu so I can see some value in vaccinating as much of the herd as we can.
At church yesterday the pastor told us there were other ways of “passing the peace” that didn’t require a handshake. I was told that a wet, slobbery kiss was NOT one of the alternatives so I tried a Vulcan salute and “Live long and prosper.” Nope, that wasn’t the right thing to do, either, though it got me a big hug from the fairly hot though lesbian music director.
Do you know someplace official that I could find out more about this? When I tried to tell someone that millions had died of the flu about the time of WWI they told me that I misread the decimal place.
I don’t get a flu shot, I probably should. I tend to get bronchitis after even routine colds. I do have asthma, but I can usually avoid attacks by avoiding the triggers. I have had to go to the ER with some bad attacks.
Assuming the shots were in good supply what are the contraidications of getting one?
I too should make clear that I’m not saying anyone who doesn’t get the flu shot should be worried. I think we need to ensure the high risk people get their doses, and then whatever’s left over should go to the general healthy public.
In the ideal world, I believe we’d save both people’s health and lots of money if everyone who wasn’t allergic to the vaccine (that is, allergic to eggs) got the shot. Since that won’t be happening, the next-best case is to get the high risk people covered.
And I for one am grateful to you healthy people who are skipping your own shot this year so that those more in need can get them!
Can the shots be dangerous for small kids, four years old in our case?
Do they have mercury as a preservative, much like some of the past vaccines have had? The possible autism link has made us perhaps overly cautious, allowing only those vaccinations that are absolutely critical.
That’s probably because most people errantly think of the flu as a really bad cold. The book referenced previously in this thread, The Great Influenza, should have loads if info. I have yet to read it-I’m waiting for it to go on sale 
Sam
Is there any reason more people aren’t using the nasal spray? I know it isn’t quite as effective but isn’t it much better than nothing for those who are really worried but not in the “danger zone”? Is there a drawback I’ve missed?
IANAD- But all of the info I know of the nasal inoculations says they’re probably almost as effective as the needle-administered inoculation. There may be some contraindications for the elderly or other groups that I don’t know of, but I’m inclined to say the reason for the hyperventilation re: the shot is Catastrophism.
I may be wrong and one of the good docs can straighten me out if so.
Sam
IANAD either, but I did get the FluMist nasal flu vaccine last year. It’s only for people ages 5-49, and isn’t recommended for pregnant women or people with asthma or immune system problems. I had to fill out a form saying that I was between 18 and 49, didn’t fall into any high-risk categories, and didn’t live with anyone who was immunocompromised before they would give me the spray.
I don’t know if FluMist is out for this year yet. That could be why people aren’t getting it now. As for why people who could get FluMist instead of a flu shot don’t, I don’t understand that (but I have a phobia of needles, so I’m biased).
Safe, unless one is truly allergic to eggs.
No mercury in it.
It does indeed. It also offers a great example of why not to let marketing people design your websites.
Figure 3. It sure looks pretty, but:
While the vertical axis is marked “Percentage,” there’s no clear indication of how many points each line marks. Is it 10? Probably, but who knows. The awesome space-aged 3-d graphics for the bars in the graph includes shadows, making it impossible to tell how high each bar really is. From the front edge to the back edge of the shadow is almost 10% difference (assuming that the lines are spaced every 10 percentage points). Sheesh!
I understand that you can’t start manufacturing flu vaccine till you know what strains are “coming” that year, so you can’t stockpile years in advance.
But can someone explain to me why the U.S. was relying on foreign countries for its vaccine supply? Why do we not have enough flu vaccine, for a potentially deadly illness, for everyone who wants it, but we have four major companies manufacturing variations of Viagra?
As far as I know, we weren’t relying on a foreign company. No cite yet (I’ll dig one up if I’m feeling better tomorrow*), but I believe the company is based in the US. The plant where they were manufacturing the vaccine was in Liverpool, and had to be shut down due to contamination. Why we (whoever the hell ‘we’ is - the CDC?) rely solely on one company? No idea.
*I woke up this morning feeling like the Seasonal Cold Fairy ran me over with a Mack truck. I swear to god, if it’s anything more than a cold, I’m going to be pissed off as all hell.
Bingo. We weren’t “relying on a foreign countries”, to supply us with vaccine. Chiron Corp(local to me I believe), also has a plant in Britain. Not exactly “foreign” as the term generally means. Chiron just manufactured some of the vaccine overseas. No biggie really, except that it got fucked up.
Sam