Why I Get My Flu Shot Each Year [en]

[fr] En très résumé, les raisons pour lesquelles je me fais vacciner chaque année contre la grippe (reprise de mon article en français sur la question). Je suis à risque pour des complications (dès que je chope un rhume ça vire en bronchite), je ne tiens pas à me retrouver HS durant trois semaines à cause d'un vilain virus (je suis déjà bien assez souvent malade comme ça), et je considère que c'est ma responsabilité de citoyenne de faire ce que je peux pour enrayer la propagation du virus (il ne passera pas par moi!) et protéger les personnes "à risque" dans mon entourage.

Surtout, j'explique un peu la grippe: ce n'est pas le truc qu'on appelle d'habitude la grippe, et qui est en fait le rhume. (Confusion? y'a de quoi.) La grippe, c'est un truc qu'on chope en moyenne 2-3 fois dans sa vie. Je crois que je ne l'ai jamais eue, et pourtant, dieu sait si j'ai été malade (parfois durant des semaines).

Years ago, when we ended up with a separate vaccine for H1N1, I wrote an article in French summarizing my personal research on the topic of flu vaccinations: I’d decided I would be getting the flu shot.

Aside from the fact that I’m still amazed when I realise otherwise rational people think vaccines are a Bad Thing (listen to the great Science Vs Vaccines podcast episode for some debunking of common fears), here are some of the arguments that made me come to the conclusion that I was going to get vaccinated against influenza.

First, it’s important to understand what the flu is. It’s not this thing people routinely catch and call the “flu”. What we usually call the flu is in fact one of the many flavours of the common cold. You feel crappy, you might even be off work for a week, you get a fever, your nose is all stuffy, you might even have trouble breathing if, like me, you get bronchitis. I’ve been out of order for three weeks due to bronchitis developed over the common cold. If you’re falling ill, stay in bed two days, and then you’re over it, it wasn’t the flu. It was the common cold.

Why is this important? Well, the flu and the cold are different families of viruses. Getting vaccinated against the flu will not prevent you from catching a cold or bronchitis. Also, there are high chances you are underestimating how nasty the flu actually is.

On average, you are likely to get the flu two or three times in your life. I don’t think I’ve personally ever caught it in my adult life – though I have been ill with various colds and bronchitis (very miserable ones too) dozens and dozens of times. At one point I would fall ill every month in winter. Really. I’d get over two weeks of sniffling and coughing misery, feel on the mend for two weeks, and then start all over again. And it wasn’t the flu.

The flu is a disease that kills every year (numbers are tricky to compute because the direct cause of death is often the opportunistic bacterial infection that takes hold over an organism weakened by the virus). It’s the virus that had my mechanic, a super-healthy-never-ill strapping 45-year-old, off work for two weeks and unable to work “normally” for a month and a half. And he’s self-employed: as all independants know, we work even when we’re sick, because no work = no money. So him being off work so long is a testimony to how incapacitated he was.

Now that we’re clear about what the flu is and isn’t: should one get the shot?

Vaccination is risk management. And the human brain is super crap at risk management. You can’t really use your gut for it, because your gut is designed to keep you from getting eaten by wild beasts or falling off cliffs: present and immediate dangers. So, we’re going to have to be rational about this. Here are some guiding questions:

  • is being off work for three weeks (average time to get over the flu) a risk you’re ready to take? the answer to this will vary a lot depending on your professional situation.
  • are you at risk for complications? ie, do you have asthma, a weak immune system, a heart condition, or like me, a tendency to catch any upper respiratory tract infection that is lying around? chances are your doc has told you if you are, but it might be worth checking. If you are at risk for complications, catching the flu may have consequences more dire for you than for the average person. It may not be a risk you should be willing to take.
  • are you in contact with people who cannot get vaccinated, or who are at risk of complications? if you are, then you might want to reduce the risk of passing on the flu to them – by reducing the risk of catching it yourself.

The flu vaccine usually offers coverage around 70-90%. Less than some other vaccines, but still much more than zero.

In my case, once I thought about it, it’s a no-brainer: even though I’m not medically “at risk” enough to be provided with the shot free of cost here in Switzerland my doc has been pretty clear that in the event of me catching the flu, things were not going to be pretty. Plus, as somebody who is self-employed and already falls ill regularly, I’d rather not run the risk of being off work more than necessary. Not to mention the social responsability of contributing to herd immunity and doing my part to prevent the epidemic from spreading through me.

If you decide it makes sense to get vaccinated against the flu, then it also makes sense to get vaccinated each year. Unless your circumstances change dramatically, if catching the flu is not an acceptable risk for you this year, why would it be so next year? Bear in mind your chances of catching the flu are a handful of times in a lifetime – so only by getting the flu shot every year for a significant number of years do you get to reap the benefits. You can’t know in advance which year the nasty virus will try to crawl into your lap.

Time for me to go get that shot!

[PS: Comments refuting vaccine safety or efficiency will be deleted without pity. It’s not something I’m interesting in debating: the scientific consensus is quite clear.]