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Don't be selfish: Get a flu shot and protect the most vulnerable, bioethicist says

How widespread is the flu this year? Very. So far, it's spread to 47 states and it hasn't even peaked yet, according to the Centers for Disease Control and Prevention. The effects are being felt on an individual level and also on a large scale.

The mayor of Boston, Thomas Menino, has declared a public health emergency because of an explosive rise in flu cases.  In Kiefer, Okla., with the absentee rate in schools due to flu hitting 25 percent, the school district announced it would cancel classes. In Cleveland, a flu task force meets for 20 minutes every morning to handle the overflow of those sick with the flu at the University Hospitals Case Medical Center. The emergency room at Ohio State University's Wexner Medical Center in Columbus has instituted a fast-track system to move college students with the flu quickly through the emergency room to keep space free for older, more vulnerable patients. 

The best defense we have against the flu is a shot. Still, some people resist getting one. Some say they just don't work that well. Others have concerns about the contents of the vaccine. Others just think the shots aren't that necessary and they'd rather take their chances and power through the flu if they get sick. But here's the thing: a flu shot isn't just for you -- it's also for those around you.

For those who still say the flu isn’t really serious, consider the death toll so far — Minnesota has had 27 flu-related deaths reported; Pennsylvania 22; Massachusetts, 18; Oklahoma, 8, Illinois, 6, and Maryland 1. Nine nursing home residents have died in New York. Twenty infants and children have died nationwide. And those are just the confirmed flu death cases. When someone starts to go on about the risks and dangers of flu shots a quick visit to the morgue should suffice to shut them up.

Things are only going to get worse. We are barely half way through the flu season. It's a nasty flu, making healthy people very sick and sick people in need of intensive care or worse.

This year the efficacy of the flu shot is about 62 percent. That is not a great number, but it is not bad. It's still worth getting one. The ethical reasons go far beyond your personal self-interest. 

First, you ought to get a flu shot in order to protect those who cannot benefit from them. Second, the more folks who get vaccinated the harder it is for the flu to spread. Flu vaccination does a community a lot of good.

Newborns and those who are immune-compromised due to diseases, transplants, or cancer therapies cannot benefit from flu shots — they lack enough immunity capability. The elderly don’t build as much resistance to flu from a shot as do the young. And fetuses are at risk of dying from the flu unless their mothers get a shot.

The best protection those in these high-risk groups have is for those they come in contact with to have been vaccinated. Doing the right thing means protecting your grandma, your neighbor’s new baby and your son’s friend with primary immunodeficiency disease from being infected by -- you. You may not die from the flu. They could.

In addition to protecting those who cannot protect themselves there is strength in numbers in flu vaccination. The more of us who get vaccinated, even with a less than perfect vaccine, the harder it is for the flu virus to spread. This is called "herd immunity" and it applies to people as well as animals. If you think of yourself as a good neighbor and a responsible member of your community then you ought to get a shot so everyone gets the maximum benefit.

That is a hard message to get across. Most people naturally assume that if someone is sticking a needle in their arm it is to prevent them from getting sick. In fact, flu vaccination is for your family’s good, your neighbor’s good and the good of the newborn baby down the street.

A lot of us don’t like needles. But that is not enough reason to put others at risk. Many think they never get very sick from the flu.  Some don’t, but they can still infect someone else. 

Some still worry about the safety of the vaccine even though study after study shows the shots are safe and that getting a shot is far, far more beneficial than not getting one.

But, all that said, the best arguments for everyone to get a flu shot is that if we all do, the most vulnerable will be far less likely to die and we will be far less likely to infect one another. Don’t be selfish. Take care of your neighbor. Find a store or doctor that still has vaccine and get a shot. 

Arthur Caplan, Ph.D., is the head of the Division of Medical Ethics at NYU Langone Medical Center.

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