I’ve heard a lot of reasons why people don’t want to get influenza vaccinations.
“I always get the flu after I get the shot” – injections are killed viruses containing only surface antigens and subvirons, so flu shots can’t cause infection. The intranasal sprays are weakened (“attenuated”) viruses which do have the potential to cause mild symptoms. Maaaybe you can say you got the flu from the spray – not from the shot.
“Jenny McCarthy says that I’ll get autism from them” – don’t get me started. She also recommends doing routine “poop analysis” to check for “yeast, bacteria, or infections.”
“The swine flu is a conspiracy by the government (see comment section) to increase pharmaceutical profits” – um … right … let me introduce you to Ms. McCarthy over here.
“I never get the flu” – with up to 20% of the US population getting influenza each year, odds are against you.
“I’m healthy. My body can handle the flu.”
I heard someone use the last excuse recently and had to remind that person about a unique feature of the novel H1N1 virus (aka the “swine flu”). A disproportionate number of patients who died from H1N1 were young and relatively healthy. According to this Reuters article, 90 percent of the seriously ill victims in Mexico were less than 50 years old and most of those patients were previously healthy. In addition, 87% of those who died were aged 5 to 59 — compared to a usual average of 32% for seasonal flu. All of the patients who died had “multiple organ failure.” Here is another article from the Washington Post about increased H1N1 influenza deaths in young healthy victims.
Why are young healthy patients the ones dying from H1N1?
One theory is that the patients’ own immune systems are killing them. In younger children, the immune system hasn’t fully developed. In older patients, the immune system loses some of its effectiveness. The theory is that immune systems in young healthy people are “too good” and go out of control. Scientists call the theory “cytokine storm.”
I”ll attempt a simple explanation of a cytokine storm, but realize that the process is more complicated than what I am trying to explain. When a virus infects the body, the body produces extra immune cells to combat the infection. Some immune cells attempt to kill the virus, others analyze the virus and produce antibodies. Some immune cells produce inflammatory chemicals called cytokines that serve several functions. Included in the function of cytokines is an inflammatory response – an increase in inflammation throughout the body. Normally, the body holds the inflammatory response in check – similar to the way that the thermostat in your home regulates the temperature. When the temperature in your house hits a certain set-point, the furnace shuts off. In a cytokine storm, the immune response is so intense that the feedback systems become overwhelmed. Cytokine production continues out of control and a generalized inflammatory response occurs in the body. Similar responses occur in anaphylactic shock and sepsis. Think of the difference between controlling a few bees buzzing around a picnic looking for food and a swarm of bees defending a hive.
One study noted that gemfibrozil (Lopid) – a cholesterol medication – doubled survival rates in mice that had severe influenza infections. Apparently gemfibrozil has an inhibitory effect on inflammatory cytokine production.
Not saying that every young healthy adult who gets swine flu is an automatic ICU admission. Death rates for H1N1 are low, but are still about 3 times the rate of that for seasonal influenza. Just noting how strange it is that a healthy immune system may cause an increased risk of death from H1N1 virus.
Still want to skip that flu shot?
Oh yeah, and cover your mouth when you sneeze. While looking for a picture for this post, I found a video showing how many goobers are sprayed from the mouth during one sneeze. Blecch.