'Tis the (flu) season

Ahh, fall.... cooler temperatures, changing leaves, and ... sneezing?

Judging from the bombardment of ads I see everywhere, it must be flu season. I wouldn't know, since the last time I think I had the flu, I was about nine years old.

Given my propensity to question authoritative figures (especially if they don't give me much of a good reason to listen), I've been on heightened alert for things like ads, billboards, and even register tape reminders about getting my flu vaccine. And I'm also paying attention to things like high drama, scare tactics and all-out pandering to the lowest common denominator to coerce, convince and cajole us into getting the shot.

These two billboards are sitting in a corn field down the road from my house. I sped by them one day, almost scaring my family as I nearly hit the brakes in disbelief.

Marketing technique #1: Using big, scary-looking font. That really gets their attention. (As a graphic designer, I'm all about the fonts.)

Technique #2: Make ambigious statements that make the average passer-by say, "Well, they say it's safe, so it must be." Never mind that there are no sources or mention of risks at all (there isn't that much room, anyway).

Technique #3, perhaps the best one of all: Use the cute, smiling kid to tout your product. Nothing says "I got vaccinated and I'm just fine!" more than the grin of a pigtailed child.

This one is bold, yet sly, at the same time. The urgency (in that big, bold font) is almost implying that health officials are lying in wait for you to pass, stopping your vehicle and asking for documentation that you have been vaccinated. Notice, though, the interesting use of a cell phone and truncated (if not totally annoying) "internet speak" that often appeals to the younger generation (those whippersnappers!) - who seemingly are more healthy than those who are most at risk for the flu, like the elderly and those with compromised immune systems.

Saying "Stop the flu before it stops you" is implying that something bad - really bad - might happen if you don't get the shot. You might be miserably ill, perhaps even miss school or work - for at least a week, maybe not even. That sounds bad. Like it might stop me. From going to work. Yeah, okay.

Target, I noticed, is offering some kind of flu shot program and is touting it left and right - I saw banner ads on their website as well as on my register receipt after making a purchase. Their marketing technique is a little more subtle, sort of giving you a gentle nudge - rather than screaming in your face like the county government does. How ironic.

"Your timing is perfect - we have flu shots! So give it a shot - come on, you know you're skeptical and riddled with fear but too afraid not to get one, so just go ahead! Dooooo it!"

This one offers you a $5 gift card if you get the shot.
Bribery works wonders. 

Now, again, if you're already ill and have a compromised immune system - like the elderly, for example - I can agree that the flu might present more serious complications for you and it's probably worth getting protected. Some say the flu vaccine can cut the risk of serious complications and death in older people up to half.

However, there is some speculation that perhaps the vaccine doesn't work as well in older people as once thought. Although it's anecdotal, I know my grandfather got the flu vaccine every year and, if I remember correctly, still got the flu. This is possible, as the vaccine admittedly does not work for everyone - it's estimated to be ineffective for about 30 percent of the population, apparently. Perhaps for my grandfather, he was one of that 30 percent. And after his last flu vaccine, my mom said, he just wasn't the same - and it was all downhill from there. He eventually died a few months later.

Could it have been from complications of the vaccine? Who knows. We probably will never know, and it seems like if it doesn't reach out and smack you over the head literally minutes from getting the vaccine, most health officials are completely unwilling to correlate the two. Perhaps because that would scare more people away from getting the shot, ya think?

This article from the Washington Post acknowledges that the government, especially, has often used fear as a heavy-handed scare tactic to "encourage" you to get vaccinated. There is probably a lot of wheeling and dealing going on behind the scenes - perhaps from the pharmaceuticals industry - to ensure that you keep buying what they're selling. If more people realized they were being used as tools perhaps they would second-guess waiting in line for two hours on a rainy afternoon to get that much-coveted flu shot.

I remember seeing a huge line of people at the mall one year, complete with security guards standing by - and wondered, "Are they buying concert tickets or something?" Then I looked at the crowd - which mostly consisted of older people in wheelchairs, and realized, They're waiting for the flu vaccine. As far as the elderly are concerned, there is some data to suggest that actually, many of them are already immune to several strains of flu - including H1N1 - because of living through past epidemics. Which means you waited in line for nothing, basically.

"Lab tests showed that some adults, particularly those older than 60, had antibodies against the new strain, but Dr. Anne Schuchat of the CDC cautioned against reading too much into the finding. 

"We don't know yet what that will mean in terms of actual immunity or clinical protection," she said on a conference call with reporters.

Which means, don't get too excited - just keep getting that flu shot. If we had a crystal ball (or lots of money to do additional tests) perhaps we'd find that more people wouldn't get H1N1 in the first place. Unfortunately the cost of blood draws might equal the cost of the flu shot. 

Common myths about the flu pervade, according to this article. Health officials say "It's impossible to get the flu once you've been vaccinated," (because the shot doesn't contain the live virus), but actually it is - because either you're part of the percentage in whom it was ineffective or because the particular strain you got is not even included in the vaccine. So you got the shot and go the flu.

The article also says that side effects of the flu shot are a "myth." I don't really consider listing soreness at the injection site and a case of the sniffles to be adequate counsel on the true side effects, which are no doubt uncommon but still exist. Several sites say that Novartis, the makers of Fluvirin, admit in their package insert that possible side effects can include paralysis and Guillain Barre Syndrome, which can cause paralysis and even death. However, the one package insert that I found lists it as a possible side effect, but only in connection to the 1976 swine flu outbreak, in which an elevated number of cases were reported after people received the vaccine. In other words, it sounds like they use that case as a scapegoat and want to distance themselves as much as possible from the possibility, perhaps in hopes that you'll say, "Oh, that happened 35 years ago - I don't need to worry about that."

The article, titled "Flu: You're not immune," ponders whether getting the flu can improve your immunity. 

“The natural immunity you build is usually more durable than the immunity you acquire from an injection,” acknowledges Dr. Raymond Strikas, associate director for an immunization program at the Centers for Disease Control and Prevention. “However, why run the, albeit small, risk of a serious illness when it is much safer to get the vaccination?”

The language many flu vaccine advocates use sounds serious, their tone warning - as if you are completely incapable of making the decision on your own free will. "Getting the flu is not a good idea," says one American Medical Association specialist. Of course you'd say that; you work for the American Medical Association. "The primary reason is that the influenza virus undergoes antigenic variation, so on a yearly basis the strain undergoes change." That's a fancy way of saying, according to the article, "Getting this year's flu doesn't necessarily prevent you from getting next year's flu."

(It also means getting this year's vaccine doesn't protect you from this year's flu, either, if you get infected with a strain that isn't included in the shot. You kind of glossed over that part.)

Reading between the lines here, I'd say even the CDC guy reluctantly admits the risks of "serious illness" are rare. Glossing over the reality of it, he basically eases into the guilt trip and encourages you to get the shot, even though it might not make a difference either way. 

The Cochrane Review did their own study, which basically found:

Influenza vaccines have a modest effect in reducing influenza symptoms and working days lost. There is no evidence that they affect complications, such as pneumonia, or transmission.

Rather surprisingly, they also acknowledged that nearly half of the trials were "funded by vaccine companies" and "company-sponsored influenza vaccine trials tend to produce results favorable to their products..."

The review showed that reliable evidence on influenza vaccines is thin but there is evidence of widespread manipulation of conclusions and spurious notoriety of the studies.

Something to think about before you get your next flu shot.