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It’s that time of the year again: time to get our flu shots. Flu shots are undeniably safe and effective, although they are not as effective as we might wish. Studies have shown that they reduce the risk of influenza infection , and that they reduce the risk of hospitalization and death. Even if the recipient does get the flu, it is a milder case without serious complications. Vaccination not only protects the recipient but others in the community who are more vulnerable, such as infants too young to be vaccinated, the elderly, the immunocompromised, and those with chronic diseases. The CDC recommends annual vaccination for everyone over the age of 6 months. The flu season in the Northern hemisphere starts in October. Recipients are protected after about two weeks. The CDC recommends vaccination by the end of October, but if that deadline is missed, administration at a later date is still beneficial.

Many people refuse to get flu shots, for all the wrong reasons.

Dumb Asses?

Our esteemed editor emeritus Mark Crislip is an infectious disease specialist. He is especially incensed by health care workers who refuse to get their flu shots and for years he published an annual tirade calling them Dumb Asses:

I wonder if you are one of those Dumb Asses who do not get the flu shot each year? Yes. Dumb Ass. Big D, big A. You may be allergic to the vaccine (most are not when tested), you may have had Guillain-Barre, in which case I will cut you some slack. But if you don’t have those conditions and you work in healthcare and you don’t get a vaccine for one of the following reasons, you are a Dumb Ass.

He listed 14 bogus reasons and named , from the plain Dumb Ass who thinks the vaccine can give them the flu to the Paranoid Dumb Ass who thinks the government puts tracking nanobots in the vaccine.

Not dumb, just misinformed

While I share Dr. Crislip’s rancor towards unvaccinated health care workers who represent a real danger to patients, I am more charitable about their level of intelligence. I don’t think vaccine refusers are dumb. I think they are (1) misinformed and (2) reasoning poorly.

There are a lot of flu vaccine myths circulating. I needn’t list them here. The journalist Tara Haelle has provided and debunking them. I have written previously about those myths in SBM articles here and here, and I wrote a “SkepDoc” column for Skeptic magazine on .

Accurate information about flu vaccines is readily available. The CDC website consolidates the information in a .

Flu infection is no laughing matter

Some people think of the flu as a minor illness that, at worst, might keep them home from work for a few days. People tend to be more impressed by stories than by studies, and vaccine refusers would be well advised to check out the many personal stories showing that influenza can be a devastating and even fatal illness. The website collects the stories of children who died or suffered serious consequences from influenza infections. On the New Zealand Ministry of Health website there is a “. In one video, a man tells how he watched his 49-year-old wife die in the intensive care unit; he says he and his wife hadn’t been vaccinated because they hadn’t known that people who are healthy can die of the flu. The website emedicinehealth.com has of the suffering adults endure when they get the flu. The symptoms are so severe that first you’re afraid you’re going to die and then you’re afraid you’re not going to die.

What’s new this year?

Several trivalent and quadrivalent vaccines are available. A live attenuated quadrivalent nasal spray (FluMist) was dropped from CDC recommendations for two years because studies showed low rates of protection; but after reviewing new evidence, the CDC’s Advisory Committee on Immunization Practices voted 12-to-2 to reinstate it this year. It is only authorized for healthy, non-pregnant individuals between the ages of 2 and 49, and there are a few contraindications and caveats listed . A high-dose vaccine is available that provides better protection for those over 65 who don’t have as good an immune response. Scientists are working to find a better flu vaccine that would not need to be repeated yearly in response to changes in circulating virus strains.

Conclusion: get your flu shot!

The only valid reasons not to get the flu shot are age under 6 months or severe, life-threatening allergies to flu vaccine. Every other reason has been thoroughly debunked. The flu vaccine is not perfect, but it’s good insurance. If you are healthy and don’t feel a need to insure yourself, be public-spirited and get the vaccine to help protect others in your community who are more vulnerable. If you refuse the vaccine and catch the flu, you might inadvertently expose grandma or your neighbor’s new baby before you even realize you are sick.

My own testimonial, for what it’s worth

I practice what I preach. I have gotten the flu vaccine every year for as long as I can remember, and my husband and I both got the high dose vaccine again last week (as a joke, he asked for thimerosal in his!). During my 20 years in the Air Force, vaccination was required even back when the package insert said, “Not intended for children or healthy adults”. None of my vaccinated family members has ever had the flu. I have never had the flu, despite caring for a whole ward full of flu patients during an outbreak in Spain in the 1970s. I can’t be sure it was the vaccine that protected me. I may have just been lucky. But I believe it is worthwhile to buy insurance for my home and my automobile, and I believe insurance for my health is even more worthwhile.

P.S. Since someone will inevitably accuse me of being a shill for Big Pharma, I suppose I must clarify that I was not paid to write this. I have no connections with Big Pharma and I have no conflicts of interest.

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Posted by Harriet Hall

Harriet Hall, MD also known as The SkepDoc, is a retired family physician who writes about pseudoscience and questionable medical practices. She received her BA and MD from the University of Washington, did her internship in the Air Force (the second female ever to do so),  and was the first female graduate of the Air Force family practice residency at Eglin Air Force Base. During a long career as an Air Force physician, she held various positions from flight surgeon to DBMS (Director of Base Medical Services) and did everything from delivering babies to taking the controls of a B-52. She retired with the rank of Colonel.  In 2008 she published her memoirs, .