Get your flu shot

Much attention is being paid to the rise of preventable outbreaks of whooping cough, measles, and other diseases that can be prevented, at both the individual and population level, through immunization. Quite rightly, misguided anti-vaccine activists such as Jenny McCarthy have been sharply criticized for their harmful and inaccurate statements which undermine public health.

If you read TIE, you probably agree with these criticisms. So here’s a personal question: What about your own flu shots?

Influenza kills thousands of Americans every year. This is an important issue. Yet surprising numbers of educated people who shake their heads at false claims of a link between vaccines and autism don’t get their flu shots—one of the simplest and most effective steps you can take to help yourself, those close to you, and the broader community.

Flu shots are quite safe. They are among the most carefully-studied medical interventions around. Precisely because these are administered to millions of people every year, medical and public health experts know more about their side-effects. I was reminded of the value of this epidemiological enterprise when I grabbed the July 11 issue of JAMA, which included two articles exploring the safety record of the H1N1 vaccine.

In the first study, Pasternak and colleagues  performed a nationwide cohort study examined birth outcomes of 53,432 Danish infants delivered between November 2009 and October 2010. These authors found no increase in risk for major birth defects, preterm birth, or fetal growth restriction among infants exposed in-utero to the vaccine.  As an accompanying commentary discusses, this study and others suggest that flu shots are safe when administered during pregnancy. Such findings are especially welcome because pregnant women have specific vulnerabilities to flu itself.

A second study, by De Wals and colleagues, assessed a sensitive and legitimate issue: Guillain-Barré syndrome. These authors assessed the risks following vaccination of an estimated 4.4 million residents of Quebec. These authors did find elevated risks 4-8 weeks after vaccination. Yet the estimated excess risk of Guillain- Barré was extremely small: about two additional cases for every million doses, with no no indication of increased risk among people younger than 50 years of age.

No, flu shots don’t confer perfect immunity. Their effectiveness varies across people, across flu strains, and across years. They do markedly reduce your individual flu risk. That’s quite enough incentive to hit Walgreen’s next flu season at lunch hour. The contribution to herd immunity, and to protection of the elderly and the immune-compromised may be more important. Child vaccination data from Japan suggest that vaccines prevented between 37,000 and 49,000 deaths every year–about one death for every 420 children vaccinated. That’s not a trivial number.

So before you cluck your tongue at Jenny McCarthy, make sure to get your own seasonal vaccines. This is a real responsibility of citizenship in a modern society.

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