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Flu shots?


Each winter, the media bombard us with articles telling us to get a flu shot. Here’s a typical headline: “The flu vaccine is only about 30% effective but you should get it anyway.”

No thanks. I’ll do my own calculus on whether to get a flu shot.

Those of us who avoid vaccinations are regularly told that we’re being anti-science. “Anti-vaxxers” are often mentioned as the left-wing equivalent of right-wing climate-change deniers. But I would argue that there is room for rational individual calculus about whether to get flu vaccines. The calculus is not the same for everyone, though. The adult calculus is different than the calculus for children. And the calculus is different for, say, smallpox (mortality rate 30 percent) than influenza (less than 1 percent to around 2 percent, keeping in mind that mortality from the H5N1 bird flu is much higher but is not known to be transmitted from human to human).

From the public health perspective, the calculus supports “herd immunity.” The idea is that even a vaccine that is only 30 percent effective will reduce the overall number of flu cases and hospitalizations. Assuming the vaccines themselves are safe (which I don’t necessarily assume), then that public-health calculus makes sense.

However, from an individual perspective, the calculus may look different.

For those who work in hospitals, or at grocery store checkouts, or on airplanes, or who have children in school — people who are constantly and unavoidably exposed to other people and their germs — the individual calculus almost surely would support getting a flu shot.

But I mostly stay home during flu season. When I do go out, I try to avoid rush times, to minimize the number of people I encounter. I keep my distance from people, especially if someone is coughing or sneezing. I watch what I touch. I wash my hands. I keep little towels in my pockets and in the car.

I do acknowledge that we as individuals have an ethical responsibility — even to others — to keep ourselves healthy. If we have something that’s contagious, we have an ethical responsibility not to spread it. Those of us who refuse the flu vaccine are told that we’re making ourselves more dangerous to ourselves and others, that avoiding vaccinations is antisocial and antagonistic toward public health. That is no doubt true with diseases that are highly contagious and when vaccines are available that are known to be safe and effective. (We are told that the mercury preservative in some vaccines is safe. Do I have to believe that?)

But if I avoid getting the flu, and if I therefore don’t help the flu spread by giving the flu to someone else, then my argument would be that I have met my ethical responsibility to others and that I am not harming pubic health. I also would argue that my no-vaccine, minimal-contact method of avoiding the flu is more than 30 percent effective, is rational, and is aware of the science.

It has been 25 years since I’ve had the flu. So far so good.


  1. Henry Sandigo wrote:

    Understood. I got a flu shot because I would be exposed, any time, any where, any day, by the thousands of folks who touch-sneeze-cough etc. I was at Raley’s grocer and behind to the right of a woman who began coughing while pushing her cart…she didn’t stop pushing the cart and continued to cough as if it powered her cart. Not one time did she cover her mouth. I did a fast U turn and got out…I am considering using masks every time I go anywhere. At Kaiser Hospital at the entrance is a large sign asking you to wear a mask (they supply them) if you have a cold, etc.

    Tuesday, January 30, 2018 at 4:24 pm | Permalink
  2. daltoni wrote:

    Yikes, Henry. People who are that careless with the health of others probably are the same people who text and drive.

    If I’m in a store and hear someone cough or sneeze, I move in the other direction if I possibly can. I also read recently that it’s a good thing to do what I instinctively do — breathe out if someone gets too close to you, and hold your breath until you get away.

    Tuesday, January 30, 2018 at 4:34 pm | Permalink
  3. Henry Sandigo wrote:

    Don’t hold your breath too long, you may pass out…

    Friday, February 9, 2018 at 3:17 pm | Permalink

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