This season's must-have thing is the flu shot.
It's the Furby for adults.
This season, it's everywhere--at your office, at your Y, at the corner church, the local school, your supermarket. "Paper or plastic, and you want a flu shot with that?"
Haven't gotten yours yet? Well, what's the excuse? It can't get any easier.
You could have done it atop the Foggy Bottom Metro stop, for heaven's sake, a few busy Fridays ago--shift the briefcase handle over the wrist, place the paper coffee cup on the ground for a second, roll up the shirt sleeve, take the needle and run--smoother than a NASCAR pit stop.
You could have done it at Rodman's--had a smidgen of hemagglutinin antigens grown in chicken eggs stuck into your deltoid, then picked up some micro-brew, a nice dried salami, cocktail napkins and maybe some Revlon lip liner during the 15-minute wait to make sure there are no adverse reactions. Some places in Florida, where the oldsters can't or won't walk anywhere, have perfected the drive-thru flu shot.
This mass immunization program is really quite remarkable, a public health triumph of information and penetration: Last year, the Visiting Nurses Association doled out about 40,000 vaccinations in the Washington metropolitan region. This year, VNA nurses will administer about 100,000 shots, and that doesn't count the huge numbers of folks getting it from government programs or their own physicians. "We are finding that our corporate segment, with the shot free to the employee, just continues to soar," says the VNA's Karen Holt. No surprise there.
We are lining up dutifully, whether we need it or not. And most people probably don't.
According to the Centers for Disease Control and Prevention, influenza and its evil shadow, pneumonia, are associated with about 30,000 deaths each year and up to 300,000 hospitalizations. The flu's devastating, dire complications come first to the 34 million people over 65 and the 32 million with underlying, chronic health problems, including heart, lung and kidney diseases and asthma, diabetes or severe anemia. Those people are in the risk group that public health officials want immunized, along with women in the second and third trimester of pregnancy and health care and child-care workers.
Teresa Wu rubs her sore arm and says she doesn't fit into any of those categories. Her mother-in-law made her get a shot. "She insisted," says Wu, 40, and so she waits in a line of 20 people at the Safeway in downtown Bethesda. She's never had the flu, but she "guesses" she needs the vaccine. "I don't really pay much attention," says Wu.
Keri Christenfeld, 49, had the flu once, when she was 7. She gets a shot every year, thinks it's magic. "I just know when we find a vaccine for the common cold, I will be very happy," she says.
Thousands, nay, millions of citizens are just like her. Folks have no respect for illness anymore. Taking to bed with the tissues and shakes holds no allure. The flu shot is modern medicine at its finest--a cheap, fast, safe fix-it. And isn't it easier than natural flu warriors, those old-tech solutions of hand-washing, eight hours of sleep and plenty of sunshine?
Yet a look at the numbers hints that mass immunization programs may be most successful in their reach into the population of the healthy, the paranoid and the control freaks. Only 67 percent of white people over 65 have gotten the vaccine, according to a CDC survey, and only 50 percent of black seniors and 58 percent of Hispanic seniors. Fewer than 30 percent of people under 65 who are identified as high-risk get the vaccine. Public health officials said they keep no statistics on the vaccination rate among healthy adults.
The policy is that anyone who wants the vaccine should have it, although in some free clinics in California, Massachusetts and elsewhere this season, programs have gone begging for vaccine. "It's a very, very sick feeling to have to say to a fragile senior who's on limited benefits, 'We're out of it,' " a hospital vice president in Orange County, Calif., told the Los Angeles Times. Drug companies have made about 90 million doses for this season, according to the CDC's Tom Skinner, which should be enough to inoculate the 66 million at risk and plenty of healthy Americans as well.
To be sure, the flu must be respected.
"It doesn't touch you," says Suzanne Mongeon, a registered nurse who cheerfully sticks thousands each fall. "It beats you." The symptoms are high fever, headache, body aches, extreme fatigue and cough, sore throat and runny nose. They last and last. They can only be endured. If you aren't sure you had it, you didn't.
Anne Horowitz is 59, and she remembers the flu she got when she was 14. "I was sick more than two weeks, with a temperature of 104 or 105. There were hot flashes--well before my time!--and body aches that made it seem my entire being was falling apart," she says. For 45 years, she was flu-free, and then she got two flu shots. And after each time, she got the flu.
"It was a lot milder, and only two or four days, but the same thing--fever, pain," says Horowitz. "And some trouble breathing, like an asthmatic." This is never supposed to happen. Health officials insist that the vaccine, which is killed and safe, cannot give the flu. "I just think it's very surprising that I cannot get the flu for all those years, and then, after both shots . . ."
And yet, here she is, lifting her sleeve for Flu Shot No. 3. She shrugs.
"You don't want to miss any work, right?" suggests nurse Caroline Jackins, who is handing out clipboards holding standard release forms and collecting the $15 the VNA charges ($5 tax-deductible).
Medicaid reimburses. The Clinton administration started that in 1993, and, by the way, POTUS has had his flu shot, and so has Surgeon General David Satcher (who is pleased to announce that gospel star CeCe Winans will be doing flu ads, in case anyone has missed the publicity blitz). No one would want those guys missing work, and Friederika Nonnenmacher's employer doesn't want her out sick, either. Nonnenmacher is a German au pair, 19, the very picture of robust fitness. "My house mother says I must have one, so I can work, so I get one," she says, pushing her young charge in a supermarket cart.
At the Safeway, Mongeon administers 37 vaccinations an hour. She takes 100 to nearly every site, and usually uses most of them up. It's as if her patients all have read this CDC directive and believe it speaks directly to them: "Persons who provide essential community services should be considered for vaccination to minimize disruption of essential activities during influenza outbreaks."
Billable hours could be lost. Consumer data could go unmined. Massive egos could go unstroked.
Over at the Senate, staffers troop into the nurse's office and bare their arms. Jim Jones, policy director for Sen. John Kerry (D-Mass.), gets one every year.
Ever had the flu?
"Because," says Jones, "that's just what people do here."
CAPTION: This won't hurt a bit: Suzanne Mongeon gives Jamie Peyser a flu shot at a supermarket in Bethesda.
CAPTION: Better to get stuck with a needle than stuck with the flu.