The flu that transformed the 20th Century | Hacker News Reader

The flu that transformed the 20th Century

bbc.com

51 pointsnairteashop25 comments

PBS did a documentary I happened to watch last month. It reveals that mailmen were a serious vector of transmission, even when quarantines were put in place. Medicine's main disadvantage was not understanding that it was viral and airborne, so that quarantines could be more effective. Doctors were looking for a bacterial cause up to the end of the pandemic. https://www.youtube.com/watch?v=l0juBE-ra3A

Currently there is concern that the new form of the H7N9 virus in China could morph into a form as lethal as the 1918 Spanish flu which killed up to five percent of world's population. Forewarned is forearmed. But it seems:

China Has Withheld Samples of a Dangerous Flu Virus

https://www.nytimes.com/2018/08/27/health/china-flu-virus-sa...

so possible development of vaccines has been hampered.

> so possible development of vaccines has been hampered.

That wouldn't prevent the Chinese from developing a vaccine...

Better to have multiple heads working on one problem and have one race to finish first, like with Ebola. Will the Chinese develop one on their own in time if an outbreak actually happens?

> Better to have multiple heads working on one problem

Yea, I know.

> Will the Chinese develop one on their own in time if an outbreak actually happens?

Maybe they already have one?

Somehow NIH believes it's all good?

[...] Two new clinical trials testing an experimental vaccine to prevent influenza caused by an H7N9 influenza virus are now enrolling volunteers at sites across the United States [...] March 15, 2018

[1] https://www.nih.gov/news-events/news-releases/h7n9-influenza...

The article prominently cites the fact that the 20-40 yr old population had not been exposed to H1N1 and thus their immune system was not primed to fight it.

I wonder, then, if we are better equipped today because of increased globalization as well as widespread use of flu vaccines. Virus strains can fly all over the world easier than they could 100 years ago, so there is more 'mixing'. At the same time, we are getting a flu shot every year with the current batch of popular strains. By the time we reach the age of 20, we have likely been exposed to most subtypes of Influenza.

I am not an Anti-vax person, but I am leery of the Flu Vaccine. Could you help me understand why it is better to be immunized against last year's flu instead of surviving this year's flu? If this isn't the place and/or you aren't the person, I'd appreciate a gentle nudge in the right direction. Thanks!

> I am not an Anti-vax person, but I am leery of the Flu Vaccine. Could you help me understand why it is better to be immunized against last year's flu instead of surviving this year's flu? If this isn't the place and/or you aren't the person, I'd appreciate a gentle nudge in the right direction. Thanks!

It is not that you're immunized against "last year's flu"; the flu virus mutates, and in designing a vaccine for what we predict is going to be this year's flu, taking into account what ended up being the dominant strain last year is a good input.

The NYTimes has a good piece explaining why it's better to get the flu shot than to get the flu: https://www.nytimes.com/2016/10/08/health/lets-talk-a-millen...

One thing they don't mention, though, is that, while the flu shot doesn't ensure that you won't get the flu, it does decrease the severity of your illness and symptoms if you do end up getting the flu. Which, if your alternative scenario is "surviving this year's flu" is still a win.

The flu shots are not anywhere near 100% effective, which likely has to do with what you note: they are based on a laboratory concoction that tires to predict what the new strain might look like.

Plus, aren't you polluting your immune system with the long-term presence of antibodies that soon become irrelevant (if they ever were relevant to begin with?) It's like stockpiling garbage information in a database. Over time, could this constant introduction of rubbish not tax the capacity of your immune system, so that you lose immunity to something important like tetanus?

There is some evidence that chronic flu shot users, those who get them year after year, actually become weaker against the flu.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4387051/

https://www.ctvnews.ca/health/serial-flu-shots-may-limit-bod...

In the paper you link the suggested mechanism for vaccine fatigue is the immune system under-reacting to the new vaccine, because because it's too similar to the old vaccine.

The effect vanes over time, and most certainly is not relevant to tetanus.

[...] This hypothesis holds that the impact on the current season’s vaccine effectiveness is most pronounced when the difference between last season’s vaccine component and the current season’s vaccine component is small (this year they’re identical).

In that case, the current season’s vaccine may boost memory of the earlier vaccine’s antibody responses; then these “old” antibodies may mop up the current vaccine’s antigen before the newly vaccinated person can mount an immune response to it (this is called antibody interference). [...]

Because flu is painful and takes days out of your life, while the shot is (relatively) painless and takes 15 minutes out of your Walgreens shopping time?

The flu shot cuts down infection probability by 2/3. If a given unvaccinated person gets flu 6 years out of 10, that same person with vaccination would only get sick 2 years out of 10. This is a huge difference.

Whether they used last year's strain or any other method is immaterial so long as it delivers the 2/3 reduction.

That seems very short sighted in evolutionary terms. Guns, Germs, and Steel has served to give me a bit of trepidation about avoiding sickness for convenience sake.

Okay. Which diseases are you willing to brave to facilitate the continuous evolution of mankind? Flu? Hepatitis-C? Polio?

We have a real vaccine for polio that is 99% effective after three doses.

So?

And doesn't have to be taken year after year for new strains of polio, filling your immunological memory with outdated junk.

So, apples and oranges.

There are reasons to have reservations about flu shots that do not apply to polio and such.

> filling your immunological memory with outdated junk.

you have no idea what you are talking about.

So, enlighten me, immunologist.

What purpose is currently served in your body by the imprint created by a flu shot that you had seven years ago (at which time it was 60% effective at best to begin with)?

I didn't mean to offend. I'm a historian so I tend to think in blocks of time. I often miss the moment. It is a failing. I should have thought before I posted.

“ If a given unvaccinated person gets flu 6 years out of 10,”

6 years out of ten? Dude, the ppl around you are not washing their hands!

And you must be riding the public transit system instead of driving or taking the bike.

Yes, all you have to do is wash your hands and no more flu. /s

At age 35, I’ve never had the flu, and only got the shot a couple times in my life (it floors me - so I usually only get it when it includes a bad flu season)

But I wash my hand obsessively. Ppl are gross and then lecture you for not taking the shot, go figure.

It's to protect the elderly, young, and immunocompromised people around you who you might pass it along to. Or if you have friends who are parents of babies- you could give them the flu, and they could give their baby the flu and the baby could die.

If you have the vaccine, that's less likely to happen. How much likely, depends on how protective the vaccine is in any given year. But it's better than nothing.

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