Does Not Getting a Flu Shot Make Me an Anti-Vaxxer?

If there’s one time you should follow the herd, it’s when it involves immunity

Last year, I didn’t get a flu shot. It wasn’t because I don’t believe in them, or because I think that I’m an especially virile man whom illness cannot penetrate. I just forgot, or rather, I never really made it a priority. But I know how dangerous not getting a flu shot can be, and how vulnerable certain people are to the flu, which kinda makes it a dick move. Or maybe it’s even worse than that — maybe I’m more than just a dick, maybe I’m technically one of those asshole Anti-Vaxxers?

“By getting vaccinated, you reduce the chance, very profoundly, that you can spread the flu to other people,” says William Schaffner, an infectious disease specialist at the Vanderbilt University Medical Center. “You don’t want to give it to your Aunt Sally, who’s 70 years old and has diabetes and who may get complications from influenza (including pneumonia) that may land her in the hospital.” He also explains that some people who have had cancer or other illnesses that require immunocompromising drugs may be put at risk. “These people don’t respond very well to the flu vaccine, so we protect them by having everyone around them vaccinated,” says Schaffner.

The thing is, even if the elderly or sick do get vaccinated, the flu vaccine is way less effective for them. There may not be one specific reason reason why the vaccine is ineffective on these groups, but environmental health professor Donald Milton, of the University of Maryland School of Public Health, explains, “The elderly are more vulnerable because their immune system doesn’t respond well to lots of things. Also, they’ve had a lot of different flus over the years, and when they get the vaccine, the antibodies they already have may prevent the vaccine from creating the new antibodies.”

He also cites studies on mice that showed that when you vaccinate young mice, they make two kinds of antibodies — one in the blood, and another that coats the respiratory tract. However, with elderly mice, they only created the blood antibodies, which may not be sufficient — and may be similar in elderly humans. As for those with compromised immune systems, their systems can’t quite create the antibodies needed to fight off the flu. With infants, their systems aren’t developed enough to effectively build the antibodies needed.

Part of understanding the dangers of not getting a flu shot has to do with understanding what “herd immunity” is. “Data shows that when you vaccinate large populations of young people, which includes school children and young parents and young adults, you can protect those vulnerable groups,” says Milton, by creating an immune “herd” of people. So if people are vaccinated, not only do they help block the flu from infecting them, if they come into contact with an infected person, they basically don’t give the flu anywhere to go. This means they can’t carry the flu either, as many people (20 to 30 percent) can carry the flu without ever showing symptoms.

The effectiveness of herd immunity depends entirely upon how immune the population is, versus how contagious the illness is. Milton cites the example of the measles, which he says can “spread nine infectious doses per second in the air around an infected person.” When you consider that, it’s easy to understand how measles can currently be spreading throughout Europe and New York City.

Schaffner adds that there’s sufficient data to support the idea that anti-vaccination activists have created whole communities of vulnerable children. On a global scale, the the Council on Foreign Relations has developed an interactive map that illustrates the devastating results of the global anti-vaccination movement, much of which is predicated on the idea that vaccinations cause autism, a theory which there’s absolutely no scientific basis for whatsoever.

But back to the flu (which Milton says can spread about one infectious dose per minute): Last year was a hell of a bad one for the flu, where a record-breaking 80,000 Americans died, according to the CDC. So have I played a part in this by not getting the shot? Have I, in short, effectively lumped myself in with the regressive anti-vax mob?

“The studies simply haven’t been done,” says Milton, explaining that we don’t have the data to support such a comparison. And emergency medicine doctor Benjamin Wedro feels that, since the flu vaccine is a “one-off immunization and only works for a specific virus for a short period of time,” it was a little like comparing apples and oranges.

As for Schaffner, he tells me that while anti-vaxxers are often also against the flu vaccine, he believes the biggest problem with the flu vaccine isn’t so much intent as it is a lack of intent (i.e., me, forgetting to get it done). “It’s a pain in the ass to get every year,” Schaffner admits, before adding, “Now that you can get it at the drugstore, at many employers, in your doctor’s office and even in some grocery stores, your excuses are getting harder to come by.” Which, yeah, fair.

I also reached out to the CDC to see what they had to say on the subject. While they didn’t directly answer my question of whether or not this made me anti-vax, they did point out, “If vaccination rates increased by just 5 percentage points across the entire population, another 483,000 illnesses, 232,000 medical visits and 6,950 hospitalizations associated with influenza could be prevented.” Basically, in much the same way that a small percentage of people can have a devastating impact and spread a disease, a small group of people can also have a major impact in not spreading it.

So, if you’ll excuse me now, I’m going to go get a flu shot.