October 7, 2004

  • Flu shots and demons


     


    The flu vaccine shortage presents a bit of an internal, self-image struggle for me.  I have been taking the flu shot for the last several years because I fell in the “chronic disease, compromised immune system” group and also because my wife insisted.  Whether or not to take the shot was never much of a struggle.  I didn’t feel there was any risk in taking it, it didn’t cost anything at the local health department, and with the exception of last year there was always plenty to go around.  Even last year they were able to come up with enough doses to cover everyone that were in the risk groups, plus many more.  So the way this settled out in my mind was that it was a smart thing to - ounce of prevention and all that - and if it kept me from feeling miserable for a week sometime during the winter, I should just do it.  I didn’t have to weigh my need, justification for, or right to the medicine against others’ need.  I wasn’t taking it because I had a special need. I was just taking it because it was available, might avoid some brief misery, and it didn’t affect anyone else.


     


    This year with the quarantine of the UK supplier’s production, the situation is different.  The world supply of vaccine is about half of what is necessary.  Should I be one of the ones who get the vaccine?  In dealing with the lymphoma, I play this game with myself; at the same time that I am constantly aware that I have the disease; I also deny that it has any real influence in my life.  Any physical limitations that I experience in my daily life, I attribute to letting myself get out of shape and getting towards the high side of middle age.  Whenever I hear, “Are you sure you should do this” – usually in reference to plans to do something physically strenuous or something with some infection risk” I am always quick to answer, “sure, I can do what I’ve always done”.  This isn’t macho, or bravado kicking in as a result of not wanting others to see me as weak.  It is a more complicated internal struggle.  It is me trying to control the tendency to let the disease be a crutch, trying to come to grips with my own motivations and discipline; a struggle with self-awareness.


     


    Now I am faced with having to compare my need for the limited drug with others’.  The dose that I take will not be available for someone else who has a medical need.  My problem is that I realize that I have to make this decision by myself.  Any of my support group that I would ask, family, friends, or medical, would make the case for me taking the drug.  Is it a life and death question, probably not in my case, but not out of the question?  Clinically, on paper, I have a weakened immune system but, in practice I seem to recover from bugs of different sorts at the same rate that I always have.  My self-image can’t put me in the same group as those that are considered necessary candidates for the vaccine.  The demon that I struggle with is trying to resolve whether my decision is influenced mainly by ego and self image or by rational thought.  I can’t decide. 

Comments (2)

  • (struggling very hard not to come back with the knee-jerk reaction of the family/friend/medical category.  not sure I'm winning)

    It is surely as impossible to ask any reasonable thinking adult to assess his own "need," in relation to others, as it is to ask his spouse or friend.  Perhaps it is more impossible.  After all, you've been trained all your life, from the very beginning, to take other's needs into consideration, often above your own.  "Share with others."  "Give the lady your seat."  "Careful -- he's younger than you!"  "Turn the other cheek."  And so on.  Under no circumstances can someone in your position be asked to do triage on yourself.

    So I say this:  when in doubt, follow the letter of the law.  The letter of the law (from the CDC's recommendations regarding vaccine), says that persons with the following conditions should get the vaccine:

    <LI>all children aged 6–23 months;
    <LI>adults aged 65 years and older;
    <LI>persons aged 2–64 years with underlying chronic medical conditions;
    <LI>all women who will be pregnant during the influenza season;
    <LI>residents of nursing homes and long-term care facilities;
    <LI>children aged 6 months–18 years on chronic aspirin therapy;
    <LI>health-care workers involved in direct patient care; and
    <LI>out-of-home caregivers and household contacts of children aged

    Let's consider "persons aged 2-64 years with underlying chronic medical conditions."  This does not say anything about whether you're currently on the lucky side of your own condition.  Nothing about whether your side-effects are manageable, or even attributable to things other than your condition.  Nothing about the (highly disputable) possibility that if you get it, some disabled two-year-old who would otherwise lead a long and successful life won't.

    It says you should get the shot.

    DO IT.

    (or I will come striding across the length of the facility and personally knock your block off.  And yeah, I may be smaller and female and unfamiliar with physcial combat, but a surprise attack lends a lot of oomph to the punch, you know )

  • The vote is now 2-0.  Take the shot.  And don't feel a bit guilty about it.

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