Fall time, Flu shots, and Fallacies

Fall time: kids are going back to school, many of them new drivers getting out on the road for their first high school commutes. And we’re stocking up on flu shots to get us all through the winter as healthy as we can.

Photo by Shuto Araki on Unsplash

When we humans make decisions, sometimes we use the rational, logical parts of our brains, and sometimes we use shortcuts and knee-jerk reactions that reveal biases and fallacies. When the subject is an emotional one like whether or not to get the flu shot, it’s especially easy for logical reasoning to get derailed into the realm of visceral reaction.

As a result, we can buy some baseless myths and faulty reasoning when examined through the eye of science and logic. In order to discuss some of these myths and fallacies, I took some of the common reasons I hear people use to say no to the flu shot, and applied them to the decision whether or not to wear a seat belt. I hope you find it amusing and informative.

I’ve never worn a seat belt and I’ve never been in an accident before, so why would I need a seat belt now?

People often cite their own survival without seat belts growing up in the 70’s and 80’s as evidence that they aren’t necessary today. This is called a survivor bias. But of course, not needing a seatbelt in the past doesn’t make you any less likely to need it in the future. Similarly, when it comes to flu, your track record of not having had the flu in the past will not protect you in the future. Like a seat belt, you never need a flu shot until you do.

The one time I wore a seat belt I got in the worst accident ever, so I am never going to wear a seat belt again. 

This is the fallacy of drawing a conclusion from coincidence. Obviously, it could have been a lot worse if you hadn’t had that seat belt, and it would be ludicrous to stop wearing it because you had an accident. This same magical thinking leads us to conclude that flu shots cause the flu. Flu shots are often given during viral season when the recipient is likely to pick up another virus, and they then blame the flu shot for making them sick. Flu shots don’t prevent (or cause) the common cold. They also don’t prevent (or cause) the “stomach flu” (vomiting and diarrhea) which is actually not the flu at all, but a stomach virus such as enterovirus. It’s worth knowing the difference.

Most accidents are fender-benders so what’s the big deal?

Even though most accidents are minor, between 30,000 to 40,000 people still die in car accidents per year. Similarly, most of the time flu is the relatively mild “fender-bender” type of illness. However, bad flu happens, and up to 80,000 people die from it each year, not to mention that more than 200,000 people get hospitalized with it every year. Children under age 5 and especially children under age 2 are at higher risk of complications such as these from the flu.

Seat belts are more likely to hurt you than the actual accident is. 

A well-designed restraint is much less of a threat compared to breaking glass, crunching metal, and rough pavement. Flu shots contain a tiny piece of the virus called an antigen. This small antigen cannot cause the disease, as opposed to the actual entire virus.  As the immune system responds to the flu shot and starts to create antibodies against the flu virus, you can get some mild aches, chills and low grade fever, but these are usually brief, lasting only hours or a day at most, and are a sign the flu shot is doing its job and training your body to fight off the flu. But you cannot get the flu from a flu shot. 

I am a good driver- I don’t drive distracted, I obey traffic laws, and my car is in good shape, so I don’t need to wear a seat belt. 

We’d like to think that all the factors that can lead up to a car accident are in our control, but we would be foolish to truly believe that. It pays to have good health habits, but they are not enough to prevent the flu. Even healthy people need a flu shot. Circulating strains in recent years have severely affected young people without chronic conditions. It’s recommended everyone get protected ages 6 months and up as the best prevention for flu, in addition to good hand washing, adequate sleep, good nutrition, etc.

I know someone who was wearing a seat belt and they still died in an accident. So seat belts obviously don’t work. 

This is the fallacy of drawing a conclusion from a sample size of one. It’s impossible to tell how effective the flu shot is based on one person’s experience. You have to look at data from large sample sizes. Granted, effectiveness varies from year to year anywhere from 10-80%. But, the vast majority of people who die from flu every year did not get the flu shot, while those who did get the flu shot were much less likely to have complications, including death, if they got the flu. Getting a flu shot does greatly decrease your probability of complications.

Seat belts don’t prevent accidents anyway. 

You wouldn’t fault the seat belt for failing to prevent an accident. The purpose of a flu shot is to keep the flu from sending you to the hospital, causing complications, or killing you. On a year that the flu vaccine is a good match with circulating strains, it may prevent the flu completely. On other years, it may not prevent you from getting the flu. But it will make the illness more mild and less likely to cause missed work or school, pneumonia, ear infections, dehydration, hospitalization or death. 

Seat belt companies are just convincing us we should wear these when we drive so they can make a lot of money off of us. 

Yes, seat belt companies have to stay in business in order to provide us seat belts. Yes, flu shot manufacturers have to charge money for those flu shots. It’s capitalism. Fortunately, we do have both seat beat companies and flu shot manufacturers. The cost to most patients of getting a flu shot? Nothing, as they are usually covered by your insurance because it saves your insurance company money when they don’t have to pay for your hospitalization or doctor’s visit for the flu.

You really have to buckle the seat belt every single time you get in the car? If is really worked, wouldn’t you have to just put it on once?

Some people are frustrated that they have to get a new flu shot every year. That’s because each year the circulating flu strains are different members of the same virus family. Epidemiologists have to predict the top circulating strains for inclusion in the flu shot based on global patterns of flu spread. Some research suggests that for those who consistently get their flu shot year after year, there is likely some additive benefit to having immunity to so many different strains of flu virus… like an immune system rewards program.

Seat belt manufactures don’t really know if wearing a seat belt is the best protective strategy for the type of crash you are going to be in, they are just guessing that it might protect you. 

It’s admittedly a tough job for vaccine makers to predict the strains that will be circulating each year to include in the flu shot, but even if there isn’t a full match between the flu shot and the actual circulating strain, there will still be some cross-protection, which is still better than going without.

If you get in an accident, it’s better for your body to protect itself naturally rather than have an artificial restraint pulling on it.

Rather than working against the natural processes of the body, the flu shot strengthens (not weakens, contrary to popular belief) your natural immune defenses to be able to fight off the infection… naturally, the way the body was designed to fight off infections, just better.

Babies should not be buckled in the car because they should never have those tough straps wrapped around those delicate little baby parts.

When babies are young and their immune system is the most inexperienced, they need the flu shot the most to strengthen their defenses against the flu. The CDC and AAP recommend immunizing all babies starting at the age of 6 months against the flu. Delaying the flu or other vaccines until a baby is older is like buckling them in the car seat after the trip is over!

Kids should choose whether to be buckled in or not. If they don’t want to be buckled, you shouldn’t force them because that makes you a mean parent.

What if we judged everything we did as parents by our kids’ approval rating? We wouldn’t be parents. When it comes to shots, we should accept it as a given that pretty much no kids wants them. Take my advice, don’t ask them if they want a flu shot. You already know how they will answer. Just be the parent and buckle them in.

For more information on myths surrounding influenza and flu shots, see https://www.health.harvard.edu/diseases-and-conditions/10-flu-myths