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Bonkers pricing of "free" flu shots shows what's wrong with US healthcare
The annual flu shots that are free to those with health insurance are not immune from the convoluted and contemptible price-gouging that plague the US healthcare system.
Health insurance companies pay wildly different amounts for the same vaccines depending on how negotiations go with individual medical providers across the country. In some cases, providers have forced insurers to pay upward of three times the price they would pay to other providers, according to an investigation by Kaiser Health News.
The outlet noted that one Sacramento, California, doctors' office got an insurer to pay $85 for a flu shot that it offered to uninsured patients for $25.
Though $85 might seem like a trifling amount in the bloated scheme of the US healthcare system, such prices quickly add up as tens of millions of people receive a flu shot each year. And while the Affordable Care Act requires insurers to cover the full costs of all federally recommended vaccines, including the flu vaccine, any extra costs to insurers get passed on to patients through higher insurance premiums, economists told KHN.
Looking further at what insurers paid for flu vaccines, KHN found that costs spanned the whole range from $25 to $85. A doctor in Long Beach, California, got insurer Cigna to pay $47.53 for a shot, while a CVS in downtown Washington, DC, got $32 from Cigna for the same shot. A CVS just 10 miles away in Maryland got $40.
(Score: 4, Insightful) by PartTimeZombie on Thursday November 21 2019, @12:43AM (18 children)
That is not true. If he didn't get sick it worked as it was supposed to.
If he got the flu anyway, it means the vaccine was for a different strain of flu.
The CDC has more info here. [cdc.gov]
(Score: 0, Disagree) by Anonymous Coward on Thursday November 21 2019, @12:49AM (11 children)
The way vaccinations work is by triggering your immune system to think an infection is present. If a vaccination induces no response, chances are it didn't take. The point is you are supposed to be *less sick*, at a time of your choosing.
(Score: 1, Insightful) by Anonymous Coward on Thursday November 21 2019, @02:39AM (2 children)
The influenza virus uses Hemagglutinin to bind to the Sialic Acid present on the Columnar Epithelial cells present in the respiratory tract. It is literally impossible to get the flu (a respiratory illness) from something injected in your blood. In addition, there aren't many such sites in your body to cause a similar infection. The only symptoms most people get is from the general immune response from your body and if you are otherwise in good health, it is very possible to get literally no symptoms. In self-reporting studies, only ~57% of people reported any adverse effects at all, including a sore arm, and 12% reported their children had any symptoms other than a sore arm and the rate of adverse events is even lower, as in almost zero, the older you get, until you reach 65-70, where it climbs up to the approximately 5%. Even if those reporting rates are markedly lower than the real ones because people don't want to be "wusses," it is still far from a guarantee that you will get any symptoms, other than a sore arm, if you increase them by an order of magnitude.
(Score: 0) by Anonymous Coward on Thursday November 21 2019, @03:56AM (1 child)
Wow only about 60% of people report any adverse event, and this drops with age? I wonder what else is reported to happen about 60% of the time and drop with age... Can you think of anything?
(Score: 0) by Anonymous Coward on Thursday November 21 2019, @10:41PM
Anti-vaxxers learning something new?
(Score: 3, Interesting) by Immerman on Thursday November 21 2019, @03:00AM (6 children)
It triggers an immune response, yes. However, without living viruses there's no actual infection, so it's just the initial immune response you have to deal with - maybe some minor discomfort for a day or two, quite likely nothing at all. While catching the flu will likely lay you down for a week or two. (actual influenza, not whatever unrelated cold you might call "a touch of flu" - there's a lot of other stuff also going around during "flu" season)
Of course the legitimate counterpoint is that in order to get a flu shot you will probably go to a doctor or clinic - a particularly pathogen-rich environment where you're much more likely than usual to catch something else.
(Score: 0) by Anonymous Coward on Thursday November 21 2019, @03:58AM (5 children)
Why are people just parroting talking points at me? Where did anyone say the flu shot is giving you the flu? A vaccine that doesn't make you feel sick, is a vaccine your body didn't respond to, is a vaccine that didn't work.
(Score: 0) by Anonymous Coward on Thursday November 21 2019, @04:24AM (2 children)
You might be retarded.
(Score: 0) by Anonymous Coward on Thursday November 21 2019, @04:50AM (1 child)
Nope, you are just very wrong and have too low of self esteem to admit it to yourself.
(Score: 3, Informative) by Mer on Thursday November 21 2019, @07:23AM
sure vaccines made from weakened viruses were the first vaccines
sure some vaccines are made from whole viruses genetically tweaked to be harmless
MOST vaccines are just the empty shells of viruses without the RNA inside, because that's easier and less dangerous when it works
Shut up!, he explained.
(Score: 4, Interesting) by Immerman on Thursday November 21 2019, @03:00PM (1 child)
Because you're wrong.
Feeling sick is almost entirely a reaction to an infection consuming your body to produce more of itself, while making you as contagious as possible (sweaty hands, cough, mucous, vomiting, and/or diarrhea are all infection channels promoted by the disease), NOT to your body learning to fight it off. And a vaccine only triggers the second reaction.
Unless you're allergic to the vaccine, at worst it will trigger a response similar to very mild allergies, and probably not even that. Think of all the diseases with no symptoms until days or weeks after your infection - your immune response fires up immediately - but symptoms don't begin until a critical mass of infection is present to cause the disease to change its strategy to Phase 2.
(Score: 1, Informative) by Anonymous Coward on Thursday November 21 2019, @10:06PM
Half, right, anyway. Still modded you insightful.
Sickness reactions are both the illness reproducing itself and also the body's defenses in fighting it. Fever (raise the body temperature because most pathogens are very temperature sensitive), increased mucous and other fluid production to isolate and contain the pathogen, achiness from inflammation (and the inflammation itself from histamine reactions again trying to constrict the pathogen's movement, as well as the body's innate defenses killing off the agent and leaving detritus which the body must then rid itself of or recycle), nausea (often from body chemistry changes from needing the sudden activation of the immune system), etc. Diarrhea is the body's way of trying to *clear* the alimentary canal by slowing moisture absorption from the canal and adding moisture to it in order to flush the pathogen out, not the illness acting. The sicknesses are just as much the body's "selfish" defenses acting as the damage caused by the illness. Passive defense before active defense can react.
That said, the active defense system takes time. It takes the body between one and two weeks to recognize the antigens, synthesize enough antibodies to attack them, then carry out that counterattack. (Plus train the B-cell memory cells which will recognize the disease next time around and mount the defense more quickly).
Vaccine reactions, if they happen at all, are usually the passive immune system reacting to some component of the vaccine. And if it is an actual illness.... you probably already had that illness incubating before you got the vaccine.
(Score: 0) by Anonymous Coward on Friday November 22 2019, @04:12PM
That's so wrong it's not even right.
(Score: 2) by HiThere on Thursday November 21 2019, @04:01AM (4 children)
I think there's a few different meanings of "got sick" here.
If a live flu vaccine works, then you will get the flu, and will be contagious for a few days, but it will be such a mild case that you probably won't notice. The doctor should have told the guy to be careful around his mother for a few days.
If it doesn't work there are two modes of failure:
1) The vaccine wasn't weakened enough for your system, and you get the flu you would have gotten anyway.
2) The vaccine was too weak, and you didn't get the disease or the immune reaction.
The first failure mode is quite uncommon. The second failure mode is common among the elderly, and others with weakened immune systems. They often recommend a stronger vaccine to properly stimulate the immune reaction.
Javascript is what you use to allow unknown third parties to run software you have no idea about on your computer.
(Score: 3, Informative) by All Your Lawn Are Belong To Us on Thursday November 21 2019, @10:20PM (3 children)
No, you will NOT "get the flu" by getting the vaccine. [cdc.gov]
The particles of influenza that are in the vaccine have been INACTIVATED. As in made not possible to replicate or be transmitted. You will NOT be "contagious". All that will happen is your body's active defense systems will train themselves to recognize the antigens of the strain delivered so that if you get that particular strain of flu the body begins its active defenses to kill it right away because it recognizes the pathogen.
If it "does not work" it has happened for three primary reasons:
1) You contracted one of the other hundreds (thousands?) of strains of flu the vaccine didn't cover. The vaccine only covers the four strains that researchers feel are the greatest threats in the coming season. You can read this [cdc.gov] to begin to get an idea how complex the subject becomes.
2) You ALREADY had the flu but it hadn't reached the stage of making you sick yet. (i.e. the vaccine was delivered too late).
3) You may have a very mild reaction to the shot. In a controlled placebo study it was found the same rates of mild symptoms occurred in those given sterile water injections and not the vaccine. I'm not sure about that (rough to take just one study), but I am sure that those mild symptoms are not the flu.
Again: YOU DO NOT GET LIVE INFLUENZA FROM A FLU VACCINE.
This sig for rent.
(Score: 2) by HiThere on Friday November 22 2019, @12:21AM (2 children)
That's not what my doctor said.
And he specifically told me to stay away from immune challenged people for several days. I didn't notice any symptoms, which is what I expected, but I expect that I got an extremely weak case of the flu. (A short web search says that that is true only of the nasal flu vaccine, but I think I'll continue to trust my doctor over the web.)
Javascript is what you use to allow unknown third parties to run software you have no idea about on your computer.
(Score: 1) by Sulla on Friday November 22 2019, @12:52AM
Doctors are often very bad with pharmacological knowledge. Pharmacies spent a lot of time on the phone with doctors trying to rectify bad prescriptions. Eg. ear drops for ear infections prescribed for eye infections, double the dose needed of drugs that have side effects, drugs which in combination cause death.
Trusting your doctor when it comes to an area they are not experts in is a bad idea
Ceterum censeo Sinae esse delendam
(Score: 3, Informative) by All Your Lawn Are Belong To Us on Friday November 22 2019, @04:07PM
You are correct that the nasal spray vaccine contains an attenuated live virus. However, it too CANNOT give you the flu [cdc.gov] - it doesn't have the ability to enter cells and replicate. There is exactly one recorded possible exception to this in the case of a toddler. One. (And any exception to this would be big medical news).
It's a smart idea to stay away from immunocompromised people if you may be sick. And it is routine advice to tell people to stay away from immunocompromised people if you are receiving any live attenuated vaccines (nasal flu, MMR, oral typhoid, yellow fever, herpes zoster, rotavirus, oral polio). From 2014 guidelines, only OPV is contraindicated to administer [aafp.org] to an immunocompetent person living in a home with an immunocompromised individual. But the only reason to do so after getting the vaccine is because you are not yet protected - it takes a week to two weeks for your body to respond fully to the vaccine. And again, if you already have the virus in your system getting the vaccine will not help.
But again, you did not get the flu from the flu vaccine. That you trust your Doctor, great! Wish more people did. Should you trust "the internet"? No. But will you trust:
Harvard Medical School [harvard.edu]
University of California San Francisco medical school [ucsfhealth.org]
Columbia University [columbia.edu]
Johns Hopkins medical school [hopkinsmedicine.org]
And, as before, CDC [cdc.gov]
Those aren't just "the internet." Those are the leading medical schools in the world telling you that you don't get the flu from the vaccine. And if you still don't want to believe that then there's not much else to be said. Hopefully others will read them and understand.
But, at the risk of being rated redundant: Again, the point of flu vaccines (as with most all vaccines) is not that your body begins multiplying the virus - the virus cannot multiply in the forms that are in vaccines, which is what "inactive" means. (One exception: Oral Polio Vaccine, a live attenuated vaccine and not inactive - it is known that a very small number of people do in fact develop polio from OPV in far fewer numbers than the live virus spreads. Which is why it is not used in the United States and the shot form of polio vaccine is inactivated). Instead, just the small amount of inactivated virus in the vaccine trains your body's active immune system to be prepared to fight the real live virus if it is encountered. Influenza mutates very quickly and there are multiple strains, which is why it is possible to get a flu vaccine and still actually get the flu later... just not from the vaccine.
But all that said, THANK YOU for getting vaccinated!
This sig for rent.
(Score: 0) by Anonymous Coward on Thursday November 21 2019, @06:49AM
or his body simply had a similar immune reaction to actually having the flu, but without actually getting the flu.
Does one actually contract tetanus after getting a DTAP or tetanus booster shot and subsequently enjoying a sore shoulder for a week to 10 days afterwards? No?