3 ms·

> The general advice knowing nothing about you is to get the flue shot. A doctor looking at you can tell if your BMI is over 40... The general advice should be

> The general advice knowing nothing about you is to get the flue shot. A doctor looking at you can tell if your BMI is over 40... The general advice should be for people that are otherwise healthy, or be very specific about the risk factors being considered for the average case. Someone with a a BMI of 40 should be worrying over a whole lot of other things beyond the flu, and conversely it makes no sense to advise overall healthy people to be taking any type of drugs just because the risk is not that high. Granted, this calculus changes with infectious diseases with high fatality rates. This is why it's absolutely sensible to recommend everyone to be vaccinated for measles (1-2% IFR) and polio (5% IFR for kids, 20+% IFR for teenagers), but questionable to apply the same logic to something like influenza which is 100 to 1000 less fatal (0.01% IFR) and when fatality rate is highly concentrated (75%) on 65+ people.

Retric 2y ago
> The general advice should be for people that are otherwise healthy Not from a public health standpoint unless healthy people would actually be harmed. 1/3 of adult Americans are obese. It varies by country, but add in various other health issues and risk factors like smoking or being around lots of other people at work and most people have some risk factors elevating their benefit from minimal to meaningful. So as everyone benefits at least a little and some people get a very significant benefit the general recommendation is for everyone over 6 to get a flue shot.
- rglullis 2y ago
  Obesity is not contagious. If obesity is a risk factor, then by all means include that in the list of people who the vaccine should be recommended. Mind you, the flu virus is highly mutable. Vaccinating healthy people does very little for "herd immunity" because most vaccines contain only year-old strains and at best it will not prevent infection but merely reduce the window of time where people are contagious.
  - Retric 2y ago
    Health messaging works better the simpler the message. Start listing 4 dozen at risk groups and people stop reading the list. Even if you’re healthy simply spending less time sick is a meaningful benefit. Perhaps you only get the flu one year in 20, that’s still a world of suck you can largely avoid. And frankly it only gets better from there.
    - rglullis 2y ago
      Your argument is resorting now to a very crude defense of white lies and Pascal Wagers. Not only this is borderline unethical to be used as support for any serious, national-level health policy, it is also bound to backfire and create even more suspicion from those who are not ideologically aligned with the Government du jour. In other words, if your health messaging is hiding crucial details because more information "is less effective" (at what? Informing or getting people to comply to a certain pre-defined plan?), then don't complain later when people share videos online about "what they don't want you to know".
      - Retric 2y ago
        > white lies and Pascal Wagers What white lies? Same deal with a huge number of other heath issue, you can tell basically anyone to exercise more and it’s good advice. Not for Olympic athletes, but from a public health perspective “get up a move” is a perfectly reasonable message. > at what? Keeping people healthy. The idea that the only possible benefit is saving your life is moving the goalposts on health policy. You specifically would benefit from getting an annual flue vaccination. Your doctor’s recommendation that it’s not something to stress about is likely correct, but it doesn’t somehow mean getting it would be a net negative for you personally. Skipping it isn’t a big deal for you, so if you’re stuck with some irrational fear then no big deal. But would you benefit? Yes.
        rvnx 2y ago
        There is a difference between irrational fear, and the situation here, which is about not willing to self-inflict pain and days of suffering for a potentially helpful vaccine. The physical pain and struggle that you endure during vaccination is very real (you fight the spike protein fragment) versus a relatively weak virus now. Also with the vaccination and the virus, you get some very nasty side-effects (micro-thrombosis, etc). Calling it a guaranteed benefit is odd. It may benefit in some circumstances, but each case has to be individually assessed. For now it has very low real-world utility for most people but it practically guarantees real suffering, not just “irrational fear“. Because of that I don’t think that forcing everybody to get again vaccines is a good idea.

Retric 2y ago

> The general advice should be for people that are otherwise healthy Not from a public health standpoint unless healthy people would actually be harmed. 1/3 of adult Americans are obese. It varies by country, but add in various other health issues and risk factors like smoking or being around lots of other people at work and most people have some risk factors elevating their benefit from minimal to meaningful. So as everyone benefits at least a little and some people get a very significant benefit the general recommendation is for everyone over 6 to get a flue shot.

rglullis 2y ago
Obesity is not contagious. If obesity is a risk factor, then by all means include that in the list of people who the vaccine should be recommended. Mind you, the flu virus is highly mutable. Vaccinating healthy people does very little for "herd immunity" because most vaccines contain only year-old strains and at best it will not prevent infection but merely reduce the window of time where people are contagious.
- Retric 2y ago
  Health messaging works better the simpler the message. Start listing 4 dozen at risk groups and people stop reading the list. Even if you’re healthy simply spending less time sick is a meaningful benefit. Perhaps you only get the flu one year in 20, that’s still a world of suck you can largely avoid. And frankly it only gets better from there.
  - rglullis 2y ago
    Your argument is resorting now to a very crude defense of white lies and Pascal Wagers. Not only this is borderline unethical to be used as support for any serious, national-level health policy, it is also bound to backfire and create even more suspicion from those who are not ideologically aligned with the Government du jour. In other words, if your health messaging is hiding crucial details because more information "is less effective" (at what? Informing or getting people to comply to a certain pre-defined plan?), then don't complain later when people share videos online about "what they don't want you to know".
    - Retric 2y ago
      > white lies and Pascal Wagers What white lies? Same deal with a huge number of other heath issue, you can tell basically anyone to exercise more and it’s good advice. Not for Olympic athletes, but from a public health perspective “get up a move” is a perfectly reasonable message. > at what? Keeping people healthy. The idea that the only possible benefit is saving your life is moving the goalposts on health policy. You specifically would benefit from getting an annual flue vaccination. Your doctor’s recommendation that it’s not something to stress about is likely correct, but it doesn’t somehow mean getting it would be a net negative for you personally. Skipping it isn’t a big deal for you, so if you’re stuck with some irrational fear then no big deal. But would you benefit? Yes.
      - rvnx 2y ago
        There is a difference between irrational fear, and the situation here, which is about not willing to self-inflict pain and days of suffering for a potentially helpful vaccine. The physical pain and struggle that you endure during vaccination is very real (you fight the spike protein fragment) versus a relatively weak virus now. Also with the vaccination and the virus, you get some very nasty side-effects (micro-thrombosis, etc). Calling it a guaranteed benefit is odd. It may benefit in some circumstances, but each case has to be individually assessed. For now it has very low real-world utility for most people but it practically guarantees real suffering, not just “irrational fear“. Because of that I don’t think that forcing everybody to get again vaccines is a good idea.