Lots of interesting thoughts today. Since my life is all H1N1 all the time right now, may I respond to some posts?
Ian, I so agree that part of the reason vaccines freak people out is the needle. It's one of those lizard brain things, the way we all instinctively fear snakes and falling off cliffs. We are programmed to avoid painful things. Couple a painful thing with NO IMMEDIATELY VISIBLE BENEFIT and it's easy to see why vaccines are scary to people. I think it's basically a premodern suspicion/gut feeling that people then wrap in a vaguely scientific-sounding objection (e.g. "I heard there is too much thimerosal", "what about the squalene?" etc) so as not too appear too superstitious. All the disease and death averted by vaccines is too abstract and diffuse for people to grasp on that basic intuitive level at which this fear operates. Maybe the nasal spray vaccine will help with this a bit.
Other things that contribute to fear of vaccines are the common feeling, call this the parental guilt factor, that if a child gets an extremely rare side effect of vaccines, you the parent did that to him, while if a child gets a vaccine-preventable disease, then that was just sheer bad luck. People consistently prefer errors of omission to those of commission, even if the error omission is demonstrated to be more harmful. It's well known form of cognitive bias:
"Herd" immunity is definitely uninspiring and vaguely bovine. It's unfortunate, because if it could be rebranded as "group" immunity or "protecting the vulnerable" who can't get vaccinated, like Scruggs' daughter, I think it would be much more appealing to people.
I agree, the corporate malfeasance of drug companies and their cozy relationships with doctors (all those professionally flirtatious drug reps with their briefcases full of company-branded loot), the disgusting ghost-written journal articles, and the company names all over every physician's pens and post-it notes... there's enough atrocious conflicts of interest, profiteering and influence-peddling to make anyone suspicious of Pharma and their products.
LFMD: I am so sorry to hear about your husband's grandfather. Guillain-Barre syndrome is a frightening thing. It's important to note that many things cause it, including influenza infection itself, along with a lot of other bacterial and viral infections (and thus, if a flu pandemic was avoided by the vaccine, overall the number of GBS cases is lower than it would have otherwise been!) Over the last 20 years, we estimate that there has been 1 additional case of GBS for every million persons vaccinated for seasonal flu. So is this increase in risk worth it? From a public health perspective, in terms of severe illness and death from flu that has been avoided, definitely. But it's hard to say that when it is you or someone you love who is that one person with the rare side effect.
Claverack Weekender: "Flu vaccine = ok. H1N1 vaccine = questionable." H1N1 vaccine is a flu vaccine, made in the same way by the same methods as the regular seasonal flu vaccine. The only difference is the type of antigen (the H and the N stand for different protein fragments from the outer viral coat) included, which always changes from year to year anyway. In fact, if H1N1 had emerged earlier in the year it would have just been included as one of the strains in the regular seasonal flu vaccine. "note if you do get it that some forms contain thimerisol and FDA seems to have reserved the right to add squalene, too". I discussed this in my post a few days ago. Thimerosal-free vaccine is available. The US flu vaccine does not contain squalene. But we are studying some squalene-containing vaccines -- like the ones approved in Europe -- just in case the flu pandemic takes an unexpected much more severe turn (with 1918 type death rates), because this would allow lower doses of vaccine to be given and let us stretch the vaccine supply to cover many more people.
Schultz, this disease is not "more mild than seasonal flu". It is as or more severe, and affects a population that is not at high risk for severe disease from seasonal flu -- children and young adults. Neva is right, even though most will recover uneventfully and only a small percentage will require ICU care or die from H1N1, this will still be a lot of kids and young adults, since they have no immunity and tons of them are getting sick.
Amy, you don't have to put a needle in your arm. You could get the nasal spray instead. "Also, my neighbors (and kids' playmates) get the flu shot every year. 2 out of the last 3 years, they have ALSO gotten the flu. What is the point if it might not even work?" Actually, the H1N1 vaccine works very well. The thing is, there are lots of viruses that cause colds. People often say they had "the flu" when they mean a bad cold. I doubt that your neighbors' kids were really infected with the flu strain in the vaccine. The same logic applies to people who claim that the flu vaccine gave them the flu. This is just not possible, but it is very possible they were coming down with something at around the time they got the shot.