Wednesday, January 2, 2013

Flu Shots

This year will mark the first time I have ever received a flu vaccine and I only did so because it was recommended by our doctor as a way to protect our as-yet-unborn son. While my trepidation concerning influenza vaccination is hard to explain, it is not derived from a lack fear. I had a full-blown case a few years ago and it took the combined effort of two boxes of Tamiflu, ten days on the couch, and a member of the Lutheran clergy to relinquish its hold on me. Things looked so grim that I was afraid my wife was going to change her Facebook relationship status and start dating again.

I also understand the sound logic behind herd immunity (the idea that once you immunize north of 80% of the population the other 20% are protected by default) but I still cannot shake the perhaps irrational fear that we are coddling our immune systems. There are even some who believe mass immunization is forcing the mutations responsible for the virus’s continued prevalence. While I do not believe we possess the empirical evidence necessary to make that determination, we do know that some of the deadliest flu pandemics occurred when a new strain of the virus made the jump from animals to humans. The inaccurately-christened “Spanish Flu” pandemic of 1918 infected one-third of the world’s population and is estimated to have killed more than twenty million people making it comparable to the Black Death.

Strangely enough, those most vulnerable to this strain were young, healthy adults. One study places 99% of the United States fatalities occurring in those under the age of 65. One theory is that the virus caused an overreaction of the host immune system which would explain why the strongest immune systems proved to be the biggest liability. Others point to the fact that many of those over 65 in 1918 would have been exposed to the Russian flu pandemic of 1889 and therefore developed a resistance to closely-related superbugs.  In either case, there were no vaccines in place to force these mutations so in many ways their existence remains a mystery.

This leads us to the plight of hospital workers. Many states, like Connecticut, have seen hospital employees terminated for refusing to get the flu shot. If the employees do not qualify for a medical or religious exemption, they are placed on unpaid leave or permanently replaced. This has caused some heated disagreements concerning whether or not an employer should be able to fire an otherwise competent employee for not receiving an injection.

Certainly those working in acute care facilities have a greater responsibility to guard themselves against infectious disease than, say, a forklift operator, but how far should the employer go to coerce that person into healthy habits?  Should they fire obese smokers or people who date Brett Michaels just because their lifestyles could lead to communicable diseases? On the other hand, they provide religious and medical exemptions so what possible excuse could the holdouts have? We ask the surgeon to wash their hands, this is not much different.

In the name of tempering personal freedom and public responsibility, I have devised a solution: cash money. Each employee that voluntarily receives a flu shot will be entitled to a one-time bonus of $250 and if for some reason they still miss work because of the flu, the sick days that they use to recover will not count against them. This provides a tangible, monetary incentive for compliance while reassuring the employee that their company did not save money by injecting them with a placebo. I imagine those with religious objections will renounce them and those medically exempt will earn their $250 by publicly ridiculing non-participants until they comply.

Currently, the CDC recommends that children be vaccinated against sixteen different maladies from chicken pox to mumps and there has been blowback from a minority of parents who feel all of these vaccinations are leading to other conditions such as autism. What the medical establishment is forgetting is that the only thing America hates more than a preventable tragedy is being forced to take steps to prevent a tragedy.

That is why the CDC needs to create better titles for these diseases that terrify the populace into making the right choice. Let’s be honest, “Rubella” sounds like an Eastern European exotic dancer and “mumps” sounds like a second tier Muppet character. It is difficult to frighten people into submitting themselves to injections if they are not properly frightened.  I can guarantee it would not take much arm twisting to convince Bill from marketing that he needs to take precautions against “Black Death” or “typhoid fever” since the name alone conveys the proper sense of impending doom. 

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