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.]

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Faut-il ou non se faire vacciner contre la grippe? [fr]

[en] A very well-written article on deciding whether to get the flu shot or not. First of all, the reason we have two vaccines this year is that H1N1 arrived too late to be included in the seasonal mix. It will next year. So the question is not "should I get the H1N1 jab" but "should I get a flu jab" (and if yes, to do both seasonal and H1N1). For a healthy person, risks linked to contracting the flu and to getting the vaccine are both tiny (compared to driving everyday with your car, for example) -- it's up to each person to decide how they want to manage those tiny risks.

Alors que je constate avec satisfaction que mon vaccin anti-H1N1 ne semble avoir d’autre effet sur moi qu’une légère courbature au bras injecté, j’aperçois un peu par hasard dans les flux de tweets et de statuts facebook un lien intitulé “Faut-il ou non se faire vacciner contre la grippe?“, accompagné d’un commentaire très positif de Stéphane Perry.

A mon tour de vous recommander vivement la lecture de cet article, très complet et pertinent, qui ne prend pas parti pour ou contre la vaccination mais se contente de vous donner de quoi prendre une décision informée. Ce que j’ai retenu:

  • si on a deux vaccins séparés cette année, c’est parce que la souche H1N1 inquiétante est apparue trop tard pour être inclue dans le cocktail du vaccin saisonnier
  • même si H1N1 n’est pas plus dangereuse que notre grippe normale, on a tout de même mis en branle un protocole de production de vaccins qui avait été prévu pour la grippe aviaire H5N1, bien plus meurtrière
  • la question à se poser est “est-ce que je me fais vacciner contre la grippe” tout court (et si la réponse est oui on fait les deux vaccins)
  • pour une personne en bonne santé, le risque de conséquences adverses graves sont minimes aussi bien pour ce qui est de la vaccination que de la grippe (à chacun donc de peser les risques et faire son choix entre les deux, sachant que prendre sa voiture tous les jours c’est déjà nettement plus dangereux).

Certains lecteurs seront peut-être surpris que je me sois fait vacciner, après ma prise de position dédramatisante de cet été. La raison pour cela est assez simple: je fais partie de la population “à risque” (complications pulmonaires et cardiaques), et après ma très vilaine crève de l’hiver dernier, mon médecin m’avait d’ores et déjà fortement conseillé de me mettre à faire le vaccin contre la grippe, ce que j’avais décidé de faire.

Je réponds donc “oui” à la question “est-ce que je me fais vacciner contre la grippe”, et donc j’ai fait les deux vaccins (pour la petite histoire, il semblerait pour le moment que le vaccin contre la grippe saisonnière m’ait bien plus assomé que celui contre la grippe A, que j’ai fait hier).

En passant, prenez le temps de lire d’autres articles sur le forum d’échanges médicaux Atoute.org, qui semble être un excellent site d’information médicale, qui n’est pas sans me rappeler Bad Science, même si l’angle d’approche est un peu différent. J’ai trouvé particulièrement intéressant cet article sur l’inutilité (voire la nocivité) des excès du dépistage, ainsi que “Touche pas à ma prostate!

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