The following blog  is directed at heath care workers, but I thought I'd share with everyone considering the dumbassery I have recently read regarding the flu shot.  Mark Crislip is an infectious disease specialist/doctor/whathaveyou.  He has heard many reasons why health care workers do not get the flu shot.  He has decided to list these reasons and state plainly why those reasons are really dumb. 

Flu season is here, kinda sorta, it never really went away thanks to H1N1.  I was rounding today, lucky me with the three day weekend, when one of my colleagues mentioned a post I had written a year ago at the old blog about the flu vaccine.  It was printed and put up in the break room, and he saw it, took it home to his wife, who promptly mailed it to a colleague that is a proud "I never get the flu vaccine" kind of guy.

It is like people who are proud of being ignorant of science.  I never understand why people brag about being ignorant or stupid. You would think they would be embarrassed, but then they are probably a... well, let us just see.

Anyway, he read my short rant and evidently changed his mind about getting the flu vaccine this year.  Yippee.  So what was the powerful, reasoned essay that altered the course of human (well, maybe one human) history?

I give you, slightly rewritten for 2009, a Budget of Dumb Asses.

I had my flu shot today. Well, my anti-flu shot. Protected me, my family, and my patients from sickness and death for another year. Whew.

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, 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 health care and you don't get a vaccine for one of the following reasons, you are a dumb ass.

1. The vaccine gives me the flu. Dumb Ass.

      It is a killed vaccine. It cannot give you the influenza. It is impossible to get flu from the influenza vaccine.

2. I never get the flu, so I don't need the vaccine. Irresponsible Dumb Ass.

      I have never had a head on collision, but I wear my seat belt. And you probably don't use a condom either. So far you have been lucky, and you are a potential winner of a Darwin Award, although since you don't use a condom, you are unfortunately still in the gene pool.

3. Only old people get the flu. Selfish Dumb Ass.

      Influenza can infect anyone, and one of the groups who are more likely to die of influenza are the very young. Often those most at risk for dying from influenza are those least able, due to age or underlying diseases, to respond to the vaccine. You can help prevent your old, sickly Grandmother or your newborn daughter from getting influenza by getting the vaccine, so you do not get flu and pass it one to her. Flu, by the way, is highly contagious, with 20 to 50% of contacts with an index case getting the flu.  However, Granny may be sitting on a fortune that will come to you, and killing her off with the flu is a great way to get her out of the way and never be caught.  That would make a good episode of CSI.

4. I can prevent influenza or treat it by taking Echinacea, vitamin C or airborne. Gullible Dumb Ass Cubed Then Squared.

      None of these concoctions has any efficacy what so ever against influenza. They neither prevent nor treat influenza. And you can't boost you immune system either. Immunity is not a Jamba Juice. Anyone who says that the immune system can be boosted is also a dumb ass.

5. Flu isn't all that bad a disease. Underestimating Dumb Ass.

      Part of the problem with the term flu is that it is used both as a generic term for damn near any viral illness with a fever and is also used for a severe viral pneumonia. Medical people are just as inaccurate about using the term as the general public. The influenza virus directly and indirectly kills 30,000 people and leads to hospitalization of 200,000 in the US each year. Influenza is a nasty lung illness. And what is stomach 'flu'? No such thing, dumb ass.

6. I am not at risk for flu. Denying Dumb Ass.

      If you breathe, you are risk for influenza. Here are the groups of people who should not get the flu vaccine (outside of people with severe adverse reactions to the vaccine): Former President Clinton, who evidently doesn't inhale. And people who want to be safe from zombies. If you don't get the vaccine you do not have to worry about the zombie apocalypse, because zombies eat brains.

7. The vaccine is worse than the disease. Dumb Ass AND a Wimp.

      What a combination. Your mother must be proud. Unless you think a sore deltoid for a day is too high a price to pay to prevent two weeks of high fevers, severe muscles aches, and intractable cough.

8. I had the vaccine last year, so I do not need it this year. Uneducated Dumb Ass.

      Each year new strains of influenza circulate across the world. Last years vaccine at best provides only partial protection. Every year you need a new shot. And we have a new strain this season, H1N1, so you cannot be a parasite on the immunity of others.

9. The vaccine costs too much. Cheap Dumb Ass.

      The vaccine costs less than a funeral, less than Tamiflu, less than a week in the hospital.

10.  I received the vaccine and I got the flu anyway.  Inexact Dumb Ass.

      The vaccine is not perfect and you may have indeed had the flu.  More likely you called one of the many colds people get each year the flu.  Remember there are hundreds of potential causes of a respiratory infection circulating, the vaccine only covers influenza, the virus most likely to kill you and yours.

11. I don't believe in the flu vaccine.  Superstitious, Premodern, Magical Thinking Dumb Ass.

      What is there to believe in?  Belief is what you do when there is no data. Probably don't believe in gravity or germ theory either. Everyone, I suppose, has to believe in something, and I believe I will have a beer.

12. The government puts tracking nanobots in the vaccine as well as RFID chips as part of the mark of the beast, and the vaccine doesn't work since it is part of a big government sponsored conspiracy to line the pockets of big pharma and inject the American sheeple with exotic new infections in an attempt to control population growth and help usher in a New World Order. Well, that excuse is at least reasonable. Paranoid Dumb Ass.

So get the vaccine.  And pass this url on to someone else.  The life you may save may be your own. Or be a dumb ass.

BTW: budget is an archaic term for a quantity of material, usually written. I do love dem dare archaic words, don't cha know.!comment=1


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Sep. 18, 2009 at 1:27 PM

Thank you for sharing your information and the varying levels of dumbassness associated with each.   

I am curious of your thoughts on the efficacy of Vitamin D on Influenza and other common (and uncommon) viruses.  Before tossing it out with items mentioned in #4 you may want to do a search of scholarly reviewed medical 

What I think is dumbass and uneducated is thinking there is one and only one way to prevent and treat anything.

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Sep. 18, 2009 at 1:52 PM

From what I have read, taking vitamin D only helps you if you are low in it.  Taking extra doesn't do anything for you. 

Do you have any references that state that taking vitamin D when you are not deficient in it is useful in avoiding the flu?

There are many ways to skin a cat (my apologies to my cat).  Vaccination is just one weapon in the arsenal of flu prevention.  Washing your hands, not touching your face, avoiding sick people, giving people who cough without covering their mouth the stink-eye, all can help stop the spread of this illness.  I think doing all you can (save for locking yourself up in your home for the next four months)is the most responsible thing to do.

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Sep. 18, 2009 at 2:12 PM

I would have to find medical sources of suspected deficiency rates but I have hungry kidlets demanding to be fed right now :).  I do believe a good portion of people in the US are currently thought to be Vitamin D deficient due to many factors.  

I am one of those annoying "natural" people but I don't get any of my information from one source.  I always go to the medical journals myself to find corrobarating, sufficient and reliable research.  I have a graduate education and since becoming a mom I thrive on seeking out brain stimulating statistics and data. 

I do know the research related to Vitamin D as it related to numerous issues (Influenza, cancer, TB, Alzheimers) is fairly extensive and interesting to me.  

Oddly...though we probably have little in common on the surface I think we would get along swimmingly :).

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Sep. 18, 2009 at 2:13 PM

Pardon my typos....*corroborating*.  My kids are watching Calliou and the sound of his voice makes me want to jab my eyeballs out.  

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Sep. 18, 2009 at 3:38 PM

There is nothing annoying about natural!  It's just "woo" that pisses me off. =)

I did a quick search regarding vitamin D and it appears that many are deficient.  I'll admit that I have my own filter that I go through and then I go to the studies.  Not all studies are created equal, etc. 

All I know is that I drink plenty of milk, take my calcium pill and multi-vitamin so I should be filled up on my vitamin D.  And I ever get outside (15 mins in direct sun should fill you up also), I do get a "boost" that way. 

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Sep. 18, 2009 at 4:57 PM

Yeah, I'm not sure about the claim that you can't boost immunity.

No way echinacea, vit. D, or other supplements are going to (do enough to) protect you from the flu, but poor nutrition has been shown to suppress immunity while proper nutrition has been shown to support it. E.g., the antioxidants and carotenoids rich in fruit & veg help the body produce germ-fighting cells; bioflavinoids, in particular, strengthen cell walls, protecting cells from pathogens. Another e.g., an excess of bad fats damages the cardiovascular system, making it harder for germ-fighting cells to travel the bloodstream and do their work; while omega-3 fats reduce inflammation, helping the cells to travel the bloodstream and do their work (a Danish study of infants supplemented with omega-3s showed improved immune function).

Meanwhile, stress and negative mood has been linked to suppressed immunity, as mitigated by cytokine response... So it's not totally nutty to say that meditation, say, or a walk in the woods might support proper immune function.

Finally, you are more prone to acquire an infectious disease if your immune system is already overwhelmed by non-infectious disease brought on by bad diet and lack of exercise (heart disease, diabetes, etc.). Obesity has been linked to weakened antibacterial immunity.

So the link is not direct, and it is silliness to say that a specific supplement like echinacea is going to boost your immunity significantly, but I'm pretty sure even the hardest-core CDC doc would admit that following a healthy diet and exercise will help protect you from infectious disease.

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Sep. 18, 2009 at 5:03 PM

...but I'm pretty sure even the hardest-core CDC doc would admit that following a healthy diet and exercise will help protect you from infectious disease....

Just not nearly enough to render flu shot superfluous. :o)

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Sep. 18, 2009 at 5:32 PM

72 views on not on the top thinks I'm being voted down...

I'll have to look further into Crislip's statement about boosting immunity.  I think this may be more of a semantics thing...

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Sep. 18, 2009 at 6:03 PM

Don't blame me, I voted it "popular"!

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Sep. 18, 2009 at 6:35 PM

Also: re: vit. D deficiency, the emerging research is showing that the current recommended doses for vit. D, while sufficient to protect against rickets, are insufficient to protect against presentation of so-called subclinical symptoms as well as various cancers, heart disease, osteoporosis, and some infectious diseases. From the Wiki entry: "Vitamin D deficiency tends to increase the risk of infections, such as influenza[52] and tuberculosis[53][54][55].

And it makes sense that more of us are deficient than we realize. Our recent ancestors were getting a heck of a lot more than 15 minutes a day, and all without sunscreen or sun-protective clothes. The 15-minutes-a-day-rule is as much a statement on limiting exposure (to prevent skin cancer and photoaging) as it is on getting enough vit. D.

And this is speculation on my part, but I'll go ahead and speculate, anyway, that the overweight/obesity epidemic is contributing to vit. D deficiency. Why? Because of a high ratio of volume to surface area. The heavier the person, the greater the number of internal body cells, and, in turn, the greater the cells' demand for vit. D.; but volume being disproportionately high to surface area, there just aren't enough dermal/surface cells collecting sunlight to provide the vit. D needed to meet demand. Or that's what I get from studies like this one, that link overweight/obesity to vit. D deficiency. (Although that could just as easily be a sign of too little outdoor activity.) Feh! I shouldn't be speculating, I know. :o(

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