Flu, God, and Medical Math
Arnold Solof, MD
Belief Systems
People have certain trigger topics that upon hearing them initiate an automatic recall of not only a set of believed “facts” but a visceral set of associated feelings. Examples of this include God, religion, and abortion. There are trigger topics in medicine as well. Examples are circumcision and Flu vaccine. Everyone doesn’t have exactly the same triggers or have them to the same degree, but the phenomenon is real and present.
So, in the case of Flu vaccine, when the topic is mentioned, a response is set off. The individual “knows” about it and “understands it”. If the person happens to know incorrect facts, trying to correct or explain the error is like trying to negate the existence of God in a believer. The person doesn’t want the correct facts and is unable to consider the possibility that the universe is different than they perceive it. At this point, the veracity/reliability of the source of their current beliefs is irrelevant. To them, it is known and accepted. By the same token, the authority/knowledge of the new/alternate source of information is also irrelevant. Having incorporated the facts/perceptions into their current belief system preempts all other considerations.
So, for people who “know” that Flu Vaccine:
- Is bad for them
- Will make them sick
- Will give them the Flu
- Is a conspiracy of the medical profession
- Is something they should not get and should not let their children get
It is more of a faith/religious-like belief system than a set of facts and scientific understanding promulgated by a reliable source of medical information with a convincing argument.
However, at times when the Flu hits particularly hard and is viewed repeatedly on the daily news cycle (like what is happening now), fear and panic set in and temporarily suppress this trigger-like emotional response system. These people are getting the Flu Vaccine. This is occurring despite the fact that this years vaccine is only about 1/3 to 1/4 as effective as the average annual Flu Vaccine and that it is mid-February and so perhaps we have 2 months remaining out of the total 8 Month Flu season (1/4 of the season). This Flu season is especially severe. There are far more cases than usual and we are seeing many more deaths. It is roughly 4 times more severe than the average Flu season.
The Math
For those of you who haven’t gone to medical school and spent a lifetime contemplating vaccine administration strategies; for those of you who don’t automatically compute the odds of various risk scenarios in your head in an attempt to reach rational decisions, let me break it down for you mathematically.
We will estimate how many people out of 100 we will protect.
M = Months of protection
E = Efficacy
S = Severity
Current Flu Vaccine Situation:
- 100 X 2M/8M X .2E/1E X 4S/1S = 10 (ie. 10 cases out of 100 prevented)
Standard (average) Season Flu Vaccine Strategy
- 100 X 8M/8M X 0.8E/1E X 1S/1S = 80 (ie. 80 cases out of 100 prevented)
What Will Happen?
Next year when the next average Flu season arrives and without the current panic/daily news cycle reminders, people will revert to their automatic triggers and belief systems. It won’t matter to them if 1+1=2 if it contradicts their belief system. They will assume the math must be wrong for some reason. They will leave themselves and their children unprotected.
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