Going Viral

Many of the techs had been there a few decades, long enough to see the old factory through a string of corporate mergers and buyouts, which instilled in them a stoic humor and stubborn pride. Come what may, the vaccines would be made. Through two world wars, the Great Depression and countless changings of the guard, theirs was the proud site that had churned out the bulk of America's vaccines, including most of the shots that helped eradicate smallpox in the late '70s.

It was a real family place, too, the kind where co-workers were also spouses, siblings and childhood friends. Some of that closeness was inspired by the urgency of our work, though no one there would admit that to you. But a lot of it was a consequence of simple geography: the factory sat on the edge of a sparsely populated mountain town with only a handful of places to socialize and practically no other places to work. So we ate together and drank together and learned to love and hate the same things about our shared experience.

Despite my faith in the good people of the vaccine plant and despite my deep faith in science, I have never actually been injected with the flu vaccine myself. In fact, every time someone asks me whether they should get a flu shot, I almost always tell them no, even if they are elderly. Especially if they are elderly. It's actually a misconception that older people stand to gain the most from the influenza vaccine. Yes, like the very young, people over the age of 65 tend to have weaker immune systems. And yes, that means that they face a greater risk of contracting whatever devious bugs happen to be flying around. But studies have shown that, unlike infants and toddlers, the immune systems of elderly people are less adept at converting the influenza vaccine—meaning the shot does not trigger in them an immune response strong enough to protect against subsequent infection. In fact, a 2005 analysis by the National Institutes of Health suggested that giving the flu shots to elderly people has not saved any lives over the past three decades. (The CDC still includes people over the age of 65—along with infants and toddlers, pregnant women and health-care workers—among those who should most definitely get a flu shot. That policy will not change until more studies are done).

Kids, on the other hand, have no trouble with conversion, and their penchant for playgrounds and general disdain for washing hands make them the ideal beneficiaries of the vaccine formulators' efforts. If my 10-year-old niece were to ask my opinion, I'd tell her to get a shot straight away. I am not alone here. Many experts have begun to suggest that school-age children would make a much better target for protecting the population at large. Again, more studies are needed before the CDC will change its policy.

In the meantime, I am a firm believer in the theory of herd immunity. As long as a certain portion of the population has been inoculated against a given infectious disease, the rest of the population will be largely protected. The portion that needs to be vaccinated for this to work (called the herd-immunity threshold) depends on several factors, including what pathogen we're talking about. For influenza, it's around 70 percent. That means as long as somewhere near 70 percent of the people around me have gotten their shots, I don't really need to get mine, because most people I interact with will not be capable of catching the virus or passing it on to me. Their vaccinations basically act as a firewall that protects me and anyone else too busy with holiday shopping to make it to the doctor. I admit it's a bit of a gamble; the percentage of New Yorkers who get vaccinated may be well below 70 percent, and there's no accounting for tourists. But it's just not the biggest gamble I take. After all, I still smoke.

© 2008