White Coat Underground

Swine flu in my home state–grim news

Michigan has suffered enough. We’ve been devastated by economic and manufacturing changes, leading to mass unemployment, poverty, and poor education. That last one is really killing us.

According to news reports, more than half of Michiganders plan to forgo vaccination, mostly for reasons that betray a lack of education. This is at a time when schools across the state are closing their doors because of the flu. They aren’t closing their doors out of irrational fears, or for quarantine or isolation purposes, but because so many people are sick that it’s not worth it to keep the doors open. The economic impact of school closures and parents needing to stay home is likely to be significant.

Why aren’t people planning to get their vaccines? In conversations I’ve had with friends, family, patients, and staff, many are planning on getting the seasonal vaccine but not the H1N1 vaccine. Here’s what I’m hearing:

  • “I’m afraid of this new vaccine, that it’s not tested enough”: this vaccine has been tested, but more significantly, it’s not different from the usual flu vaccines. All flu vaccines are made the same way, growing the relevant strains in chicken eggs and refining the product into vaccines. The swine flu vaccine would have been incorporated into the seasonal shot if there had been more time. This year, we’re stuck with two similar jabs.
  • “I can’t afford to get sick, so I’m not risking a flu shot”: this reasoning is understandable but backward. Flu shots do not contain live virus and cannot give you the flu. We give flu shots during cold and flu season
  • “I’ll wait to see what happens. If lots of people are sick and dying, I’ll get it then”: lots of people are sick, and some are dying. The point of vaccination is to prevent disease, and this takes time. If you wait until you are surrounded by sick people, the vaccination may not have time to produce the antibodies you need to prevent infection. Also, we don’t have an infinite number of vaccines (although supplies are anticipated to be pretty good)—the longer you wait, the more likely you are to not be able to find a vaccine.

I’m seeing in my clinical practice several cases of flu a day. These numbers are unusual for this time of year, and even compared to previous flu season peaks, it’s pretty crazy around here. Please don’t be a victim—educate yourself and be proactive.


  1. #1 rob
    October 20, 2009

    how long will it be until people stop the small pox vaccination and we see a resurgance of small pox? or polio? or some other disease of the past?

    it is sad that the worlds population is so scientifically ignorant that they will risk their health and the health of others out of pure stupidity.

  2. #2 Jefrir
    October 20, 2009

    how long will it be until people stop the small pox vaccination and we see a resurgance of small pox? or polio? or some other disease of the past?
    Smallpox can’t come back, barring human release – there are no wild reservoirs left, and it only exists in labs. Polio is still out there in a few counties, and could theoretically see a resurgance in the West if vaccination rates fall low enough. It’s only safe to stop once a disease is completely eliminated, not just gone from a particular place.

  3. #3 cb
    October 20, 2009

    Dr Oz must be one of those uneducated fools you are referring to. He has said on national TV that his wife and 4 kids are NOT get the vaccine. I wonder how he managed to accomplish everything he has while being under educated.

  4. #4 Jack
    October 20, 2009

    CB – If you listened to the Dr. Oz interview you’d have heard the dozen or so points he made IN FAVOR of getting the flu shot – he in fact, sounded quite educated and knowledgeable on the matter. His comment about his wife and children not getting the shot (while he explicitly stated he IS getting the shot) wasn’t supported with any information aside from him saying “when I go home I’m Mr. Oz”… Sounds like when he goes home he’s not the one wearing the pants. Hope you don’t make your decision whether or not to get vaccinated based off that.

  5. #5 Arnold T Pants
    October 20, 2009


    I wonder how he managed to accomplish everything he has while being under educated.

    By kissing Oprah’s ass.

  6. #6 cb
    October 20, 2009

    I put much more trust in Dr Ozs’ judgments than PalMDs’. I heard Dr Oz talking in favor of the flu vaccine on the interview but the fact that he would allow his wife and kids to go without makes me question his convictions. I am sure PalMD would never allow that.

  7. #7 flim flam
    October 20, 2009

    What exactly has Dr Oz accomplished?. He’s not exactly Paul Offit is he?. Has he done any groundbreaking research? Developed a great new surgical procedure? Cured cancer?. No, he’s just a bog standard cardiologist who managed to get in with Oprah queen of the woo’s and now he’s on the telly talking crap, in his surgical scrubs ( am i the only one that finds this enormously annoying, like he’s trying to give the impression that he rushed onto the set straight from the operating theatre, rather than spending 2 hours in make up). Big deal.I’d be much more impressed if he actually called oprah and jenny on their bullshit.
    Imagine Dr Oz telling jenny she’s full of shit and advising parents to get their kids vaxxed,then i’d be impressed. I’d also be expecting a call from satan telling me to pack my ski’s because hell’s frozen over….

  8. #8 cb
    October 20, 2009

    Paul Offit the inventor of the rotavirus vaccine that was RECALLED. Yea.. your right. Dr Oz is not exactly Paul Offit

  9. #9 JustaTech
    October 20, 2009

    CB: Citation please re: the rotavirus vaccine being recalled. And you can’t really blame Dr. Offit if something went wrong in manufacturing, that’s like blaming Edison for a light bulb that burns out.

    And doesn’t Dr. Oz live in NYC? Why would anyone who is able *not* get vaccinated living cheek-to-jowl with that many other people? Seriously, duh.

  10. #10 military wife
    October 20, 2009

    Dr. Oz’s wife and kids have access to a guy who can write a Tamiflu prescription at the first sign of a fever, too. He can test them for flu at home and prescribe immediately if needed.

    That’s not exactly true for most of the rest of us.

    My kids had their swine flu vaccinations today at the health department. They aren’t giving them to anybody but school kids yet, but at least they will be protected when their response develops.

  11. #11 Dianne
    October 20, 2009

    Paul Offit the inventor of the rotavirus vaccine that was RECALLED

    One rotavirus vaccine was recalled in the mid-1990s. As far as I can tell, it was not the one or not the only one which Dr. Offit helped develop. The current vaccine is effective and does not carry a risk of intussusception, the problem which led to the recall of the earlier virus.

  12. #12 gaiainc
    October 20, 2009

    I got my swine flu vaccine today and dealt with two people whom I think has swine flu. One is pregnant. The other is 15. I’m worried about the pregnant woman as H1N1 seems to be hitting pregnant people either moderately ill or critically ill. She seems to be doing OK and is on meds. We’ll see what happens.

    If Dr. Offit was speaking out against the influenza vaccine, I might pay attention. Dr. Oz? Yeah, not so much.

  13. #13 k
    October 20, 2009

    Dr Paul Offit’s rotavirus vaccine, RotaTeq,
    is one of two currently approved in the US. (See

    The vaccine voluntarily withdrawn in 1999 was
    called RotaShield. (See http://www.cdc.gov/mmwr/preview/mmwrhtml

    I plan on getting the swine flu vaccine
    as soon as I can – I’ve read too much
    about people in my age group ending up on
    vents or heart-lung bypass in ICU, often
    dying. Better safe than sorry.

  14. #14 Chris
    October 21, 2009


    That is not even wrong. First, he was not the only “inventor”. It was part of a team, and there were two other principals that share in the royalties. The bulk of the royalties goes to his institution.

    Second, it was RotaShield that was recalled. Dr. Offit and his team worked on RotaTeq, which is one of two rotavirus vaccines approved (I forgot the name of the third one).

  15. #15 Adam Cuerden
    October 21, 2009

    I was “lucky” enough to get flu this year before I had a chance to get the jabs. I’m getting the jab tomorrow for the other strains, because three weeks’ forced bed rest, followed by me still tiring very easily, really is not fun.

  16. #16 BB
    October 21, 2009

    Then there are those of us who aren’t getting the H1N1 vaccine because it is NOT AVAILABLE in our area yet.
    How are Tamiflu reserves holding up?

  17. #17 PalMD
    October 21, 2009

    The swine flu vax isn’t widely available yet. Nasal live-attenuated vaccines are shipping in many places, but many of us aren’t able to take those. They should be out in the next few days to weeks, hopefully in time to blunt the pandemic.

  18. #18 catgirl
    October 21, 2009

    I got the seasonal flu shot already like I do every year, but the swine flu shot isn’t available yet. I’m more worried about it than I usually would be because coworkers at my current job never stay home when they are sick. It’s partly the company’s fault because of our leave system, but it’s partly because my coworkers are just inconsiderate.

  19. #19 Mu
    October 21, 2009

    Flu shots do not contain live virus and cannot give you the flu. We give flu shots during cold and flu season

    Does that mean the usual “cant get it if you’re not feeling good” exemption doesn’t apply (we’re having the big flu shot clinic this weekend, and I don’t want to miss it).

  20. #20 Nomen Nescio
    October 21, 2009

    how long will it be until people stop the small pox vaccination

    that happened years to decades ago. i’m 36 and never got it.

    (i did, however, get the polio vaccine, and would not want any family member of mine to lack it. that’s still out there in the wild.)

  21. #21 ABradford
    October 21, 2009

    I plan on getting the vaccine as soon as I know I can get it, but I’m only now hearing about some being available around here.

  22. #22 TGAP Dad
    October 21, 2009

    I’m not getting flu shots this year, primarily because my doctor’s a total asshole, and the office staff and billing department are worse. And for all the pleasantries they charge for me an office visit. Screw them. I’m not an anti-vaxxer, and my wife and kids are vaccinated. (They have nicer doctors than mine.)

    FWIW, I seem to have a pretty robust immune system, and don’t get sick much. I also wash my hands completely and often and bury my coughs and sneezes in my sleeves. I’ll take my chances.

  23. #23 JustaTech
    October 21, 2009

    TGAP Dad: Have you tried your local Costco? My SO (who has health insurance!) doesn’t have a doc, so this year he got his flu shot at the local pharmacy chain, and the previous year got it at Costco. (No, it doesn’t come in a 500cc syringe, but that’s a funny image!)

    I get mine at work for free(seasonal only), mostly because we share space with a cancer treatment hospital, and it would be unconscionable to go unvaccinated into there.

  24. #24 Kim
    October 21, 2009

    I’ll be a little bit surprised if I don’t catch it before a vaccine becomes available to me.

  25. #25 Jennifer B. Phillips
    October 21, 2009

    I’ve been battling the eugene woo mavens on Facebook about H1N1. One appalling comment from the anti-side:

    I know a mother in town who’s three year old got the swine flu. Although she even needed to stay in the hospital, her daughter made it through and is stronger for it. I believe that more important than the vaccine is making sure our children have healthy strong immune systems. We have such wonderful healers in our town to help our families live healthy lives. I believe the vaccine’s effectiveness really can not compete with our own anti- flu resources.

    Yeah, I’m sure that three-year old will look back on her hospitalization one day with such a sense of accomplishment. Horrifying.

    I stood in the health clinic line with my under-10 kids for the nasal H1N1 vac yesterday. I was pretty appalled by the administering nurse (?). She stated four or five times that it was a “LIVE vaccine”, and that we should stay away from immunocompromised people because we would “GIVE THEM THE FLU”, and that the LIVE vaccine might GIVE MY KIDS THE FLU if they didn’t wash properly (??). Having had the opportunity to thoroughly research all this, I wasn’t swayed from my commitment to getting my kids the vaccine, but I wonder how many people walked away after such a lopsided disclaimer?

  26. #26 TGAP Dad
    October 21, 2009


    There is no “local” Costco where I live – a city of over 100,000 in the great lakes region. There are some pharmacies and retailers offering the flu vaccine (type not specified), but all are charging at least $25 and I’m a cheapskate. But like I said, I usually don’t get sick – with or without the flu shot – even when someone in my family does.

  27. #27 Tsu Dho Nimh
    October 22, 2009

    TGAP Dad – Many of the vaccine clinics are accepting health insurance with no co-pay. It’s a good deal for the clinics and the insurers.

    By not spending $25 now you are ricking spending a lot later, in missed work, and maybe hospitalization.

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