the flu

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.


Pair of privileged Jewish teens first used ‘affluenza’ defense in 1924

JTA — In June 2013, Ethan Couch, an inebriated 16-year-old Texan, was speeding and driving illegally on a restricted license when he slammed into a group of people standing on the side of the road. Four died; nine were injured, including two of Couch’s passengers, who were seriously hurt.

The case became a topic of national conversation because, despite the severity of his crime, he got off with a slap on the wrist thanks to a unique defense: “affluenza.”

A psychologist testified that Couch didn’t understand the consequences of his actions because his parents taught him wealth buys privilege. Somehow, despite killing four people and testing positive for alcohol and drugs, he was sentenced to just rehab and probation. (Couch has again been in the news for fleeing the country; he was found partying in Puerto Vallarta, Mexico, with his mother. He’s currently at a juvenile facility in Texas.)

Couch’s featherweight sentence in a way proved his parents correct: Wealth does have its privileges, such as the ability to hire crackerjack lawyers who dream up creative defenses.

Though press accounts didn’t mention it, Couch wasn’t the first high-profile case to use the “affluenza” defense. That dubious honor goes to two young Jewish men accused of committing the “crime of the century” over 90 years ago — Nathan Leopold and Richard Loeb.

The names Leopold and Loeb live on, but for most people, what they did has become clouded in the mists of history

The names Leopold and Loeb live on, but for most people, what they did has become clouded in the mists of history. That will likely change after PBS airs the American Experience documentary “The Perfect Crime” on Tuesday, February 9 (check local listings), which examines this blockbuster case.

The pair, both 19, seemed to have it all. Leopold and Loeb were both scions of families worth multi-millions of dollars in 1920s Chicago, back when a million bucks still meant something. They were smart, University of Chicago students who believed themselves “ubermenschen,” as defined by Nietzsche — so exceptional that they are not bound by law or morality.

They started committing comparatively minor offenses before attempting what they intended to be the perfect murder — a crime they planned for more than half a year, just to see if they could get away with it. On May 21, 1924, they lured 14-year-old Bobby Franks, Loeb’s second cousin, into their rented car, killed him almost immediately, and then dumped his disfigured body in a railroad culvert in Indiana. To obfuscate the nature of their crime and throw the police off the trail, they made it appear as though it was a kidnapping for ransom.

When the cops found the body, they discovered clues that pointed to the pair. At first, because of their wealthy background and theretofore clean records, Leopold and Loeb were dismissed as likely suspects — but once they were brought in for questioning, their stories eventually fell apart.

Defense attorney Clarence Darrow, center, meets with his clients Nathan Leopold (seated left) and Richard Loeb (seated right) in 1924. (Courtesy of Charles Deering McCormick Library of Special Collections, Northwestern University/via JTA)

The Loeb and Leopold families hired Clarence Darrow, the most famous defense attorney at the time, to defend the boys. It seemed hopeless — the teens demonstrated no remorse and, in fact, snickered throughout the proceedings. Though the pair pleaded not guilty before Darrow was brought in on the case, the volume of evidence the police compiled against them seemed insurmountable.

But the families wanted their kids to survive, even if in jail — as did Darrow, an ardent opponent of the death penalty. He changed their plea to guilty, essentially avoiding a trial and going straight to a sentencing hearing.

The teens demonstrated no remorse and, in fact, snickered throughout the proceedings

For 12 hours, Darrow argued that there were mitigating circumstances: The two were ignored by their parents and raised by governesses. They were privileged sons of wealth who led sheltered lives with cold families. This was the dawn of the age of Freudian psychology. No one had ever tried a defense like this before. Did it work?

Yes — and no. Leopold and Loeb avoided the death penalty. The judge claimed it had nothing to do with the psychological mumbo jumbo — that’s not a direct quote, by the way — that was offered by the defense. Rather, he merely refused to sentence teenagers to die. But did Darrow’s argument influence the judge? No one really knows.

What we do know is that science of psychology has matured and its use as a defense for crimes has been accepted in legal circles. Unfortunately, the baloney defense is still around, too.

Take the recent case in San Diego of John David Weissinger, who was on trial for threatening members of a Muslim advocacy group. His lawyer admitted he was guilty, but blamed it in part on his client binge watching Fox News — a defense that became known as “Foxfluenza.”

This particular argument didn’t take, and Weissinger was sentenced to a year in prison plus five years probation.

With economic inequality a hot-button issue at the moment, the “affluenza” defense may be a tougher sell than it was in the 1920s. Couch, for one, has been roundly reviled in the court of public opinion.

Of all the Jewish-influenced innovations PBS could have highlighted, Loeb and Leopold’s defense isn’t the proudest.