getting sick

You should get the flu shot—even if it won’t keep you from getting sick

This might sound like sacrilege, but it’s not hard to understand why over half of all people in the U.S. avoid getting the flu shot every year.

It’s a real pain—let’s just start there. Lots of people hate needles or are outright afraid of them, and that’s reasonable enough. Very few people want a stranger to poke them in the arm with something sharp. Sometimes you even get fatigue, or aches in your muscles. Then, to add insult to injury, you sometimes end up coming down with the flu anyway. What was even the point? And they want you to do this every year? Voluntarily?

Nope, no way. Most years you don’t get the shot, and you never get sick. And the flu isn’t even that bad! So why bother?

These kinds of reactions are common, because misunderstandings about influenza and the flu shot are common. The trouble is that the standard answers aren’t all that compelling, even if they’re true. We all hear the same evidence in favor of vaccinating every single year:

You can’t get the flu from the flu shot.

The flu can kill people, even healthy adults.

It takes a few weeks for the vaccine to kick in, so if you get sick right after the shot it was just a coincidence.

If you still get the flu, the vaccine helps you fend off life-threatening complications.

These are all absolutely true, and they’re all solid reasons to get vaccinated. But for many, they’re just not that convincing. Measles? Mumps? Polio? Those all sound like diseases to avoid at all costs, and you don’t need even to get the vaccine every year to do it. But the flu? Most people’s anecdotal evidence will tell them that they’re not likely to get a really serious case. When polled, 48 percent of those not planning on getting the shot said it was because they just didn’t need it. And they’re right. Healthy people can die from influenza…but mostly they don’t. And it’s not unreasonable to think that an imperfect vaccine isn’t worth the trouble. What’s the point of a vaccine that doesn’t give you total immunity?

So yeah, you shouldn’t get the flu shot because it will keep you from getting the flu. You should get it because it will keep other people from getting the flu.

We talk a lot about herd immunity when it comes to measles or rubella, but it doesn’t get as much airtime during flu season. The reality is that, on the whole, healthcare professionals aren’t all that worried about 25-year-olds dying from pneumonia contracted as a side effect of the flu. Yes, that unlucky young person would be better off if they’d gotten vaccinated, but that’s not going to be a concern for most of us.

Flu season is mostly a hazard for just a few categories of people: the elderly, the immunocompromised, the pregnant, and the very young. In other words, people for whom the consequences are huge.

Babies under six months and severely immunocompromised people—think those on chemotherapy or with chronic immune diseases—simply can’t get the shot. Their immune systems don’t get a gentle poke from a vaccine, they just get sick. Worse, they’re likely to get those potentially fatal side effects that healthy adults don’t have to worry about. It’s important to note, though, that this doesn’t apply to all immunosuppressed people, since plenty of them have a functioning-enough system that the vaccine will actually help them avoid getting a deadly case of the flu.

Older people tend to have somewhat compromised immune systems already, which makes them more susceptible to the flu virus. It also makes the shot less effective, since the whole principle of immunization depends on immune cells responding to the deactivated virus. One study in England and Wales found that vaccinating young people was a more effective strategy to prevent flu in the elderly than vaccinating the elderly themselves.

Pregnant people can (and should) get the flu shot, but those who don’t are doubly liable. Influenza often causes a fever, which can permanently damage a growing fetus, and the parent is prone to contracting a more serious case of the flu should they get infected.

These are the people for whom you’re getting the flu vaccine. Elderly men and women in nursing homes die from influenza regularly, and it’s not because they’re gallivanting around town getting infected—it’s because someone brought the virus to them. Maybe it was the man who brought their lunch, or their neighbor’s visiting granddaughter. Either way, it was probably someone who thought they weren’t likely to be affected by the flu—and they were right. It was someone else’s problem.

The beauty of herd immunity is that once you get above a certain threshold, it matters a lot less that the very old and very young don’t have protection. The virus just can’t spread well. To reach that point for the flu, we’d need to get around 80-90 percent of people vaccinated, depending on how effective that year’s shot was. This is how many people actually got vaccinated last season:

flu vaccine coverage

Vaccine coverage for adults in the U.S. is way below what we’d need for herd immunity to work.

Infographic by Sara Chodosh

Not a single state got anywhere close to that goal. Meanwhile, hundreds of thousands of people have been hospitalized every year from the flu, and thousands more have died. Statistically, you’re not likely to know anyone who landed in the emergency room—much less someone who passed away. But you might have passed one on the street, or touched a door handle before one, or sneezed in the same bus. That’s all it takes.

So don’t think of the flu shot as being about you. It’s about everyone. And we can do better.


People are getting sick from a bacterial disease — and pet-store puppies might be to blame

A disease linked to puppies sold at Petland, a nationwide chain of about 80 pet stores, has sickened 55 people and hospitalized 13, according to the Centers for Disease Control and Prevention.

Since the outbreak began in mid-September, the disease has spread from seven states to 12 states, with cases reported in Florida, Kansas, Maryland, Missouri, New Hampshire, New York, Ohio, Pennsylvania, Tennessee, Utah, Wisconsin and Wyoming.

While Campylobacter is a fairly common bacteria among puppies and dogs, it’s unusual to see a large, multistate outbreak of human infections, said Mark Laughlin, a CDC veterinarian, in an email. Most cases are associated with eating raw or undercooked poultry or meat, or from cross-contamination of these and other foods.

The infection can cause bloody diarrhea, vomiting and fever.

Lab results show that puppies sold through Ohio-based Petland are probably the source of the outbreak. About 35 of the people diagnosed recently purchased a puppy from Petland, visited one of the chain’s stores or visited a home with a Petland puppy that was sold before the outbreak began. Fourteen of the people diagnosed are Petland employees.

But animals can also be infected, and can spread the disease to people even though they might not show any symptoms. People who touch even a small amount of feces on a dog’s fur or food bowl, and then inadvertently touch their mouths, can get an infection, Laughlin said.

The  Campylobacter strain in the recent outbreak appears to be resistant to commonly recommended antibiotics, Laughlin said. But most people who get sick don’t need antibiotics and can recover within a week without any specific treatment.

Children under 5, adults over 65 and people with weakened immune systems might require additional treatment, Laughlin said.

16 more people sick in Campylobacter outbreak linked to puppies. Wash hands after touching dogs & dog poop. 

Petland said in a statement Tuesday that “regardless of where they are from, any puppies and dogs may carry Campylobacter germs.” Petland said it has been able to provide traceback for any puppy purchased as requested by the CDC. The company is redoubling its efforts on education regarding proper hand sanitation as well.

“The CDC has no new recommendations for Petland but continues to advise that Petland reinforces proper hand sanitization before and after playing with any of our puppies with the many sanitation stations in each store,” Petland officials said in the statement.

The CDC estimates that about 1.3 million cases of Campylobacter occur in people each year, about two-thirds of which are food-borne. The remainder of cases come from animals and other sources. Most of the people infected during the current outbreak are in Florida or Ohio.

The CDC has seen 13 human outbreaks of Campylobacter infections linked to contact with dogs since January 2009, Laughlin said. Those outbreaks have caused 47 illnesses and two hospitalizations.

Most infections related to this bacteria do not spread from one person to another, but activities such as changing an infected person’s diapers or sexual contact with an infected person can lead to an infection. During the current outbreak, one person contracted the disease from sexual contact with a person with a confirmed illness linked to Petland, according to the CDC.

The CDC announcement has spurred criticism of pet stores that source puppies from commercial breeding operations, which increasingly have become the targets of animal-protection groups. More than 200 cities and counties have enacted laws that ban pet shops from selling what are known as puppy-mill puppies, and Petland is now the only major national chain selling dogs from commercial breeders.

As the CDC continues to investigate the outbreak, the American Society for the Prevention of Cruelty to Animals is calling on states to protect their residents and consumers by stopping the importation of puppies for resale until the source of the outbreak is fully determined.

Last month, The Washington Post’s Karin Brulliard and Lena H. Sun reported that the Animal Legal Defense Fund  filed a class-action lawsuit in July against Petland, saying it defrauded customers by “guaranteeing” puppies it knew were prone to illnesses and other defects.

The company, which says it only sells puppies from breeders licensed by the U.S. Department of Agriculture and with clean federal inspection reports, provides a “Health Warranty” to purchasers of puppies and kittens saying the animal has been examined by two or three veterinarians before being offered for sale.

But the animal group’s director of litigation, Matthew Liebman, said Monday that those inspections are cursory at best and sometimes “rubber-stamped” by veterinarians who are beholden to the company. While Campylobacter is not among the conditions that customers have reported to the group, Liebman said he was not surprised to hear about the outbreak.

“It’s not hard to see how animals raised in these cramped and unsanitary conditions, trucked hundreds of miles from puppy mills to the pet stores, intermingled with other fragile young animals and handled by numerous employees and customers could become disease vectors,” he said.

To avoid contracting the illness, the CDC advises owners of puppies and dogs to wash their hands well after handling their pets and to promptly clean up feces, urine or vomit. It’s also a bad idea to let a dog lick your mouth or face, CDC officials said.