I'll add my 2 cents (it could actually be worth less -- or is that worthless? :) ). In the past 6 years that I've been a doctor and recommended thousands of flu shots to my patients, I have seen *one* (1) case of GBS - and the etiology of it was never clearly identified (though the flu shot was not in the running as a potential cause). People also need to understand that Guillain-Barré syndrome can follow ANY viral illness - not necessarily the flu shot or even the flu itself. (see the WebMD short blurb on GBS). I also agree with Gil that medical treatments are an analysis of risk-benefit and that is a very individual decision.

Docs (MDs and DOs) have the struggle of dealing with the individual health of their patients as well as the public health implications of their decisions. While I totally support the individual decision not to get the flu shot based on prior experience or analysis of their own situation, I also believe that the flu shot is effective and safe for the vast majority of the population (based on multiple studies that have been done). The more people that get the flu shot and prevent their catching the flu, the less flu there is in the population and the less likely that the remainder of the population will catch the flu as well. This is especially important in regards to the extremely high-risk population out there (extremely immunosuppressed patients such as our patients on chemotherapy, AIDS, etc.) as well as our moderately high-risk patients such as our elderly patients with chronic diseases such as asthma, emphysema, diabetes, and heart disease.

In many ways, this is the same problem that we have with childhood immunizations. We have some parents that are highly opposed to immunizing their kids for multiple reasons (concerns regarding vaccine safety, worried about vaccine side effects, worried that vaccines are part of a federal plot to track their kids' movements :D ). These parents and their children benefit from the vaccinations that the other kids are getting - simply because with less disease in the population because of the vaccinations, the unvaccinated children are much less likely to catch the disease as well.

An assortment of random thoughts from my tired mind at the end of the day. In the end, to summarize: get the vaccine if you want and you qualify, don't get the vaccine if you don't. But I'll also say that I put my money where my mouth is. Amanda and I get the flu shot yearly.

Masaki