10 replies to this topic

[Garris]

Hi everyone,

     I found out from my employer (Rhode Island Hospital) that our flu vaccine supply won't likely be in until Thanksgiving.  Considering I'm at high risk (as a healthcare provider), considering I've already suffered through two minor viral syndromes this season already (I'm feeling cursed), and considered my barber got his flu vaccine weeks ago, I wanted to find out where to get the flu vaccine in RI.

     Here's where:

     This website from the RI Department of Health lists vaccine clinics for the entire state.  

     Remember the flu vaccine does not prevent you from getting the flu (good handwashing; avoiding touching your nose, mouth, and eyes; staying away from likely infected individuals; etc does help with prevention).  It just makes the flu far more mild and shorter if you get the strain you're vaccinated against.  

     The flu is serious business.  Consult the list and get your vaccine.

     Stay well everyone!

- Garris

[runawayjim]

is it really necessary to get the flu vaccine?  i've heard the pros and cons and a lot of people i know swear by it and about the same amount say that they've gotten it several times and each time, they got a nasty case of the flu.

from a purely scientific/evolutionary standpoint, wouldn't it be bad for lots of people to get the vaccine and then the flu just mutates again (my degree is in evolutionary biology)?  and wouldn't fewer (or zero) people getting it prevent it from mutating?

[Garris]

runawayjim, on Oct 19 2006, 01:47 PM, said:

is it really necessary to get the flu vaccine?  i've heard the pros and cons and a lot of people i know swear by it and about the same amount say that they've gotten it several times and each time, they got a nasty case of the flu.

Well, first, as I suggested, the vaccine is only protective against the strains that experts predict may hit.  It's still possible to get another strain.

The more important issue, which I've seen from my experience working in ER's and urgent cares, is that 99% of what people call "the flu" really isn't the flu at all.  Instead, people call run-of-the-mill upper respiratory viruses or viral syndromes "the flu," when they're hardly that.  So people saying, "I got the vaccine but still got sick that Winter!" doesn't mean much to me...

The most important reason for people to get the vaccine is that influenza kills upwards of 40,000 or so people in an average year, especially the high risk folks (elderly, immunocompromised, people with lung disease, people with heart disease, etc).  In theory, if you don't get it or get a more mild course because you were vaccinated, it makes you less likely to spread the disease as well.

runawayjim, on Oct 19 2006, 01:47 PM, said:

from a purely scientific/evolutionary standpoint, wouldn't it be bad for lots of people to get the vaccine and then the flu just mutates again (my degree is in evolutionary biology)?  and wouldn't fewer (or zero) people getting it prevent it from mutating?

My undergrad degree was in classical biology (especially evolutionary) too!   

Your question was one of the biggest mysteries in virology for a long time.  Why did strains of influenza pop up, cause pandemics, kill tens of millions of people in a year, then vanish?

While I'm the farthest thing from an immunologist or virologist, my recollection of the answer to this question is that the influenza virus has many, many strains that, due to its molecular methods of replication, have genomes that are in a constant state of flux, much of which actually has near zero to do with us.  That's just its natural state.  

Many experts are becoming convinced that strains which hit us hard (including the pandemics of the past, which popped up, killed millions, then vanished) had success not because they were superbugs that through evolution learned how to beat our immune systems, but because they essentially had random dumb luck.  

Thus, the flu's evolutionary mechanism of survival is its genome's inherent instability and mutations.  It does a million variations, throws them against the wall, and hopes something sticks.  While the virus will once in a while strike it big, that same instability prevents it from having staying power, and thus that strain vanishes by mutation just as easily as it popped up...

Fascinating stuff...  I recommend the book "Flu" by Gina Colata for those interested in the search for existing samples of surviving virus from the 1918 pandemic to study.  

So by that reasoning, there's no reason not to get vaccinated (unless you're one of those with a contraindication to getting it, which are also listed on that website)...

- Garris

Edited by Garris, 19 October 2006 - 02:42 PM.

[runawayjim]

great response.  evolution, in and of itself, is generally based on "dumb luck".  while we might be able to see and determine what traits will probably carry on, it's just about impossible to predict how a species will evolve.

i'll stick with not getting the vaccine, mainly because i've only ever gotten the flu once (although it was only 2 years ago), and it didn't stop me from going on the ski trip i went on.      i took the tamiflu stuff they gave me and that was that.

[Gusterfell]

Another thing to keep in mind with Garris' explanation is that a virus doesn't really want to kill its host.  A dead host won't pass the virus on to others, so a 'superflu' that quickly kills thousands isn't necesarrily as successful, from an evolutionary standpoint, as one that doesn't kill but manages to spread to millions.

[KRC]

I can say in my experience that I've really only had the flu once in my life back in 2002.  Up to that point, I thought I had contracted the flu on several occasions.  However, as I learned in 2002 those cases of illness were definately not the flu.  What I caught 4 years ago was the worst illness experience of my life and it was diagnosed as the flu.  (Thank you, Toronto!  I really enjoyed my visit. )  I was out of work for a full week and it took me an additional 2 weeks to get over the effects.  I think what caught me off guard the most was how sick I really got.  I was completely unfunctional.  There was no way I could follow my normal life routine at all.  On top of the high fever, congestion, chills and cough you get a nice slice of heaven with the addition of severe body aches.  I mean "don't touch me" kinda stuff.  While it may not be a perfect protection barrier, the shot will at least give you some protection.  I, personally, get one every single year.

To runawayjim's point, I didn't see the doctor until 3 days after my symptoms began.  I didn't get Tamiflu (if it was even available at the time.)  Maybe earlier detection would have made the difference for me.

[runawayjim]

KRC, on Oct 27 2006, 06:42 AM, said:

I can say in my experience that I've really only had the flu once in my life back in 2002.  Up to that point, I thought I had contracted the flu on several occasions.  However, as I learned in 2002 those cases of illness were definately not the flu.  What I caught 4 years ago was the worst illness experience of my life and it was diagnosed as the flu.  (Thank you, Toronto!  I really enjoyed my visit. )  I was out of work for a full week and it took me an additional 2 weeks to get over the effects.  I think what caught me off guard the most was how sick I really got.  I was completely unfunctional.  There was no way I could follow my normal life routine at all.  On top of the high fever, congestion, chills and cough you get a nice slice of heaven with the addition of severe body aches.  I mean "don't touch me" kinda stuff.  While it may not be a perfect protection barrier, the shot will at least give you some protection.  I, personally, get one every single year.

To runawayjim's point, I didn't see the doctor until 3 days after my symptoms began.  I didn't get Tamiflu (if it was even available at the time.)  Maybe earlier detection would have made the difference for me.

when i got it, i didn't go to see the doctor for a couple days because i thought it was a cold, but it never got any better (not any worse, just not better), so i went and they did a flu test.  the place i went (statcare in warwick, a walk-in emergency care clinic) seemed to take it very seriously because they told me i couldn't go to work and gave me a doctor's note and everything.

[jencoleslaw]

UP Meet UP!!!

Providence   11/10/06   Noon-3pm   Biltmore Hotel    11 Dorance St.   $22  Walk-in

[Garris]

runawayjim, on Oct 27 2006, 07:21 AM, said:

when i got it, i didn't go to see the doctor for a couple days because i thought it was a cold, but it never got any better (not any worse, just not better), so i went and they did a flu test.  the place i went (statcare in warwick, a walk-in emergency care clinic) seemed to take it very seriously because they told me i couldn't go to work and gave me a doctor's note and everything.

Hehe.  I giggled a bit reading your story.  There certainly are people I've seen with mild symptoms who test positive for the flu (whether those people have a run-of-the-mill upper respiratory virus and test positive for the flu because they are briefly colonized but never really get full blown infection/symptoms is another story).

In general, though, your overall health and age matters.  The flu will likely slam a 25 year old into the ground a lot more than a 15 year old, and a 35 year old a lot more than that 25 year old, and so on and so on.  

Again, though, most flu experiences are like KRC's and they have NO question that they've got the real deal.  I used to see young 20-something year olds in the urgent care setting and the flu was really the first real significant health threat they'd ever had.  They were soooo panicked!  They'd say, "Help me!  I'm dying!!!" and, "Wow, this experience is really making me question my mortality..." and, "Wow, I am so NOT immortal after all!"  

My last time getting the flu was, I think, Winter of 2002-3, the only year I hadn't yet gotten vaccinated.  I was so sick.  My residency (a medical residency!) wouldn't give me time off, despite the fact I was working in the intensive care unit!  They had me wear a mask.  I was so useless.  I'd barely stay upright all day and would go home and sleep dead to the world, shaking in my own sweat in bed, for like 14 straight hours.  It was terrible...

- Garris

[runawayjim]

i'm the same person who had mono and thought it was just a short bug.  actually... being a gastro-guy, you might appreciate this story...

i was working in a high school in CT at the time (in fact, it was just after i got the job offer here in providence and i was finishing up my last 3 weeks at the high school).  it was the week before thanksgiving week.  i went to work on monday feeling like i had a bad allergy attack, which wasn't uncommon for me.  didn't get better on tuesday or wednesday, felt like a mild cold.  thursday came and i woke up and threw up even before my shower.  i called out sick that day because my stomach is made of steel and that never happens unless i drink too much.  i ended up spending almost the whole day in bed.  friday came and i woke up to go to work and i still felt a bit out of it, so i called out sick again figuring the weekend will help.  i slept a lot that day, but not as much as the previous day.  the weekend helped and on monday i was back in work.  well... on monday i noticed after going to the bathroom that the whites of my eyes were all yellowy orange (like the color of the yellow stripe at the top of this page).  i knew there could be something serious.  so i went to the doctor and they did all sorts of bloodwork (i had no insurance... it was $500 worth of bloodwork).  turned out i had mono and it did something to my liver.  so i started my job here in providence looking like an alien.  someone told me they thought i was "ethnic or something".  i laughed since my last name is clearly italian.  anyways, it took 3 months of blood tests every 2 weeks (and the people at quest were so bad it looked like i was a heroin addict) and seeing a gastro-enterologist here in providence before the jaundice left.  the worst part of it was that it made my whole body really itchy to the point where i scratched off a lot of the hair on my legs.  that was not a pleasant experience.

so anyways... i don't get hit with sickness too hard, which is probably why testing positive for the flu may have been the flu, but it wasn't hard hitting... since my case of mono barely affected me (although it stumped the gastro guy as to why the jaundice woudln't go away).

[JJK5]

Just saw this on Digg, curious what you all think.

http://www.medicalne...hp?newsid=55301