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Public Health Spaces

A Public Health Stranger in the Land of Medical Care

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Posted by Stewart Auyash at 8:07PM   |  13 comments
Saudis prepare for the hajj

 I cannot recount the number of times in the past few weeks friends, relatives, students, and strangers have asked me whether they should get the H1N1 vaccine.

 Some are concerned about the side effects or wonder whether the vaccine has been tested. Parents are worried for their young children.  They are concerned about the claims of links between vaccines and autism even if they know that there has never been a credible study demonstrating it.  Some of my students say that the flu sucks, but it isn’t bad enough to get a vaccine.  They ask: Is it effective? Will the vaccine make me sick?

 Let me be clear: I am neither a physician nor a scientist.  On the other hand, many don’t seem to trust physicians or scientists who claim the benefits of the vaccine with near unanimity even while some admit that we really will not know how effective the vaccine is until H1N1 has run its course.  So when people ask for vaccine advice (or any medical advice for that matter), I hesitate to tell them what I think.  I can only tell them what I would do.

 I would vaccinate. And I will vaccinate after they cover all those who are most at risk.  Why, you might ask.  There are two major reasons for vaccinating. One is self-interest. Who wants to be sick? Second, I don’t want to infect anyone else.

 Most of us don’t think of the second reason, especially in the U.S.A.  In many parts of Asia, for example, the culture of community responsibility is embedded (admittedly, it is also mandated in some places). Living in Singapore in 2003, residents would wear masks if they had symptoms to prevent the spread of infection. And that was BEFORE the SARS epidemic.

 Luckily, I am a generally healthy 50+ year old. Thus, I am low on the priority list for the H1N1 vaccine.  But when I am called, I will be vaccinated.  I hate being sick, but I also don’t want to infect pregnant women, young children, or anyone else who might be at higher risk than I. 

 For anyone who is wavering, think of it as giving a gift to those around you who will NOT be infected because you vaccinated. 


I would have to agree that most people do not think of vaccinating in order to stop the spread of viruses. Personally, I hadn’t thought of it as a reason to get myself vaccinated for H1N1. That point in this post really got me thinking. Are we so selfish about our own needs as Americans that we cannot take what could be a small risk in order to protect the greater community from a larger risk? It is so interesting that other countries cultures have community responsibility as a high priority. Sometimes I cannot help but think that this “all for one, one for all” mentality is not present in the United States when it comes to health. Rarely have I ever seen people walking around in masks if they were experiences symptoms of the flu. I cannot recall any time I in my life that I saw this until I came to college, besides when SARS came about. And still, I do not recall seeing anyone but Asian Americans wearing the masks. I am not sure if this is about “image” and how it may not look “cool” to be seen walking around in a mask, or if it is because wearing a mask lets everyone know that you are sick.
I was almost set on not receiving the vaccine, because I did not think it would be a big deal if I got the flu, considering I have no other underlying health issues (that I know of). Now, however, I realize that even if I do contract the flu and eventually get well, I run the risk of spreading it to my roommates, only one of which has gotten the vaccine. If I were to go home to try to protect my roommates from the flu, I run the risk yet again of spreading it throughout my family at home. If they contract the flu, they can in turn spread it to their coworkers or other members of the community.
Although I have come to these realizations, I am still at odds about whether or not to get the vaccine. It seems that everyone I ask about it has a different opinion and I cannot seem to pick a side in the argument around the vaccine. I know it is almost a lose- lose situation if I do not get the vaccine. 1) I could get sick and 2) I could spread H1N1 to others around me unintentionally. Even though I know this could happen, I am not sure what is holding me back from getting the vaccine. I have always been a little weary about putting foreign things in my body and I only take medicine when absolutely necessary, but I do feel that this is an important and necessary vaccine to have. I think I just have a standpoint of many Americans in feeling that this is a very new vaccine and new things generally tend to stir up conflict of interests between groups here in the United States. I still have a few more days to think about getting the vaccine so hopefully I can make a decision soon while the health center here at IC still has vaccinations available.

I agree with you that most people don't have warm feelings for getting the H1N1 vaccine. I am also one of the people who does not want to get vaccinated. For most, I think it's because they never think they'll ever get H1N1, so why spend the time waiting in line to get it? I fall under the scared category. I remember hearing from my health class last year that in the 1970s (I think) there was a swine flu epidemic or at least everyone thought it was going to be really bad so a vaccine was quickly made for the public, and if I remember correctly, more people ended up dying from the vaccine than the swine flu. I might not be remembering the facts right, but I know many people did die from the vaccine. There are also horror stories in the news. This one girl received the vaccine and ended up becoming paralyzed. For me I rather get H1N1 than have those side effects. Also, I've never had the flu before, not seasonal flu or H1N1, so I have this mind set that if I haven't had it I probably won't get it. As I'm writing down my reasoning's against, it's starting to not make a great deal of sense to me, but that's how I feel. I'm guessing many other Americans have this feeling as well. Yes, getting the vaccine I may have a few side effects and could prevent getting H1N1 and prevent spreading it, but me and many others don't think this way. We just think of ourselves, we live in the now and right now we aren't sick. I've heard many convincing arguments for the vaccine and many against, but as of right now I don't believe I'm going to get it. I have recommended the vaccine to my sister who is asthmatic after I heard of someone who died and had asthma, but I personally believe I am healthy and I don't know of any preexisting conditions that I have. Maybe there will be something in the news that will scare me enough to get the vaccine.

You bring up a really good point in saying that we live in the now and right now we aren’t sick. I think this characterizes many Americans thoughts about the H1N1 virus. I am glad to know I am not alone in being confused about the vaccine and also not alone in not knowing why I haven’t gotten the vaccine yet. I haven’t come up with any other reasons not to get it besides the side effects it could possibly cause. Another really good point you made is that you aren’t scared enough to get the vaccine. It helped me realize that this may be a reason that I also have not gotten the vaccine. I am not afraid of getting the flu because I don’t have any other medical issues. Like you, I have also never had any sort of flu before. I would consider myself pretty healthy as well and maybe I am being over confident but I think I could withstand the flu if I did contract it. After thinking about it some more, I was also thinking I would not get the vaccine so that I would not be taking it from people with other medical conditions who may need it more than I necessarily do. It is a very confusing subject for me and I cannot seem to choose a side. However, the idea that we are not scared enough to get the vaccine is still staying in my mind. I really believe that this feeling reigns true for most Americans in general. We’re not thinking about protecting others from the virus by getting the vaccine, but just thinking we are healthy enough that we don’t need it considering that most people who have died had other outstanding medical conditions.

Before reading this blog it had never crossed my mind that there are two different reasons that we should get the vaccine, self interest and interest of others. I always thought of getting the vaccine as just helping myself and that is why I have not gotten the vaccine. I believe that you don't need a vaccine for such a thing as a type of flu, you'll eventually get over it. However, knowing that there are higher risks for certain people does make the issue a bit more troublesome. But then again the most intelligent people would be smart enough to stay away from people when they are ill so that they won't infect other people especially those that are at a higher risk. Even after knowing this information I still don't think I would get the H1N1 vaccine. I have not gotten the regular flu season vaccine since I was really little and do not see the point in getting a vaccine now for something that I can just get over on my own. However, some people feel differently and if people are comfortable getting the vaccine then that is great but I don't find it necessary.

Brittany--I think you bring up an interesting point and I commend you for your honesty. Most people would not out right say that we do in fact live in a selfish society. We often think of ourselves without caring for others. I do agree that people may fear the consequences of getting the vaccines and only associate direct consequences not once do we think about indirect consequences. How the impact of our personal actions indirectly affects one person, the country or the world. I just think it is interesting because I wonder if there were a huge resistance against vaccines for smallpox or other deadly diseases,where would we be today? Then I also wonder how unlucky we are to only care about ourselves. I think of other countries around the world and individuals who fighting for their lives from disease that could easily be vaccinated in this country (i.e TB). How I wish there was a program sends a free vaccine to those developing countries for everyone that turns it down here. Obviously many vaccines are required in order to attend school here but I wonder if you had the choice would you decide not to get the other vaccines that were given to you as a child? Personally I agree we often have to be brought to the level of fear in order to commit to something or take action. I think that's unfair because with the many scenarios had we waited till we feared something, maybe it would be too late. I don't think you should let the idea of fear be the catalyst in your life. And the reason that you take action, let it be genuine care and empowerment to take action for the right reasons--not just yourself but for others. :)

I’ve been having an extremely difficult time making the personal decision of whether or not to get the H1N1 vaccine, and this blog has actually made that decision harder for me by pointing out that vaccination is not strictly a personal decision. I’ve been trying to educate myself about both sides of the debate but conflicting information and radical opinions on both sides have confused me all the more. Ultimately, I decided that I didn’t know enough about the vaccine to risk getting it, but as this blog and other posters point out, not getting the vaccine is actually putting others at risk. I had justified my decision to myself, though, until I started thinking about the H1N1 vaccine in relation to other vaccines—why do I think my personal safety rates above that of the community, yet I look down upon those who decide not to vaccinate their children for polio, etc? I think that their fears are unfounded and that their decision is putting us all in danger, but then you could say the same thing about me declining the H1N1 vaccine. I guess it all comes down to the difference between the vaccines: testing time, possible side effects, and proven effectiveness (all of which I do not know enough about for either). What is it that makes it acceptable to not get the H1N1 vaccine as opposed to others? I’m still not sure.

On a side note, I’m posting a link to an interesting article I found that critiques our response to the swine flu “pandemic”. The article is titled “Swine Flu—One of the Most Massive Cover-ups in American History,” and though it sounds very radical, it seems to have some credible science to back up the author’s opinions. One interesting point he makes is that studies have shown that pregnant women are not at increased risk, but rather that obese people are. I hadn’t heard this argument before and think the whole article is something worth reading. Here’s the link:

Hi Stewie,

Good posting, interesting reactions. Swine flue has spread through Ulaanbaatar, and I believe that I had it a couple of weeks ago. For someone in the same general demographic as you, I'd have to say, it wasn't that bad. I had a lot of trouble breathing for several days and some fever, but in terms of other flus that I have had, well, I've had much worse. The vaccine hasn't been available here, but if it had been, I'd have gotten it for the reasons that you mention.

I'm curious about those masks. Lots of people wear them here. I think for various reasons, pollution, protection from the cold, due to the flu, and sometimes, I think, as a kind of fashion statement (given the various styles). Are they useful?

Thanks for the thoughtful analysis.

H1N1 has definitely been a major issue being on a college campus. I found it very interesting the comment on not wanting to infect others as a reason to get vaccinated. Many people don't think about people who may be at high risk for contracting the flu virus. I chose not to be vaccinated. The reason being that I never got the flu in past years, and I didn't see the benefit of getting it this year. I have also had reactions with past vaccinations, and I didn't want to take any chances. I feel that it is a personal decision to get vaccinated, but I agree with you that people usually only think about themselves. As we know now, H1N1 has seemed to peak, which is really good news. As I'm writing this I'm realizing that maybe I think I'm just invincible and that "it can't happen to me". I feel like many people share this outlook. This could be troublesome, and more thought in this decision might be a good idea.
It seems like many people often forget that this is a worldly issue, and not just happening in the US. I suppose vaccines are one of the best ways to control the outbreak, it's just hard to produce enough and get everyone to receive them.

I personally feel the reason why some people don't get vaccinated is probably because they feel it will never happen to them. It's the mentality of bad things happening to other people and not me, which is prevelant everywhere, including Singapore, where i live in. While some people prefer not the be vaccinated because they feel they are strong and it's not necessary, very few have actually considered others as an option. And the decision, although personal is influenced by cultural factors as well. For example, when H1N1 hit, my friend who had gone to Europe on a holiday, mentioned that people there don't make a big deal about h1n1, which kind of surprised her because over in Singapore, face masks had even gone out of stock in stores around the country and everywhere you go your temperature needs to be taken. People say there was a fear SARS would reoccur, and since Singapore is a very small country, th damage of a spread would be disastrous to the nation, socially and economically. And the reasons people wore masks when they travelled, were more to protect themselves or to avoid getting stares from other people when they sneezed or coughed on the train. That was when h1n1 was at it's peak, but right now, nobody does that anymore. Perhaps, people don't see the situation with the same urgency anymore, hence the lack of vigilance to get vaccinated.

From my point of view, I wouldn't take a vaccine that has only just been developed and then put out in the market for public sale. I would still have doubts and fears as to how safe the vaccine really is. Or whether it would end up creating more harm than good. The vaccine's benefits and side effects can only really be shown once its been out in the market for a period of time which has been consumed by a vast majority of the global population to test its effect on various races and genes.

I think regardless to us immunizing ourselves on prevention and contracting diseases, I think it's vital that we develop the mentality of having personal hygiene and basic common courtesy. For it is not just stemming from jabbing ourselves with injections to prevent contracting a disease, we should also be targeting the birth of new diseases.

New strains of diseases stem about from the bacteria or virus becoming drug resistant and evolving to form a new strain of its previous form. If scientists continue to develop new drugs that these bacteria or viruses become immune to each time, this would be a never ending cycle.

The only way that I see through this break in the cycle, is for us as a global citizen to be concerned over our own hygiene as well as others, through basic common courtesy.

For example, when we cough or sneeze, we should cover our mouth and nose, by using a piece of tissue or our hand, but that we must make sure to wash our hands after to prevent residue from being left behind. This would go to great extents in preventing others from being in contact with our bodily fluids.

It's just like washing your hands after using a toilet and so forth. It is also a general matter of common sense.

However, I would advocate a balance of filth and cleanliness. We should expose ourselves to normal dirt, like kicking a soccer ball in the field and getting muddy as it helps balance our body in withstanding common strains of bacteria and recovering from viruses.

We can definitely be more selfless if we practise such acts of personal hygiene, and not just definitely through the hard and fast rule of immunization.

I agree with the author. I personally will also get myself vaccinated because of my own health as well as the health of others. If we fall sick, our loved ones will suffer as well. When we are well, it's a gift to others. Those who are able to afford the vaccination should not omplain too much because we need to think of others who desperately want to get an injection but unable to do it due to costs.

The scare surrounding the outbreak of H1N1 was really silly. It's essentially harmful in the same way the flu or other common things are. Sure it would be advisable for the same age groups who should get the flu shot to have gotten the H1N1 shot. However, national/international? paranoia over it was unnecessary.

It is interesting reading this article after the whole H1N1 scare has pretty much died down. The country was calling swine flu an epidemic and advertising vaccines like candies. I personally did not get the vaccine because I agreed with the idea that the flu was not worth the vaccine. This comes from several influencing factors. Firstly, my mother is one of those people who reads too much about the risks of things such as vaccines. Therefore, the articles claiming that the vaccines could do more harm than they could prevent scared her to death, and prompted her to not encourage our family to get it. In addition, I actually have a pretty severe needle phobia. This is quite unfortunate, because I also have a pretty weak immune system. I get the flu every year and am plagued with viruses and diseases all year round. So, to the surprise of no one, I ended up getting swine flu the summer of 2009. As far as the sicknesses that I've experienced, it was pretty low key. I felt that I would have suffered more getting the shot than living through the week-long flu. However, I had never considered that other people could come by harm through my thoughts that getting the disease was worth not getting the vaccine. I could have gotten other people sick who could not have bounced back from it like I did. This makes me feel terrible, and I should really work on my needle phobia in the future. I am not the only one who has to deal with the consequences of my actions.

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