9-Jan-2020 (Thu)
Wherein we are a disease vector

Some time ago I walked by one of those "Free Flu Shots" signs, and I thought, we should be doing that at the club!

People come here to sweat on each other, become sleep-deprived and swap saliva. Basically we're where you come to get the flu, so why shouldn't we try to do our part to get ahead of that problem? Let people get their flu shot on the way into the club or on the way home. After all, it's not uncommon for organizations like DanceSafe or H.E.A.R. to set up their table at clubs, either inside or outside, to help people take care of themselves. This should be a no-brainer!

Well, it was very hard to get answers, but after investigating this off-and-on for over a year, I think we've learned that it's impossible.

One of our bartenders is a registered nurse, so our first thought was, does her accreditation allow her to just set up a table and stick people? She looked into it and the answer, unsurprisingly, is "Hahahahaha no."

It appears that the only people who adminster those "free" flu shots are Walgreens and CVS. And while they advertise that they'll come to your office and do your employees, it was hard to tell whether they'll come on site to do that for the general public, let alone at night. But after some phone calls, the answer seems to be yes?

But here's the problem: those free flu shots aren't free. They're covered by most insurance, but if you don't have insurance, or proof of insurance, they're $40 each.

First off, that pretty much makes this plan a non-starter, because most people don't think to bring proof of insurance with them when they're going out clubbing, and no way are they gonna pay forty bucks for it. I'm sure some people just carry that with them everywhere, but the chances of that go down the skimpier the outfit gets.

Bur second, WHY ISN'T THIS FREE? What kind of Libertarian hellscape is this that thinks that herd immunity works if you only immunize people who have insurance?? Spoiler alert, it doesn't, watch this video:

The best way for you not to get the flu is for everyone else to get a flu shot. Even if you don't care about anyone but yourself, you still want that herd immunity to be out there to protect you. That's why the Randian philosophy of "I got mine, fuck you" doesn't work when applied to disease prevention. (Or anything else.)

So we outsourced this to for-profit supermarkets instead of letting SFDPH administer it as a matter of... public health. Cool, cool.

I'll bet this also means that it's just about impossible for the homeless to get flu shots.

14 Responses:

  1. phuzz says:

    In the UK, flu jabs are free on the NHS for "clinical risk groups", ie children, the elderly, asthmatics etc.
    Otherwise it's about £12 privately (~$15).

    • robert_ says:

      Indeed. I'm a Type 1 Diabetic so my flu shot is free on the NHS.

      BTW my company also offers free flu shots each year as a perk to all employees.

  2. Nick Lamb says:

    As a datapoint, the current influenza vaccination modality is of sufficiently marginal value that Britain's free-at-the-point-of-use NHS doesn't give it to everybody for free. The relevant Cochrane Review (meta-analysis of relevant studies) says: "Inactivated vaccines can reduce the proportion of healthy adults (including pregnant women) who have influenza and ILI, but their impact is modest."

    I get invites because my immune system is not in good shape (It had cancer, which the NHS did fix for free, and so now it has holes in it but I'm not dying any more) and my friend who is a nurse gets invites for that reason. But random people don't get free shots here. If they want shots they can pay for them (cost about 1.5 hours minimum wage), but in my experience very few people bother.

    Herd immunity is a great additional reason to give your kids measles vaccine and so on - but because Influenza mutates so much and so fast, and it spreads so effectively you need to immunise every single year, and studies suggest you might need almost 100% penetration to achieve herd immunity (it varies with the mutations) each time. That's just not going to happen.

    Our best hope as a species is work to actually out-flank influenza and teach our immune systems to recognise all mutant variants in one shot, at that point herd immunity could be worth going for.

  3. ace says:

    Here in Canada, the annual flu shot is free to all now. Previously it was offered to seniors, children and those whose immune system was deemed to be compromised at no charge. Now, you show your health card at virtually any pharmacy and get the shot.

    Effectiveness is probably not as good as it should be; thousands still die of flu and flu-related complications. One day the shot will probably be much more effective. The strategy here is to keep a vaccine industry busy here, anticipating the time when an emergency supply is needed quickly in response to a new variant that is more lethal.

    • Owen says:

      As you might guess, provincial health care picks up the tab for those. They're only free in the sense that if you're covered, you don't pay at the point of service. Given how prevalent provincial health care coverage is in Canada, it's easy to forget that there are people around you every day who don't qualify - tourists and recent immigrants, most prominently - who would have to pay out of pocket for a "free" flu jab.

      Having said that, the prices are better, too. Most pharmacies charge between $10 and $15 if you're not covered.

  4. Kirsten B. says:

    We were able to do a flu shot clinic at my library by partnering with the local health department. It was “free with insurance, $30 otherwise” but they also made it clear that no one would be turned away if they didn’t have insurance/cash. Still has all the issues with proof of insurance, etc., but at least they were able to cover the folks who couldn’t afford it otherwise. I dunno if your health department is that sane, though.

  5. Here in Oregon you can get a free flue shot if you are "old and decrepit" which means over 65. The pharmacies of Safeway and Kroger were advertising them. The vaccine for the over 65s is a different cocktail, allegedly better.
    Note: In the US flue kills about 45,000 people a year.

  6. Eric says:

    The idea of subsidized flu shots makes a lot of sense, but it's hard to see how that would happen when a sizable chunk of the voting population believes that vaccines make you fart chemtrails.

  7. Lloyd says:

    If this went ahead, where exactly would you do it?

    I hear shooting up in the bathrooms is considered traditional...

  8. McDanno says:

    The US is the only country I can think of that pushes flu vaccines for everyone, regardless of health or age. There's only two problems with that:

    1) As you've noticed, someone has to pay for all that, be it taxpayers, insurance companies, or people directly.

    2) The vaccine doesn't work all that well most years, and this year's looks particularly ineffective. Influenza is highly mutagenic, so each year's vaccine is different based on predictions of the dominant strains. Sometimes that works out well, but much of the time you get < 50% coverage.

    OK, there's really three problems with that:

    3) The culture of "working through illness" in the United States that encourages people to come to work sick (because otherwise they won't get paid or they'll lose their jobs, and then their health insurance) spreads things like the flu more quickly, rather than in civilized countries where people are encouraged to do weird things like "stay home and rest" when they're ill.

    All three of these reasons combine to produce things like this chart (see page 13), where European countries highly target flu jabs to vulnerable populations:

    https://www.ecdc.europa.eu/sites/default/files/documents/seasonal-influenza-antiviral-use-2018.pdf

  9. Joe Luser says:

    the costco across the street from you sells flu shots for $20, doesn't require a membership to use their pharmacy (or liquor store!), doesn't advertise anything as "free", and is generally a much better company than walgreens. since this is getting close to the price of a single drink, maybe that would be a better option if you could talk their pharmacist into stopping by after hours?

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