One of the biggest news stories in global health this past month was about a possible laboratory accident in Russia involving plague. Media outlets reported that a 28-year-old woman working at a plague research facility in Siberia died from pneumonic plague and that 200 people were placed under observation. Russian officials denied that the case was plague, attributing her death to "pneumonia of unknown origin."
Stories spread across mainstream media and social media about whether there might be a resurgence of the plague or the emergence of a new pathogen. How did I respond? I made an appointment at my local pharmacy to get the annual flu and COVID vaccines. Let me explain.
We Fear What’s Rare and Forget About What’s Common
With many public policy problems, humans tend to react most viscerally to low-probability, high-consequence events. Think about the fear and intensity of media coverage that comes from airplane accidents compared with car accidents. Plane accidents are extremely uncommon. Most people do not fly very often and, even if they did, the National Safety Council estimates that the lifetime odds of dying in a plane crash are too small to even calculate.
Compare that with car accidents. Almost every American rides in a car regularly, and many spend several hours a day in one. The lifetime odds of dying in a motor vehicle crash are about 1 in 101. But a car accident barely registers in the news, and it usually only becomes something we discuss when we have a connection to the people or place involved.
In public health, we see a similar pattern. A bioweapon or dangerous pathogen accidentally spilling into the population and causing a pandemic is a real risk, but the likelihood of it happening is extremely small. (Note that the scientific consensus is that COVID emerged in nature and was not the result of an intentional or accidental laboratory incident.) If it does occur, it will generate enormous fear and attention, as happened with the incident in Russia.
The infectious diseases that most regularly make us severely ill or kill us, however, rarely get that intensity of reaction. Think about flu and COVID. Last winter, CDC estimates the flu season caused at least 32 million illnesses, 390,000 hospitalizations, and 24,000 deaths. For COVID, from mid-2024 to mid-2025, CDC estimated there were 290,000 to 450,000 hospitalizations and 34,000 to 53,000 deaths. While most people do not get hospitalized or die from these two respiratory viruses, many who get infected will still get sick, feeling miserable for days and missing school, work, or important social events. These illnesses have real costs to our lives.
What the Flu and COVID Vaccines Actually Do
We have vaccines for both of these infections that are safe and effective.
The flu vaccine has been given to hundreds of millions of people over decades, and its safety record reflects that. Most people experience a sore arm, mild fatigue, or a low-grade fever for a day or two. It is not biologically possible for the vaccine to cause the flu. When people report getting the flu soon after the vaccine, it is most often because flu is circulating in the community around the same time they are getting the vaccine.
How well the flu vaccine works varies from year to year, depending on how closely the vaccine matches the strains that end up circulating. Last season was a poor match because most circulating influenza A viruses belonged to a new strain that differed from the vaccine strain. Even so, among adults, the vaccine reduced the risk of flu-associated hospitalization by 30 percent. Even a small benefit can help you individually and the community overall.
The COVID vaccines have been studied almost as much as any vaccine in history. The side effects are similar to the flu vaccine. While there is a rare risk of myocarditis (inflammation of the heart muscle), the risk of getting myocarditis from the virus itself, not the vaccine, is far greater. As for effectiveness, a large CDC study of the 2024–25 COVID vaccine found effectiveness of 33 percent against emergency department and urgent care visits and, in elderly adults, 45 percent against hospitalization.
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Other Benefits of the Flu and COVID Vaccines
Respiratory viruses trigger inflammation in the body that can destabilize the heart and blood vessels, which is why many studies have found that heart attacks rise in the weeks after a flu or COVID infection. Vaccination can protect against that risk.
A meta-analysis of randomized trials found that flu vaccination was associated with a 26 percent lower risk of heart attack and a 33 percent lower risk of cardiovascular death. For COVID, a study of nearly 2 million infected patients found that full vaccination reduced the risk of major adverse cardiovascular events by 41 percent.
Effective Does Not Mean Perfect
Let me be blunt. Effective does not mean 100 percent effective. Almost nothing in medicine works every time, for every person. Statins do not prevent every heart attack, and seat belts do not prevent every death in a car crash. We use them and we use vaccines because they shift the odds in favor of health and safety.
You can still get the flu or COVID if you are vaccinated. But you are less likely to end up in the hospital, less likely to die, and less likely to have heart-related complications.
When you hear about a potentially deadly infectious disease emerging, it is important to pay attention. The risks are real, and we need to invest more in the systems to prepare for, detect, and respond to them. In our daily lives, though, there is very little any of us can do to mitigate that risk.
There are steps we can take to reduce the complications of the infectious diseases we face every winter and keep ourselves healthier. That is why the news about plague prompted me to get my annual flu and COVID vaccines. I urge you to do the same.