Tuesday, October 28, 2008

Vaccinate


I had an email from a friend today, advising against getting a flu vaccine and voicing suspicion at the value of inoculation. Admittedly this particular friend was talking specifically about the flu 'mist' spray that apparently is prevolent in US pharmacies. He also received received some poor medical advice when his GP recommended a TB injection without first doing a 'Mantoux' test but . . . it got me thinking about the value of inoculation and the controversy that it sometimes raises.

We've all got one of those little scars on our left upper arm yes? Was it worth it. I mean as a child I had measles and mumps, I never had whooping cough but often heard my father talking about the diphtheria and polio ambulances taking children away from his working class Manchester street. And even our local swimming baths in Stockport were closed due to a polio outbreak in the early 60's.

When I was at school, it was common to see children in leg calipers, recovering from the debilitation of polio and when I was 10, Sabin syrup delivered liberation and became a mandatory medication, paid for by public health.

Now I'm not for or against flu shots. Had one last year and got a pretty nasty cold, didn't have one this year and escaped the 'flu' even though those around me had some pretty nasty bouts of the real deal. Personally, we provide them for staff members who want them and with varying levels of success but if you're aged, young or vulnerable, I can't see the harm in protecting yourself from a thoroughly miserable state of affairs. Out here, people catch heavy cold and call in sick with 'the flu'. Influenza is worse, you ache, you fever, you feel like your teeth are going to fall out and your head is going to burst. I actually have had real full blown influenza twice in my life. Once as a child, once as an adult and neither experience was pleasant.

A common myth about the flu shot though is that it can actually cause the flu, this is total rubbish. It’s a dead virus in injection form. The bigger problem is that people often wait too late to have the vaccine and have not built an immunity before being exposed to live flu viruses. The other problem is that this rapidly mutating virus has changed and the protection you've received, no longer applies to the new upgraded virus. It's like working on Windows 2000 and not being able to upload SP2 because your system won't allow it. The injection should be administered in March in the Southern Hemisphere and in August in the Northern Hemisphere to allow immunity to develop. But the flu shot used is made from dead influenza viruses, which means that it's impossible to catch the flu by receiving it. You might have an allergic reaction if you have a problem with eggs (the virus is bread in albumen) or soreness on the site but that’s common with injections.

There is a nasal spray flu vaccine which is made from live viruses, it may cause flu-like symptoms, including runny nose, headache, vomiting, muscle aches, and fever. I don't think it's available here. These symptoms however, hardly require emergency room treatment unless perhaps you have a child with a fibrillating temperature - symptoms are relieved by using paracetamol and bedrest, even if you do feel like death warmed up. Or are we a bit tough out here? Emergency is for when you’re leg’s hanging off or your brain’s squeezing out of our ears and it annoys me intensely that people use casualty departments in hospitals for sniffles and sneezles. There’s absolutely no point going to the emergency department for flu! It’s incurable. Symptoms can be treated with high fluid intake, bedrest and over the counter pain relief. And if you've had a flu shot, and the strain hasn't mutated, 'she'll be right' as we say down under.

The way flu works is it constantly mutates like a cold virus so the vaccines/mists contain amounts of viruses from the previous season – over here, the three most common influenzas from the previous year are included in the following year’s inoculations. Drug companies do need to manufacture flu viruses and other pathogens in order to make the vaccine. Much as other antigens and anti-venines are developed from live cultures. In fact we inject horses with snake and spider venom in order to extract anti-venine from their blood! Now there’s a shot you’d be glad to have in a hurry! Pharmaceutical companies also manufacture or maintain things like like Anthrax/Smallpox - I've even heard Bubonic Plague - but not to kill everyone! Except when a rogue employee decides to pop a bit in envelopes! Oh and the usual ‘reserve’ stocks for potential biological warfare - now there's a bit of viral conspiracy theory I do believe but the dangers of releasing a virus is that it's totally indiscriminate, air or water borne? Doesn't make sense - how do you know you'll only affect your target. Mustard gas or Cyanide is far more effective!

People who should not get a flu shot include:

anyone who's severely allergic to eggs and egg products (ingredients for flu shots are grown inside eggs)
infants under 2 years old
anyone who's ever had a severe reaction to a flu vaccination (although most people do not experience any side effects from the flu shot)
anyone with Guillain-Barré syndrome (GBS), a rare condition that affects the immune system and nerves
anyone with an existing fever
As for other inoculations, I am a believer. We’ve all but eradicated TB, Smallpox, Diphtheria, Polio, Whooping Cough, Measles, Mumps, German Measles and many other diseases that used to be endemic in the Western World. We even inoculate teenagers against cervical cancer!

Unfortunately a belief that a reaction might be severe is preventing some people from inoculating their younglings and these diseases are enjoying a recurrence. Particularly TB and whooping cough. Sure, every one-in-a-million might suffer a debilitating reaction, in which case it sucks to be you, but these diseases are childhood killers and the lives saved are immeasurable.

My mother had TB when nursing infected children in the 50’s. This resulted in a lung lobe being removed at 20 years of age, mere months after she married and a subsequent TWO YEARS of bedrest and sunshine until an appropriate antibiotic was available. Had Streptomycin and a TB vaccine been available then, she would have survived intact with healthy lungs and would have also survived the head on collision that killed her in 1992. The collision punctured her remaining lobe. I certainly wish that there had been a TB vaccine for her those years ago. She'd still be popping in for a cup of tea at 10:30 after her shift!

Even Clare, a total needlephobic to the point of veins collapsing and fainting spells, inoculated herself before her travels. She suffered Hepatitis, Malaria, Cholera, Tetanus and Typhoid injections and luckily has enjoyed robust health during her travels in many far flung and tropical and disease ridden places.

The only conspiracy here is drug companies making a shit load of money out of the production of relatively cheap vaccines and flogging them for a hefty price. Drug companies want us alive and paying for our medication! Quite contrary to my friend's, friend's theory that the Government uses vaccines in an effort to reduce the population.

Hard as it is to watch your kid squirm under the threat of a Triple Antigen or your teenager object to Rubella and Mantoux testing, to my mind, it's worthwhile and nothing that a lollipop afterwards can't fix.

Personally, I think we've dropped the ball on vaccination. We've forgotten that whole Asian, Melanesian and Polynesian populations were decimated by measles and smallpox brought by the white man. We've forgotten that only 30 years ago, smallpox vaccination was mandatory to come to Australia and that curable diseases plagued our indigenous populations - oh yes it was - we all had festering sores on our arms as the then live vaccine did its inoculatory work before we emigrated. Would you believe that in the 60's you even needed a Cholera vaccination if you wanted to travel to Europe.

So my friend. . .much as you might think there's a conspiracy out there, I would rather live in the disease free world that Westerners enjoy today than take the risk of infection. As for the third world, if only they had the ability to pay, I'm sure there would be a vaccine against AIDS! There's no profit in protecting Africans.

22 comments:

Ces said...

So did you get the vaccine? I still need to get mine, I do every year but I always delay because I am afraid of needles. I just deleted a lengthy dissertation about AIDS but decided, I am too tired for arguments, not necessarily with you. Haha!

Bear Naked said...

My doctor always gives me my flu shot in October never August.
His receptionist tells me that is when they receive the vaccine.

Bear((( )))

laughingwolf said...

i got my first flu shot, ever, two weeks ago from my gp, supply arrived that day... time will tell if it works

Quickroute said...

I worry about the ability of viruses to mutate and adapt

I have veered away from flu shots but then again I avoid doctors and needles at all cost because I'm sqeamish.

Grannymar h said...

I am a pro vaccination person! With ticker problems I am on the list for the flu jab each winter.

The Flu clinics as they are called run through the month of October. Enquiries in Sept are burshed off with the 'Oh, you are much to early!'

TCL said...

I get the flu shots when it is available through my employer. When they don't I'm lazy about visiting a doc to get the shot. I've a natural phobia about visiting medical establishments. They make you wait forever and then act like they are doing you a favor. Unless it's a broken bone or something, I tend to stay away from doctors. Maybe I just had bad docs who don't manage their schedule well.

I got the little vaccination scares on my arms because I wasn't born in the US. But I don't think American kids get them anymore.

Baino said...

Not this year Ces and only two people in the workforce survived a particularly nasty bout of flu this winter. Save the AIDS talk for another day huh? My friend also mentioned that his ex- girlfriend HAD to have flu injections as a condition of her job - she's a nurse!

I got the dates from a US Health website Bear . ..being in the south ours are due in March/April.

Good luck Wuffa. It helps if infected people DON'T TURN UP TO WORK. I get furious when people soldier on throught the day with the snots!

Surely you've had the travel shots though Quickie. Better safe than sorry!

I'm guessing that's because the vaccine isn't availble that early Grannymar. There must be a 'rush' on reproducing vaccine which includes the most likely strains.

I'm slightly doctorphobic myself TCL you get caught in the trap of investigations and the web of medical examination. You're right, today's vaccines are much more discreet. I remember my father (who would be 78 now) had massive scars from Diptheria, SmallPox and Whooping Cough injections as a child.

Megan said...

I don't usually get the flu shot, although every year I think about doing it.

The school keeps me on track as far as the offspring goes, so he is fully "shot up" per requirements.

I remember my grandmother talking about having scarlet fever. Scary.

Megan said...

P.S. I'm with you on that last bit...

steph said...

Baino

Are you trying to do my job for me? ;-)

Actually, you've made a bloody good job of promoting vaccination and also in explaining how the flu vaccine works!

The only antibiotic which works well for me these days is one that's used to treat Anthrax so at least I should be immune to that fate.

btw Sorry to hear about your mum. It really makes you realise how much medicine has changed since the 1950's where today, overuse of antibiotics is causing it's own set of problems.

Ces said...

The Influenza and Pneumoccocal Vaccines season start on october 1st. I should know, I wrote a rule that automatically reordered the screening on all patients who were admitted to the hospital before october 1st. It's a requirement of the Joint Commission for Accreditation of Hospital Organizations. There were over 1,000 patients in our hospital system on October 1st and they received the reassessment order without the nurse having to enter it in the computer. What do you think of that? Fancy huh? Does Australia need a rules programmer?

Miladysa said...

Another great post Baino.

I have not been offered the flu jab over here. I think it goes on age - over 60/65 or a history of asthma.

I strongly believe in inoculation and think that only bloody idiots fail to ensure that their children are inoculated.

Having spent some time living on a children's cancer ward I know that little Johnny's failure to be inoculated can mean the death of some poor child undergoing/having undergone chemotherapy or radiation treatment. Measles/chickenpox etc. might not kill your own child but failure to inoculate against them can help to kill someone elses.

Baino said...

Well Steph, it's been a hotbed of debate here lately with young mums not fronting up for vaccination of their babies, particularly with triple antigen. I was very concerned with the 'misinformation' that my friend had accepted at face value actually so did a bit of research.

Ah that reminds me we also encourage voluntary vaccination of meningococcle 12 - 18 year olds via schoolAh well my little Clinical Analyst, I'm sure we could do with three of you to write process rules for our hospitals! You are indeed a clever little possum. I stand corrected on the date! I'm sure your skills would be highly valued down under! .

Ces said...

Can you adopt someone your age?

Nick said...

Never had a flu vaccination, have only had flu about three times in my entire life. I seem to have a very strong immune system. But as you know I have plenty of mental ailments to be getting on with....

Jay said...

Aah ... you're talking to the wrong person, Baino.

Yes, I vaccinated my kids, apart from the one who was allergic to egg - he missed the ones that were grown on albumen. And yes, I've had the tetanus shots as needed - working with animals and the risk of bites and scratches, you'd have to be daft not to.

But I will never, ever volunteer for the flu shot, or any more unnecessary vaccinations.

About ten years ago (?) I was offered the flu shot on the grounds that I was asthmatic. My new doc was insistent and didn't even check if I was allergic to eggs (I am). I asked, she said 'Oh .. yes, perhaps you'd better not' but then bullied me into the pneumonia shot. OK, I didn't resist too much, because up to then I'd been very pro-vaccination.

Within a week, I started to feel rough. Very rough. But not in a coughing, spluttering, pneumonia-y way. Tired, achey, lethargic, just bleagh. It went on, got worse, docs didn't know what was going on. Long story short, I now have fibromyalgia and myxoedema. Perfect health before, half-disabled afterwards.

My Mum was worse. She was talked into the flu shot when she was 80-something. Within a very short time she went from being a healthy, active old lady with no health problems, to a fully disabled, snivelling wreck with polyarthritis of a rare type which couldn't get diagnosed for over a year. Even the docs admit this is probably a result of the flu jab. She's now wheelchair-bound and on methotrexate plus supporting drugs with hideous side effects because that's the only thing that works.

So forgive me if I don't join in with this one. I'm a bit jaded.

Baino said...

Oh Ces!

Nick lucky and tough stock you and I. Like I said I had a flu vaccine once and caught the flu but not this year and was one that didnt' get sick so I don't see the point of it.

Ah Jay . .well you're one of the 'shouldn't' get a flu vaccine types' and your doctor was at fault not asking about allergies etc. This is another problem, you lob up to the GP "hey I think I should have a flu shot" and they give you one without fully asking about your medical history. They should KNOW that if you have an egg allergy it's not a suitable vaccine. That said . . the others I still believe are vital. Sadly, someone somewhere will have an adverse, perhaps fatal effect but it's rare and the countless lives saved for me, . . make up for the sacrifice of others. Very sad about both you and your mum, fair enough having a healthy disrespect. She was indeed unfortunate. Methotrexate is not pleasant, my 50 year old best friend takes it for Rheumatoid Arthritis.

kj said...

i always get the flu vaccine and i haven't had the flu for years. these days my larger plan is eating nuts and losing weight. exercise is not part of the plan yet, but of course it should be.

:)

Il Cuoco Milanese said...

With TB making a serious comeback lately you'd be a fool not to have the BCG vaccine.

That or badly sickened.

Babysis said...

Oh Baino I could not agree with you more on this blog!

Working in a Medical Centre I have a flu injection EVERY year (in April). Never have I had a reaction of ANY kind. It is quick, simple and PAINLESS! I have never had the flu whilst working there and I constantly talk, touch and am breathed on by ill people day in and day out.

As for childhood vaccinations - this is imperitive. In our practice we actully find very few people who DONT have their children vaccinated. Sometims there can be tears - but not that often really. Surely if you can prevent a major illness a tear or two is worth it. I did have mumps as a child, but now thanks to the MMR vaccine - all children vaccinated are covered. My own children have also been vaccinated against meningoccocol. We even vaccinate against chickenpox these days if you like - I chose not to - its not life threatening. And the cervical cancer vaccine for teens and young adults is a MUST!

I cannot stress the importance of confidence in your GP and of course your right however to decline vaccinations - a form has to be completed and sent to the department of health - so they have a record of those who have been and have not.

If you have a known allergy you should make this VERY clear prior to being vaccinated.

drb said...

I totally agree with you Baino.
I have flu shot almost every year as I am asthmatic, except once a couple of years ago. Of course, I caught the flu and my hubby escaped it as he was vaccinated.

angelin said...

Not vaccinating children, or delaying to do so, can potentially have serious individual and public health consequences. The collective time lost from school, the individual misery, and the formidable complications make it worthwhile to once again make few diseases obsolete.
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Angelinjones
Advisor