When are you going to get a Flu Shot?

[jimbogumbo]

Like mamselle I don't get the flu (had it twice when much younger), so I haven't been vaccinating. Planning to emulate kay and get the shingles and pneumonia vaccines though, and figured I'd add flu this year out of an abundance of caution.

[TreadingLife]

Since I am social distancing and wearing a mask around others, isn't my risk of catching flu already massively diminished?

You also get the flu shot to reduce the chance you get sick so that you don't give that child with cancer the flu, or that old lady at the supermarket with COPD the flu.

The flu shot isn't just about protecting you. It never has been just about protecting you, but COVID has really brought out this debate about what responsibility we have towards protecting others, particularly the most vulnerable in society.

If your own mother or father had cancer, would you get a flu shot to reduce the probability you don't get sick and give it to them? If the answer is yes, then why not reduce the chance someone else's mom with cancer has a lower chance of getting the flu? It isn't that far of a leap to care about others, if you care about people who affect you. But if you wouldn't do it for someone close to you, then the argument is more of a stretch when extended to others.

[phi-rabbit]

I got mine yesterday.  I get one every year and always find it surprising when other people (especially people who aren't just anti-vaxers) don't.  I started getting one every year when I was an undergrad and since then I've only had the flu twice: once when I'd had the shot but ended up getting a very mild version of the flu that only lasted a day or so, and once when there was a vaccine shortage during the 2004/5 season so I wasn't able to get one.  That year, I got the flu and was the sickest I've ever been in my adult life.  I had a miserable time with the flu for a week and then it started to go away and I had the blissful relief of thinking I was getting better... and then bronchitis coat-tailed on in.  I coughed until it gave me a permanent ache in my side, and then coughed some more, for another couple of weeks.  On a purely self-interested basis, I am more than happy to stop by the pharmacy for a quick jab if it helps keep me from ever going through that again.  But I would do it anyway to protect others, as TreadingLife says very well.

[Juvenal]

Why anyone would think it's better to avoid a vaccination (flu, shingles, measles, mumps, etc.) to not having one--a mystery.  But humans are full of mysterious matters.  Daredevils are we!

I do think that I had what was called the "Hong Kong Flu" on my birthday in 1957--miserable, but soon recovered; and some un-named flu in the latter Seventies (more misery).  Nothing since.  So I can't quite put myself in the category of those who "never get the flu, and thus never get a flu shot."  Well, I have never had a car accident, so there's no reason to cinch the seat belt, right?  Sigh.

As soon as there is even any availability of a COVID vaccine being out there--I'll be on the line.  Sheltering in place is getting very old (for someone, old, who lives alone).

[histchick]

Since I am social distancing and wearing a mask around others, isn't my risk of catching flu already massively diminished?

You also get the flu shot to reduce the chance you get sick so that you don't give that child with cancer the flu, or that old lady at the supermarket with COPD the flu.

The flu shot isn't just about protecting you. It never has been just about protecting you, but COVID has really brought out this debate about what responsibility we have towards protecting others, particularly the most vulnerable in society.

If your own mother or father had cancer, would you get a flu shot to reduce the probability you don't get sick and give it to them? If the answer is yes, then why not reduce the chance someone else's mom with cancer has a lower chance of getting the flu? It isn't that far of a leap to care about others, if you care about people who affect you. But if you wouldn't do it for someone close to you, then the argument is more of a stretch when extended to others.

This, exactly this. Mom had cancer last year (literally finished treatments in February).  She's higher risk for flu and COVID-19. Putting our own risk aside for the moment, there's no freaking way I would take the risk of seeing her without having the flu shot.   

[pigou]

I got mine a couple days ago at CVS. Took all of five minutes and requires no appointment. Any health insurance plan that is subject to ACA regulation has to offer the flu shot with no deductible and no copay. Plus, major pharmacies like CVS will give you a $5 coupon for getting it there in most states. If you don't have insurance, I think Target's pharmacy is the cheapest at $15 and CVS among the most expensive at $40. Depending on the state you live in, there's probably a hotline that'll get you a waiver and you can get it for free at a pharmacy, too.

I don't understand the sentiment that someone doesn't get the flu shot because they don't get the flu. Do they also not wear seatbelts because they don't get into car crashes, don't use condoms because they don't get HIV, and not get the MMR vaccine because they don't get measles? The whole point of vaccines is to make diseases less prevalent... if you never get measles, that's a sign that the measles vaccination program is working well. And we need more uptake, because no vaccine is 100% effective for 100% of the population. This is also going to be true for the COVID vaccine, where an efficacy of 50% or so seems to be the threshold for it to be useful.

The flu hospitalizes between 150,000 and 800,000 people per year in the US. It kills between 10,000 and 60,000 people. We could bring those figures a lot closer to zero if vaccination uptake were 90% instead of the 50% it is today. Anti-vaxxers aren't really the problem here -- there's not enough of them.

[dismalist]

I'm going to CVS shortly.

Last time I went, it took 10 minutes: 1.5 to get the shot and 7.5 to fill out the paper work. :-)

In addition, moreover, everything that Pigou says. To make it work we can pay people to get that shot, too!

[the_geneticist]

I got mine today!

I've had the flu once in graduate school and it was MISERABLE.  I was too weak to open a water bottle, couldn't stand up long enough to shower, and basically lived on the couch for a week.  Don't want to go through that again.  And I was lucky that missing a week didn't cost me a job or my health insurance.  But, you know, that's a "mild case" in today's COVID-19 world.

I also got vaccinated  to: 1) increase the herd immunity for the flu; 2) set a good example for my family; 3) not be a hypocrite when I tell my TAs to get vaccinated too

[jerseyjay]

I got mine a couple days ago at CVS. Took all of five minutes and requires no appointment. Any health insurance plan that is subject to ACA regulation has to offer the flu shot with no deductible and no copay. Plus, major pharmacies like CVS will give you a $5 coupon for getting it there in most states. If you don't have insurance, I think Target's pharmacy is the cheapest at $15 and CVS among the most expensive at $40. Depending on the state you live in, there's probably a hotline that'll get you a waiver and you can get it for free at a pharmacy, too.

I have been getting a flu shot every year since I happened to be in Mexico City during the H1N1 outbreak. (I didn't get sick then, so I suppose I could have concluded I don't need to get the shot, but instead, having observed how bad the flu could be, I decided to avoid the flu at all cost.)

For the past 10 years I have been getting the shot at the big name pharmacy across the street from my house, for no cost. This week I went to get the flu shot only to find out that my insurance no longer covers it. I called them and they said they had eliminated this benefit, in the middle of a pandemic. But I will look into what you wrote about insurance companies having to cover it. 

[jimbogumbo]

I got mine a couple days ago at CVS. Took all of five minutes and requires no appointment. Any health insurance plan that is subject to ACA regulation has to offer the flu shot with no deductible and no copay. Plus, major pharmacies like CVS will give you a $5 coupon for getting it there in most states. If you don't have insurance, I think Target's pharmacy is the cheapest at $15 and CVS among the most expensive at $40. Depending on the state you live in, there's probably a hotline that'll get you a waiver and you can get it for free at a pharmacy, too.

I don't understand the sentiment that someone doesn't get the flu shot because they don't get the flu. Do they also not wear seatbelts because they don't get into car crashes, don't use condoms because they don't get HIV, and not get the MMR vaccine because they don't get measles? The whole point of vaccines is to make diseases less prevalent... if you never get measles, that's a sign that the measles vaccination program is working well. And we need more uptake, because no vaccine is 100% effective for 100% of the population. This is also going to be true for the COVID vaccine, where an efficacy of 50% or so seems to be the threshold for it to be useful.

The flu hospitalizes between 150,000 and 800,000 people per year in the US. It kills between 10,000 and 60,000 people. We could bring those figures a lot closer to zero if vaccination uptake were 90% instead of the 50% it is today. Anti-vaxxers aren't really the problem here -- there's not enough of them.

I am NOT an anti-vaxxer, and have all the vaccinations that were available to older Americans. The fact that I don't get the flu is far more likely due to me having it twice before in the 1957-58 outbreak and again in 1968 rather than how well the flu vaccine is working. I'm getting the pneumonia and Shingrix tomorrow. Given my age, I will get the flu vaccine this year.

I have had measles, chicken pox, mumps, whooping cough and scarlet fever. I do not recommend those experiences to anyone. I have been vaccinated against smallpox, polio, and tetanus (several times). You HAVE to no that the flu vaccine each year, unlike the ones I mentioned, is largely a guess as to the strain. To say we would get the number of influenza infections close to 0 with a 90% vaccination rate simply isn't true.

[downer]

In the US, it is recommended that anyone over 6 months gets a flu vaccine. CDC also puts emphasis on certain groups.
Emphasis should be placed on vaccination of high-risk groups and their contacts/caregivers. When vaccine supply is limited, vaccination efforts should focus on delivering vaccination to (no hierarchy is implied by order of listing):
Children aged 6 through 59 months
Adults aged ≥50 years
Persons with chronic pulmonary (including asthma), cardiovascular (excluding isolated hypertension), renal, hepatic, neurologic, hematologic, or metabolic disorders (including diabetes mellitus)
Persons who are immunocompromised due to any cause, including (but not limited to) medications or HIV infection
Women who are or will be pregnant during the influenza season
Children and adolescents (aged 6 months through 18 years) receiving aspirin- or salicylate-containing medications who might be at risk for Reye syndrome associated with influenza
Residents of nursing homes and long-term care facilities
American Indians/Alaska Natives
Persons who are extremely obese (BMI ≥40 for adults)
Caregivers and contacts of those at risk:
Health care personnel, including all paid and unpaid persons working in health-care settings who have potential for exposure to patients and/or to infectious materials, whether or not directly involved in patient care;
Household contacts and caregivers of children aged ≤59 months (i.e., <5 years), particularly contacts of children aged <6 months, and adults aged ≥50 years;
Household contacts and caregivers of persons with medical conditions associated with increased risk of severe complications from influenza.


In the UK, it is recommended that the following groups get a flu vaccine:
anyone aged 65 and over
pregnant women
children and adults with an underlying health condition (such as long-term heart or respiratory disease)
children and adults with weakened immune systems

WHO Europe recommends the following groups get the flu vaccine:
pregnant women
individuals >6 months with certain chronic diseases
elderly persons
residents of institutions for older persons and the disabled
children aged 6–59 months
health care workers.


Why are there different recommendations for different countries?

[pigou]

For the past 10 years I have been getting the shot at the big name pharmacy across the street from my house, for no cost. This week I went to get the flu shot only to find out that my insurance no longer covers it. I called them and they said they had eliminated this benefit, in the middle of a pandemic. But I will look into what you wrote about insurance companies having to cover it.

Your insurer might limit coverage to in-network providers, which the pharmacy may not (or no longer) be part of. For the most part, it's in an insurers interest that you go get the flu shot at a pharmacy and not at your doctor's office, so that'd be somewhat confusing. However, vaccinations most definitely have to be covered under the ACA with no co-pay and no deductible, so this isn't a "benefit" that they can just waive.

You HAVE to no that the flu vaccine each year, unlike the ones I mentioned, is largely a guess as to the strain. To say we would get the number of influenza infections close to 0 with a 90% vaccination rate simply isn't true.

True that it's guesswork, with an important caveat: even if the strain that infects a particular person isn't included in the vaccine, there may still be some cross-protection. What it effectively does is reduce the effectiveness of the vaccine when the guess is off. As a technicality, I did say "closer to zero" and not exactly zero. Even at 70% effectiveness over many years, there'd be some decent progress on this...

Why are there different recommendations for different countries?

Cost. The US values a statistical life at $9.6m, while the UK values is at 7.5m (VSL) and so that's going to affect what kind of reduction you need in case fatalities to make the vaccine worthwhile. Similar logic applies to hospitalization, which is more expensive in the US.

[jerseyjay]

For what it is worth, here is an update: I called my insurance company and it turns out that yes, they do cover free flu shots. If I go to my doctor's office it is free. If I go to the pharmacy, I need to pay whatever they charge me, then send in the receipts and a form and the insurance will reimburse me. All that said, I have now spent probably two hours on phone calls and aggravation for something that in the past took a few minutes in the pharmacy. And I still haven't actually got the shot yet.  This seems all rather counterproductive, especially in a pandemic.

[downer]

Why are there different recommendations for different countries?

Cost. The US values a statistical life at $9.6m, while the UK values is at 7.5m (VSL) and so that's going to affect what kind of reduction you need in case fatalities to make the vaccine worthwhile. Similar logic applies to hospitalization, which is more expensive in the US.

So the US values life at about 30% more than the UK or other European countries? It's slightly odd, especially since people in Europe live 3 or 4 more years longer than in the US. It doesn't seem that the health benefits gained by giving healthy people aged 6 months - 65 are that decisive. Especially since all health care in the US is expensive compared to Europe.

I was looking for info in the US about the drop in numbers of people getting their annual physical. That's often when people get a flu shot. I couldn't find any statistics. Similarly for dental check ups. (I did hear that plenty of older dentists have retired, putting strain on the system. I wouldn't be surprised if the same is true for doctors.) My guess is that there will be a massive drop in numbers of people bothering to get a flu shot for the coming season.

[the_geneticist]

Why are there different recommendations for different countries?

Cost. The US values a statistical life at $9.6m, while the UK values is at 7.5m (VSL) and so that's going to affect what kind of reduction you need in case fatalities to make the vaccine worthwhile. Similar logic applies to hospitalization, which is more expensive in the US.

So the US values life at about 30% more than the UK or other European countries? It's slightly odd, especially since people in Europe live 3 or 4 more years longer than in the US. It doesn't seem that the health benefits gained by giving healthy people aged 6 months - 65 are that decisive. Especially since all health care in the US is expensive compared to Europe.

I was looking for info in the US about the drop in numbers of people getting their annual physical. That's often when people get a flu shot. I couldn't find any statistics. Similarly for dental check ups. (I did hear that plenty of older dentists have retired, putting strain on the system. I wouldn't be surprised if the same is true for doctors.) My guess is that there will be a massive drop in numbers of people bothering to get a flu shot for the coming season.

There are plenty of other places to get a flu shot other than a doctor's office.  Here, there are vaccination clinics at drug stores with pharmacies, lots of the "big box stores" like Walmart & Costco offer them, so does the student health center on campus.  The local RiteAid ran a promotion last year that was really successful to increase the vaccination rate - get a flu shot & get a coupon for a free scoop of ice cream at the ice-cream counter in the store.  Lots of folks are happy to get a free ice cream cone with their free flu shot.