to inject or not to inject, that is the question

to inject or not to inject, that is the question

Last week I took my wife and children for our yearly family flu vaccination.  The one Elysa used to call her ‘flea shot.’  Lord knows we’ve had enough fleas; if that would work, I’d consider it.  But I digress.

The same day, I went to work and found that the employee health/infection control folks were offering H1N1 vaccines.  I was told that as long as I took it in the opposite arm, I could go ahead and have mine.  So, possessor of two punctured arms, I went back to work and felt fine.  In fact, that was four days ago and I still feel fine.

It turns out that only two people in our department took the vaccine that day.  Myself and one of our young nurses, who is adorably giddy with her first pregnancy.  No one else wanted it; not yet, anyway.  The unit clerk, the charge nurse, the other nurses, the PA and second doc, all refused.  ‘I may get it later,’ they said.

Many of them have heard concerning reports, or concerning rumors, about the vaccine.  Some of what they fear is simply untrue.  Some of what concerns them could yet prove to be true.  Some say, ‘I’ve never taken the flu shot, and I’ve never had the flu.’  Others say, ‘the flu vaccine routinely is produced for the wrong virus, I’m not getting it!’  Some believe the hype is government generated, some believe the media drives it all.

I guess  I’m simple.  ‘They’ tell me we need the H1N1 vaccine because it’s a potentially dangerous virus, and we’ll be caring for patients infected with it.  I shrug.  Sleeve up, I present my deltoid.  It’s a done deal.

Others are angry, and I have to say I understand.  No one came to the department with a file of explanatory information, or a question and answer sheet about common misconceptions.  They came and said, fairly abruptly, ”Take the shot, or for the entire flu season you have to wear a mask if you’re within six feet of a patient.’  Their explanation, all too simple, is ‘we have to protect the patients from the staff!’

A fine time.  Few concerns in the past about protecting us from schizophrenic patients who are aggressive; few concerns about protecting us from potential TB patients; few concerns about shielding us from abusive drunks or drug seekers.  But this time?  Beware nurses bearing influenza?

I’m a believer in vaccines.  I mean, I get a tetanus shot, I’ve had the HepB series, my kids have had their childhood immunizations.  I even give my animals rabies shots, right?  Granted, it’s a vaccine that’s been around a long time, and its side-effect profile is pretty well established.  Oh, and EVERYONE dies if they actually get a rabies infection.  Flu?  Not so much.  I really don’t want to bring H1N1 home. Especially an unpredictable strain like this one, when I have four children, one with insulin-dependent diabetes.

But listen closely, people in charge.  First of all, mandatory needles are an affront to the American idea of freedom.  We’re all about fed up with mandatory anything.  Government paternalism is growing at a terrifying pace.  So back off of the heavy-handed rules.

If you want medical personnel, or anyone, to take the darn thing, educate them and answer their questions.  Don’t demean them, don’t talk to them like they’re flat-earth nuts.  Frankly, their are unresolved questions, both about H1N1, and about the vaccine.  Sometimes, even in an age of ‘evidence-based medicine (which can too easily deteriorate into ‘authority-based medicine’), the evidence is just murky.  Sometimes, even the questions are unclear.

I’m not afraid of this vaccine.  Every medicine has risks.  I am concerned about the risk of a dangerous pandemic; history has frightening lessons for us.  But I’m also very concerned about the very real risk that in our snooty, self-righteous panic, we’ll have an epidemic of lost freedom, lost self-determination and an acute anemia of good thinking.  On both sides of the vaccination debate.


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