Last week, Meridian Bioscience of Cincinatti mistakenly shipped flu test kits that contained a strain of the virus that got public health agencies worried. “Deadly virus” the mainstream media called it.
This strain of flu is from 1957. It’s deadly because our immune systems haven’t been exposed to it since then. Without immunity, the World Health Organization worried that the virus could wreak havoc once again.
The risk from death by flu is from just this kind of situation, a situation we now face with the Asian bird flu. Our immune systems haven’t been exposed and so don’t have the right antibodies to take out the virus.
The dominant method for getting the right antibodies is by vaccination. However, it’s important to say that your immune system is much more than antibodies. In fact, antibodies are what’s called your specific immune response. Your non-specific immune response is what protects you from unknown bad guys. It’s also what launches the production of antibodies in the first place, whether in response to a vaccination or natural exposure..
A great deal of public health effort is put into making sure people, especially people at risk, get vaccinated with the right virus. Currently, “people at risk” means the elderly and medical personnel: the elderly because 80% of flu deaths are among people over 65 and medical workers because they have the greatest exposure.
This strategy highlights how infectious disease spreads: susceptibility and exposure. The elderly are likely to have weak or compromised immune systems and doctors, nurses, paramedics, and the like come in contact with people who are sick–people with the flu and people with weak or compromised immune systems.
A recent study brought this strategy into question. The researchers examined the relationship between vaccination rates and flu-related deaths among the elderly. They couldn’t find one. This led them to conclude that vaccinating children first would be more effective.
Their strategy is to dramatically reduce exposures and so keep the elderly safe. To achieve this so-called “herd immunity,” the vaccination rate would have to be around 70% among children. Currently, the voluntary vaccination rate is less than half that. Even among medical workers, the rate is around 50%. Which raises the spectre for some people of forced vaccinations. Yet a study of pre-teens and teenagers found that, while vaccination prevented a third of these kids from getting the flu (a less than spectacular outcome), it had no effect on the spread of the flu.
The point of all this is that vaccination is not a bulletproof vest. What’s more important is susceptibility and exposure, vaccination or not.
The most likely place for a kid to be exposed is at school. For you, it’s at work. Kids go to school sick and their parents go to work sick and expose your kids and you. They should stay home and get well. Why don’t they?
In too many cases, it’s because they can’t afford to. The parent has to go to work sick because, one way or another, they fear losing their job or can’t lose the income. The kid has to go to school sick because their parent can’t afford to stay home or hire someone to take care of their kid.
So my public health strategy isn’t herd immunization through forced vaccination, but a living wage, job security, humane working conditions, and sane child care.
