With much debate continuing to focus on the merits of getting vaccinated against the flu, here is something to consider: refusing to get vaccinated might be morally wrong.
I’ve recently become convinced this is true. Let me explain.
While no one particularly likes getting shots, the flu shot is not much of a burden. The cost of the vaccine is fully covered by most health plans; if not, it is usually just a small co-pay.
The vaccines are also incredibly safe: no one has ever died and serious allergic reactions are incredibly rare.
The costs of getting vaccinated are pretty minimal.
It is true that many people report getting a shot and then getting the flu; they then think the shot caused it.
However, since the shots take up to 14 days to take effect and the virus in the vaccines is completely dead, what really happens in these cases is that you came down with the flu before the immunity from the vaccine could stop it.
Hard luck, but it is not the vaccine’s fault.
On the other hand, even though the vaccine only provides protection against three strains of flu a year and is not completely effective (not everyone who gets vaccinated gets the same amount of immunity), the potential upside is really large.
Getting the flu is dangerous — the World Health Organization estimates between 250,000 and 500,000 worldwide deaths per year.
The flu also worsens other chronic health problems, including asthma, heart disease and diabetes and can lead to serious complications like dehydration or bacterial pneumonia.
Of course, most of the people who die from the flu (or get serious complications) are not college students, faculty or staff, all of whom are generally healthier than much of the rest of the population.
It is easy to think that each of our chances of getting the flu is pretty low. Even if we get it, we’ll probably recover with no problem. So there’s no harm in waiting for next year to begin getting vaccinated, we think.
Even if the benefits of getting vaccinated outweigh the personal costs, it’s still a bother to do so. That’s a big reason many of us don’t do it.
This line of thought misses the most important issue: the effect that your flu vaccine has on other people.
To take the simplest case, if you get the flu shot but your roommate doesn’t, she still benefits from your immunity.
After all, if you can fight off those three strains of the flu then her chance of picking them up from you will be almost eliminated.
Similarly, if all your friends were to get vaccinated, your chances of picking up the flu from them would go way down, even if you didn’t personally get the vaccine.
Now consider other people who might catch the flu, in particular children and elderly people. Both groups are at much higher risk of getting and then dying from the flu.
Even if the vaccine only protects against three strains, both groups have a great incentive to get it. But unfortunately, both are also less likely to develop robust immunity as a result of the flu vaccine.
That means that the chances of a very young or very old person getting the flu has far more to do with the people with whom they interact.
The more people they are in contact with who have been vaccinated, the less their risk of serious disease or death. If most of the people they interact with have not been vaccinated, their risk of harm is much greater.
It is not just a question about convenience or inconvenience for you, it’s a question of how much of a risk you pose to others.
Unvaccinated, we pose a greater risk of passing along a potentially life-threatening disease, especially to vulnerable populations.
Vaccinated, we pose a significantly lesser risk.
When thinking about getting vaccinated, we need to think more about the larger social costs and benefits than just the minor inconvenience to ourselves.
Do we want to be less of a threat to others, or more of one? Whether we get that little shot has much bigger implications than just a small stick.
Editor’s Note: Dr. Zac Cogley is an assistant professor of philosophy at NMU.
The Professor’s Corner is a weekly column in The North Wind. Professors interested in appearing in The North Wind should contact the opinion editor at [email protected]

























Martin • Mar 12, 2013 at 3:58 pm
Students- good job picking up on the “collectivism” argument. Collective morality, collective salvation, and the like are terms you should read with a discerning eye. Keep asking prudent questions!
Zac • Mar 4, 2013 at 1:48 pm
Thanks for commenting on the op-ed piece, folks. I appreciate your feedback.
Beth, thanks for bringing Dr. Skowronski’s work to my attention. It’s notable that in the articles I found about the studies, Dr. Skowronski tells people that they should still get the seasonal vaccine, precisely because of the danger of seasonal flu. Facilitating other strains is a concern, obviously, but Skowronski’s judgment seems to be that the immunity provided against the seasonal vaccine is more valuable than the possible increased risk against other strains. Remember, the seasonal flu is harm harmful, especially to infants, pregnant women, and the elderly. As your last paragraph sums up nicely, my argument won’t convince you if you completely reject the effectiveness of the vaccine. However, if you accept that the vaccine can be effective, my argument is worth consider.
JF, I don’t see why my argument requires the assumption that asymptomatic people spread the virus. In fact, I would assume that it’s the symptomatic people who do most of the spreading of it. I guess your thought is that if symptomatic people just stayed home, the risk of transmission would go down significantly? I’m sure it would (though transmission to household members is still an issue, plus people often have mild symptoms without realizing what they have). That said, it’s terrible that you’re required to work while sick both b/c it makes you miserable and also has potential negative effects for anyone you interact with at work. I’m in agreement with you that employers have a moral obligation to provide sick leave.
JF • Feb 23, 2013 at 10:18 pm
This premise that healthy people should take a flu vaccine to protect the vulnerable is based on the assumption that asymptomatic people spread the illness. If you look at the medical literature, you see it admitted that this has not been proven to be the case. There may be viral shedding as detected by nasal swabbing, but transmission hasn’t been proven. This is because asymptomatic people by definition aren’t sneezing or coughing, and transmission requires exchange of infected airway mucous. In fact, 25-33% of all cases of influenza are asymptomatic!
My question is, why is it my “moral” obligation to take a flu shot , but it is not a moral obligation of employers to provide a certain number of paid sick days? People like me who work for an hourly wage and live paycheck to paycheck can’t afford to stay home unless we are really, really, sick if we want to pay the rent at the end of the month. This would help prevent the spread of all contagious illnesses (only 7% of influenza-like illness is caused by influenza types A or B), not just a few strains of influenza. This makes infinitely more sense to me given the poor efficacy of current flu vaccines (59% for healthy adults, and possibly for only 3-4 months before immunity wanes, so if you got a shot in September you may be SOL by the time flu season peaks in January or February).
Dana • Feb 23, 2013 at 4:12 pm
Scaring the people didnt work that well now you are going the ‘moral obligation’ path. Spare your time for honorable work. This moral thing wont work.
Beth B • Feb 23, 2013 at 9:29 am
It is true that many people report getting a flu shot, and that they contracted influenza anyway. Now, there is medical research performed on ferrets that actually supports that hypothesis. Dr. Danuta Skowronski of British Columbia took note of the fact that in multiple provinces in Canada, people who received a seasonal influenza vaccine were over twice as likely to contract H1N1 (Swine Flu) in 2009 than those who were not vaccinated with seasonal influenza vaccine (which at that time did not contain H1N1 antigen.) Dr. Skowronski was recently able to replicate this epidemiological finding in ferrets in 2012. Ferrets who were vaccinated with TIV, were sicker (with greater H1N1 viral replication) than the unvaccinated control animals, when exposed to H1N1 virus. Two hypotheses emerged from this study – 1. A Direct Vaccine Effect- whereby seasonal influenza vaccine induced some cross reactive antibodies that recognized H1N1 virus, but those antibodies were at low levels and were not effective in neutralizing the virus. In this circumstance, you could have antibody that rather than coating and killing the virus, hooks onto the virus and helps facilitate and link it into the cell, aka antibody dependent enhancement.
2. An Indirect Vaccine Effect- whereby seasonal influenza vaccine is effective in protecting against seasonal influenza, but actual seasonal influenza infection (not vaccination) can give better cross-protection against an array of other viruses such as H1N1. If you have a vaccine that blocks seasonal infection, you block that cross protection.
I do not buy into the idea that anyone has a moral obligation to accept an invasive, non-efficacious, medical procedure, on an annual basis no less, for the protection of others that carries the risk of Guillain-Barre, no matter how slight that risk might be. Additionally, there are no long term studies showing that annual flu vaccination does not result in a much higher incidence of autoimmune diseases for those taking annual flu shots. All people who are concerned about the potential connection between vaccination and auto-immune disorders should be able to read the results of such an important study, before they are mandated or bullied into receiving annual flu shots by either their health insurers or their employers.