Tag Vaccines

Trash Talk

Michael 4 Comments

We are already firmly into the fourth month of 2021. That itself is frightening, but more is that we still are filling our conversations with 2020 sound bite phrases (and some even older) which even in 2020 was depressing. So in the spirit of culture cancelling, let’s make a Second Quarter Resolution to, in no particular order, cancel these.

Eraser

Cancel Culture: Cancelling is becoming the new fad falling somewhere between hobby, and cottage industry. Old fogies like me tend to confuse cancel culture with “the mob” burning books or tearing down statues. It originated with some fashion or beauty type person who apparently was tight enough with the Kardashians to have amassed close to 2 Billion views on his YouTube channel lost over a million followers in a single day because of some spat he had with another YouTube beauty person. Seriously. You know I don’t make this stuff up. With origins that trite it’s time to cancel this bit of unculture.

Unprecedented Times: Many of last year’s news stories were unexpected, life-changing events. Of that there is no question. Were they unprecedented as the hyperbolic news media introduced every story. Consider this. To be unprecedented something must not have a precedent and a precedent is not merely the first of something, but the first of something to be used as an example for others to follow.  Let’s look at some of 2020’s “unprecedented” happenings. The pandemic was responsible for many of these events. First, there is the pandemic itself. Unprecedented, yes? Well, no, the WHO is currently tracking twenty different pandemics across the globe. Since 1900 there have been 12 worldwide pandemics, the most recent pre-CoViD were the 2013-2016 Ebola virus and the 2015-2016 Zika virus pandemics. Surely the vaccine response was unprecedent. Impressive yes, particularly in scope, unprecedented no. The 1947 smallpox vaccination drive in New York City claimed to have vaccinated 5 to 6 million people in less than a month. Verifiable data indicated 1.2 million doses were administered in the first week and a total of over 4.4 million administered during the 18 day campaign. Other “unprecedented” news stories from mass closures, to social unrest, to riots, to elections, even to the storming of the Capitol had precedents. The January attack on the Capitol was the sixth time the building had been breached and two other deadly incursions involving Capitol personnel occurred within its perimeter fencing.

Essential Worker – Clearly almost every worker can make an argument that a job is essential to somebody. Weather forecaster in San Diego might be stretching things but given that is only sunny there 362 days a year it could be essential for residents to know which three days to stay indoors. While I’m on this topic, there is no question of who qualifies as a Frontline Worker. If you have to ask, you aren’t one.

The New Normal – Do I have to say more?

Uncertain Times – A second cousin to Unprecedented Times, “Uncertain Times” is the nice little catch all to define any time that is uneasy or induces stress, real or imagined. Back when I was ineligible for AARP discounts, we called it a Get Out of Jail Card, AKA An Excuse to Get Out of Anything. You wanna know something, every time is uncertain. It if wasn’t it’s already past.

And finally, one to nip in the bud – Herd Immunity – Yes, it is a real thing, but unless you have a PhD in epidemiology or are a physician specializing in infectious diseases, you don’t know enough about it to carry on a Facebook level conversation let alone an intelligent one. Leave this to the experts. Hey, nightly news people, I’m talking to you, too.

There are a few hundred other choice words and phrases due for retirement: Blursday, Election Fraud, Super-Spreader, False Rumor (can a rumor actually be true?), and Remote [Anything]. Eliminate these and we have a good start on the return to intelligent life on this planet.

Genius

Hugging Hope

Michael 9 Comments

March 11, 2020: “WHO declares corona virus disease pandemic.” March 11, 2021: “Government says in person nursing home visits OK.” Who would have thought in a year we’d be turning this corner already? That’s who, little letters, not WHO. I don’t know that WHO is that optimistic. The CDC is not that optimistic either if you read beyond the headline. Not unlike another headline from this week, “Fully vaccinated people can have small gatherings indoors.”

It’s been a year. More than a year really as WHO probably should have declared the pandemic a pandemic 2 or 3 or maybe more weeks earlier than it did. People want to return to normal even though many can’t define normal. I will say that we are approaching a point in an exit to the pandemic that I figured we would not have reached until the end of this summer. That’s approaching(!) an exit. But there are many encouraging signs: Three approved vaccines in the US, four in Canada and the EU, twelve different vaccines throughout the world. Export and travel agreements and restrictions minimizing rampant spread. Voluntary mitigation efforts taking place in larger than anticipated numbers when official orders have expired – with some notable exceptions. All that and more is hastening a resolution to the pandemic, not an eradication of the virus and its disease, and a resolution is the best we can hope for against as cunning enemy an enemy as Orthocoronavirinae betacoronavirus-2.

But many people – and most Americans – aren’t good at reading beyond the headlines and that’s why the same papers also are running headlines, “Texas Rangers plan to allow full capacity of fans for 2021 MLB Opening Day,” “Gov. Wolf indicates Pa. restaurants and bars can celebrate St. Patrick’s Day,” and “Wyoming to lift statewide mask mandate next week.” (If you are wondering, Wyoming will join 16 other states without mask mandates.)

It is a great thing that the fully vaccinated and can re-socialize with other fully vaccinated and low risk individuals (fully vaccinated occurs 2 to 4 weeks after the final shot), and that nursing home residents can enjoy indoor visits with contact (hugs!), but there is more to the guidance beyond the headlines. In the nursing homes contact visits are allowed for residents who have completed their vaccination, precautions such as wearing masks and using hand sanitizer should continue, and outdoor visits are still preferred. When the CDC released new guidelines earlier this week that included, “Fully vaccinated people can visit with other fully vaccinated people indoors without wearing masks or physical distancing, visit with unvaccinated people from a single household who are at low risk for severe COVID-19 disease indoors without wearing masks or physical distancing, and refrain from quarantine and testing following a known exposure if asymptomatic,” the same guidance document recommends,“ it also noted that fully vaccinated people should continue to:

  • Take precautions in public like wearing a well-fitted mask and physical distancing
  • Wear masks, practice physical distancing, and adhere to other prevention measures when visiting with unvaccinated people who are at increased risk for severe COVID-19 disease or who have an unvaccinated household member who is at increased risk for severe COVID-19 disease
  • Wear masks, maintain physical distance, and practice other prevention measures when visiting with unvaccinated people from multiple households
  • Avoid medium- and large-sized in-person gatherings
  • Get tested if experiencing COVID-19 symptoms
  • Follow guidance issued by individual employers
  • Follow CDC and health department travel requirements and recommendations

20201004_185802We do well to celebrate the approach of near normalcy but approach the celebration cautiously. Otherwise these will be the more representative headlines in the next few weeks: “Brazil hospitals buckle in absence of national virus plan,” “Africa’s new variants are causing growing concern,” and “1 in 5 in US lost someone in pandemic.” You don’t want to be one of the 1s or you may find out “Why the ‘grief pandemic’ might outlast the worst of COVID-19.”

______

Please Note: All headline quotes are actual headlines from Associated Press, Austin American Statesman, BBC, CBS Sports, CTV News, and the Pittsburgh Press from March 8 through March 11, 2021. CDC Guidance from “Interim Public Health Recommendations for Fully Vaccinated People,” Centers for Disease Control and Prevention, US Dept. of Health and Human Services, March 8, 2021. Links included in guidance direct to CDC web-site.

5 0 0 , 0 0 0

Michael 3 Comments

Five hundred thousand. 500,000. Five with five zeros after it. Half a million, half a mil. 500 K. Unless you’ve been under a rock or outside the reach of American news outlets, you’ve heard than number a lot this week.  Earlier this week it was reported that’s how many deaths the US has suffered attributable to CoViD-19. That’s 20% of the world’s CoViD death total. Not bad for a country that represents a little over 4% of the world’s population.

500,000…that’s a lot of people. That’s like all of the people in Vermont. Or Atlanta. That’s five times the people who can fit in Ohio State’s football stadium, about ten times the capacity of Yankee Stadium. Five hundred thousand deaths is 167,000 times the number of people killed in the 9/11 attacks on the USA.  It’s as many Americans who lost their lives in World War II, and Korea, and Vietnam. What it took three major wars almost 30 years to do, Orthocoronavirinae betacoronavirus-2 did in one year and 2 weeks.

That’s 20% of the world’s deaths from a country not even 5% of it’s population. Well, why would that surprise us. After all, that same 4.27% of the world controls almost 30% of its wealth, and damn near 99% of its football (as opposed to football). We’re badass. We don’t need no stinking masks, we don’t need no stinking social distancing. Oh but give us those vaccines. Oh yeah baby. The good old US of A has gotten almost 30% of the vaccine doses that have been produced.

We might as well give some back because 30% of Americans polled say they won’t get the vaccine. Last July that was almost 60%. It’s even gone down some since last November when 39% said they wouldn’t get the vaccine. Still, that’s almost 100 million people who I guess think the virus is a hoax. Idiots.

Sorry – no funny stories, no cute picture, no clever wrap up.  But one bright spot – at least it’s not politicians making me sick this week.

The Most Wonderful Time of the Year

Michael 4 Comments
It’s that time again. Actually tomorrow is that time again. Technically tomorrow morning, around 9:30 give or take is that time again. Specifically tomorrow morning around 9:30 if you live in the northern hemisphere is that time again. It’s fall! Autumn. The end of summer. The autumnal equinox. All that stuff. And flu shot time!!!
 
Yes it’s time for me to harass the unsuspecting, cajole the semi-suspecting, preach to the choir, and harangue whoever is left. Whomever? Whatever, just go get your flu shot.
 
The only legitimate reason to not getting a flu shot is because you don’t want to get a flu shot. And that isn’t. But really, if you don’t want want to get a flu shot just say you don’t want one, you don’t care that you may potentially infect billions of others, that you might contribute to trillions of dollars of economic losses or that you may be single handedly responsible for a facial tissue/acetaminophen shortage. But don’t say you will get sick, it doesn’t work, it’s too expensive, your doctor advises against it, or you are allergic to it.
 
Cue the harangue! 
 
Excuse 1. You won’t get sick from the shot. You might get sick at the same time you get the shot and if that happens you would have gotten sick had you not gotten the shot anyway. The other thing that might happen is you’ll have a slight reaction to it. Your arm will be sore because they are sticking a small neeedle in it. Yes, that will hurt. Get over it! You might feel chills a few hours after. That’s because you’re body is getting ready to make the antibodies. That will go away in an hour or two if you get it at all. You might be tired for 2 or 3 days. Again, that’s normal. Your body is working hard bulking up for the onslaught of flu viruses and that takes work. Don’t be a wimp! You won’t be any more tired than after a hard day at the gym or a hard night at the bar back in the day.
 
Number 2. It does work. With a few caveats. It is not a miracle cure. No vaccine is. (Keep that in mind when a COVID vaccine eventually reaches the public.) The flu virus changes and the folks making the vaccine have to think like a virus and decide what form it will take this year. (Keep that in mind at COVID vaccine time also.) Sometimes they hit the nail on the head and all ends up right in the world. Sometimes they are close and you might not completely escape the little buggers but what you get is much less severe than had you not gotten the shot and don’t ever forget the worst that could happen is death. Slow, fevered, shaking, quaking death.
 
fluNon-reason the Third. Even if you don’t have insurance you can get a free flu shot. Many hospital systems and county and state health departments have free flu shot days because it’s cheaper to give away a vaccine that to treat the disease. Some retail pharmacies give free flu shots and some give you a shopping coupon equal to your cost. If you have insurance you are covered. All insurance plans must cover vaccines. You might have to go to a doctor or clinic of your carrier’s choice and/or you may have a co-pay but you are covered.
 
Harangue Paragraph Four. If for some reason your doctor advises against a flu shot and you are certain he or she is a real doctor and didn’t just print a diploma down at Kinko’s, get a new doctor. You aren’t long for this world trusting your health to that person and not getting a flu shot is not increasing your odds.
 
Excuse the Fifth. There once was a time when egg allergies posed a serious limitation to the universal recommendation for flu shots. Likewise with gelatin and latex. Today’s flu shots are safe for almost all allergic patients. There are very very very very very very very very few exceptions. You may be one. You may also have won the Powerball. That does happen. If you are, you know you are and probably came close to death at some time and don’t want to do that again. 
 
Epilogue: Nothing is perfect. There are two groups of people who should not get the flu shot in addition to the analogous lucky lottery winner. Group 1 – If you are not yet six years old don’t get the flu shot. If you are not yet six years old and you are reading this immediately ask somebody to play the Powerball numbers you are thinking of right now! The second group of people who should not get the flu shot are a subgroup of those with Guillian-Barre Syndrome. If you have a history of Guillain-Barre Syndrome talk to your doctor specifically about the flu shot. (Doctors advising against the flu shot under these circumstances are exempt from Harangue Paragraph Four.)
 
A special word about immunosuppressed individuals (like me) and pregnant women (not like me). We know some vaccines for us can be as dangerous as getting the disease. These are the live virus vaccines. Some vaccines actually contain weakened strains of the virus and these can overrun the weakened immune system in these individuals. An example of this is the early form of the shingles vaccine. But the flu shot is not a live virus. All FDA approved injectable flu vaccines are inactivated vaccines with no live virus. However, the nasal form of the flu vaccine contains weakened strains of live virus and these should not be used by immunocompromised individuals or pregnant women whose immune systems are already working double time. But there is no reason for an immunosuppressed or immunocompromised person not to get an injectable form of the vaccine. The shot’s mild side effects may be exaggerated or prolonged but it is still very safe. I had my vaccine Friday and Friday night I had some chills and in Saturday I didn’t feel like doing much but by Sunday afternoon I was my old self. One of these days I’m going to feel like my young self and when that happens, look out world! Oh. Sorry. I digress.
 
A special word for everyone. If you are already sick don’t get your flu shot now. Wait until your cold or infection passes then get the flu shot. 
 
Now that all of that nonsense is out of the way, back to the business at hand. Do you remember when Fall would start on September 21? Fall was September 21, winter on December 21, Spring started March 21, and Summer came on June 21. Maybe the 22nd. None of this “Autumn begins at 9:31:27am September 22 when the sun is somewhere over the edge of the flat side of the world not visible by those perched on the pole pointing away from Venus while drinking a pumpkin latte on a horse drawn hay wagon.” Those were the good old days.
 
 

It’s All Falling In Place Now

Michael Leave a comment

Listen up…today is the first day of fall, the onset of autumn, the equinox (at 3:52am at my longitude). It’s also the best day to get your flu shot. Yes this post is going to be more PSA than post but if you can’t trust me, who can you trust.

It’s time you get a little background so you have at least a little faith in me when I say GET YOUR FLU SHOT! And I’ve been doing this blog for almost 8 years so I guess you deserve some background information. (Really, eight years. Can you believe that? My first post was on Nov. 7 2011.) (woah). November also marks my 40th year as a licensed pharmacist (Nov. 12 1979). (double woah) Of those 40 years I spent 32 of them working in hospitals and four of them I taught undergraduates at college of pharmacy and administered continuing education courses for registered pharmacists.Then last 4 I’ve been living the Life of Riley and let me tell you, Riley really doesn’t live a high life.

But I still have my license and keep up with my annual education requirements so I think I can still speak about drugs pretty well. And when that drug is the flu vaccine I can tell right now who should NOT legitimately get the annual flu shot. Nobody! Okay, as the people who give away free stuff, like your cell phone carrier, there are some exclusions. Maybe 10 of them. Not 10 exclusions, ten people. Not 10 groups of people, ten people. That’s how many people 2 years ago (the last year with complete data available) had anaphylatic reactions to some component of the flu vaccine in the United States. Ten. Out of almost 8 million vaccines administered.

To put that in perspective, out of 56 people who got the flu that year 10 were hospitalized. And almost eighty thousand people died. That’s 10,000 more people than were at the Super Bowl last January.

Considering those numbers, why would you not want to get a flu shot. Hmmm?

flu

“I never get the flu.” Lucky you but by getting the flu shot you help minimize the flu’s effect on the very young, the very old, and immunocompromised which depends on the “herd effect,” that is the more of the mass that is resistant to a pathogen the less severe its effect to the individual.

“I get the flu from the flu shot.” No you don’t. The flu vaccine is a dead vaccine and it cannot give you the flu. You may experience some discomfort at the injection site, it is a needle being stuck in you arm after all, and you may experience some tiredness while your immune system is doing its thing (which might go on for up to 48 hours), or you could be getting the flu because you waited too long to get the flu shot!

“I’m immunosuppressed or take immunosuppressive drugs.” So am I and so do I and I have and for almost 20 years. I’ve had a fkubsjotbgirveacj one of those years and I’m still here, other issues notwithstanding. The prohibition to vaccines for immunosuppressed individuals is restricted to live virus vaccines (MMR, Oral Polio (not used in the US any longer, the injectable vaccine is not a live virus), Chicken Pox (but not the new shingles vaccine). As we already noted, the flu vaccine is a dead, inactivated virus.

“I’m allergic to eggs.” Sorry, this excuse want out of business before I gave my first shot. Today’s flu vaccines are not grown in egg media. The initial antigen is still grown in eggs so there is the slightest chance that an egg allergic patient can experience a reaction. If that reaction is just hives or rash get the shot, if it’s shortness if breath have it done at a doctor’s office or hospital rather than at a campaign like at work unless you work at a doctor’s office or hospital. If you’re still concerned there is a product that is completely egg free. That is Flublok (r) by Sanofi Pasteur. While we’re talking about it, no vaccines contain aluminum, or mercury and most do not contain thimerosal. No single dose vaccines contain thimerosal or latex and some multi brands are stoppered with non-latex materials. Again, if you’re concerned about any allergies, ask. There is a flu vaccine right for you.

“I got the shot but still got the flu.” Unfortunately this can happen but if you should get the flu even though you had a flu shot for the season you are probably going to experience a less severe reaction. Why does this happen anyway? The flu virus is a cunning little critter and it can mutate during the season. Or you might have had the timing wrong when you got your shot, either too early or too late.

That brings us to timing and why the first day of fall is the best time for you to get that flu shot. Immunity from the shot does not happen as soon as the needle plunger squirts the solution into your arm muscle. It’s just there to get your own immune system ready to fight off the flu and that takes time, about 4 weeks to get to an effective level. Once your immunity is established it will stay at effective levels for up to 24 weeks. That takes us from October through April, bookending the usual flu season.

So, trust me. Get a flu shot today.

We now return you to your regular blog posts.