Got my high-dose "Old Geezer" flu shot today.

[Ms. Toad]

87. It's a balance of risks v. benefits.

I have both personal and family autoimmune diseases - and the general rule of thumb is that when you have one, there are others lurking.

Autoimmune disorders involve an overactive and misguided protection system against intruders. I'll use my daughter's, since her system is simpler to explain than mine. My daughter's involves being activated by an actual intruder (in this case something eating she is allergic to), and then mistaking parts of her body that are in contact with the intruder (in this case her colon) for being part of the intruder, so instead of attacking just the actual intruder ( the stuff she is allergic to), it attacks her own body (her colon). Then, even after the intruder is gone, her body cannot figure out how to stop the attack. It costs $200,000 in medical care every year to control her autoimmune response - and when she fails to contain it, the cancer risk that is associated with inflamation increases. That's a simplified explanation - but it may help you understand the nature of the risk.

On the vaccine end, vaccines are often not strong enough to provoke the immune response needed to create immunity - so they are often paired with adjuvants, whose only job is to rile up your immune system so you have a stronger response. So an even more amped up immune response to a system that is already overactive and confused creates a risk of greater autoimmune damage (and the cancer risks that go along with it).

My own immune disorders (at least the two I've been diagnosed with) are a lot blander - but the system works the same way - so I'd rather not rock the boat unless there is a good reason.

Good reasons include highly effective immunizatins against inherently deadly diseases (measles, polio, tetanus, etc.). My daughter has had all of the major childhood vaccines - and the HPV vaccine (she is sexually active), and hepatitis vaccines (a second autoimmune disorder involves her liver) - so the benefits of those outweigh not insignificant risks.

Personally, at least at this stage in my life, the risks of a relatively ineffective influenza vaccine or the pneumonia vaccine (the effectiveness of which I have not explored) don't outweigh the benefits. I rarely catch the flu (twice since 2003, and I don't have a good recolletion before that). I rarely catch colds (and those I do catch are relatively easy to hasten away now that I have discovered zinc), and there is nothing wrong with my respiratory system.

I don't know the personal circumstances of everyone considering whether to get the flu vaccine - but everyone has the right to full information on which to make the decision. Most conversations completely omit how ineffective the influenze vaccine is - and, unfortunately, when it is raised the messenger is generally attacked as being anti-vax.