Thinking Hard About the Flu Vaccine
Sharon October 14th, 2009
I am not a vaccine absolutist – I do not adhere to either pole of the vaccine debate. I neither believe that all vaccines are a bad thing, nor do I believe that they are all universally good and should all be taken. Indeed, I think it is a serious mistake to speak of “vaccines” as though they were a single, monolithic concept.
Both my paternal grandmother and my father’s second wife, my step-mother (not the same person I refer to generally here as my step-mother – that marriage ended years ago) had had polio in their youth, and I saw in both of them the consequences of that disease – the heavy brace on my step-mother’s leg, and the struggle to keep up with her children; the gradual decline in her health as my grandmother moved back, from the cane she’d laboriously achieved over years of rehabilitation, back to the walker, and then the wheelchair, as her last years were rendered miserable by post-polio syndrome. How could I not see the polio vaccine as a gift? Or tetanus, that scourge of anyone who works with dirt, that unbelievably painful and fatal illness. Who isn’t glad that there’s a rabies vaccine for our pets so that summers don’t end like a Harper Lee novel?
My oldest son, as you all know, is autistic. It would be easy to blame the mercury content of his vaccines – except that my son was born on the cusp of real awareness of this, so for the most part, he didn’t have mercury laced vaccines. We declined some vaccines – chicken pox and thankfully, rotavirus. We accepted others. But I don’t see an answer to his condition there – like all parents, we made the best choices we could, and if I’m wrong, and there were consequences, well, they were still the best choices we could, though I might wish for better.
I think it behooves us to speak not generally of “vaccines” but of specific vaccines – of the risks and benefits of each one. They are not all the same – vaccinations have managed to remove the scourge of polio – if you can’t imagine how terrifying it was in the summers when that swept through the cities, try – read a novel in which it happens. Tetanus is, I personally believe, a wise choice for everyone – the bacteria resides in soil, and what we do to care for our land puts us at greater risk.
On the other hand, I am somewhat more skeptical of the flu vaccine. I have received it in the past – when we cared for my husband’s grandparents, it was my profound fear that my children would bring home something that would kill them, and we considered the benefit analysis to be positive – even if the shot wasn’t fully effective in older people, we could perhaps reduce the risk of exposure.
I probably will get an H1N1 vaccine this year – mostly to avoid spreading the flu to extended family members with health issues. While I think that some of the claims about the effects of the flu vaccine are undersupported by research, I also think my body can handle it, and, frankly, I think it is worth a little shot in the arm to marginally reduce my risk of killing some elderly family member. But that doesn’t change the fact that it seems reasonably clear that there are more effective ways to address influenza – and that we won’t use the most effective tools we have.
In the current flu outbreak, there does seem to be some evidence that younger people are getting sicker. I haven’t fully gone back and read the study though, to see what the absolute numbers are. Nor is it clear to me that all the cases were confirmed as H1N1 – about four years ago, something similar was reported in an early winter flu that seemed to have a high mortality rate among young children – but that flu season turned out not to have a higher overall mortality rate. There are things we will not know until we know them.
A lot of the anti-vaccination material out there is pretty poorly reasoned – but this article from the Atlantic, I think does a fairly good job of exploring the limits of the flu vaccine. It doesn’t answer all the questions – that is, looking back at some of the papers, it seems like we may have some evidence that vaccinating school children would reduce overall mortality in the elderly and among those with immune-compromised systems – they are the least likely to get severely ill, of course, but since school kids are among the most likely people to transmit the disease, the overall benefit might be sufficient – but we’re not sure of that.
But what’s really important about the article is the end – which points out that we eschew the methods that we *know* would reduce flu mortality – ie, staying away from one another during an outbreak. We have tools to keep the elderly and ill safer than they are – but we don’t use them because the industrial economy is so adamant that it cannot afford us time to be sick, or to be safe.
This, I think is the most important part of all of this – I’ve written before about the ways that the industrial economy tries to subsume us all, and our time. Women who want to nurse babies can’t be freed – they must work. Sick people can’t stay home. Parents can’t care for sick children. The industrial economy must go on – it does not serve our needs, we only serve its. And this is the true purpose of the flu vaccine – not to prevent deaths, but to continue on our merry ways *without disrupting the economy.* And this alone makes me suspicious of the process.
Of course most of us can’t afford to buck the dominant paradigm – if we stay home when flu is running through our office, we’ll be fired. If we take the kids out of school, someone has to stay home with them. And who has more than three days of groceries at home anyway? Of course, our government could help here – but it has chosen a side – the economy uber alles.
Sharon
- health
- Comments(37)
The way the flu vaccine is pushed to keep the industrial complex running is so reminescent of how industrial agriculture uses antibiotics to deal with overcrowding (the disease there that can run rampant of course would be much less severe if the animals were not crowded).
Funny, I was thinking about this very topic this morning on my way to work.
I have been torn on what to do. Like you, I am selective on my vaccinations and do believe
some are needed. I also refused chicken pox (altho, the peditrician gave it to my younger son w/o
asking me first, but that is another story). My children, husband nor myself have ever received a
flu vac. I trust their immune systems. I know at my ped’s office, the method of coercion is to tell
you that by not vaccinating your child for X, you are “killing other children”. I love that method!
(sarcasm).
I also worry about the what if my one of my children do (G-d forbid and another bigger worry altogether)) become ill and it is determined to be H1N1 and, because I chose not to vaccinate, I am deamed a neglectful parent and brought up
on charges.
No doubt, there is much to think about on this topic!
Sorry about the typos-my computer is not cooperating with me this morning!
I was disturbed when you mentioned the so-called vaccine-autism link in your book. Now that you’ve mentioned it here (although it sounds like you are no longer considering it), I have to respond. Given your extensive research on so many other topics, it bothers me that you appeared to have not extensively researched this. It makes me call into account anything else you say since I know this one thing is blatantly not true. What about other items I don’t know anything about–can I trust you? (I have chosen to do so, overlooking this one, but it still bothers me enough that I had to post. I don’t want others to not believe you!)
Are you aware that there is absolutely no proof of any link? The authors of the original study have thrown out their theory–including retracting the publishing of the study, http://discovermagazine.com/2005/jan/vaccine-autism-link-debunked/?searchterm=autism . Even if they didn’t, the original study was only on 12 children and no one at all has ever produced another study that confirmed any link between Thimerasol/mercury and autism. See for instance http://www.webmd.com/brain/autism/news/20050712/new-intensity-to-debate-over-autism-cause and http://www.cdc.gov/ncbddd/autism/documents/vaccine_studies.pdf
According to the Times in London, the original data was actually altered to report the link: http://www.timesonline.co.uk/tol/life_and_style/health/article5683643.ece
Please don’t publish anything further suggesting a link. Mainstream media still does it, and I hope you continue to combat their misinformation on so many things!
Yeah, it’s probably inevitable that the frothing anti-vaccine fanatics are now being countered by frothing pro-vaccine fanatics. One of the memes they’re currently pushing hardest is that even if the cost-benefit analysis doesn’t make a given vaccine worth it for you, only a disgustingly “selfish” person would refuse it, because the real reason to vaccinate you is to protect “the herd.” Hey, maybe The Herd can at least pay for a flu injection for me, rather than demanding that I shell out $25 at Walgreens every year (for Sharon’s family, that would be $150 a year
). For those vaccines that require one or more doctor’s visits, maybe The Herd could pay our copays — or the $100+ a simple office visit can cost those who don’t have insurance. If vaccination is a matter of “public” rather than individual health, should it not be supported by the public, i.e., the government? To think I used to oppose “socialized medicine” … but then I developed some common sense.
Dewey, to be fair, the H1N1 vaccine should be available free across the US and in public sites.
AnnMarie, I agree that the research on the vaccine-autism link shows no link – which is one of the reasons I mentioned that this wasn’t a factor for us – to forestall that discussion. I think you misread me in both my book and here, and are assuming that any mention of the concern indicates an endorsement of an idea. Trust me, when I endorse ideas, most people don’t have any trouble telling that I have done so
. As for whether you should believe me or not, that’s really up to you. I do think that the case for reducing mercury exposure in infants and children is ironclad – there’s no good reason to use thimerosol-containing vaccines on children, period. Moreover, I think there’s good evidence that children on the autism spectrum tend to be less tolerant of even low levels of toxicity in a host of ways, and mercury is particularly bad for them. So I don’t spend much time criticizing the vaccine link people, simply because I think they’ve largely done us a service by getting attention drawn to vaccine preservatives.
Sharon, I appreciate your balanced view toward vaccines. My grandmother contracted polio at the age of 3 and suffered from its effects for the rest of her life, my mother almost died of whooping cough as a child and I had a truly awful brush with mumps at age 16 which left me in poor health for several years. Even the usually benign chicken pox led to viral meningitis in my then 8 year old daughter; fortunately there were no long term consequences but she was miserable for months.
I believe many of the anti-vaccine people have no idea how terrible some of these once common illnesses are. That said, I also think some of our current vaccines are unnecessary and ineffective, or needlessly dangerous. I think there is always a trade off between benefit and risk that we must accept as a society. I believe many people overestimate the risk of the vaccine and underestimate the risk of the disease.
Lorna
My children have received all of their vaccines on the recommended schedule, though I have
long been suspicious of the chicken pox vaccine. But recently my mother-in-law contracted a
terrible case of shingles. She was told that children who have had the cp vaccine are at much
lower risk of contracting shingles as elderly adults. Given how sick my MIL was, and how the
damage of shingles can result in permanent pain, I am re-thinking my concerns about the cp
vaccine.
So true about the “protect-the-industrial-complex” angle — I think that is what underlies Kevin’s (Cryptogon) preoccupation with vaccine issues.
Isolation has a long and venerable, if not always well-directed or effectual in all cases, history. Remember The Journal of the Plague Year? Or the Decameron? Or Leviticus?
Think about those food bins, y’all. A cup may be half empty or half full, but a food bin that’s half empty is halfway to empty.
Up to half of my student shelvers have been out with flu/cold-type symptoms for the past week. I’m about this close to issuing official warnings to anyone else who comes to work sick. And I can’t do anything about the student who was clearly feverish and so didn’t come to work, but instead sat in the main study area working on homework and sniffling at half the school. Sigh.
I admire your balance Sharon, I am trying to acheive the same thing. My children have all had their vaccines, although not always on schedule I do believe my younger two were several years behind on theirs. I refused the most recent vaccine for girls only (HPV vaccine) because I wasn’t comfortable with the reports of side effects, even though they were rare. And since one of the enticements to get the vaccine was “even if your daughter is chast, she may get it from her partner” I’m left wondering why it isn’t offered to boys, no explaination has been given there.
My entire family did get the flu vaccine two years in a row, and those two years were the worst I can remember. I usually only get one flu a year, if that, but those two years I caught everything that was going around. While not scientific, it gives me personal confirmation that there is something to the study which showed that those that got the flu vaccine were more likely to catch the remaining flu’s they weren’t vaccinated for.
My biggest concern for the H1N1 vaccine is the knowledge that they will be full of adjuvents such as squalene which I believe has been fingered as the probable cause of Gulf War syndrome.
I take that back, my biggest concern is that I will make the wrong choice, that my precious children will suffer the consequences of the action I did or did not take. That is what fills me with fear, what keeps me awake, keeps me looking for more answers and information.
There was a rather heated argument about flu vaccines on a list I’m on. The “selfish” argument got trotted out regularly, as if anyone refusing the vaccine were on a par with Typhoid Mary.
According to the CDC and other sources I’ve read, flu has a short incubation period and it’s not easily passed along before one becomes symptomatic. The person who is not yet sneezing and coughing is not passing it to others just by being in the same room.
Self-quarantine can therefore be an effective method of containing the spread of influenza, but it’s not possible for everyone. We don’t all have the means to hole up at home at the first sign of illness. Not everyone lives alone or with disease-resistant people.
Some of us have regular interaction with people who are very young, very old, or immuno-compromised. Others of us have little interaction with anyone at all.
Some of us can easily take time off from our jobs, or maybe we don’t have jobs. Others don’t have paid time off and a sympathetic employer, and will feel compelled to work as long as possible, even while sick.
Some of us have full pantries and can self-quarantine for months. Others don’t even have tonight’s dinner waiting in the fridge.
I don’t think there’s a one-size-fits-all answer to whether any particular person should get the flu vaccine. One shouldn’t refuse it out of ignorant fear, but it’s also quite possible to be rational and correct in deciding that one’s particular circumstances make getting a flu shot no one’s business but their own.
Ann, if quarantine were a serious option, it would have to include help in doing it for a lot of people – but that’s perfectly viable, and probably more successful than a flu vaccine, if reducing mortality were the priority.
So much a not one size fits all situtation.
So far, flu vaccines have worked well for me — one year I didn’t have one, I had the flu, ended up in the ER, blah blah, blah
I work in a public library — hello exposure. One child is medical fragile; my father, who helps care for my children, is immuno supressed. My 4year old nephew who I see 5 days a week has asthma.
Simply put, it seems worth it for both my parents, my both my children, and me to be vaccinated.
My housemate, who seems to have a resptory tract made of iron, choses not to get the vaccine (which we get free as county employees) even though she has even more contact with the general public in the library.
While I don’t mind people who don’t have their children vaccinate, I do find the attitude I’ve run into several times which boils down to “I don’t know if vaccines are safe, so I won’t have my children vaccinates, and I don’t have to worry about them catching whatever, becuase the slacker parents who don’t care as much about their children will have had them vaccinated and my children will be safe” rather up-my-nose-getting (which would be a wonderful word in german, don’t you think.)
MEA
Helen, they’ve been giving the chickenpox vaccine for 15-20 years now; how exactly are they going to demonstrate that children who receive it are less likely to contract shingles??? They originally thought the kids wouldn’t catch chickenpox (since that’s the goal of the vaccines after all), and then after 10+ years they started having an increase in cases of adolescent chickenpox (which is much more serious and when all the dangerous complications really spike) as the vaccine protection wore off. So now they’ve got a booster schedule in place.
Just remember the risk analysis. Most of us put our kids in cars on a regular basis despite the significant risk of morbidity/mortality. Even polio, which several here have mentioned including Sharon in the original post, is 95% benign if contracted. The problem with communicable diseases is not really the disease – it’s the communication!
MEA, what’s the german word???
I only had a flu shot one year (I’m allegic to chicken feathers, so doctors always told my parents/me not to get one, since it was cultured in eggs)—that was the year before last; I got sick within a week after receiving it and stayed sick for nearly a month. Most other years (including last year), no flu shot, and only the usual sniffles and coughs lasting a few days. This year? I don’t know. I have a doctor’s appointment in a couple of weeks for my annual A1C test (I’m diabetic) and I’ll talk to her.
Sharon, your statement “And this is the true purpose of the flu vaccine – not to prevent deaths, but to continue on our merry ways *without disrupting the economy.*” sounds a little too conspiracy-theory for me to accept.
I get a flu shot because I don’t want to get the flu or bronchitis/pneumonia, which I come down with every year I don’t get a flu shot. It’s not a matter of worrying whether my workplace would slow down if I got sick.
In fact, I would argue that my workplace could afford to lose me for a week – or a month – more than my household could. If I became gravely ill for 10 days and weak for another 20 during peak garden prep or harvest season, our food supply would be drastically interrupted. So you might say the real purpose of the flu vaccine is to be able to continue on my merry way without disrupting my gardening. Would that statement make you skeptical of getting the flu vaccine?
Christina,
I don’t think there is an actual word tha mean up-my-nose-getting, but I understand that you can build words in German, and I’m betting that up-my-nose-getting translated into German would sound very impressive.
MEA
I got the flu shot for the first time on Monday, since I’m pregnant. I will also get H1N1, since I work in a school where there were cases last year, and as you state, parents don’t keep sick kids home.
If I was not pregnant, I would have no plans to get either vaccine. I feel about flu vaccines the same way I feel about other medications: I don’t take them unless I REALLY REALLY need to. I can’t remember the last time I took an aspirin.
Harmony – if the squalene makes a difference for you in deciding whether to get your kids the flu shot, the H1N1 shot does not contain adjuvants, so it has no squalene (whose link to Gulf War Syndrome is not well-demonstrated anyway). European vaccines use adjuvants so are equally effective (or not) with half as much antigen, meaning that the same amount of killed virus can vaccinate twice as many people. Some feel that Americans are, yep, “selfish” in essentially taking up 100 or 200 million extra doses, which this year will therefore not be available to developing countries in time to do much good, because of our unwillingness to incur a probably minute extra risk from adjuvants in our vaccines.
Emily, read the Atlantic article. This is not “vaccines don’t work” automatic rhetoric, but “the flu vaccine doesn’t seem to do what it has been reported to do on large populations.” We know what would work – when pandemics hit, close schools, subsidize employers to close work in non-essential professions, cancel public events. We *know* that social distancing reduces deaths. There’s not clear evidence that the flu vaccine does. The point is that the flu vaccine seems to mostly be a placebo to keep people going to work, rather than responding as they would. I don’t think it is a conspiracy theory at all – the discussions of pandemic flu by the government have focused heavily on the economic impact of closed businesses and economic disruption – all of this could be in some measure mitigated by government involvement to enable a temporary closing, but it won’t be. So if they give you a flu vaccine that doesn’t reduce the risk of illness dramatically, and on tamiflu and relenza whose impacts seem to be overstated, I think it is just common sense to observe that there’s a reason why the primary investment is in strategies to keep everyone going about as usual.
MEA, I tend to agree with you in most cases about the “well, I care about my kids, but I’m taking advantage of herd immunity from yours” bit. And yes, that would be a good word. In this case, I think the possible statistical benefit of the flu vaccine is pretty simple – what might be good about the flu vaccine is that if all the healthy young people get vaccinated, some of the older people who don’t or don’t respond to the vaccine might not die. But that’s a possible statistical benefit – even that hasn’t been fully confirmed.
Sharon
I am single, self-employed, and my work is a peripheral part of public health, among other things. I consider myself to have a DUTY to stay well in order to serve my community, and I also simply cannot afford to lose work due to illness. And with dangerous diseases (of which flu is one), I don’t think it’s ethical to get sick with it and then blithely spread it around without concern for others. So I got my seasonal flu shot recently (and GASP, didn’t die), and will get the H1N1 shot soon.
It’s interesting to read everyone’s comments. Thank goodness we live in a free country where people can make their own educated decisions on matters such as these.
Who pays for health care and what do they want? Employers pay, and what they want is exactly what you said: back to work/school as soon as possible.
To be fair, the CDC has really been stressing the “stay home if you’re sick” message pretty hard this year.
Should have been stressing it harder all along, of course, but at least the message is getting out there now. And is being echoed by our state and county health departments. Along with cover your mouth and nose when you sneeze or cough and wash your hands often.
I’ve been the one writing the flu stories for our paper, and have seen those phrases repeated in press releases, and typed them into my stories, so many times now I could type them in my sleep.
Our county health department has also been talking to local businesses about the need to plan for how they will operate if a large number of their workers are out sick. They hand out plastic viruses, to illustrate the point. (Now, everyone holding the flu bug, raise your hands … Now, managers, see how many of your workers are out sick? How will you …)
One of the school districts in the metro St. Louis area is closed for a week, apparently because of flu cases reducing attendance. It’s one of the smaller ones, well out in the burbs. I don’t know if the cases have been confirmed as being H1N1, or if it is a mix of diseases with similar symptoms.
Thanks for linking to the AM article; lots of very good info there. I haven’t been convinced of the effectiveness of either the flu vaccine or the antiflu drugs, since I was aware of what the article mentioned about years when the vaccine either wasn’t available or was the wrong type, and because my DH was given Tamiflu once, so we read the info that came with it, including the bit about it reducing duration of flu by an average of 24 hours. At $10/pill, it didn’t seem worth it to us.
Vaccines seem to be something that works better for certain types of illnesses than others. Something like flu, which mutates so rapidly, seems to be less suitable to the vaccine approach than something like smallpox (even there, a small number of people became ill from the vaccine). I’d like to see more work done on when a vaccine approach makes sense and when it doesn’t. It sometimes seems to me that researchers fixate on vaccines, as if they are a cure-all. Sort of the same way they fixate on antibiotics for bacterial diseases. It doesn’t mean either approach has no merit, but that indiscriminate use may do more harm than good.
I’d also like to see more care taken with making the flu vaccine (and others as well), particularly to use the old ways of making vaccines rather than genetic engineering techniques that may have hidden dangers such as fragmenting parts of the genome than then express themselves differently than they would have normally done. I understand that disrupted structure of nonadjacent portions of the genome has been shown in the few studies that have been done to look for this effect. Such a disrupted structure might lead to disrupted functioning. I’d like to see a lot more testing done to ensure that the entire genome still functions normally following genetic engineering.
I too suspect that the reliance on flu vaccine and antiflu drugs has more to do with keeping the economy and businesses functioning as usual than it does on what works best to reduce the spread of flu.
Having seen a friend lose a child to a normal vaccination I’m not happy to go there myself. I think I’d rather take my chances with the disease.
That said, if something really nasty with a high death rate came along I wouldn’t say no.
viv in nz
NM, that’s good to hear. That’s why I was also somewhat encouraged by the state of Massachusetts representing quarantine as a real alternative to vaccination in a crisis situation *and* by requiring unemployment benefits for anyone who enters quarantine.
Again, the problem is not that I think there’s a vast conspiracy – the problem is that I think it is taken as a given that we can’t allow economic consequences from illness, that the economy has to come first.
Sharon
My stepsons school district is giving free flu shots to all middle and high school students but if your kid is in elementary school – you know, the age group least likely to consistantly wash their hands and cover their mouths- then you are on your own.
I wonder what is up with that reasoning…
There’s some reason to believe that elderberry could cut more than 1 day off the flu if taken early – and the best and most expensive product I know of only costs $1 per lozenge, and you don’t have to go to an MD to get permission to buy it. I think I already had flu this season and knocked it back to nothing in 3 days with elderberry – but if I didn’t and I get it later, that’s what I’ll be relying on. The other thing about Tamiflu is that like every single-compound antipathogenic drug, it induces resistance relatively fast; they usually pretend that’s not a problem, but suddenly they’re asking healthy people who aren’t seriously ill NOT to come in for Tamiflu; apparently they don’t want to see it happen in the middle of a pandemic. Who’da thought.
I hope I was clear — it wasn’t just that these are relying on herd mentality to protect their children, it’s that they scoff at the vaccinators as “not caring as much about their children” as the parents who are speaking care about their children. I dont mind providing herd immunity for others, I mind being told that in helping protect their children, I’m being a bad parent.
MEA
Sharon,
Could you recommend reading (a web site or a book) that discusses the merits and dangers of different vaccines for infants and children? It’s hard to know what to trust and what is balanced.
Thank you.
Dewey_ Hi, and thanks for your response. I should clarify, I’m in Canada and our H1N1 vaccines will have adjuvants in them. I thought that while the US trial vaccines had no adjuvants, the vaccine that would be available for the rest of the population would. That is part of the problem, sorting through all the information (some of it conflicting ie adjuvants vrs no adjuvants) and making the best decision for the well being of my family.
MEA – I would never for a minute think that you (or any one else) care less for your children than I do if you choose to vaccinate and I do not (my decision has yet to be made). I find it offensive that anyone arguing against vaccinaton would even imply that! As parents we act in the best interests of our children and from a position of unconditional love, we will not always agree and that should be respected on both sides!
I keep my children home when they are sick, and will not be basing any part of my decision on “well I don’t have to get my children vaccinated because everyone else will be”. I just don’t trust the government and the pharmacutical industry to always be 100% honest and above board with me. And it doesn’t help that my Grandfather was one of those that almost died from the vaccine against the other swime flu.
Harmony, thanks for your kinds words. I, for one, appricate your sensible decision regarding keeping sick children home. (I bet your kids do, too.) And I was thinking about a select few when I made my comment about being called a bad parent.
My grandfather lost the sight in one eye from smallpox — which helps inform my choices. You, sadly, had a terrible loss, which as you said, doesn’t help you sort thought your choices. And, as you said, let’s support each other!
Best,
MEA
Wow. I just finally read the Atlantic article, and it is fascinating. My husband and I are still thinking about whether to get vaccinated this year (for seasonal or swine flu). But in the meantime, I’ve stocked up on elderberry syrup, ginger tea, licorice tea, and made a number of herbal remedies to keep on hand, along with making sure there’s plenty of food in the house.
I’m hoping that the main effect of this mild pandemic is to serve as a training exercise for the country, for viruses generally. (People dragging themselves to work when sick are a personal peeve of mine).
As I mentioned earlier, the CDC really is putting out a lot of information about how to stay healthy (and their website recommends keeping a supply of food on hand, preparing for disasters, etc.) Here in Oregon, the state, as well as our local county, have been putting a lot of emphasis on the practice good hygiene and stay home if you’re sick message as well. Colleges have put out information to students about isolating themselves in case of illness, hospitals are asking people not to visit people there if they have the flu (! gee, you’d think you wouldn’t need to spell that out …)
One Arizona county has even announced it will fire people who come to work with a temperature of 100.4, or flu symptoms (because they want people “to feel free to call in sick.” Anyone else find that line funny?)
Etc. I just really hope the basic “be sensible” message sticks as a long-term general good idea.