Thursday 19 October 2017

Who am I

Instead of a stupid patient story this week, I've decided to play a game with you, my loyal (and disloyal and peripatetic) readers.  No damn it, I don't mean we're going to play a game like Jigsaw, nor are we going to play Global Thermonuclear War.  No, a normal game.  A kid's game, actually.  Remember "Who am I"?  Perhaps it had a different name when (and where) you played it, but the rules are always the same: I will tell you a series of facts about something or someone, and you have to guess who I am.

I have a feeling this little experiment will go swimmingly.  If you think you know the answer, please refrain from shouting out your guess so that others can continue to play.

Ready?

Let's play.


  1. I am not a person, but rather a thing.
  2. I was invented not too long ago to help prevent a major cause of death and injury.
  3. Millions of people use me regularly, and most do not give me a second thought.
  4. Proper use of me only takes a couple of seconds and is not uncomfortable when applied properly.
  5. I am very safe when used properly, but I can be misused.
  6. I am exceedingly effective at protecting people's lives.
  7. Use of me is strongly recommended everywhere around the world and is even mandated in some places.
  8. Despite the fact that there are many laws around the world regarding mandatory use of me, some people still eschew me and choose not to use me.
  9. There are very few real reasons not to use me.
  10. There are several more recently developed items that have been invented and found to make use of me more effective.
  11. Despite my excellent safety profile, there are rare instances where I can cause major injury or even death.
  12. Because I can rarely hurt people, some believe I am evil and will always refuse me.
  13. People who are against me actually think they are safer without me.
Are we getting any ideas here?  Yes?  No?  Do you need more time to think?


Well if you guessed SEAT BELTS, then you are CORRECT!


What?  What do you mean you weren't thinking I was seat belts!  Wait wait wait, you weren't thinking I was VACCINES, were you?

Hm . . . well now that I read my description back, it sure does sound like I could be vaccines, doesn't it.

You are correct; that wasn't a question.

This stupid little game was inspired by some stupid little tweets that I've read over the past week or so regarding the flu vaccine, including this humourous little gem:
But that's from noted lunatic and all-around asshole Mike Adams, so I mostly let that go.  Not really:

Waste of skin.  Heh.  But the one that really got to me was this one:
I wish I could remember where on Facebook I found that, but in case you can't see the picture it is a nurse bleating about the fact that she is being forced to wear a mask because she refused a flu shot.  What this nurse apparently forgot is that nurses are on the front line when it comes to patient protection, and they should be first in line to get their goddamned flu shot.  Because this isn't about you and your stupid hurt feelings madam, it's about not transmitting a potentially fatal disease to the most vulnerable people for whom you have chosen to care.

While the vast majority of the 200+ responses to my tweet were supportive, some of them were less than enthusiastic.  Ok, that's putting it mildly.  I'll change that to "complete bullshit".
No, seriously.  "My own immune system".  I can't even make this shit up.

Others groused about the nurse's informed consent:
Let me assure you that we all sign informed consent forms prior to receiving the vaccine, and they say the same things it says on the consent forms that the general public signs.  And making a nurse wear a mask doesn't violate her privacy, and it doesn't violate informed consent.  I have a sneaking suspicion that when she was hired (or when her hospital adopted a mandatory flu shot policy) she signed a form acknowledging that she would either get the shot or wear a mask.

Then there were multiple people claiming this:

NO.  No it absolutely can not.  If you take nothing else away from this stupid blog post, take away this: it is a 100% biological impossibility to catch the flu from the flu shot.  End of.  Full stop.  PERIOD.  Before you rush down to the comments to say "BUT THE FLU MIST IS A LIVE VIRUS VACCINE YOUR STUPID LOL", I didn't say the flu vaccine, I said the flu shot, which is an inactivated (read: dead) virus vaccine.  The flu mist is a live attenuated vaccine which has unfortunately not been nearly as successful as anyone had hoped.  Regardless, You can't catch the flu from a flu shot, you can't transmit it to others, and it doesn't fucking shed.  You may feel crummy for a day or two due to the immune response, but that is NOT the flu, which knocks you on your ass for a week or two and may fucking kill you.

Now I will be the first to admit that the flu shot mostly sucks.  I don't mean getting it sucks, because just like Donald Trump, it's a tiny little prick.  As I mentioned in my stupid little game, it has an excellent safety profile.  No, what I mean is that compared to all other vaccines, it just doesn't work as well.  Compared to MMR (97% effective with 2 doses), polio (99% effective with 3 doses), Haemophilus influenza (95% effective with 3 doses), and meningitis (85-100% effective with 3 doses), the flu vaccine just doesn't quite stack up:
It sure is easy to denigrate such terrible-looking results.  I mean, just look at 2014-2015 when the flu shot was just 20% effective!  And for fuck's sake, in 2004-2005 it was less than 10% effective!  Why the hell do we even fucking bother with this shit?

The reason we fucking bother with this shit is because it DOES work sometimes, and that is better than nothing.  Even if it is only 10% effective, that is 10% higher than ZERO PERCENT.  The flu kills thousands of people every year and happens to target the most vulnerable of our population (children, elderly, sick), so it is NOT just a bad cold.  The flu shot is extremely safe, with fleetingly rare reports of serious adverse events at a rate of around 1 per 1.4 million doses.  Plus, in some years the effectiveness approaches 60%, which is actually pretty goddamned good.  And the flu vaccine has also been found to decrease both the severity and mortality of pneumonia during flu season.

The bottom line is this: influenza is not just a bad cold.  The flu sucks.  The flu shot works (sometimes).  The flu shot is safe.  The flu shot is inexpensive.  And the flu shot does not give you the flu. 

So if you are a child, a healthcare worker, an elderly person, are pregnant, or have a chronic medical condition,

89 comments:

  1. I am neither a child, an elderly person or a healthcare worker. I get a flu shot every year because I had pneumonia once, I have permanent lesions in my lungs now, and besides, it damn near killed me. Any opportunity to avoid it is worth taking. Besides, having the flu sucks.

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  2. I am a home health nurse and get my flu shot every year. Way back when I was a child in early 1970, I had a very bad case of flu. I have since looked up flu for that year and said was Hong Kong Flu. I remember being so very ill my parents took me to the ER. Missed 2 weeks of school. Since that time I had the flu a few times but not as bad. I have gotten a flu shot every year for several years now.

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  3. I have M.E and sundry other health issues which are a buggeration. I am also (for my sins) a full time carer for my uncle who is happily working his way through the medical A-Z and who is now on dialysis via neckline since he is also waiting for a heart bypass and at least one valve replacement so they can't do an AV till he has the heart op.
    The only thing currently unaffected by anything is his spleen which is on his honey do list. I had my flu shot and made him have his(much to his disgust) and also have him booked in for a pneumonia shot since he has had that previously (lucky he was in hospital when that decided to join the party)
    If you need to have the shot because of your age or health issues or if you are going to working around those vulnerable to getting flu and wandering off this mortal coil then get the damn shot.
    You don't want it on your conscience that your not getting the shot is the reason dear old Aunty Gladys is now pushing up the daisies when she had a few good years still in her or worse, seeing off someone elses poor old Grampa Billybob who would have seen his century in a couple of months and up till he got the flu had been in fine fettle.
    Flu kills, sometimes it is you,more often it is some other poor sod who for whatever reason couldn't have the shot before they crossed paths with you.

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  4. I'm a little disappointed, I thought it was condoms ...

    Okay okay, #8 and #11 ruined it, I admit ;).

    Great post nevertheless. Had the flu once while running a kids camp - never again, I swore to myself. Here in Central Europe the shot is ridiculously cheap.

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  5. I was going to go all 'Murican and guess automatic firearms with large capacity magazines...

    kidding.

    my department had a mass immunization the year of the H1N1 outbreak. despite confirmed exposures, we had a 100% infection free year. - and the majority of us had the attenuated virus mist.

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  6. Shouldn't the last line say that everyone should get a flu shot?

    Personally... I don't believe I've gotten a flu shot, at least in the past few years... I know I should really fix this, but every time it comes up, I always seem to forget. This fall though, I've been slowly progressing through a damn cold or sinus issue that won't leave me alone... it certainly reinstated my desire to not have the flu ever.

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  7. What's your opinion on this one? Can inflammatory pain from vaccination alter the permeability of the blood brain barrier or the BBB? https://www.ncbi.nlm.nih.gov/pubmed/11179069

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    1. you mean besides that article having nothing to do with vaccines?

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    2. Pain and inflammation is the body's natural response to a foreign invader after vaccination. According to the study above they can also alter the permeability of the blood brain barrier. Altered BBB equals danger if it is true,

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    3. except that article wasn't about being ouchy from a needle stick or having the immune system rev up in response to a new target. and the increased permeability of the BBB was about permeability to medications it is ALREADY permeable to.

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    4. What article?

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    5. Anon - No. What the investigators injected is used in animal models to induce cutaneous inflammation. There is little to no inflammation with a vaccine injection. You are conflating an immune response to a vaccine with inflammation.

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    6. The inflammatory response is an essential part of the innate immune response after vaccine. That's just basic vaccine immunology.

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    9. Anon - You may not post random links here without comment in an attempt to prove something that has been disproven repeatedly.

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    10. Well, I know you hate science. But since you've already made a claim that there is little or no inflammation that comes with a vaccine injection, I've come to the conclusion that you don't know jack shit about vaccine immunology. So why should I explain those links to you genius?

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    11. Oh dear Anon, you seem confused. You see, you seem to be trying to make a claim that has been thoroughly disproved, and you post links that you seem to believe support that claim, which they don't, without even trying to explain how you think they support it. Then when challenged, you resort to insults, again not even trying to support your claim.

      It looks like I'm not the one who doesn't understand how science works here.

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    12. Sounds like our old chum jumping on yet another bandwagon. Perhaps he could do us the favor of taking a long run off a short pier.

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    14. Anon, maybe you didn't know this, but we know that you don't know what you are talking about.

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    15. My pet rock from when I was 6 knows more.

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    17. I see you've taken to signing your blather, now.

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    18. Least if he signs it itll make it easier for Doc to tell who he should delete

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  9. Maybe the flu shot can't give you the flu, but it gave me a round, hard lump about the size of a nickle at the injection site. I had to apply warm compresses for more than 2 weeks before that sucker finally went away. Got the flu shot again the next year in the opposite arm, same thing happened. And I'm not allergic to eggs. If that's what you consider "safe", you can have it. That was 6 yrs or so ago. I haven't had a flu shot since. Haven't had the flu either.

    I'm 56 now & I didn't even start getting flu shots until I was in my 30's. I know you believe in them, Doc, but I honestly don't think healthy people with normally-functioning immune systems need to have a flu shot every year. Plus the fact that they're free makes me suspicious. You can't get birth control or even an aspirin for free from any pharmacy in America. But this time of year, Walgreens, CVS, Rite Aid & every supermarket you walk into are all giving away flu shots, thanks to our ridiculous gov't subsidies to the drug companies. But if I needed an Ebola vaccine, I'd have to sell my car to pay for it.

    So I'll continue to skip the the flu shot, thanks anyway.

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    1. It's like you didn't read any of what he said.

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    2. "Walgreens, CVS, Rite Aid & every supermarket" don't "give away" flu shots. They bill your insurer for the cost and you (likely) never see an EOB.

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    3. RC, Are you seriously more concerned about a temporary local reaction at the injection site than you are about an illness that can possibly cause serious complications and/or death? Your logic slays me.

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    4. CARDERA: I read everything Doc said, I simply choose to disagree. Which is allowed around here. If YOU took a drug that was not medically necessary & that gave you a hard, painful knot on your arm -- twice -- would you just blindly keep taking it? Why should a flu shot be any different? I had a bad reaction to it twice. The 2 doctors I saw had no clue & offered me no treatment. I get a headcold maybe once every 3 or 4 years, but I haven't had the flu in ages, even without the flu shot. Based on my past experience, I'd be a fool to risk getting another flu shot just because people like you think I need one.


      ANON: So, now my insurer can refuse to provide free birth control because Prez Cheeto says any company that doesn't want to provide contraceptives for its employees doesn't have to, yet part of everyone's monthly premiums goes to provide free flu shots on demand? Only in Trumpland...


      CATHY: What slays me is that you, who haven't had a bad reaction to a flu shot, would insist that I should keep getting them! If what I had was an allergic reaction, it could be progressive. Supposed I get another shot & end up with those nodules all over my body? Or if they developed internally instead of externally? I guarantee you no doctor will know what to do about it & I'll be SOL.

      I know how to handle the flu. I've had it before & just like the vast majority of healthy folks who get the flu, I survived it. And I'm confident that because I'm healthy, I'll survive it again if I catch it. Doc's chart showed that the current flu vac is only about 45% effective, yet you're so convinced the flu shot is going to protect you. Where's the logic in that?

      You believe the hype because you choose to accept what the media has been feeding you for years. That's your choice, but it doesn't have to be mine. I've managed to avoid the flu for the last 5 yrs without a flu shot, which means I haven't inadvertently infected anyone else. So I'm gonna stick with what works for me.

      CONNOR: Don't be a jerk. My life is clearly not at risk from avoiding the flu shot.

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    5. you mean only in Obamaland. I'm sure Trumpcare won't cover vaccinations. particularly, since the only thing I've seen it specifically cover is tax breaks for the 1%.

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    6. RC - I must respectfully but vehemently disagree.
      1) The reaction you had was a local one from the shot itself that was self-limiting and entirely benign. Trying to make the argument that you are avoiding it because you're afraid you'll get them all over your body (or internally) is patently ridiculous.
      2) "I haven't gotten the flu so I don't need the flu shot" is the exact same illogic as "My house has never caught fire so I don't need smoke alarms" or "I've never been in a major car accident so I don't need to wear a seat belt".
      3) Likening a public health measure like flu shots to a personal health measure like contraception is a fallacy, to put it as politely as I can.
      4) Quoting the flu vaccine's efficacy statistics against them is silly, as you well understand that 45% efficacy is literally infinitely better than 0%, which is what you have now.
      5) "I know how to handle the flu" is just about as ignorant and misinformed a statement that I will allow here without deleting it. It is exactly what I would expect an antivaxxer with no understanding of medicine to say.
      6) You are teetering dangerously on the line of conspiratorial nonsense with your "choose to accept what the media has been feeding you" bullshit.
      7) Yes, your life IS, in fact, at risk from the flu if you catch it. I don't care who you are or how strong you think your immune system is. The flu kills healthy people with healthy immune systems EVERY. SINGLE. YEAR.

      If you want to refuse the flu shot, fine. But don't give me the same bullshit arguments I hear from antivaxxers. Not you.

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    7. Nobody is safe from anything. Any day, anything could sieze you unlike anything youve seen before. "Dont worry itll be just like last time" doesnt apply to viruses. Viruses mutate. They become new viruses. Its the reason why despite smallpox being eradicated we still have inert versions in labs- another virus can mutate into it and start the cycle all over again.

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    9. Thank you for outing yourself, John. You know you've been banned.

      For those of you who saw John's attempt at cherry picking and wish to understand why John is wrong, he was quoting a study which he thinks showed no benefit of the flu shot, but he neglected to reveal the title of the study, which was "Mortality Reduction with Influenza Vaccine in Patients with Pneumonia Outside “Flu” Season". You see that "outside flu season" part, John? That's called intellectual dishonesty, otherwise known as fucking lying.

      Fuck off, John. You're not welcome here.

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    11. I see you still know how to cut and paste, don't you John. And I see you can still cherry pick, even from Cochrane. This review in no way invalidates the efficacy of the flu shot, which is recommended worldwide for the elderly, children, and chronically ill.

      Fuck. Off.

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    13. Less worst nightmare and more ever so slightly annoying returning rash. It shows up for a few days to slightly annoy you, but goes away quickly and is easily ignored.

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    14. Doc,

      You know I'm not an anti-vaxxer! I've never told anyone not to vaccinate their kids. And I don't tell people not to get the flu shot. Get all the jabs you want, folks! But for ME, it's just not a risk I wanna take.

      I know from personal experience that allergic reactions can be progressive. I got my first bee sting when I was 9 or 10 & kept right on playing. I got another bee sting a year or so later, it felt like nothing more than a pinprick. It got a little red & itchy, but it was no worse than a mosquito bite. So bee stings weren't a problem for me. Until I ruined a perfectly good family vacation in Hawaii at age 13 when I got stung by a bee & ended up hospitalized for anaphylactic shock.

      Since that vacation, I have been skydiving, survived 1 motorcycle accident & 2 car crashes & none of that shit scared me as much as the anaphylaxis. I nearly died, which is terrifying when you're a kid! (Which is not to say nearly dying doesn't terrify adults. But kids don't ever think they'll die from a random mishap.) And from the time they first hit the market back in 1988, I've been that chick who always has an Epi pen with her. Even in the dead of winter. Even when I go out in a cocktail dress with a tiny little evening bag. I may leave my wallet at home, but my Epi pen is ALWAYS with me.

      Can you promise me that the next flu shot I get won't have me a bad reaction? No, Doc, you can't. Yet I've managed to avoid getting the flu without getting a shot for 5 years straight -- which you totally discount as meaningless! Your own source material said the current shot is only 45% effective. You wouldn't tell people their home must have a smoke alarm that was only 45% effective -- you'd demand much better odds than that. Yet you tell everyone they should get a flu shot that has less than a 50% chance of actually working? Just because it MIGHT help them avoid the flu, or make their flu "less severe" if they do get it? That doesn't seem very logical or scientific to me.

      And you are also not allowing for varying risk factors, Doc. I believe that I've managed to avoid the flu for so long in part because my exposure to it is pretty low. I don't have to interact with the public at my job. I almost never use mass transit, so I'm not stuck in a bus or a subway car with dozens of strangers & all their germs on a regular basis. I avoid children by and large -- they are rude, filthy little monkeys riddled with all sorts of diseases, save for the ones in my family tree, who are all beautiful, well-mannered & healthy. But I only see them at holidays & birthdays & their parents have sense enough to keep them at home if they're sick. And I'm not around a lot of oldsters with all their ailments. So my risk of exposure to the flu is prolly a lot lower than most peoples'.

      Bottom Line: FOR ME, the low efficacy of the shot, my past reactions to it & the fact that I've successfully avoided the flu without the shot for this long are good enough reasons to keep doing what's been working for me thus far. But I'm not telling others to follow my lead.

      And I promise you, Doc, if I do get the flu, It Will NOT Kill Me! It WILL Not!

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    15. Rc as he already said- 45% INCREASE is better than 0.

      You bring up how bee stings effected you differently as you grew older, yet refuse to acknowledge the fact that the flu can do the Same thing? 400 people in china and india dies of the flu before flu season was considered to even start THIS YEAR.
      Do you remember bird flu? Swine flu? Both relatively recent strains of the flu that were VERY DEADLY and debilitating? Permanent damage being a result of both?
      All it takes is a sneeze or a cough in your direction and you will be Screwed.

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    16. Connor, you are the worst alarmist I have ever see around here! How do you even manage to leave the house without a hazmat suit?

      I've not been "screwed" by the flu virus for the past 5 years without getting a flu shot. So I will keep doing what works for me.

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    17. To give you an idea of what a four-year curriculum at a medical school in the U.S. might look like, let’s take the example of the Keck School of Medicine of the University of Southern California. The first year would include Anatomy, Biochemistry, Cell Biology, Embryology, Genetics, Human Behavior, Immunology, Neuroscience, and Physiology. No course on Vaccinology. The second year curriculum lists Clinical Medicine, Microbiology, Pathology, Pharmacology, and Advanced Cardiac Life Support. No Vaccinology. The third year lists Family Medicine, Internal Medicine, Neurology, Obstetrics and Gynecology, Pediatrics, Inpatient Services, Outpatient Rotation, Psychiatry, and Surgery. No Vaccinology. The fourth year lists Acute Care, Ambulatory Care, and Medicine Sub-Internship. Nothing on Vaccinology.

      Doctors today are given extensive training on how to talk to ‘hesitant’ parents-how to frighten them by vastly inflating the risks during natural infection. They are trained on the necessity of twisting parents’ arms to conform, or fire them from their practices. Doctors are trained that nothing bad should be said about any vaccine, period.

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    19. And you sound like john. Goodbye john.

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    20. RC - I hear you say "I'm not an antivaxxer", but you are using the same antivaxxer arguments I've seen and refuted countless times. For the sake of this argument, I'm going to treat you just like anyone else who tries to use these ridiculous points. You should expect nothing less from me.

      it's just not a risk I wanna take.
      Fine, then don't take it. Nobody is forcing you. All I'm doing is giving you facts, and you are ignoring the science in favour of your obvious bias because reasons.

      What you had was NOT an allergic reaction. It was a local, self-limiting, harmless reaction, and those are NOT progressive. Stop using that argument. Just stop.

      What I find most stunning is that you admit to skydiving, riding motorcycles, and driving in a car, all of which are inherently more dangerous than a flu shot. You have no problem jumping out of a plane, but you won't get a flu shot because of a risk much smaller than driving in a car, even though you've never had a serious reaction to it? Really?

      You carry an EpiPen, which is preventative medicine just in case of a serious reaction, but you refuse a flu shot, which is preventative medicine just in case of a serious infection.

      Can you promise me that the next flu shot I get won't have me a bad reaction?
      No, of course not. But this, and your "But I haven't gotten the flu in 5 years!" are both terrible arguments. If smoke alarms were only 45% effective, I can guarantee you with 100% certainty that I would STILL have one in every room of my home because 45% is, as I've said before, infinitely more effective than 0%. Yeah, they don't work all the time. But when they do, you avoid contracting a potentially deadly infection that can also spread to other people.

      And I promise you, Doc, if I do get the flu, It Will NOT Kill Me! It WILL Not!
      This is what gets me most, RC. You sit there and ask me if I can guarantee you won't get a reaction to another flu shot, but then you have the audacity to guarantee that the flu won't kill you if you get it. If you believe nothing else I have ever said or will ever say, believe this: THE FLU KILLS. Not everyone, not even remotely. But in your (supposedly) richest country in the world, it still kills nearly 5000 people every year. Granted most of those deaths are elderly, sick, or young people. But it kills healthy people too. Every single year, healthy people just like you are killed by the flu. THE FLU IS NOT JUST A COLD, RC.

      As I said before, if you don't want the flu shot, don't fucking get it. No one will force you. NO ONE. But don't you dare come here, sling some typical antivaxxer bullshit, and expect to get away with it.

      As I said, you've been here long enough so should expect nothing less than this reaction from me. And a note to any other regulars here: anti-science arguments will always get pro-science treatment from me no matter who you are. Full stop.

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    21. Anon - I see you are just as clueless as I would expect any antivaxxer to be. It's obvious based on your banal screed you haven't been to medical school, and I always get amused and/or irate when someone who has NOT attended medical school tries to explain how medical school works. Let me see if I can clue you in here:

      When you were first learning maths, did you learn differential equations before addition? Did you learn long division before subtraction? No, you learned the basics first. That's how medical school works. You learn the systems first, then you get more advanced, then only at the end do you learn how to practice in your chosen field.

      Year one, in your example, includes immunology. That's where students learn the basics of the immune system, including how vaccines work.

      Year two includes clinical medicine, pathology, and pharmacology. Those courses teach how vaccine science is applied.

      Year three includes paediatrics, general internal medicine, OB/GYN, and surgery. This includes teaching how and why vaccines are used.

      Fourth year further narrows down the scope of teaching so students can choose their specialty.

      So no, there is no course on "vaccinology", as you put it, because there does not need to be. There also is no course on hernias, which is an integral part of my practice. Does this mean I'm not qualified to repair a hernia? There is no course on diabetes, which is a major part of any GP's practice. There is no course on eclampsia, which is an important aspect of obstetrics. Get what I'm saying yet? Vaccines are part of every medical school curriculum, just like every other medicine, technique, procedure, diagnostic test, etc.

      Doctors are trained that nothing bad should be said about any vaccine, period.
      Don't fucking try to tell me how doctors are trained when you haven't gone through it. Unlike you, I and all of my colleagues have been. I have met and spoken to literally thousands of doctors in my career, and not a single one has even been trained or coached about denigrating vaccines. Zero. That just doesn't happen and is merely conspiratorial bullshit.

      Now, do you have anything else incredibly stupid for me to refute soundly, or are you all done making a fool of yourself?

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    22. When I went and got my vaccination a week ago, the person who administered it said this years flu was believed to b a strain of the swine flu, or at least Very similar in how it acted. Remember how bad That was? My sister even knew a few people who caught it and almost died.
      Also, as I said elsewhere, the spanish influenza killed More people in World War I than the war itself did

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    24. Yes anon of course because the only way to be a real doctor is to be from the US right?

      And a quick google search of keck could tell you Everything doc said anyway. Before you start committing further ad hominen, how about we see Your credentials since your so hellbent on Docs.
      I expect to see it presented in triplicate

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    25. Why is that your suggestion, xenophobic troll? Are you suggesting American doctors are somehow better than others? Because that's sure how your stupid comment reads. Let me assure you that doctors in other countries are just as well-trained, just as smart, and just as qualified as American doctors. I doubt you believe that, and I doubt even more that I care whether you do or not.

      As for your continued harping on my comment about inflammation, there is a very mild and transient systemic inflammatory response in response to vaccines. I was merely saying it is not clinically significant, and it is evidence that vaccines are doing what they are designed to do. You, on the other hand, use this to try to insinuate causation of everything from autoimmune disorders to autism, all of which has been disproved repeatedly.

      So obviously you're not done making an ass of yourself, so where shall you go from here?

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    26. in short, dumbfuck, there is no such thing as vaccinology, the same way there is no such thing as suturology, or splintology.

      I never took a lass in squirtwaterology, but I assure you I am still fully qualified to know when it is time to put the wet stuff on the red stuff, and I never took a class in dumbfuckology, but I still know you are one.

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    28. Oh I see, so you've been proven wrong about your stupid "vaccinology" fuckwittery, so you change the subject. Well let's see, vaccines haven't been studied for their effects on liver cells. They haven't been studied for their effect on retinal cells. Or cardiac myocytes.

      You know what they HAVE been studied on? Whether or not they cause autism. They don't. So you can take your BBB bullshit back to your antivax discussion groups.

      In case you aren't the same anon, you can ignore the first sentence. The rest remains as is.

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    29. Ken i dont know what college you went to but I did take a class in dumbfuckology. Or was that

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    30. I went to one of those old fashioned ones that actually made you learn the material in order to graduate.

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    31. Doc, I have a question about Medical School in Australia. Is it true that Australian med schools teach much less basic science in comparison with US med schools?

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    32. I don't know about "much less", but from what I understand there is less emphasis on basic science teaching in Australia and more emphasis on clinicals.

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    33. For some reason my comment posted without the punchline. It was (insert random class here)

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    34. I took a couple of random classes in college. the classic "I need a class in this window in my schedule, lets see what's on offer for that time slot"

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  10. Working for a "large" hospital corporation which requires flu shots of all (who haven't a documented medical allergy to the vaccine components), no mask option for the non-allergic. If one refuses, signing the refusal form is also a resignation of employment. Personally having last had the flu in 1988 while 6 months pregnant, I haven't missed a shot since. I don't ever want to be that ill again, nor to be a vector for anyone else!

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  11. I'm pushing 68 and have gotten it yearly since I was 60 or so. I did get the flu, despite the shot, a few years ago and then got "mild" pneumonia. That combo really knocked me out, and I am a healthy person, so now I really don't want to get the flu again. Buuuut . . . it just lessens the odds, a bit. I'm not terribly afraid of death but scared to death of suffering, and those 2-3 weeks included some definite suffering. And I don't know where some of these commenters live, but I have always had to pay for a flu shot, btw.

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  12. I have asthma and pretty much detest people who are too good for the flu shot. Influenza could put me in the ICU. I get my shot every year, but it's less helpful if people around me are refusing to do it because they think they have steel immune systems. Which is funny because, wasn't it the overreaction of the immune system that was killing off the young H1N1 patients several years ago?

    Even if the flu shot isn't great, it's that much less chance I get hospitalized. When people won't get the shot, I just assume they don't care if they hospitalize or kill a vulnerable person with a flu they could have prevented.

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    1. what was killing the young H1N1 patients was that it was a particularly severe strain of influenze. if you are old enough, you might recognize it by its other name; Influenza A. older patients had already been exposed to it and so had antibodies present. (having survived it once before)

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    2. Actually Ken your antibodies to Influenza A are not useful against a different strain such as H1N1 if you've never been exposed to it. That's why we need yearly vaccination. Slight but frequent changes in the virus RNA makes it different every year (new strains) and our immune system by itself won't prevent re-infection in most cases.

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    3. This comment has been removed by the author.

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    4. And saying that it is just Influenza A is oversimplfying it, there has been multiples strains of Influenza A over the years resulting in major epidemia : H1N1 with spanish flu 1918 and swine flu 2009, h2n2 with asian flu, h3n2 with hong kong flu, etc.

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    5. Louis: I was referring to the fact they didn't use the same nomenclature in earlier epidemics.

      and I didn't say the antibodies would give full immunity, just improved the odds of survival.

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  13. I hate needles, but I still get the flu shot every year. I hate being confined to bed for a week or more a lot more than I hate a couple days of mild misery.

    And as for seat-belts, I always use them. For everyone who says "They chafe my neck/shoulder on long drives," do keep in mind most modern cars have adjustable heights. Anyone else who claims "It messes up my hair/shirt/whatever," just remember that an accident where you hit the steering wheel or get a glass collar from your windshield will mess up more than just cosmetics.

    Now, air-bags... I'm still not a fan of something designed to explode being aimed at my face and chest. My solution to that one, however, is simple: Drive Defensively. After all, the airbag only goes off if I crash. So, don't crash.

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    1. having been an invited guest at a lot of front impact collisions, I can tell you for certain, if you don't like the seat belt, you're going to hate how we will secure you to the backboard if you hit your face on the steering wheel or windshield.

      and I have an aversion to needles, too. I'll take the snort, even if it is a "live" virus. - though the H1N1 just gave me a runny nose until it got absorbed.

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    2. Ken, the vibe I’m grtting isn’t “I don’t like airbags, or seatbelts, so I don’t use them” but “despite the fact that I use seatbelts, I dislike the comsequences of needing them, so I acoid needing them, again, despite the fact that I use them.”

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    3. that was aimed more at the same audience Dakala was speaking to.

      I am at the point where I feel underdressed if I don't have a seatbelt on. - and it is just a reflex to put it on any time I get into a vehicle; sometimes even if I know I am only going the 20 feet to the end of the driveway and getting back out to drop a letter in the mailbox.

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  14. I was going to say a seatbelt

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    1. frightening thing is it could apply to nearly ANY safety equipment.

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  15. To any who even question how deadly the flu can be: the flu killed more people during World War I than World War I did.

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  16. I have an anecdotal story about the flu shots. I got mine last year, my husband forgot. He got the flu, and was miserable for nearly two weeks. I didn't get the flu and was miserable because my husband is a really crappy patient and whined and complained incessantly. It would have been worse if I'd gotten the flu, too. I almost left home for the duration!

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  17. I don't have any health insurance (long story short...DOL sucks!) but I checked around and I'll be getting mine at the Costco pharmacy in 2 weeks. It's 19,99$ and it's the quadravent. Best price around. And the damn CVS pharmacy person who waited on me 2 days in a row, asking me if I wanted to get a flu shot can stop asking.
    Husband never gets one. He doesn't get sick or so he says, but when he does get a cold, it's the worst cold ever, no one has ever suffered like he does.
    Moms gets the flu and pneumonia shots at 93.

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  18. Double lung transplant recipient here. GET YOUR FLU SHOT. I get mine, of course, because I'm not stupid, but if YOU don't, and I'm around you, I might be screwed, because, hello, compromised immune system here. If I get the flu, I'm in Trouble (with a capital T and that rhymes with P....). Don't be dumb, folks.

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  19. I did guess vaccines on your game, but uncomfortably so, because a few of the points don't quite match. Seat belts definitely fit the bill much better, just didn't think of them.

    "Millions of people use me regularly, and most do not give me a second thought." - I would think most people do give a second thought to vaccines.

    "Proper use of me only takes a couple of seconds and is not uncomfortable when applied properly." - I wish it only took a couple of seconds. In reality, the process of going there, waiting in line, and actually receiving the shot can easily take an hour.

    "I am very safe when used properly, but I can be misused." - I'm sure vaccines CAN be misused, but not really by the average joe... right?

    "There are several more recently developed items that have been invented and found to make use of me more effective." - actually I'm just curious what these are for vaccines :) I know seat belts are made safer with airbags and whatnot

    So that turn from vaccines (in my head), to seat belts (feeling slightly stupid about not thinking of seat belts when vaccines barely matched), and back to vaccines - that was a real rollercoaster.

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  20. My university on campus pharmacy doesn't have the flu shot until Monday! I'm really annoyed, all off campus pharmacies already have it and we're so behind. My friends and I are having a flu shot party on Monday though. Getting the vaccine and then getting ice cream, basically.

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  21. I know SOMETIMES my upper arm gets sore after a flu shot, but the injection itself is nothing. Mostly I can barely feel it. The nurse that did it this year was so quick and gentle that it was over before I even noticed that she had already put on the bandage and we were done. Probably the easiest flu shot ever!

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    1. Soreness in your arm after a shot is completely normal.

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  22. I've received the flu shot for at least 20 years. I used to come down with a serious case of bronchitis in the late fall-early winter every year before I started. I've had neither the flu nor bronchitis during this time. It's crazy to not take advantage of vaccines of any kind. They save a lot of misery and lives.

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  23. My employer has a clinic come in and provide flu shots to us on site We’ve had only a handful of flu cases in the past 10 years or so.

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  24. To the old people who refuse to get flu shots because they think it will make them sick, I just don't care anymore. I get one myself and tell my friends to get them.

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  25. Thank you for the reminder. The military base where I receive my health care was having supply issues receiving the vaccine. When I go for mine, I also need to make sure that my other vaccines are up to date. A few of them I can't recall the last time I received.

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  26. I just wish that my goddamn health insurance would stop leaving me voicemails telling me to get a flu shot that I already got last month.

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I'll start this post by answering a few questions that may or may not be burning in your mind: No, I'm not dead.  No, I didn't g...