Follow Up

December 4, 2020

I almost deleted yesterday’s post because I am tired of feeling punctured by (some of) the comments, but I am afraid if I do so then it will be misconstrued further as some sort of anti-vaccine treatise.

Which it was never meant to be.

I’m sure my thoughts were influenced by the meeting I attended at work earlier this week which did contain an air of caution. After yesterday’s post, I approached the speaker (who is a researcher that I trust) and they stood by the fact that there are some unknowns.

They also said they felt that “getting the vaccine is probably the right thing to do. (Speaks to your readers concern).”

And I WILL admit that I had not considered those community aspects as much, possibly because they had not been emphasized in the meeting. So perhaps that makes me a horrible person in some people’s eyes. I am not sure what to do with that, but guess I have to accept that by choosing to write publicly and share more than most, I cannot please everyone all the time. And maybe that’s okay.

I appreciate those who sent in resources, and I plan on reading/listening to them (this morning’s listening will be this one: Deep Background (with guest Dr. Paul Offit). I believe this way I will be able to approach the decision with full confidence if it comes up in the coming days to weeks (which is where I was leaning anyway — as I thought I expressed). (IF is definitely a key word here – clearly I am much farther from the front lines and lower risk than many, so depending on supply I may not be offered and that is completely appropriate.)

Well. I’ve been up since 3:40 (combination of feelings related to all of this and continued kid-related sleep issues). I am filled with dread about my level of functioning today. Happy Friday.


  • Reply Laura December 4, 2020 at 6:19 am

    I am so sorry you are up early and that you are feeling punctured by comments here. Your blog is such a gift – that you make time to keep writing and sharing in the middle of such a busy life. I know you know I appreciate it but let me say it again!

    • Reply Clare December 4, 2020 at 7:06 am

      100%!!! Internet commenters can be vicious

    • Reply Stacy A December 4, 2020 at 8:36 am

      I’ll echo Laura’s comment on your blog being a gift. I enjoy reading it because you have such a level headed approach to decision making & managing life as a working mother. It’s evident in how you plan your personal and professional goals and how you’ve talked through different life issues. You’ve never advertised your blog as being a place to receive medical advice or guidance. The fact some readers placed unreasonable expectations on you is their problem not yours. You’re a human being first, wife and mother second, and a physician third. Having a moment of pause on the vaccine, given the uncertainty with everything COVID, is completely normal and expected.

      • Reply Connie C December 4, 2020 at 9:11 am

        What Stacy A said. Let the haters go.

    • Reply L December 4, 2020 at 11:07 am

      I agree with all of the above. I hope your day goes well. ❤️

    • Reply Rebecca December 4, 2020 at 11:16 am

      YES!!!! THIS! Most of us appreciate your honesty and thoughtful insight. Haters gonna hate but you aren’t here for them!

    • Reply Nicole December 4, 2020 at 1:11 pm

      Hi Sarah: I found you because of Laura and long time fan of BBW… just sending another comment to let you know your blog is a gift and your words (from a lawyer’s perspective) were clearly expressed. I heard you loud and clear. Keep on, keepin on! Love the podcasts, love the ideas and connection I share with you and Laura.

    • Reply Sara December 5, 2020 at 7:25 am

      Your blog is a gift! I only follow a few blogs these days and yours in one of them. I appreciate that blogs are some people’s main source of income and, with that, unfortunately they may have to make some compromises on being as authentic as they’d like. Everything about this pandemic involves so much mental capacity to make risk-based decisions (if one is lucky to even have choices!) and it’s exhausting.

  • Reply Amy December 4, 2020 at 6:52 am

    As someone said in the comments yesterday, asking questions and considering all of the positives and negatives is part of thoughtful decision-making. Don’t apologize for that.

  • Reply Joy December 4, 2020 at 7:04 am

    I’m sorry that you are losing sleep over some of the comments. I appreciated your honesty in thinking the issue through and sharing that publicly. I have minimal time to read blogs but always appreciate your honesty here, which is why I come back. I don’t always agree with everything you write, but that’s actually one of the main reasons I read your blog. It helps me to think outside my own box and perhaps change my mind and/or grow as a thoughtful human being. So, thanks!

  • Reply Heather December 4, 2020 at 7:04 am

    I hate that some of your readers have lumped you together with the anti-vaccers. To me, you were just writing about perfectly acceptable, natural fears. I also never got the vibe that you were planning on NOT getting the vaccine.

    You shouldn’t have to act as if you are fear free just because you are a doctor. I always want my doctors to express their concerns and trepidations because it allows me to make a more informed decision.

    I have NEVER gotten the conspiracy theory/ anti anything vine from you. I’m shocked that people were so quick to judge. I have always appreciated your honesty in your writing, so I hope this does not change the way you approach your blog.

  • Reply gwinne December 4, 2020 at 7:32 am

    I hear you, Sarah, and respect you sharing your thought process about all this.

    I took a calculator that tells me when I’m most likely to get a vaccine….and there are about 4 million people in my state ahead of me. I was not on the fence at all (will take when available)….but I suspect by then we’ll know a lot more.

  • Reply ER December 4, 2020 at 7:44 am

    Sarah, your blog is my favorite on the internet and the first one I read when I sit down with my coffee every morning. I’ve never read it for medical advice, but for the humanity found in your posts. That you are willing to be vulnerable and share your ups and downs brings me comfort and a sense of fellowship, even though we’ve never met. I’d hate to see that authenticity disappear because of the critics. As far as vaccines, I am not a medical professional but I am a PhD researcher in a university and I see nothing controversial or half-baked about saying you are nervous and will do more research first. What would become of science if we weren’t willing to ask questions? And if I were coming to you for medical advice, I would find your reflective capacity reassuring, not disappointing.

    • Reply Grateful Kae December 4, 2020 at 8:57 am

      Exactly what I thought. I would be much more concerned to hear of a doctor NOT asking questions or fully considering all sides/research of an important issue. That’s just part of the process! She never said she was against it, just that she didn’t have the full information yet.

  • Reply Shelly December 4, 2020 at 7:48 am

    I appreciate your honesty in this blog. We all read from the context we are in and I can see those that are more directly impacted by Covid will have their views and others like a reader who had a son with a vaccine injury will see it from their context.

    I was pregnant with my first child during H1N1 and I had already had a previous miscarriage. I was nervous to get the vaccine. For those that are specialists in the field may have felt that my nervousness was ridiculous but it had been an emotional road to pregnancy and as another reader said there can be some risk. I went ahead with the vaccine after my research but it took me a bit to work through some fears.

    I donated a kidney to a family member a couple of years ago. My kids were fairly young and there is a 1 in 3,000 chance of death. When you look at the percent it’s very low but what if…. At some point I had to stop thinking about that. There were a tonne of tests to go through to make sure my body could handle it and I could so I went through with it.

    All I’m saying is that I appreciate dialogue of a bit of trepidation of a new vaccine. I have some nervousness but I will not be in the first rounds of the vaccine as I am not on the front lines.
    I can appreciate anyone whose on the front lines are beyond exhausted and need this to be over as we all do but attacking a dialogue that was not promoting against the vaccine doesn’t help anyone. If anything Sarah you have made me more aware of some good research on it as your readers share in the responses and for that I say thank you.

  • Reply Anastasia December 4, 2020 at 8:02 am

    I appreciate your blog as well, and just because I personally think the discussion/comments you received were valid doesn’t mean you’re a horrible person or “cancelled” in any way. You are human and therefore imperfect. But I do think how you respond, move on from this, pick your self up from this will show what kind of person you are and your true colors. And almost matters more than the mini scandal itself. Thank you for not deleting the post or comments and for following up further today.

    • Reply Milly December 4, 2020 at 8:30 am

      I grimaced a little bit at your comment, Anastasia. So now, how Sarah processes through her own feelings and what she chooses to share or not share is indicative of her true colors? And if her process is not up to random internet strangers’ standards, her true colors are…. what then? At that point, is she a horrible person? Just trying to understand the intent here. Seems a bit backhanded to me, but I am reading it from my own perspective.

      • Reply Stacy A December 4, 2020 at 8:38 am

        Me, too. Nothing here was a scandal…mini or full size. Some commenters are blowing things way out of proportion.

      • Reply Amy December 4, 2020 at 10:12 am

        Seriously. She’s allowed to ask questions and do research of her own when it comes to medical interventions. As another commenter said, what would become of science if we didn’t ask questions? I am far more trepidatious of a world / social environment where we are not allowed to even ask questions pertaining to what’s going on around us. This is a ridiculous comment.

    • Reply L December 4, 2020 at 2:06 pm

      This right here. Is WRONG. How she processes her emotions neither right nor wrong. It simply is. News flash- none of us currently do nor will we have any insight into her “true colors” from this. Can we please let people be themselves and stop placing such unnecessary and inappropriate expectations on them via the internet? Oh and while we are at it can we stop pretending we “know” them so well because we read their blog? Seems simple. Apparently is not.

    • Reply Anastasia December 4, 2020 at 2:23 pm

      I called it a mini scandal because I didn’t know what else to call it (I’m an accountant not a writer!). I do not think it’s really a scandal. And what I meant was kind of a golden rule, what we try to teach our kids. Of course we will all make mistakes and receive critique. What matters more than the actual “mistake” or whatever you want to call it is how we respond and react, whether we are defensive or if we can really look inward. I think a lot of the feedback and critique was valid. But I’m not going to get into an internet fight about it! I still appreciate the blog and podcast etc etc! But if respectful feedback isn’t welcome then maybe it shouldn’t be public (not saying this is SHUs perspective, as I said I appreciate her not deleting the post and comments and following up – many bloggers would have)!

      • Reply omdg December 4, 2020 at 2:57 pm

        I agree. Disagreement or disapproval of one blog post is not the same as “cancelling” someone or “attacking” them (even if the recipient feels attacked). I am troubled that it is processed in this way, and find it to be somewhat emblematic of the problem with social media in general: either you have to 100% or agree or disagree and are cancelling someone. It’s not productive and serves only to set humanity back.

  • Reply Sanjay December 4, 2020 at 8:15 am

    As a fellow physician, I completely agree with your thoughts and understand your healthy skepticism. I follow your podcast and read your blog for your ability to “keep things real”. The ability to question what we are told and seek answers is the very essence of science. Until I see published peer reviewed research of the vaccine trials, I would be a little wary of taking the vaccine as well. There are many physicians who are saying the same. You are not alone by any means. Please keep doing the good work you do!

  • Reply Heather December 4, 2020 at 8:38 am

    I’m going to be honest. I’m not a healthcare professional. My children have gotten their vaccinations all on time and we all get flu shots every year. I have concerns about the vaccine, as I think most people do. The comments here yesterday from healthcare providers made me really concerned that mine and my children’s doctors won’t take my questions and concerns seriously and that their attitude is going to be that I should just shut up and take it.

    • Reply Amy December 4, 2020 at 10:12 am

      Seriously! This is a great point.

      • Reply K December 4, 2020 at 3:57 pm

        Yes! The comments from physicians really made me upset. Honestly, it feels as if they were saying “shut up, take it, and don’t ask questions.” This is not the kind of relationship I would want to have with my healthcare provider.

  • Reply Ro December 4, 2020 at 8:48 am

    Sarah, your blog is a gift for all of your readers and I’m so sorry to hear that the mean comments are getting you down. Please know that for every vocal, negative commenter you have many more silent supporters! I almost never comment but I’ve been reading faithfully for years, and I enjoy your posts every single day.

    • Reply Kristen December 4, 2020 at 10:15 am

      RO took the words right out of my mouth! Proud to out myself today as one of those silent supporters.

    • Reply Marthe Renders December 4, 2020 at 11:14 am

      Yes! Thank you for all you do!

  • Reply Amanda December 4, 2020 at 8:56 am


  • Reply Ali December 4, 2020 at 8:57 am

    FWIW, I appreciated the tone of your post. To me it shows you are being thoughtful aka thinking through your decision. I am also as far from an anti vaxxer as it gets, and the idea of something new does make me nervous. Fortunately, I will be in one of the lowest priority groups to receive the vaccine (healthy 30 something not interacting with the public or working in healthcare), so I figure we’ll have months of safety data before I’m even offered the shot (which I will gladly take at that point). Thank you for your honesty, and I’m sorry that you wound up getting burned in the comments. (To me, they misread the tone of the original post.)

  • Reply Dr Eva Lantsoght (@evalantsoght) December 4, 2020 at 9:15 am

    I’m sorry to read you’re so impacted by the comments on yesterday’s post. Your blog is one of my favorite places to read, and I love your podcasts.

    I can understand some of the reactions yesterday as well – they come from the point and place of the commenters. My nearest family are strong antivaxxers and they would/could misinterpret your post as an endorsement for their movement. Then again, cherry-picking and misinterpreting are the favorite tools of the antivaxx movement, so that’s their problem and does not say anything about you and your musings. But it may have created this atmosphere of walking on eggshells.

    My hope for 2021 is that here in South America, we will be able to get access to the vaccine and at a reasonable price. It’s already a major difficulty each year to get the flu shot (for my daughter and mother in law), with things getting delayed in customs, so I’m afraid we will be the last in line to even be able to get any access to the vaccine.

  • Reply Ali December 4, 2020 at 9:20 am

    As a Biologist, I’m interested in people’s concerns about the new mRNA technology. It hasn’t been tested super long term yet, but I can’t even think of a mechanism by which it could be dangerous. Our bodies are full of mRNA (and degraded mRNA) and mRNA breaks apart SUPER quickly. It’s not going to hang around causing trouble.
    I guess there could be issues with the carrier chemicals, but the quantity is so small. and we know a lot about what makes chemicals dangerous vs safe for injection.

    I’ve been trying to talk with my ugrad students about the vaccine and there is a lot of vague ‘concern’, but no concrete thoughts about why or how it could be dangerous. Given what we know about the dangers of covid, getting a vaccine seems like an easy choice to me.

    • Reply Sarah Hart-Unger December 4, 2020 at 10:18 am

      I think it’s more the newness of the mechanism, but your points are really good (similar to what I heard on the Paul Offit interview), and in the process of learning more I’m feeling more and more comfortable with the technology.

    • Reply Erin December 4, 2020 at 11:56 am

      I’m a public health researcher (behavior-focused, NOT an epidemiologist) with a bio background and had some of those vague concerns I really couldn’t articulate and had no idea where they were coming from. I had a work call today with a statistician friend who reminded me “hello, it’s mRNA, you know how this mechanism and clinical trials work” my concerns are gone (we both sit on our institution’s review committee that includes drug trials). I work in a large healthcare system that just emailed their vaccine distribution plans to everyone and as a non-essential non-patient-facing employee I’m pretty far down on the list (which is appropriate) but I’ll definitely be in line when it’s my turn.

      • Reply Erin December 4, 2020 at 11:58 am

        Also wanted to add that we had the same discussion of risk/benefit of vaccine vs. COVID we agree that the risks from COVID very much outweigh any risks from the vaccine.

    • Reply Anon December 4, 2020 at 12:27 pm

      The immune response and auto immunity, among others.

  • Reply Kristina December 4, 2020 at 9:23 am

    Fellow physician here. I NEVER comment on blogs but felt compelled to do so in this case. I share your hesitations about the vaccine (which doesn’t make me an anti-vaxer but rather makes me a critical thinker). What this pandemic has shown me is that the public expects us to put ourselves in the front line again and again in so many different ways without any regard for how we as healthcare workers are affected. The outrage displayed by some in the comments on yesterday’s post are a perfect example. I think it’s easy to say you would be first in line to get the vaccine if offered to you when that’s not what is likely to happen. In reality, healthcare workers are likely to be guinea pigs for the vaccine and then others will have the luxury of seeing how it affects us before making the choice about whether to get it. And again—I agree exactly with your thought process Sarah—after reflection YES I probably would get the vaccine, but I think it’s unfair to expect us not to have any pause about it.

    • Reply Katie December 4, 2020 at 1:28 pm

      I’m not a physician or scientist (CPA here) and agree with you completely. Critical thinking has become a lost art, while being incredibly critical of others seems to come far too easily to many.

      To add another perspective, I’m pretty sure President-Elect Biden said he would take the vaccine when Dr. Fauci says it’s safe. This seems like a reasonable approach for those of us who don’t have the knowledge or skill set to make the decision ourselves based only on the scientific data. To my knowledge that has not yet happened, although I’m sure it is forthcoming assuming everything that has been released about the efficacy and safety of the vaccine is true.

      I’m sorry this is causing you additional stress, Sarah. A child who won’t sleep is quite enough.

  • Reply Roxanna Kassam-Kara December 4, 2020 at 9:28 am

    I can totally appreciate feeling punctured for writing honestly in a public space – especially in a time of high anxiety. And of course you are not a horrible person – you are responsible and thoughtful and sharing your feelings here on the internet,

    I hope you didn’t think my comment yesterday was rude or offside or vicious – I just wanted to alert you to the community piece and voice my feelings too. To the extent that I read the comments, the first few were the same – not vicious or accusatory, just alerting you to some issues we may have noticed. A blog is a forum of give and take, after all.

    But – being highly sensitive myself – I know how the comments, however appropriately framed, can feel like a knife in the gut. I’m sorry for how you are feeling right now, and I appreciate you being vulnerable enough to share that with us. Gosh, it so hard sometimes. Sending you good thoughts and vibes that you have a better day.

  • Reply Rachel December 4, 2020 at 9:45 am

    Absolutely love your honesty. It is so brave to share on a public blog, especially with how often you post. There is so rarely a day where something like this comes up, so I hope it provides some comfort with how much people like and respect your blog! I know it’s hurtful when people assume they know your character though. You’re amazing and we all find your honesty a breath of fresh air in this overly fake online world.

  • Reply Chelsea December 4, 2020 at 9:46 am

    Just wanted to show my support as well. I think this was a case of people reading their own frustrations into your post. I get that a person who is on the front lines is frustrated by feeling like they don’t have the luxury of considering any possible negatives of getting *this brand new* vaccine. Whatever negatives there could possibly be are outweighed by the real consequences of Covid. I also get that – as Eva says above – people who have to deal with antivaxers find anything even remotely critical (not even critical – just analytical) about a vaccine to be frustrating fuel to that fire.

    As someone who is in the enviable position of being healthy and not a front-line worker, I did not read anything like that into your post. But I am sympathetic to the people who expressed those frustrations yesterday. Not that they were necessarily directed in right direction…

    What would our medical system be without exactly the kind of thoughtful questions Sara raised in her post? That’s the whole idea behind the peer review system. Again, we’re not talking about the the TDap here… we’re talking about a brand new vaccine based on a brand new technology.

    I’m absolutely heartened by the fact that it seems to be working with minimal side effects, but I would be lying if I said I wasn’t a bit glad I’m going to be last on the list to get one (and rightly so, there are so many people more in need than I am). On the other hand, reasonable people can come to different conclusions. My parents, who are healthy but over 70, want to be first in line as soon as it is their turn to get the vaccine, and I respect that.

  • Reply Young December 4, 2020 at 10:07 am

    I appreciated your post yesterday. I felt like it spoke for many people who feel the same way— feeling mostly favorable toward getting the vaccine but with slight trepidation that seems completely warranted what with the unprecedented speed with which it was developed and the mRNA factor. I felt like more than anything, you are curious and wanting more information which is completely valid. I never read your blog for medical advice as I know that this is not what the blog is for. Also, you are not a writing an Op Ed in the Times or anything like that. I have more sense to base something as important as this on a stranger’s blog post who is not my personal physician (no offense!). I plan on getting the vaccine when it is offered to me, but at this point, I also feel nervous because of the unknown long term effects. Is it a crime to feel nervous or to question? No, I don’t think so. I also plan on listening to the podcast with Dr. Offitt.

  • Reply TAS December 4, 2020 at 10:20 am

    +1 to all of these. I don’t know why people think that these spaces are open for attack. You provide a FREE place where we can pop in for some distraction and to hear how another (educated, funny, kind) human thinks, feels, and lives. The gift is the reflection back to our own lives. Perhaps those that feel the need to go on the attack in these spaces will spend less time on blogs and more time thinking about what is missing in their lives that makes them feel entitled to attack thoughtful strangers. I read those blogs that edit every work for fear of attack and they are inauthentic. And let’s not forget that we lost our beloved meal plans and book suggestions from Lagliv because of the jerks. There’s a great book on fatherhood by the lead singer of the punk band Pennywise; in it there’s a quote I keep on the fridge: “there’s a lot of nice people in this world that you’ll never meet, but the a**holes will come up and prove it to you all the time. It’s great to see so many nice people show up to say hello.

  • Reply A. December 4, 2020 at 10:48 am

    « In a new informal survey of 700 epidemiologists by The New York Times, half said they would not change their personal behavior until at least 70 percent of the population was vaccinated..»
    As a reader here and a writer in my daily life, I stand for what I said on the last post; sometimes think out a loud on very sensible subject exposes to criticism. It is not about staying on your gards, but listening: discomfort and confusion were expressed for reasons. You can maybe try to understand why. People were not angry, they were shock and sad and wtf, they said.

  • Reply Kersti December 4, 2020 at 10:53 am

    Love your work, Sarah! Sending good vibes.

  • Reply Kathy December 4, 2020 at 10:56 am

    Regarding feeling punctured by the comments – I’m a highly sensitive person and a female professor of physical sciences at an elite STEM school. I have read literally thousands of anonymous comments by first-year college students telling me exactly what they think of me, in addition to the reviews I receive in my scholarly life and feedback in my administrative role. The book “Thanks for the Feedback (even when it is off-base, unfair, poorly delivered, and frankly, you’re not in the mood)” by Douglas Stone and Sheila Heen helped me a lot. Criticism is inevitable (at least, if I want to do anything interesting), so it helps to have strategies to process that feedback, learn what I can, and leave the rest behind.

    • Reply Shaundra December 4, 2020 at 12:32 pm

      I will have to check this book out, thanks for recommendation!

    • Reply Dr Eva Lantsoght (@evalantsoght) December 4, 2020 at 9:07 pm

      Thanks for the recommendation. I’m a professor as well, and sometimes I’m thrown off for weeks by a student comment on my evaluation… I’ll need to read this book.

  • Reply Elizabeth December 4, 2020 at 11:04 am

    Sarah, you say this today: “ I have to accept that by choosing to write publicly and share more than most, I cannot please everyone all the time. And maybe that’s okay.”

    To you I say: not MAYBE okay—this is 100% okay! YOU CANNOT PLEASE EVERYONE ALL THE TIME. Your responsibility is to be true to yourself and your family, not to random strangers on the internet!

    I am certain I would feel the same in your shoes. Your blog is special and you d built a community of readers who are by & large supportive and kind. I’m sure it felt extremely personal and painful to read some of those comments yesterday.

    I can see why someone who is or has been personally impacted might feel, frankly, enraged to read that someone who has the opportunity to get vaccinated even has to think twice about it. In general, when you’re desperate for something and hear someone else casually debating whether or not they want that thing you so deeply desire, it stings.

    However: you did nothing wrong. I thought your post yesterday was full of valid critical thinking. It did not come across as anti-vaccine to me nor flippant about the risk/reward analysis of getting the vaccine. Everything in life offers risks and rewards and to treat this as somehow different is absurd.

    Take heart, Sarah. Sending a hug. And hopefully an early to bed night.

  • Reply Holly December 4, 2020 at 11:40 am

    Sarah, have read your blog since the med school days, and I know you think conscientiously and critically about things, and are so generous to share your thoughts and feelings openly and honestly on the internet. But I think characterizing the comments yesterday as puncturing-ly unfair or unreasonably critical is…also unfair. People did express shock at the post, but I think that came from a real place of being surprised to see you publicly share this deliberation, not because they were trying to shame you or call you a bad person.

    I say this gently, not to pile on from yesterday but to support your introspection and growth – I do think this is one of those cases where if a majority of commenters are expressing a similar opinion…it is worthy of considering that you may have come across differently than you intended. This is not some random post on Facebook that got circulated where angry strangers are adding their thoughts. This was on your blog, where you have built a community of active, kind, and like-minded readers and commenters. Their critiques and opinions were not intended to shame you, but to point out their concerns with your logic and messaging, and moreover, may indicate how this post could be perceived more broadly (by non-critically thinking readers, by your patients or coworkers, etc.).

    Finally, I just want to say – I don’t think ANYONE said you were a “bad person” for not considering the community impact. But as a physician (and more importantly – a seemingly kind, empathetic, and community-oriented member of society), it was surprising to not have that basic tenet of vaccine philosophy featured. I see why, based on today’s follow up, but I hope you can see why the commenters thought it was necessary to bring up in a discussion about vaccines.

    Yes, it sucks to share your life publicly on the internet and have people criticize it. But also…you must have your reasons for why this isn’t just a private journal. Presumably, most days you get value from this community of commenters who is so willingly ready to chime in or present alternative opinions. I would imagine you sometimes take solace in having other hard choices validated and confirmed by strangers on the internet. The flipside of the coin is tough, I imagine, but part of it!

  • Reply Stacy December 4, 2020 at 11:54 am

    I don’t usually comment on blogs but I wanted to say that while I’m sorry you felt attacked, I think most of the criticism was respectful and valid. I would hope that respectful disagreement is ok on your blog (if not you should turn off commenting, which is probably what I would do if I had a blog because I’m also sensitive!). I’m a scientist, working in pharma/biotech (not for Pfizer and not on vaccines) and I think a lot of scientists feel frustration that there is a vague sense of “concern” about vaccines and other technologies without a lot of understanding of the technology, and that concern that doesn’t come from a place of knowledge is widely viewed as valid in our society. If you had cited specific concerns based on research and understanding of mRNA vaccine technology, I would have felt differently about your post. As it is, while any vaccine carries some risk, there is no evidence that mRNA vaccines are more risky than other types. While this is the first approved mRNA vaccine, RNA-based drugs have been in people since at least the early 2000s and people have been working on mRNA vaccines for a long time before this year (see this article on the history of mRNA vaccines if it’s not behind a paywall – it’s from 2017 so even more research has happened since and the title is pretty ironic these days I also think that many people when concerned about possible dangers of vaccines also don’t give credit to the other side of the coin – known and unknown risks of catching and transmitting the disease.

    • Reply Irene December 4, 2020 at 3:53 pm

      I am really distressed by the number of comments equating expressing vague concern with asking questions and critical thinking. I agree concern without knowledge is valid as a starting point for research only. However I think Sarah is doing her homework now and I’m happy to give her the benefit of the doubt after her clarifying comments that she always intended to do so (not just chat with colleagues as I initially read her post). I hope she will share with the commenters above expressing similar concern.

  • Reply A Trainee December 4, 2020 at 12:11 pm

    I waffled back and forth on posting something, because I certainly don’t want to upset you or make you feel attacked. I do understand nervousness about a new technology, and appreciate you being honest about seeking out valid sources and speaking to the experts. I think, in medicine, and science, we certainly learn that we aren’t experts in everything pretty early, and it’s on us to seek out the data and information, which you’ve been so open about! Also, COVID has been a roller coaster. Good Lord.

    However, the part that gave me pause yesterday was your surprise that your residents were eager to get the vaccine. As a trainee, I’d feel pretty bewildered if my PD was surprised at my eagerness to be vaccinated, and (and this is totally a me thing!), I’d be a little worried they weren’t totally aware of my fears, exposures, and risks in caring for COVID patients (I’m in IM). Again, you have never come across as unfeeling or callous towards your trainees, but I did have a double-take for a second.

    • Reply Sarah Hart-Unger December 4, 2020 at 1:31 pm

      First will just note that I very much want them to be prioritized for it assuming they want it. They are front line and deserve it as much as anyone else in that group (ie, ED nurses, ED attendings, so many others caring for many sick & covid pts) and I have already put my reminder of that to our hospital leadership to makes sure they are included. My comment was more due to their age group generally being a bit less fearful and the way the talk was presented (that some of them were at) as more of a risk/benefit issue.

  • Reply omdg December 4, 2020 at 2:38 pm

    The problem, Sarah, is not that it is wrong to express out loud that the vaccine uses a novel technology with unknown side effects, it’s that many MANY people will take this information and decide that it’s “too dangerous” to risk, particularly if this information comes from a physician. This is much the same mechanism that if you say that the risks of one glass of wine per week in pregnancy are probably overblown, many people will take that as evidence that if one drink is ok, 2 to 3 to 7 must be ok too. Your post was just… very handwave-y, with no specific concerns or evidence identified, just a general “sense” that it “might” be problematic, but that you’d “probably” take it anyway. It honestly read to me as kow-towing to the portion of your readers who might be vaccine undecided, God forbid that population be alienated by reading that you definitely would take the vaccine if you were offered it. The most generous read I could come up with was that you felt that other people who were more at risk should get the vaccine before your (relatively healthy) family got it.

    Also, your post was almost flippantly dismissive of the perspective of the residents who, though largely younger and healthier, have in almost ALL cases have been far far more on the front lines of this (cannon fodder might be the right term) than you will ever be or could even imagine. This saddened me because I know you are better than this. I wondered whether I, too, will become flippantly dismissive of my residents’ concerns the further out of training I get. Gosh I hope not. Please try to imagine what it has felt like for trainees this past year. If you can’t imagine, you can go to medTwitter and hear from people who are being volun-told to the front lines, and hold the hands of patients dying from COVID every day, almost always alone.

    Imagine for a moment how much worse things would be if only 50% of people got vaccinated and all businesses opened up as is COVID never existed. The hospitals would continue to be overwhelmed for… years, probably. Millions more people would likely catch COVID and die from it. The economy will continue to struggle. This is probably what actually is going to happen. We need to do everything we can to avoid this scenario.

    I’m sorry you feel deflated, and this caused you to lose sleep last night. I just think that as a physician you need to be careful how you express things like this because it can and WILL be interpreted as support of vaccine hesitancy. One only need to read your comments to find evidence of this.

    • Reply Sarah Hart-Unger December 4, 2020 at 3:13 pm

      I just for the record was not meaning at all to be flippant about the residents wants, needs, fears or hopes. I care SO much about my residents concerns that some might say I overly advocate. And I have already taken steps to make sure they have access to the vaccine as soon as anyone else in their tier (ie, a high risk tier, same tier as the Emergency Dept staff – attendings, nurses, RTs, others, since they work there too). I just see different levels of concern or have gleaned that from behaviors I have observed — a range of caution levels I guess I’d put it, which is understandable since they are 24 different individuals with different circumstances. And many of them are quite young so personal risks are not as high (though as you point out – definitely not zero either).

      They were at the same talk I was at which to me painted more of a “there are many unknowns, consider risks/benefits” pictures. So that was where my surprise came from a bit.

      • Reply omdg December 4, 2020 at 3:23 pm

        On that front (i.e. many residents going on vacation and to restaurants, etc. as if there is no pandemic), I have seen this too, and it makes me cringe. I often wonder whether I am the lone “sucker” who is staying home and being “good” while everyone else is basically out doing whatever the heck they want, free riding off of my good behavior. I try not to think about it too hard because it makes me insane. I know you care about your residents, which is why your comment surprised me. I suspected you didn’t actually mean it the way it came across.

        It is also totally reasonable as a physician, as a scientist, to think critically about the technology. You just have to be careful how you express this to non-medical people who will take it and RUN with it.

        • Reply Chelsea December 4, 2020 at 8:19 pm

          “The problem, Sarah, is not that it is wrong to express out loud that the vaccine uses a novel technology with unknown side effects, it’s that many MANY people will take this information and decide that it’s “too dangerous” to risk, particularly if this information comes from a physician.”

          I’m not sure what kind of audience you think Sarah has, but this seems a bit overblown. This post didn’t appear on CNN. And I’ve read your blog… you’re letting your daughter have playdates and are socializing with people in your neighborhood… This seems exactly like the behavior you are criticizing other people for engaging in.

          • omdg December 5, 2020 at 4:39 pm

            My daughter only has playdates with two friends, outside, with masks on. So, no. The behavior I am criticizing is not even in the same ballpark. Cheers!

  • Reply Virginia Hahn December 4, 2020 at 3:00 pm

    Long time reader and listener, fellow physician mom. Please tune out the noise for your own sanity. I understand though- it hurts and I would be bothered by it too. I haven’t read through all the comments because they were too long/redundant. It is okay to question new therapies, weigh risks and benefits, and change our minds as new information arises. In fact it is in our DNA as physicians. We scrutinize clinical trials and pore over the supplemental materials before we change therapeutic strategy. Many of my colleagues had concerns about getting a vaccine that felt rushed. The calculus has changed a bit now that there is such widespread devastation hour-to-hour. I myself have said I’d be first in line for a vaccine (April), wait a bit for a vaccine (August), back to being towards the front whenever I’m given my opportunity. It’s okay to deliberate.

  • Reply Sherri L McConnell December 4, 2020 at 3:22 pm

    I’m just so grateful for your honesty…thank you for just really explaining all of the issues so well. I really appreciate it–and it’s one of the reasons I love following your blog and podcasts.

  • Reply Coco December 4, 2020 at 3:52 pm

    Sarah, please don’t apologise. this is your blog and you are free to share your honest thoughts, which is what long time readers appreciate the most!!!!
    I’m up since 3:30am too. hahahah….

  • Reply Elizabeth December 4, 2020 at 4:01 pm

    I think a big take away from this dialog, apart from the vaccine issue(s), is that receiving critical or negative feedback is not easy. You put yourself out there almost daily and it’s hard to hear that something you wrote really did not land for many of your readers. It is hard not to take it personally! But I would also urge you to try to see it as criticism of an idea you expressed, and maybe even mostly in the way that you expressed it, rather than of you as a person. People are allowed to have different opinions and we won’t learn from each other if we can’t disagree and express why we disagree. Also, I’m assuming that the vast majority of the commenters do not know you as a person–so this truly cannot be a personal attack.

    That said, in this case, I think it is valid to spend time considering why this got so many strong (negative) reactions. To me, the tone of yesterday’s post read as casual to a degree that implies you see the topic of COVID vaccination in that light (rather than as a serious issue). Whether it was a rushed post or if there was some other reason for the seemingly flippant approach to the topic, I would just try to see it in through the lens of trying to figure out how so many people took your thoughts in a way that it seems, from your follow up comments, to be different than what you intended to convey.

    Thanks again for all you do! From creating content that inspires such heated conversation to offering menu planning suggestions, I love your blog and can’t wait to read tomorrow’s post.

    • Reply Sarah Hart-Unger December 4, 2020 at 4:12 pm

      I appreciate it. For the record, all of my posts are written in a very short amount of time. That is why I can post daily without it being anything close to my job, and I think it is what makes this blog (and some others like it, many of which I read!) a bit different than typical journalism or news or even a more curated blog where opinions are laid out and expressed (or “tips” are given . . . rarely if ever do I ever do that!). I write casually. I didn’t even use capital letters until something like 2012 (okay, kind of regret that)! But honestly, sharing not-completely-formed thoughts and reflections has kind of been my way of writing here since the inception (2004!). There are very very few more journalistic longer posts (because I do not find them much fun to write, honestly) and I think that explains the style, but I figured my readers were used to it. You can imagine I would think twice about tackling that kind of topic as casually again, but I can’t say I’m thrilled about it.

      • Reply Elizabeth December 4, 2020 at 11:57 pm

        All lower case—lol 🙂 Yes, you have shared before that you write posts quickly as just part of your morning routine, and long time readers are used to the more conversational tone of your writing. You have every right to your own opinion. It’s your personal blog!

        As I said in an earlier comment, I’m sending you a big hug! I don’t know you but from what you’ve shared of yourself, you are thoughtful, considerate, conscientious, intelligent, diligent, and compassionate, and as I said, criticism stings. It just does. I’m hoping you don’t lose any more sleep over this. It’s not worth it. Here’s to what I hope can be a productive and relaxing weekend for you.

  • Reply Alyce December 4, 2020 at 4:39 pm

    Wow, I read your post yesterday morning and thought nothing of it (and also personally agreed with your thought process). It was a big surprise to come back this afternoon and see all these comments on today’s and yesterdays posts. I skimmed them briefly and I can see the points people are making on both sides. There’s no real right answer here. It’s really tough to put yourself out there publicly (which is probably my number one reason for not blogging, even though it’s something I think I would really like to do, because you know. I HAVE SO MANY THOUGHTS AND OPINIONS.) I think it’s tough to think about having to censor yourself in a public space that is also your personal blog. I hate having to temper my comments when I know I’m representing the federal government, and at least then I know I’m actually at work. Basically, I have no real comment, just lots of feeling of empathy for you now.

    • Reply Sarah Hart-Unger December 4, 2020 at 4:41 pm

      Well just so you know – I would read your blog in a heartbeat 🙂

  • Reply W December 4, 2020 at 5:29 pm

    Adding to the voices of support. I was very glad my parents are in phase 2 in the UK for a vaccine, and it wasn’t until I saw a video from Mama Doctor Jones and your blog that I realized that the vaccine is a completely new mechanism, and though we know it creates antibodies, and we can infer from things we do know, we actually don’t know a lot about the long term effects.

    I will probably still encourage them to get it, and I will too, when it’s available to me, but I appreciate the people who are willing to EXPLAIN the medical pros and cons, in order that I know that they exist and can make an informed decision.

    MDJ says “you don’t get to be offended by science”, and I think it’s something more people should take into account. What you write was about the known science, not a recommendation – and I’m not sure how anyone could construe it as such.


    (PS. MDJ would be an excellent guest for BOBW!)

  • Reply Jara C December 4, 2020 at 6:19 pm

    I just wanted to add my voice to the voices of support. I love your blog, and appreciated your honesty in your post yesterday! I’ll be starting rotations in a few months and am in the age group of young 20-somethings that don’t seem to care about COVID much. I will 100% get the vaccine as soon as I can, mostly because I want to set a good example for my family (some of whom are “vaccine-hesitant”) and I will likely have to see COVID patients during rotations. As a medical student, I will be completely powerless to go against what the attendings/residents say, even if I’m not supposed to have to see COVID patients. I appreciated you voicing your concerns, and definitely did not think you came across as anti-science, anti-vaxxer, or a horrible person at all.

    • Reply Sarah Hart-Unger December 4, 2020 at 6:30 pm

      Oh wow – I truly hope your attending and residents will follow your school’s rules about patients. Would be a very tough situation to have to remind them what the rules are but I hope you are able to do so if it ever comes up. I know this time is so stressful for students on so many levels.

  • Reply Lisa December 4, 2020 at 8:57 pm

    Just another comment to say I understand how it feels, although on a much much smaller scale, to read criticism from others. I lost sleep the night I saw the response to my comment about following Covid guidelines falling along party lines. In my case, I could see how problematic the statement I made was and apologized although I don’t know if any of the commenters went back and read it. It’s tough to receive criticism, even when it’s constructive and meant to make you examine something you said or did. So lots of hugs to you – try to be compassionate to yourself. It’s hard to put yourself out there like you do every day. Had you known there would be such a response to a post about your early thoughts about taking the vaccine, you would have skipped it or formulated it differently. But I respect the fact that you kept the post out there instead of deleting it.

    I will personally take the vaccine when it’s available to me but I am probably not eligible until the 2nd half of 2021 since I’m not a front like worker. But I am higher risk due to RA/immune suppressant drugs – I can’t imagine something that granular will be taken into account. I hope my parents, who are in their 70s take it, but they are expressing concerns that can be classified as conspiracy theory… things are so bad here in Minnesota so I am desperate for the vaccine to be more widely available because many seem so ready to go back to their daily lives even if that means more people will die.

    Hang in there, Sarah. Thanks for sharing your life with us – you have one of my favorite blogs and I appreciate that you keep coming back to this space, even when it opens you to criticism.

  • Reply pts December 4, 2020 at 9:32 pm

    Long time lurker, but I want to chime in – thank you for being honest. I read your post as “hey, I’m probably going to get the shot, but there are things that make me nervous.” I’ve been vaccinated for yellow fever multiple times, and everytime, reading that safety card, I have to take a big deep breath beforehand. (For those who haven’t gotten it, the risk list for that vaccine is longer than the average tdap or whatever.)

    I think it’s silly to pretend that every vaccine/otc/etc is zero risk – they’re not, and healthcare folks like you are the ones most likely to know about those risks. But we get the vaccines because we know that the benefits are worth it anyway.

  • Reply Sarah December 4, 2020 at 9:39 pm

    Sarah – Your frequent posts this year have been a bright spot for me. I agree with Chelsea; I wonder how many of your readers will use your post as their sole source of information about the vaccine. I imagine this number is quite low.

  • Reply Kari December 4, 2020 at 10:00 pm

    Just want to add another physician mom voice to the choir. I read your post yesterday and thought about how I had just had a similar conversation with my husband. I will get the vaccine, and ultimately I’m glad to be in the first batch of people to get it because I do see patients in person almost every day with perhaps less than ideal PPE, but I have felt something more nuanced than 100% enthusiasm about being the first in line for a brand new vaccine. That doesn’t mean I don’t understand the value of public health and herd immunity or understand immunology, it just means I’m a human (and a critical thinker) and that’s ok.

    Thanks for your blog! I’ve been following since my postbacc days before I started med school (and now I’m an attending!) or had kids (and now I’ve got 2) and it’s been such a great resource for me. I’ve also been so impressed with your comments section over the years and honestly this is no exception – what a thoughtful, smart, respectful group of (mostly) women. Thanks for cultivating that.

  • Reply Heather December 5, 2020 at 12:26 am

    I find it absolutely shocking that the notion of a physician thinking critically and engaging in healthy decision making processes is somehow controversial. Is this not the basis of scientific inquiry?

    As a patient, I would have difficulty trusting a doctor who dismisses concerns, shames other physicians who admit to feeling cautious prior to receiving all the relevant information, and denies feeling anything other than 100% complete confidence in new technology. To me, these doctors come across as dogmatic and pushing their own agenda with broad strokes vs. carefully considering what is in the best interest of their patients on a case-by-case basis.

  • Reply Natalie December 5, 2020 at 7:32 pm

    Another voice of support for you, Sarah! I understand exactly where you were coming from in your post– and I think most everyone, if they are honest with themselves, have had similar thoughts as well. Thank you for not only leaving your original post up, but being open to feedback. Please keep on posting– it has been such a positive thing for me personally during the pandemic.

  • Reply The Evely Pack December 6, 2020 at 3:26 pm

    girl, i guess it is just telling of the volatile nature of our existence at the moment that people are willing to lash out at you over an innocent discussion of your morning thoughts… i mean what in the world? it’s like 5 in the morning when you post, you were in the middle of processing a subject that was presented recently for the purpose of self-analysis regarding your feelings about a *potential* availability of something that isn’t even a reality yet. like what are people expecting? citations and references for self-reflection? gracious, it’s not like you were writing an article, treatise, or public guidelines. i think the “tone” was just fine, fitting with the nature of all your blog posts – a brief overview of what’s on your mind, not an in depth search into the inner workings of your soul, neither is it ever a platform for pushing your personal stance onto those around you. it’s one thing to respond with ones’ perspective on the matter, whether it be the same or different from yours, but as for criticizing either your presentation or the content, i just don’t understand the rationale for that. you presented the topic as one you are actively looking for more information about and may not even be eligible for… seems perfectly appropriate to me, and not anything i would think would warrant such heated reactions… i’d say don’t give it a second thought, but i can’t imagine i’d be able to keep from feeling the sting either… just know you’ve got peeps that love reading your blog and hearing your perspective, and thanks for sharing a glimpse of your bright spirit with the world around you… it’s what this world needs more of!

  • Reply Michelle December 10, 2020 at 12:13 am

    Long-term reader, also fellow physician and on the front-lines. I applaud you for not taking down your post and also thoughtfully considering the comments of people, even though some comments didn’t deserve consideration. So often now, society is just multiple echo-chambers, so to be able to stand to up dissent in such a thoughtful way is refreshing. To me, you have a personal blog where you write about life, kids, work, etc. Now if you had a blog where you only wrote about medicine and marketed yourself as a Medical Expert then I think that would be a problem. I too have been reading about the vaccine and I think it is reasonable to critically think about new meds and technology. Here is a nice review: I have looked into articles prior to the pandemic as I worried that competing interests may skew papers being published. This is not to say that I think the vaccine trials are not legit, but I wanted to learn about the technology as it was known pre-pandemic. Looks safe, risks of exaggerated immune response, though rare, as we may be seeing with Pfizer in the UK’s first days (I am in Canada). But individual and societal benefits should likely far outweigh risks. Also agree with comments that the public seems to think health care workers should be guinea pigs to test the treatment, just like they expect us to risk our lives taking care of they and their loved ones while they galavant around in anti-mask protests, pack bars and malls, have birthday parties, and just carry on with their lives, which is a huge part of why North America and Europe are in this shitstorm. But that is a whole other topic..Anyways, keep up the good fight and critical thinking. You don’t owe anyone an apology for balanced musing on your personal blog.

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