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Yesterday, my partner and I went to our friendly neighbourhood pharmacy and got our flu shots. It was relatively quick and painless and I'm glad it's over for another year. My rheumatologist has told me that as I have an autoimmune condition - rheumatoid arthritis - it's particularly important for me to get vaccinated every year, something that the pharmacist also mentioned. And as soon as we got home, we heard on the news that getting the flu vaccine seems to be linked to a 36% reduction in "cardiac events" - heart attacks, strokes, angina and the like. But of more immediate importance to me, I've never gotten the flu in a year when I've gotten the flu vaccine - although I haven't invariably come down with the flu in years when I HAVEN'T been vaccinated. So I'm reasonably convinced that there are at least SOME benefits to the vaccine.

What about vaccination against other diseases? Some folks I know are wont to disparage "anti-vaxers", regarding them as right up there with global warming deniers and creationists. But is vaccination unambiguously a Good Thing? Almost every procedure has some minor risks and side effects and even a very small likelihood of major repercussions. It's just a matter of deciding whether the risks - both to the patient and those the patient is likely to come into contact with - outweigh the benefits.

When I was a very young child, there was no polio vaccine. If I wasn't feeling well, my mother would sometimes get me to put my chin as far down upon my chest as possible. If I could sort of accomplish that manoeuvre, even awkwardly, she would say, "Well, I don't think you have polio, anyway." With the older kids, I guess it was a matter of discouraging them from frequenting crowded areas like public pools and beaches whenever there were rumours of a polio epidemic. I'm not sure that the recommended precautions really did any good, but I can certainly understand the fear that prevailed until the polio vaccine became readily available. And I agree that vaccinations against very serious diseases like polio, diphtheria or smallpox are essential, even if there are a few side effects. For example, I recall my daughter's DPTP shots when she was two months old: she awoke in the night quite fussy and unwell with a high fever, although it was over within 24 hours. Of course, it's better to use dead rather than live vaccine (in the case of polio immunization, the Salk injections rather than the Sabin oral vaccine), as is commonly done these days (and was with her).

Throughout my childhood, there were no vaccines against measles, mumps, rubella ("German measles") or chickenpox. As a result, I got at least one of those per year for the first few years I was in school. Measles and mumps are fairly major childhood diseases, although rubella rarely is. Still, it can be hazardous to pregnant women and fetuses, so perhaps vaccination is warranted in many cases. Chickenpox? I don't know. It's rarely all that serious in children, just uncomfortable and itchy. The prevailing wisdom used to be to give "chickenpox parties", exposing all the neighbourhood children to the disease in order to build up their immunity. Because chickenpox in adults can be pretty serious and often leads to shingles. That was another surprise question yesterday, to which I had to answer in the affirmative: "Are you over 50 and have never had a shingles vaccine?"

When I was between six and eight, I had to go and get weekly cold shots, because I caught innumerable colds when I started school. Did they do any good? They didn't seem to. And like most kids, I suppose, I hated getting a needle. Even though (or perhaps BECAUSE) there are zillions of strains of cold virus, I can't help wondering whether I might have done better just suffering through the less serious illnesses (and no doubt making everyone around me suffer too) and in the process, perhaps acclimatizing my body to all the germs and things out there so I wouldn't be quite so susceptible. After all, autoimmune conditions like mine are the result of the healthy body tissues attacking themselves. Maybe I grew up in an environment that was TOO clean and sheltered from disease!

Then there was the tuberculin "patch test" that I remember having every year all through school. I always tested negative, even after going to England with my parents and brother in the summer of 1962, but my brother tested positive from 1962 onwards. And in those days, kids who tested positive got sent off for chest x-rays. People were much more cavalier in those days about the possible risks of radiation from x-rays - shoe stores even let you look at x-rays of your feet, just for "fun"!

Anyway, did all those chest x-rays have a detrimental effect on my brother's health and life-span and contribute to his rather early death? It's doubtful, perhaps, but I guess we'll never know for sure.

I'm not with the folks who blame autism on vaccines - it seems any studies that might have linked them have been largely discredited. I don't think I even really buy the idea that autism is linked to food additives or toxins in the environment. I also think autism is vastly overdiagnosed nowadays, although the severe cases may be very severe indeed. Genetically modified foods? I don't know. I'm not necessarily against them per se, although I think consumers ought to know what they're getting and be able to make informed decisions.

But should we vaccinate everyone against everything just because we can?

In a word, no.