“The Problem Child of Seasonal Flu”: Beware This Winter’s Virus • Hacker News Board

Re: “The Problem Child of Seasonal Flu”: Beware This Winter’s Virus

#31

Post by opportune » Mon, Jan 22, 2018, 8:42 PM UTC

Jach wrote: post #18

opportune wrote: post #13

This article is good and reminded me of a key issue: herd immunity. I wish I could explain to more of my friends how irresponsible it is to not get the flu shot - they view it as simply an individual decision like "I'm choosing to not get the shot knowing full well I might get sick" - but they don't think of the possibility that if they do get sick, they may play a part in infecting other , more vulnerable people, su…

Doesn't that just raise the question of why an at-risk elderly person wouldn't get the flu shot to protect themselves from all the people who don't? I've heard this irresponsibility argument a lot, I understand it, but I think it's overblown. Herd immunity works best when the vaccine is actually effective. For flu vaccines, every year they're not very effective.

The vaccine is still >30% effective. And you may be confused regarding how vaccines for things like the flu work: they have varying efficacy against different strains but getting vaccinated for a certain strain does not at all mean you won't get sick with that strain - it reduces the likelihood.

Imagine all the people in the world as a graph with weighted edges representing the probability of one person transmitting the flu to another. The more people become vaccinated, the less the weights of the edges, and the less people get sick overall.

Re: “The Problem Child of Seasonal Flu”: Beware This Winter’s Virus

#32

Post by 8ytecoder » Mon, Jan 22, 2018, 8:42 PM UTC

Raphmedia wrote: post #21

opportune wrote: post #13

This article is good and reminded me of a key issue: herd immunity. I wish I could explain to more of my friends how irresponsible it is to not get the flu shot - they view it as simply an individual decision like "I'm choosing to not get the shot knowing full well I might get sick" - but they don't think of the possibility that if they do get sick, they may play a part in infecting other , more vulnerable people, su…

Not nitpicking or trying to be an idiot but shouldn't it be the vulnerable individuals that get the shot? It seems that the only people I know who get vaccinated for something as benign as the flu are: nurses, teachers, children, elderly. Everyone else simply take one or two day off during flu season in the event that they do catch it (most don't). Am I missing something? I have never been vaccinated for it and askin…

Evolution has provided viruses with an incubation period - the time required for the virus to develop in the host - during which you don't feel sick but you can be spreading it to the others.

Re: “The Problem Child of Seasonal Flu”: Beware This Winter’s Virus

#33

Post by russdill » Mon, Jan 22, 2018, 8:43 PM UTC

Raphmedia wrote: post #21

opportune wrote: post #13

This article is good and reminded me of a key issue: herd immunity. I wish I could explain to more of my friends how irresponsible it is to not get the flu shot - they view it as simply an individual decision like "I'm choosing to not get the shot knowing full well I might get sick" - but they don't think of the possibility that if they do get sick, they may play a part in infecting other , more vulnerable people, su…

Not nitpicking or trying to be an idiot but shouldn't it be the vulnerable individuals that get the shot? It seems that the only people I know who get vaccinated for something as benign as the flu are: nurses, teachers, children, elderly. Everyone else simply take one or two day off during flu season in the event that they do catch it (most don't). Am I missing something? I have never been vaccinated for it and askin…

It seems like healthy people that tend to power through the flu are the ones most prone to spread it far and wide, especially to those most vulnerable.

Re: “The Problem Child of Seasonal Flu”: Beware This Winter’s Virus

#34

Post by nonbel » Mon, Jan 22, 2018, 8:45 PM UTC

lutorm wrote: post #28

opportune wrote: post #20

Earlier quoted context omitted.

I suppose if it's only 0.001% effective it would not be worth it, but that's really a pedantic nitpick because we know it's not that ineffective. The vaccine this year is about 32% effective against H3N2 in the US and 39% effective overall [0]. That's not amazing but it's definitely "worth it" for a few dollars and 5 minutes at a CVS. [0] https://www.cdc.gov/flu/about/season/flu-season-2017-2018.ht...

All I had to do was take time out of my day to go to the pharmacy, copay with my insurance was $0. Which just makes sense from a financial point of view for the insurance companies, too.

This gives an inaccurate assessment of the cost. Obviously you are paying for the shot by paying more for insurance (either directly or via taxes or via taxes spent on that rather than some other government service you could take advantage of).

My point is that you can't say something "is worth it" without considering both costs AND benefits (I have recently seen friends get so ill they almost got fired because doctors ignored the side effects of prescriptions). Also, costs aren't zero just because they were prepaid or deferred.

Re: “The Problem Child of Seasonal Flu”: Beware This Winter’s Virus

#35

Post by opportune » Mon, Jan 22, 2018, 8:46 PM UTC

nonbel wrote: post #26

opportune wrote: post #20

Earlier quoted context omitted.

I suppose if it's only 0.001% effective it would not be worth it, but that's really a pedantic nitpick because we know it's not that ineffective. The vaccine this year is about 32% effective against H3N2 in the US and 39% effective overall [0]. That's not amazing but it's definitely "worth it" for a few dollars and 5 minutes at a CVS. [0] https://www.cdc.gov/flu/about/season/flu-season-2017-2018.ht...

Basically your argument is that the costs of getting the vaccine are so negligible they can be ignored? What about side effects? https://www.cdc.gov/flu/protect/vaccine/general.htm

Yes, they exist and aren't that common/severe. I mean at the end of the day it's a personal decision and if you're already unhealthy I understand why you wouldn't want to get the side effects. The problem is one of ignorance: people don't even know what herd immunity is and why it's important. In my opinion the side effects pale in comparison to the effects of getting the flu and are not a big "sacrifice" to make whatsoever - but you need to understand the importance of herd immunity to make a truly informed decision

I'm not going to continue replying to this conversation because I can sense that it's going to become unproductive

Re: “The Problem Child of Seasonal Flu”: Beware This Winter’s Virus

#36

Post by zeveb » Mon, Jan 22, 2018, 8:47 PM UTC

framebit wrote: post #19

Personal anecdata about this flu season. I got the flu shot. My spouse did not. They ended up getting the full-blown flu with 103 degree fever and a positive flu test at the doctor. I, on the other hand, felt kind of crappy but I wasn't knocked on my feet and my temperature was normal the whole time. I asked our doctor if I essentially had a milder version of the flu because I got the shot and he said that was basica…

> My spouse did not. They … I asked our doctor if I essentially had a milder version of the flu because I got the shot and he

Odd, I would have thought you'd be more familiar with the gender of your spouse than that of your doctor grin

Re: “The Problem Child of Seasonal Flu”: Beware This Winter’s Virus

#37

Post by ravenstine » Mon, Jan 22, 2018, 8:47 PM UTC

I just wish that people who get infected would wear a freaking mask when going out in public. I've heard that masks don't do much for people who aren't infected, but I imagine a mask would catch a lot of the droplets that come out of someone's mouth when they cough.

I've never been more glad to live alone.

Re: “The Problem Child of Seasonal Flu”: Beware This Winter’s Virus

#38

Post by moultano » Mon, Jan 22, 2018, 8:51 PM UTC

http://www.virology.ws/2009/06/02/pathogenesis-of-influenza-...

To keep your coworkers from getting the flu, go home as soon as you think you might be coming down with something. The amount of virus you are shedding into your environment is nicely exponential in how bad you are feeling, with one exception: The day before you start feeling really bad, you are shedding nearly as much virus as when you are feeling worst.

If you have to choose, it's better to go home early and come back before you are feeling 100%, than it is to stay at work until you are certain you are sick and stay home longer. It's always better to shift your sick days earlier in the illness.

Re: “The Problem Child of Seasonal Flu”: Beware This Winter’s Virus

#39

Post by knodi » Mon, Jan 22, 2018, 8:54 PM UTC

liveoneggs wrote: post #2

tell me about it. This year my entire house got flu at the same time and, ten days after my fever is gone, I still feel a little down. I have no idea how my kids really feel but my kid has a nasty cough and the other one seems a little "off/tired".

Ya this, for years I didn't know what getting the flu really felt like, it was always couples days and I'm fine but in 2016 I got the flu and it wrecked me for 2 weeks. Doctors confirmed it was the flu. Now I'm the first one in line for a flu shot every year.

Re: “The Problem Child of Seasonal Flu”: Beware This Winter’s Virus

#40

Post by apendleton » Mon, Jan 22, 2018, 8:58 PM UTC

nonbel wrote: post #15

opportune wrote: post #13

This article is good and reminded me of a key issue: herd immunity. I wish I could explain to more of my friends how irresponsible it is to not get the flu shot - they view it as simply an individual decision like "I'm choosing to not get the shot knowing full well I might get sick" - but they don't think of the possibility that if they do get sick, they may play a part in infecting other , more vulnerable people, su…

>"Even though the vaccine isn't that effective this year, as long as its at least somewhat effective in mitigating transmission, it's worth it" How can you tell if something is "worth it" without considering any costs (side effects, price, time, etc)?

You should consider costs. This tradeoff is a large part of what the field of epidemiology studies. Turns out vaccines don't need to be that effective to be worthwhile, because of the way disease spreads. There's this concept of a "reproduction number" (r-naught) that predicts how many people a given infected person will pass the disease to, based on a combination of the virulence of a disease, how long infected people remain contagious, how much contact people have with each other, etc. The flu often has a value of around 2, meaning the average infected person will infect two others before they're over it.

You can use this number to estimate how fast a disease will spread, how likely it is to be successfully contained, or in the case of seasonal diseases, how many people will get it before seasonal societal changes (school getting out, people spending more time outside, etc.) will effectively curtail transmission for the year.

Looking at a vaccine on an individual basis, if it's only, say, 50% effective, that sounds pretty awful -- maybe almost not worth the bother. But on a society-wide basis, if every person were vaccinated, that would effectively knock the R0 value from 2 to 1, which is huge. Transmission is exponential: if you infect two people and they infect two people and they infect two people, etc., the total number of infected looks dramatically different than if everybody only infects one person. So in isolation it's only 50%, but societally, with high vaccination rates, there's a huge multiplicative effect that has the potential to dramatically reduce each person's risk of infection if vaccination rates are high enough. And that's still true even if it's even less effective than 50%, and has all sorts of economic and social consequences.