Now I’ve got the heebie-jeebies. A woman undergoing safety training for a lab tech job was offered a smallpox vaccination because she’d be working with Vaccinia virus, and she turned it down. She didn’t understand the possible consequences at the time of training.
Naturally, what happens next? She’s trying to inject a mouse and accidentally pokes herself with the syringe needle. There are graphic photos at the link! It looks like some nasty ulceration of her finger and some systemic problems as well.
Although she continued to be treated, by day 10 her finger was looking very swollen, and she wasn’t feeling well.
“On day 12, she was treated at a university-based emergency department for fever (100.9°F or 38.3°C), left axillary lymphadenopathy [swollen lymph nodes], malaise, pain, and worsening edema of her finger,” a case report explains.
“Health care providers were concerned about progression to compartment syndrome (excessive pressure in an enclosed muscle space, resulting from swelling after an injury), joint infection, or further spread.”
She survived and is healing.
Vaccinations are important for people dealing with dangerous pathogens, but also for everyone else. Have you gotten your flu shot? If not, what’s your excuse?
Why the heck was she offered a vaccination? Why wasn’t it mandatory for the position?
Of course, what she injected herself with was the exact same virus that she was to be inoculated with.
It is also the most dangerous of all of our vaccines, as it is a live virus vaccine. Its only saving grace was, when smallpox still existed, it was far lower of a risk for progressive vaccinia or other life threatening complications than smallpox was, with its 35% morbidity and mortality rate.
Aka, 0.1% adverse events beats 35% dying from smallpox.
So, if I were working with something like vaccinia or even monkeypox or camelpox, I’d still get vaccinated with vaccinia. Again.
Was vaccinated as an infant, had a moderate reaction that required VIG treatment, had another in the military back in the mid-80’s, so I’d likely have low titer on vaccinia antibodies today.
To be clear, in a vaccination the vaccinia is not injected, they just work a little into the skin, so substantial reactions are rare. (It would leave a little scar on the upper arm.) She actually injected herself though.
I got my fly shot! I got my tdap and mmr boosters too a few weeks ago! I got a box of wine!
That’s not related, but I am enjoying it
I had been scheduled already to get my flu shot next week. Will be sure to pick up a box of wine then too in celebration.
Yes, I’ve gotten my flu shot. I had the flu in grad school and never want that to happen again. The last time I got smallpox vaccination was in 1968–I was spending time in Mexico as an exchange student and there was still smallpox there. I did it because my mom had told all of us kids about a friend of hers, in teacher’s college in the mid 1930s, who had had smallpox and had had terrible scars on her face. Her parents must have been the anti-vaxxers of their day. Mom’s friend had a lot of trouble finding a teaching job, after she graduated. Most places she applied told her that the administrators were afraid she’d scare the kids. I also remember the polio vaccination campaign of the 1960–I would have been eleven or twelve–and the brave people on our street, one of whom had lost a small son to polio, and the other a young mother who ended up in a wheelchair, who went door-to-door to tell their stories over and over and urged us all to get vaccinated. I will never forget that bereaved mother, tears pouring down her face, as she greeted all of us at the school auditorium where the vaccination was happening, as people told her and her husband that they had come to be vaccinated in memory of her small son who had died. People like this are the reason we rarely see polio in this country today.
Soo true. Vaccines are one of the great conquest of medicine, and antivax are morons.
No, and I won’t have it.
Got my flu shot last month and my husband got his last week. Got my pneumonia vaccine three years ago (still trying to get a straight answer on whether I need a booster…), and will be due for TDP in December. I have to go and get titred to see if I need a measles booster, too.
Basically, I’ll get any vaccine you want to give me. Thumbs high.
@2 wzrd1
Only if the probability to get smallpox is big enough. That is, P(getting smallpox) * .35 > P(die for adverse events of the vaccine).
Which I’m sure is the case for smallpox, and more so for someone professionally in contact with viruses in a needle. But just to make the point of how to compare probabilities -and thus, make rational choices.
As far as being a healthy adult? That’s no excuse. You might be fine if you get the flu, but what if you pass it on to someone who cannot be vaccinated because of age or compromised immune system? And why would you want to take the chance of getting the flu yourself? Why be miserable and contagious and take the chance of having serious complications? Why put other people at risk? Same as any other vaccination, you should get your flu shot. Being healthy is not a good reason. That’s exactly why YOU SHOULD get the shot.
This past year I got my tetanus and MMR shots together. Several years overdue for first and got measles shot again because dingbats. Got my flu shot last month. They’re not perfect, but have gotten them for at least 15 years solid with no ill effects and so far no flu. Probably just jinxed myself. I come in contact with elderly quite often and feel it a duty to contribute to herd immunity. I do have a strange fondness for George Soros and technocracy so the shots are effective!
A few years ago we could boast that we’d basically beaten smallpox – a scourge on humanity for thousands of years.
It’s insane to think that we might bring it back due to idiots like this.
@10 laurencocilova
Don’t ask to me. Listen to WHO: they recommend fun shots only to specific categories of people, and I’m not in them.
Vaccines, as anything else that has any kind of effect, have pros and cons: here in Europe,as per today, flu shots pros are not big enough for me. If/when they’ll overcome the cons I’ll get my shots.
(Please, before answering again, consider that I have to fight on a daily basis with antivaxers, so don’t use generic or rhetoric arguments, thank you)
s/fun/flu
For me the biggest cons against the flu shot are driving into the pharmacy parking lot, walking into the pharmacy, filling out paperwork, and waiting to have someone poke me in the shoulder. I have insurance otherwise it might be around 30 dollars or more, which could be a bit of an expense unless there are free shots at alternative venues.
Citation needed ‘brain’ because while they certainly have certain groups that they want to emphasise I saw nothing on their recommendations that said others should not.
https://www.who.int/news-room/fact-sheets/detail/influenza-(seasonal) “ Immunity from vaccination wanes over time so annual vaccination is recommended to protect against influenza.” And “ Among healthy adults, influenza vaccine provides protection, even when circulating viruses do not exactly match the vaccine viruses.”
@voidhawk: No that’s not an issue. She was working with the vaccinia virus, not smallpox. PZ made the issue a bit confusing when he referred to her refusing the smallpox vaccination. Vaccinia is a related virus, exposure to which confers immunity to smallpox, that’s why it was administered as the smallpox vaccine. The disease it causes is called cowpox and it’s relatively mild. So this has nothing to do with risking smallpox.
The remaining smallpox virus on earth, as far as we know, is in one Russian lab and one U.S lab. There is much debate about whether it should be destroyed.
@16 Ariaflame
The link you posted provides the answer to you. It clearly states the groups for whom the flu vaccine is recommended:
So, WHO is not recommending flu vaccine to me. Does PZ know better? Should I trust WHO or PZ? (the answer is: neither. But scientific community is currently aligned to WHO position).
“If not, what’s your excuse?”
Government doesn’t offer me one.
However I’m vaccinated against all kinds of other stuff, including yellow fever. Now only if you developed vaccins against dengue, zika and chicungunya I’d be a much happier man. From experience I can tell you that they are much nastier than the worst variations of the flu.
I just finished the two vaccinations in the Shingrix series. It was the roughest vaccine I remember having. It knocked me down for the following day both times, but I rallied faster the second one. I had a very mild case of Shingles a long time ago that was really painful. A serious case would be truly miserable. Compared to that, the vaccine was nothing.
@Waydude
Fly shot? Must be good wine.
I’m glad to hear you’re fine with spreading the flu and possibly infecting somebody who could not be vaccinated. I mean, there are too many old people and sickly infants anyway.
It’s fun how you manage to omit the sentence directly in front of the sentence you quoted:
Vaccination is especially important for people at high risk of influenza complications, and for people who live with or care for the people at high risk.
This is the list for whom vaccination is especially recommended, not the list of people for whom it is exclusively recommended.
+++
Of course, yes I did.
I have no interest in being sick
The CDC recommends everyone, including healthy adults, get the current flu vaccine annually. https://www.cdc.gov/flu/prevent/vaccinations.htm
My primary concern is protecting others. I have a friend with a severe egg allergy who can’t receive the normal vaccine. My lab has workers and researchers with compromised immune systems. I have nearby relatives who are over 65. I know people in medical professions who interact with patients who might have the flu or who might be susceptible to illness.
And I’m proud of my community, and want to do my part to keep it healthy and safe.
@brain
Within context, the ‘recommended’ list is a list of categories where the vaccine is especially recommended. WHO is not excluding you from recommendation, they’re just saying these people are particularly vulnerable.
That preceding paragraph: “Among healthy adults, influenza vaccine provides protection, even when circulating viruses do not exactly match the vaccine viruses. However, among the elderly, influenza vaccination may be less effective in preventing illness but reduces severity of disease and incidence of complications and deaths. Vaccination is especially important for people at high risk of influenza complications, and for people who live with or care for the people at high risk.’
Read that first line “Among healthy adults, influenza vaccine provides protection, even when circulating viruses do not exactly match the vaccine viruses.” This line is a pretty clear recommendation that healthy adults (you) should get vaccinated.
So you may not be in the ‘especially important’ category, but you are rather clearly in the ‘recommended’ category if you read the whole doc.
@23 ragarth
No, it isn’t. Just to make my point clear, look at what WHO has to say about measles:
Can you spot the differences in WHO recommendations for flu and measles?
Then if you feel safer getting flu shots go ahead, but you’re doing it as a personal choice. And it’s not an altruistic action, either.
Brain, I’ll take PZ and the CDC over WHO’splainers every time. My questions, are what are you really afraid of, and why are you trying to impose your paranoia on the rest of us?
I get flu shots these days because a) I’m over 65 and b) I sometimes find myself around immunocompromised cancer patients. But brain has a point. If for no other reason than because flu vaccines are not an infinite resource. If everyone gets them they may not be available for those who really need them.
Lower-case brain is asserting the WHO (and others, e.g., UK’s NHS and France) not listing other groups as recommended mean those other groups “should not” be vaccinated. That is, lower-case brain confusing “not in the recommended list” with “should not”. Those are two different things.
@25: why do you thin I am afraid? I got all the vaccines, medications and surgery that I needed without a blink, and I’ll go on this way.
Why, you are the one who is taking unnecessary medicines, so you explain to us what are you actually afraid of.
@chris61 If vaccine supply is a worry, then you can always ask the pharmacist or your doctor’s office about their stock for the 65+ formulation. If it’s low, ask them if they’d like healthy people to defer. Anecdotally as someone with primary care doctors in the family, supply seems to be pretty steady unless something odd’s happened, like a freezer breaking.
lower-case blf (wow, that’s funny, going back to 6yo mockings and nicknaming) can’t see the difference between choosing to do something because you feel that way and doing something because it’s a recommended medical practice. Those are two different things.
chris61@26, Yes, that’s another way of viewing the confusion pointed out in @27; namely, “in the recommended list” means “(should have) priority”. An example of that is here in France, where people in France’s recommended list (basically identical to WHO) are sent free vouchers for vaccination; everyone else has to pay a nominal fee (with, as I recall, provisions for waving the fee for people on a low income). If you haven’t been sent a free voucher previously (i.e., the is your first), you must go to your doctor so they can determine which variant of the vaccine, and other details, are appropriate.
Brain, you are making false statements. I take necessary medicines prescribed by the medical profession which includes recommended vaccines. Since the flu vaccine is recommended, as shown by several other presenters, it is one of several going all the way back to the Salk and Sabin polio vaccines in my childhood, and includes pneumonia, shingles, and flu vaccines in recent years. Next year is dtp and maybe a recommended hepatitis vaccine. CDC, the public health agency of the US government, recommends you get a flu shot. Your evidence you shouldn’t is not convincing. So, why aren’t you?
Chris61#26, there should be no lack of supply in the first world. In poorer countries, yes, and hence the WHO recommendations.
I’m over 65. My husband has cancer and I visit my mother who resides in assisted living. When I’m offered a vaccine, I say, “Which arm?”
brain is activating my troll sense 3000 device. :-( It’s either that or hard headedness resultant from unstated conditions.
I provided contextual evidence that the document does not say what you claim. Your response was ‘No’ and then treating WHO documents as if they are the bible.
brain, the WHO documents are not the bible. There is no claim that they’re written by a single source. In a matter of fact, its a pretty safe bet that WHO documents are not written by one person, but rather by many people with different ways of saying information.
Just because one document says things one way, doesn’t mean you can read another document out of context because the linguistic proclivities are a little different.
You’re not being rational in this discussion. Your hard headedness on this topic is a pretty good indication that you’re hiding a real reason for not getting vaccinated. Its either that or my troll detector 3000 is not broken and is accurately flagging you.
@brain
What you are doing is helping to compromise herd immunity for all those people who will be exposed to your unvaccinated self. People who cannot themselves be immunized for good reasons (severe egg allergies, highly compromised immune systems, etc.) and those for whom the vaccine is less effective (others with compromised or semi-compromised immune systems, the elderly, infants, etc.). Since I am one of those people, I’ll thank you to stay the hell away from me. I get the flu shot every year even though it is less effective for me due to the immuno-suppressive drugs I take, but am constantly exposed to people who think that because they are healthy they can somehow ignore good practice and not get vaccinated themselves. Not only are you in no way immune to the flu, but you’re turning yourself into a walking vector for others who have even less immunity. It’s an incredibly selfish and short-sighted thing to do. That is why the flu vaccine is not, for anyone, “unnecessary” medication.
By the way, you really are misreading what the WHO is saying and utterly ignoring the recommendations of the CDC, so you really need to give that line of argument up. Just go do what you should and stop putting others at risk, even if you think you can stand the risk for yourself.
@brain, you are way off the mark in that only one strain is being vaccinated against with the influenza vaccine, typically there are around six strains that are being protected against. Currently, new research is being conducted for a true universal influenza vaccine.
You also missed the mark on being healthy, so the risk is minimal. During the Spanish Influenza Pandemic, those with a robust immune system were preferentially killed, by their own immune response via what we now know is a cytokine storm.
I’ll clarify what I said earlier, for me currently, vaccination with vaccinia virus is unnecessary, as it’s beyond improbable that I’d be exposed to any pox virus. But, if I were to work in a lab where I could be exposed to any Poxviridae species, I’d be the first to be vaccinated. That, despite having progressive vaccinia as an infant, as it appears from the last time the military administered the vaccine to me in the mid-80’s, no complications occurred.
As for the influenza vaccine, it’s not the most effective vaccine in some years, but some protection beats having no protection at all. So, I’ll probably get my shot when I refill my thyroid blocker prescription next week.
According to the CDC there are projected to be ~ 160million doses of flu vaccine available in the USA for the 2019-2020 season. Unless you think that only about 50% of Americans are eligible for vaccination, that would represent a shortage if everyone got vaccinated.
@chris61
Alternatively, it could also represent pessimism that only around 160 million americans will get the vaccine.
Call me a pessimist, but given the state of critical thinking and caring-for-others in the US right now, the more pertinant question is how many doses of flu vaccine are disposed of because they hit their expiration date in the US?
My clinic is only getting their first batch of the flu vaccine next week, so I’m not vaccinated yet. But the appointment’s made!
Apparently some years they have to restart production late because the major flu strain isn’t what was predicted. I do remember flu vaccine shortages not that long ago. Luckily (?) as a diabetic I can get them first during a shortage.
I got my flu shot. It’s sad to see how many of my colleagues don’t. Every year again. And yes, I am a nurse and there is absolutely no excuse to forgo it (unless you are one of those people that can’t be vaccinated for medical reasons, but the usual reasoning here is that it’s pointless anyway, which is just flat out wrong).
In two months I start at a chemo ward in a different Hospital. This is not true for all chemo protocols (some require a longer hospital stay), but with a lot of them, the really bad drop into immunodeficiency doesn’t happen at the hospital. It happens when the patients are back home. When they are exposed to family and friends, or strangers if they have no one who will help them run errands. When the chemo cycle is over and they are sent home till the next one comes around and the lifespan of the cells of the immune system runs out at home and the bone marrow hasn’t recovered enough yet to make new ones.
Don’t be an asshole. Get your flu shot. Protect vulnerable people… and yourself.
And now I’m even more grateful that I did bother to get vaccinated against/with vaccinia when I worked with it in the lab. I wasn’t required to, but another lab would pay me $50 a blood draw if I got it, and it seemed like one of those things I was only going to get one chance at (infectious disease nerd, I’ll collect a vaccination). This was back ~2008, I think. It wasn’t fun (no swimming all summer!) and my arm swelled a bit, but I was glad I did it. Too many careless lab mates.
And I’ve gotten my flu shot, like every year. Again, infectious disease nerd. It doesn’t take a lot of reading up on the 1918 flu to not want to mess around.
mnb0 @19: There is a dengue vaccine, but it’s not great and there have been some serious side effects, and I think there are concerns about travelers who might be exposed to different strains of dengue.
I know the work for a zika vaccine is an international full-speed project, but like all things it’ll be a while.
@Justatech, yep, there are four serotypes of dengue fever. The risk of severe disease from secondary infection increases if someone previously exposed to serotype DENV-1 contracts serotype DENV-2 or DENV-3, or if someone previously exposed to DENV-3 acquires DENV-2.
Personally, from personal experience, I can say truthfully, the yellow fever vaccine sucks! Knocked me on my butt quite quickly. Still, yellow fever would suck a whole lot more.
I am very happy that I live in Canada.
As someone who administers vaccines, has an interest in the epidemiology of vaccines, and a perverse fascination with smallpox and its evolution, please allow me to correct a few misunderstandings that are running through this thread.
.1. I think we all agree that this story shows very poor judgement from the lab tech and the lab she worked in. She should not have refused the vaccine if she wanted the job and the lab should have made immunisation mandatory for working with vaccinia. And although I can’t tell from the quote provided, I do wonder if the tech was experienced enough for the lab to even contemplate training her up for this particular task.
.2. The lab tech was not infected with smallpox, but vaccinia. This is a related virus that probably evolved from horsepox. It is not nearly as nasty as smallpox itself, and indeed was the virus originally used by the WHO to eradicate smallpox in the 1966-1980 international immunisation program — as yet the only vaccination program that has completely eradicated a pathogen. (Sadly we came within about 5 years of achieving the same for measles and mumps before anti-vaccine agitators in North Africa disrupted the program.)
.3. The lab tech posed zero risk of creating a smallpox outbreak because she was not infected with smallpox. While it is true that some live vaccines can mutate back into a more virulent strain in an unlucky host, even wild vaccinia is not smallpox.
.4. Each flu vaccine usually contains 3-4 virus antigens, not just 1.
.5. Flu vaccine is an inert vaccine, not a live one.
.6. Flu vaccine shortages are common even in the first world, usually due to difficulties in getting the vaccine out in industrial quantities in good time since the manufacturers have to develop each new vaccine in less than a year. They usually only have a few months between a new strain emerging and the opposite hemisphere’s pre-winter vaccine programs.
.7. The WHO, CDC, and every major health organisation strongly recommend flu vaccine for vulnerable groups such as people with diabetes, heart disease, chronic lung disease, pregnancy, etc. as these people are at much greater risk of hospitalisation or death if they catch the flu. It is still recommended for everyone, even if they are not in a vulnerable group. Essentially it’s up to the individual whether they should get the flu vax or not. I think it’s a good idea, I wouldn’t twist brain’s arm (heh!) to do it if they don’t want to, although it would be nice if we could get past the misapprehension about who the recommendations apply to.
.8. Herd immunity is critical to the success of measles control because you around 95% population immunity to stop the spread. For influenza, that number is much lower at only 33-44%. I think it’s fair to say that most Western countries who have good coverage of their vulnerable populations would come close to that even without making an extra push into the non-vulnerable population.
.9. Having said that, herd immunity is a term for the general population. There are still local immunity effects from being personally vaccinated because it makes you much less likely to pass it on to others you come into contact with — especially important if you’re a health worker, teacher, carer, or have young children in the family.
.10. The smallpox vaccine is actually not made from smallpox and never was. Originally it was cowpox (Jenner, 1796) and later vaccinia because these viruses were not as nasty as smallpox but gave good immunity to those who had caught them. We are now up to the “3rd generation” of smallpox vaccines, created by culturing vaccinia in cell tissues and then selecting from those cells that were not as damaged to culture the next generation, thus piggybacking on standard evolutionary processes to make a strain that is even less nasty than wild vaccinia. (One of the last of the vaccine strains to come out before the eradication program ended, Modified Vaccinia Ankara, barely even replicates in humans but is still sufficient to give good immunity.)
.11. The smallpox vaccine is definitely injected. It is a subdermal injection, but an injection nonetheless. I am old enough to have been immunised with the damned double-prong smallpox needle. Youchies.
.12. For completeness, there is an inactivated smallpox vaccine that is stockpiled in Russia. I have no idea how effective it is.
a) That level of stupidity qualifies her for the Darwin Award but since she survived I guess it’ll have to be the Wallace Award instead.
b) What employer in their right mind would employ someone to work with a potentially deadly virus who refused to be vaccinated against it? The Galton Award for them.
c) For those who think their robust good health protects them from the flu so no need to get a shot. In 2009 a flu virus that did the rounds was a variant of the enormously lethal Spanish Flu of 1918-1920. A high number of deaths and severe infections occured among young people in otherwise robust health who had no innate immunity through exposure to other less lethal variants of H1N1. https://www.cdc.gov/flu/pandemic-resources/2009-h1n1-pandemic.html
Cranky old buggers like me managed to escape the bullet partly because of previous exposure and also because I get vaccinated whenever I can. I am old enough to remember the misery of measles, mumps and chicken-pox and the palpable fear as children when we lined up to be vaccinated against polio during a pandemic. I grew up with friends and teachers who had been disabled by this awful disease.
I also recently experienced the potentially lethal effects of shingles. Two weeks of confinement to an isolation room in a neurological ward with nurses attending to me wearing gloves, gowns and masks. there was no vaccination for chicken-pox when i caught it as a child so this was the end result.
The pain was so intense I was administered morphine for the first two days. I couldn’t eat because it started in my mouth. It felt like i had an abscess in every tooth on one side of my face. By the time they diagnosed it it had already worked its way up the side of my face because my beard obscured the rash so luckily they caught it before it reached my eyes. Several years later I still suffer side effects. the nerve damage has paralyzed my esophagus and I have trouble swallowing and am at risk of choking.
My message: Get vaccinated! The life you save might be your own.
And nobody’s said anything about the mouse being injected.
(The mice just don’t count, right?)
1) Got mine, and currently doing the “feeling miserable while my immune system does its job” thing.
2) brain is clearly lacking in, well… brains. GET YER FLU SHOT. Or, you know, go live alone on an isolated desert island so you can’t infect anyone else.
Nah, WMDKitty. Gotta pay money and arrange it and travel for it, should I do so; I hardly see people anyway, and if I’m infected, it’s because someone infected me. And there’s nothing wrong with my immune system.
I’ve never had the flu, only the odd cold. Sniffles are no biggie.
(When I was working, I did get them — work did it for free)
(Obs, were I to work in a lab dealing with infectious diseases, I would for sure get inoculated first. I’m not as stupid as the featured person)
If I were working in a bio lab of any sort working with bacteria and viruses, I would want the double-plus-extra-good battery of vaccines. My veins are open for business.
Up here in Canuckistan, specifically British Columbia, in my experience our pharmacists look for any way they can NOT charge us for a flu shot. There’s a long list of reasons to get that flu shot at no charge. If you scroll to the bottom of this PDF you’ll see them:
https://files.shoppersdrugmart.ca/flu-shot/C38_RX_SHT-PDS-V7_04_010019_SE_withCHKLST_BC.pdf
I’m a regular visitor to health care facilities (Mom is in a nursing home) so I get my yearly poke at no charge.
This practice helps us all. The idea of paying for a vaccine feels wrong to me. It should be supported by taxation.
Roi, in Oz we have a pretty good list too, but it’s also targeted to risk factors, not universal.
https://www.health.gov.au/health-topics/immunisation/immunisation-throughout-life/national-immunisation-program-schedule
John, I’m pretty much a hermit, and I still feel like it’s better to be safe than sorry-with-a-side-of-pneumonia.
In Alberta flu shots are free and available at almost every pharmacy and walk-in clinic.
Fair enough, WMDKitty.
No argument; it’s better to have the flu vaccine than not to have it.
(chrislawson’s #45 is an excellent summary)
However, I do look on it as a matter of personal cost-benefit, not of altruism. As did my workplace; after all, it’s overall cheaper to (voluntarily) vaccinate employees than to risk losing their services for a period (or worse, to have them come to work sick and infect other employees).
John Morales:
“I’ve never had the flu, only the odd cold.”
How would you know that? It can be subclinical. I can feel like being just a common cold.
In Quebec the vaccine is free but pharmacies can charge you a fee to get it injected ($10 at Jean-Coutu). It’s free in a government clinic.
ChrisE84 @56, good point.