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A weekly show from the folks at East Lansing Info breaking down all the news and happenings in East Lansing, Michigan.
WDBM East Lansing.
Introduction:This is East Lansing insider brought to you by ELI on impact eighty nine FM. In this show, we break down all of the news and happenings in the East Lansing community. And now, today's East Lansing Insider.
Anna Liz Nichols:Hello, everyone. It's East Lansing Info's deputy editor, Anna Liz Nichols, with this week's episode of East Lansing Insider. And unfortunately, it's flu season in Michigan. And I don't know about you, but here in Mid Michigan, it seems like everyone is sick with something. Even before the holidays, everyone was sick.
Anna Liz Nichols:In fact, there's so much illness going around right now that chief medical executive for the state of Michigan, Dr. Natasha Bagdasarian, took time out of her schedule this week to talk on the podcast about what flu season is looking like right now, especially in the context of United States secretary of health and human services, Robert f Kennedy junior, f k, seeing to it that at the start of the month that several recommendations for vaccines, including the flu and COVID vaccines, are now being scaled back for children. You know, doctor Bagdasarian, at least in Mid Michigan, it seems like just about everyone is sick with something, namely influenza like symptoms. And looking at recent CDC reporting, Centers for Disease Control on Influenza, also known as flu for those who are not aware, numbers in Michigan top the country. It's like Us and Ohio. A couple more states in the North, but mostly Southern states.
Anna Liz Nichols:Top the country for medical visits for flu like symptoms. And according to the state health department data, there's been more than two thousand influenza related hospitalizations this flu season in Michigan. Is Michigan typically a hot spot for flu? Like, I I'm a lifelong Michigander, so I know, like, we have a flu season. But what's happening this year with flu?
Dr. Natasha Bagdasarian:So, I'll tell you I'll tell you. Every flu season is a little bit different. Mhmm. And a couple things. So maybe we'll backtrack a little bit.
Dr. Natasha Bagdasarian:Number one, it's really important to remember that flu is not the only thing that's transmitting right now. There are about 200 plus subtypes of different viruses that transmit at this time of year. And the reason why they're transmitting right now is for a couple different reasons. Number one, a lot of these viruses survive better on surfaces when it's cold and dry. So those are the conditions where they survive for longer on surfaces.
Dr. Natasha Bagdasarian:They also love it when we're in indoor spaces and coughing and sneezing on each other. So we're clearly not having outdoor gatherings right now or, you know, parties with windows open. People are are clustered indoors. And then, you know, they're taking advantage of times when people are more run down and and causing, more illness at those times. And the winter season is a time when a lot of people are just feeling more run down in general.
Dr. Natasha Bagdasarian:Maybe our diets aren't quite as good. Maybe we're not getting enough sleep. Maybe we're not exercising. So those are the reasons why people tend to get sick right now, but it's not all flu. There are so many other viruses.
Dr. Natasha Bagdasarian:We know about COVID and RSV because those are the big viruses that put people in the hospital right now, flu, COVID, and RSV. But there are other viruses, like other coronaviruses and parainfluenza, so many other viruses. So so first of all, just because you're hearing about people who are sick, it doesn't necessarily mean that that is the flu, with a capital f, meaning influenza. So, yes, there are a lot of people sick right now. The next thing I'll say is every flu season is a little bit different.
Dr. Natasha Bagdasarian:And what I mean by that is there are seasons where we peak in December, and there are seasons when we peak in March. So every flu season looks a little bit different, and and sometimes we have two peaks. Sometimes it's not just one peak of flu. It's two peaks. And even though we're talking about influenza, the same virus, we also have to remember there's influenza A, all of these different subtypes, influenza B, and influenza is a virus that likes to change.
Dr. Natasha Bagdasarian:So it does what we call this is getting too in the weeds, but it does what we call drifts and shifts. So drifts are like little changes in the genetic code, and shifts are big changes. And so every year, it's a little bit different, and we never know what exactly what flavor of flu we're gonna get. Mhmm. So the way that we track this is we look at what's happening in countries like South Africa and Australia, countries on in the Southern Hemisphere to look at their flu seasons the year past.
Dr. Natasha Bagdasarian:And we look at other countries that are a little bit closer to us. Like, we look at The United Kingdom for what's about to hit us, and we sort of make our plans according to that. Now what we saw this flu season is a couple things. Number one, there was a new, subclade, a new strain that was circulating, and it's called h three n two subclade k. Mhmm.
Dr. Natasha Bagdasarian:And we saw in other countries, it hit hard. It hit early, and we were concerned that the vaccine wouldn't be quite as well matched. And that would put we were worried that it would put more people in the hospital. So we looked at early studies done in places like The UK, and they actually show that even though the flu had drifted a little bit and there was this new subclade circulating, the vaccine was still a pretty good match in terms of keeping people out of the hospital. So their early data showed that the vaccine, this season's vaccine, was about seventy five percent effective at keeping kids out of the hospital and about forty percent effective at keeping adults out of the hospital.
Dr. Natasha Bagdasarian:Yeah. And that brings me I'm sorry, Anna. I'm talking a lot.
Anna Liz Nichols:No. You're good. I'm we're getting into the flavor of what flu season we have.
Dr. Natasha Bagdasarian:Okay. And that brings me to my next point, which is that when we talk about the flu vaccine, the flu vaccine, number one, I mentioned all those other viruses. It's not protecting against all those other viruses. And number two, it's not gonna protect against mild illness. It is good at keeping people out of the hospital.
Dr. Natasha Bagdasarian:That's really what it's designed for. It's for keeping you out of the hospital, for keeping you out of the ICU, and preventing deaths. So a lot of people are like, but I got my flu shot, and then I got the flu anyway. And my first question is, was it the flu, or was it another virus? My second question is, but did you end up in the hospital?
Dr. Natasha Bagdasarian:If you didn't end up in the hospital, that's a win. And when we talk about mild illness in the health care world, we're not talking about feeling really crummy.
Anna Liz Nichols:Mhmm.
Dr. Natasha Bagdasarian:We're talking about, again, not being admitted to the hospital and being on oxygen. So that's severe flu. So what is happening this year is there was a little bit of a shift. We saw it happening in other countries. The vaccine is still effective at keeping you out of the hospital, but we've seen declines in the number of people getting the flu vaccine.
Anna Liz Nichols:Wondering in terms of flavor of flu we got this year, did we have an early season? Are we seeing more hospitalizations? I I know you talked about there's a difference between flu and flu like symptoms, you know, making you feel crummy and flu and flu like symptoms that put you in the hospital. We've had thousands of, hospital interventions for influenza like symptoms, in Michigan. Are we having a severe flu season?
Anna Liz Nichols:Are we are we having one that we're managing well? How is this kind of defined by the health care system in Michigan right now?
Dr. Natasha Bagdasarian:Yeah. Really great question. So first, when I look at this flu season compared to years past, it is early. It it is one of the earlier flu seasons. So last year, our flu peak was in the February.
Dr. Natasha Bagdasarian:The year before that, we sorta had two peaks. One was at the December. One was in February. But in 2022, we had a flu peak also in December. So, you know, we're a little bit earlier than we have been in some years, but it's also not out of the realm of, like, what happens with flu seasons.
Dr. Natasha Bagdasarian:We possibly and I have turned the corner, possibly, but it's too early to tell because, you know, again, sometimes we see, like, double peaks, and, sometimes it looks like the numbers are getting better, and then they don't. And the hospitals, we are staying in really close contact with hospitals. And part of that is because of COVID. So a lot of terrible things came out of COVID, but one of the silver linings, one of the very few silver linings, is that we really strengthen our relationships with all of the health systems. And we're talking to them weekly and making sure that, like, our children's hospitals have enough beds.
Dr. Natasha Bagdasarian:And what I am hearing from them is, yeah, there's a lot of flu. There's hospitals, a lot of people in ICUs. Urgent cares are full. Emergency departments are full, but they are still holding up okay. They are managing.
Anna Liz Nichols:So you talked earlier about the impact of immunization rates on our flu season here in Michigan. And notably, at the beginning of the year, the Trump administration rolled back some of the recommendations for childhood vaccines.
Dr. Natasha Bagdasarian:Yes. I'm happy to talk about this. So I I am a liaison member to this organization called ACIP, which I think a lot of people have heard about in the news, the, advisory committee on immunization practices. And that was the committee that was changed. The, RFK junior changed the membership of the committee in the fall and put a lot of vaccine skeptics on this committee, a lot of people who aren't really involved in health care or or health care of kids, or infectious diseases.
Dr. Natasha Bagdasarian:And they had been sort of chipping away one by one at vaccines. And then all of a sudden, in early January, they they bypassed even that committee, even this new totally revamped committee. And HHS directly, completely I will use the word decimated. They decimated the childhood vaccine series without presenting any new data, without presenting any rationale behind this. And it is it is complicated, but I'll tell you some of the key changes.
Dr. Natasha Bagdasarian:So influenza, they, change this from routinely recommended to something that is called shared clinical decision making. And I can talk about what that means, but it is confusing for everyone and pretty tone deaf to do this when we are seeing flu deaths and seeing kids in ICUs across our country from influenza. There's a vaccine called rotavirus, which is, really has been a foundational vaccine that, you know, when you talk to pediatricians, the illness that this disease used to cause was just devastating. That was again changed to shared clinical decision making. Hepatitis A vaccine was changed from routine to recommended for children traveling to international areas or shared clinical decision making.
Dr. Natasha Bagdasarian:And it's it doesn't make a whole lot of sense because our hepatitis A outbreaks in this country are not from people traveling. They are from, food that is brought into our country, and we've seen several huge outbreaks from hepatitis A related to things like frozen strawberries. They changed one of the meningococcal vaccines to either the shared clinical decision making or for people who are traveling or high risk. And then HPV, they changed from two doses to one dose. So a lot of changes.
Dr. Natasha Bagdasarian:No new evidence presented. No new data presented because there is no new data. There is no new evidence. And then before that, just in the prior months, when they were using this committee, the ACIP committee, they had already made changes to hepatitis B and COVID vaccine recommendations. So we have gone from having a really strong robust immunization schedule for kids to, one of the very weakest and and flimsiest, especially for a country like The United States, which is so complex and where we don't have universal health care.
Anna Liz Nichols:Mhmm. You know, what's the implication with the vaccine changes considering Michigan is, I don't know if we are the highest in the country for interventions with health care with with flu like symptoms, but we on the CDC scale, it goes up to purple, and and we're in purple. We're very high.
Dr. Natasha Bagdasarian:Yeah. We we are very high. There's a ton of flu, but we've also gotta think about how this impacts other vaccines. And we're seeing declines in vaccines across the board. So I mentioned that, like, we're seeing declines in flu vaccine, but we're also seeing huge declines in the number of people getting COVID vaccine.
Dr. Natasha Bagdasarian:But we're also seeing declines in kids getting just routine vaccinations that even haven't been changed. The recommendations haven't been changed. So for example, the measles, mumps, and rubella vaccine is like a core foundational vaccine that we know protects against this horrible you know, three horrible illnesses that can cause death and permanent consequences for for kids, and we're seeing those numbers go down as well. So the implications are huge. And I think, basically, these changes, not only are they impacting the particular vaccines that they've called out, but they're causing this whole trickle down effect with folks feeling just confused about vaccines in general.
Dr. Natasha Bagdasarian:I mean, it's it's hard for me. I and I I'm an infectious disease doctor. It's hard for me to even explain some of these changes. And so for the general public, people are left really confused and wondering who to trust.
Anna Liz Nichols:Given what's happening about the conversations we're having nationwide about vaccines and given the context of where Michigan is right now with the flu, is and you said there's been pretty good, post, pandemic conversations about COVID, that there's a lot of conversations between health care systems in the state. What are some of the conversations happening right now in terms of how the state is going to address illness outbreaks, not just the flu, but but other other illnesses that you've mentioned? Is there a conversation of where we might be in in next year, in five years, in ten years if the uncertainty we have in conversations about vaccinations?
Dr. Natasha Bagdasarian:That's a great question. You know, the conversations that we're having with health systems are more sort of immediate. So there's a weekly touch point that we have with all of our children's hospitals saying, do we have enough ICU beds? And if there aren't enough ICU beds in this part of the state, how do we transfer patients in a way that we're taking care of kids all across Michigan? So those are the types of conversations having happening in health care, but there is this larger conversation that is more than just health care systems.
Dr. Natasha Bagdasarian:And that is how do we how do we manage health in a country that now it's becoming more sort of acceptable or routine to to get measles. Measles, for example, is making a comeback. So last year in The United States, there were two thousand over two thousand cases of measles. This is the highest number of measles cases and deaths since 1992, and we are very close to losing our measles elimination status. So, you know, everyone heard about the huge outbreak in West Texas.
Dr. Natasha Bagdasarian:There's right now a massive outbreak in South Carolina. They saw something like a hundred cases a hundred new cases reported over just a handful of days. And we here in Michigan, we've had outbreaks of measles just last year. We had, I think, seven, outbreaks of measles. But we had, we had measles outbreaks in Michigan, and none of our measles outbreaks were huge.
Dr. Natasha Bagdasarian:They were all a smallish number of people, and that was not luck. Mhmm. That was all of our local health departments spending hours and hours of staffing time doing things like contact tracing. So if there is a measles case in a school, that school has to start getting involved and and looking at immunization records and working with that local health department, and they've gotta go and start making phone calls and making sure that people get what we call post exposure prophylaxis, that people are, you know, schools have been shut down. They make sure that people stay home and aren't going to busy areas.
Dr. Natasha Bagdasarian:We've had measles exposures in really busy places like like airports and shopping malls and emergency departments. And all of this work happens not just with health systems, but with your local health department. And this is all taxpayer dollars, And public health is really, really underfunded. So for folks who are worried about rising taxes and how we're being responsible with our money, when we think about measles, for example, the measles vaccine is something like $25. So, you know, it takes $25 to give someone ninety seven percent protection against measles.
Dr. Natasha Bagdasarian:And there have been estimates that have looked at how much it costs to do contact tracing around around measles cases, and those costs can be huge. It can be a $100,000 for someone who's traveled by airplane and moved from one state to another. All of this time and staffing that people are spending, you know, going to schools and reviewing those records and and making sure that outbreaks in urgent cares and in doctor's office are handled appropriately, it takes thousands of dollars and thousands of staff hours. So, yeah, we have to think about what this means. We also have to think about, do we want to live in a society where pediatric deaths are okay?
Dr. Natasha Bagdasarian:You know, now in 2026, as a doctor, I find any pediatric death from a preventable cause to be horrific. Kids should not die of preventable diseases. If we look back, you know, a hundred years ago, kids died all the time. It was just what happened. People had big families because you knew that, you know, maybe half your kids wouldn't make it to adulthood.
Dr. Natasha Bagdasarian:Are we willing to go back to that? Is is that where we're willing to go as a society? And I think it's really important for us to ask ourselves that.
Anna Liz Nichols:Back in December, you issued a standing recommendation regarding, you know, children's vaccination schedules. You advised that health care providers and families abide by the schedule that the American Academy of Family Physicians as well as the American Academy of Pediatrics recommends in terms of vaccination scheduling. I was wondering, in terms of messaging to Michigan specifically, what do Michigan parents, residents, health care providers need to know in the context of flu season, but in the context of these decisions and conversations we're having federally about immunization that maybe isn't being talked about to the degree that you believe as our our our state's top doc, it should be talked about?
Dr. Natasha Bagdasarian:Well, you know, that standing recommendation was was really important because I mentioned some of the changes to the vaccine schedule. And if you recall, I talked a lot. I I mentioned the term shared clinical decision making, and that is all over our new vaccine recommendations from the federal government, from from HHS now. And it's really confusing to people what that means. And it's misinterpreted, and people get a little bit anxious when they see that term shared clinical decision making, and I'll tell you why.
Dr. Natasha Bagdasarian:So instead of a a public health agency saying, this is what we believe is right for most people, but then, of course, use your judgment. What they're saying is, we don't wanna tell you, declining to give that routine recommendation. And what it does for physicians is it makes them feel like there's something extra special that has to be done, that there's some sort of extra liability on them or extra pressure on them. When we know that shared clinical decision making is something that we do every single day in medicine, there is no recommendation or medical guidance that we give our patients where we're like, you must do this. You better do this.
Dr. Natasha Bagdasarian:Everything that we talk about with our patients, we say, this is my recommendation, and then it's ultimately the patient or the parent's decision whether they wanna go ahead. And so when you are taking out that sort of, this is what we recommend broadly, and you are inserting that language about shared clinical decision making, it seems like it's something extra. It seems like it's something more. There was an interview last week where, RFK junior talked about shared clinical decision making, and implied that it had to be done by only a physician, and it couldn't be done by anyone else. And that's not correct either.
Dr. Natasha Bagdasarian:Shared clinical decision making is something that pharmacists in Michigan do all the time with vaccines. There is not any vaccine out there that people are being forced to take. It's always shared clinical decision making. And so putting that language in all of our vaccine recommendations, in a way, it's a cop out. It's not giving people broad public health guidance.
Dr. Natasha Bagdasarian:It's sort of making it seem like this is something that wasn't happening when it's routine. This is what we do in medicine all the time. So I think there's been a lot of confusion, and I think that health care providers have felt like there's something extra, like an extra burden on them. And we really want to make sure that health care providers in Michigan are following the science and following the data. And I know people are sick of sort of hearing those phrases after COVID, but but, really, there is no new science behind the HHS vaccine changes.
Dr. Natasha Bagdasarian:We would much rather that people follow the advice of these national scientific bodies. The American Academy of Pediatrics, the people who made these recommendations are pediatricians. They're health care providers. They are they are infectious disease specialists. They are people who really understand these recommendations and have reviewed the data.
Dr. Natasha Bagdasarian:And so that's why we issued this broad standing recommendations for people to follow those really scientific based guidance documents. And for parents out there, I think my message is a couple of things. Number one, the science hasn't changed. We are living in a society today where kids don't die of infectious diseases the way they used to fifty years ago or a hundred years ago. And sometimes the data is a little bit harder to convey than it is to convey stories.
Dr. Natasha Bagdasarian:And I just will will tell you one. I was I was doing a an event for the anniversary of the polio vaccine at the University of Michigan School of Public Health. And in the room, they had some people who were what we call polio pioneers. And they're in their eighties now, but they were kids at the time of the first polio vaccine trials. So they were the kids who were enrolled in those first trials, and they remember.
Dr. Natasha Bagdasarian:And what they talked to me about is how every summer, parents would just be terrified that their kid was going to come home, get a fever, and then end up paralyzed because that's what happened. Your kid would get a fever in the in the summer, and you didn't know if it was just something that would pass. Is it a virus that'll pass? Or was it polio, and and could you end up with a kid who needed to be in an iron lung or who lost the ability to walk? So the summer was a really scary time whenever kids would would get a fever.
Dr. Natasha Bagdasarian:And when that polio vaccine was first licensed, one of the one of these polio pioneers told me that church bells rang around the country. Church bells rang everywhere. And moms were sitting by their radio and listening to this news and just weeping tears of joy because they knew what it was like to live in fear, that your kid would end up dead or paralyzed or unable to breathe. And we, in 2026, don't know what that fear is like. In 2026, the number one cause of childhood death is no longer infectious diseases, not by a long shot.
Dr. Natasha Bagdasarian:Kids don't die of these infectious these preventable infectious diseases in any sort of comparable rate to to times gone by. The number one killer of our kids today, unfortunately, is is gun violence, but that is a topic for another day. But kids aren't dying of those infectious diseases the same way that they were. Do we want to go back to that era? It blows my mind.
Dr. Natasha Bagdasarian:It really blows my mind. And I think we've got to start listening to these types of stories and listening to what used to happen, fifty years ago or or even, you know, thirty years ago before we had some of the vaccines that we have today.
Anna Liz Nichols:Well, thank you so much for your insight on this. Obviously, flu season has its has a huge impact in Michigan, but we're also having this national discussion on vaccines that has been pretty prevalent in the country, but we're now seeing the implications of how that works in our health care systems, how that works in within our own families. So I really appreciate your insight and your willingness to share your your thoughts on this.
Dr. Natasha Bagdasarian:Thanks for having me on, and thank you for covering this really important topic.
Speaker 2:East Lansing Insider is brought to you by ELI on Impact eighty nine FM. We are on the web at eastlancinginfo.newsandimpact89fm.org. Thanks for listening.