It's a fairly common misconception that getting the influenza vaccine can give you the flu. The vaccine contains dead viral organisms, so it is impossible for them to cause an actual infection. However, the immune system recognizes the dead virus as being alive and a threat to the body so it responds accordingly, meaning it attacks them and creates antibodies to prevent future infection by the same strain. This process can cause a person to experience some of the symptoms of influenza infection, since some of the symptoms (symptoms such as fever, swelling, nausea, vomiting and diarrhea) a person experiences while sick are caused by the immune system fighting the infection and trying to expel the pathogen from the body. Only a few of the symptoms are caused by the pathogen itself. The symptoms caused by the immune system's reaction to the vaccine are often mild and last for less than 24 hours.
When the female drug rep walks out of the Doctor's offices, there are four plaques, each containing the name of a doctor. Three of those names are used as characters in other episodes:
Glenda Allen, M.D. - Denial Christian Varick, M.D. - Double Blind Seth Bernstein, M.D. - Ramparts
Glenda Allen, M.D. - Denial Christian Varick, M.D. - Double Blind Seth Bernstein, M.D. - Ramparts
This episode appears to be based on three separate cases/incidents:
- The 2002 Robert Courtney case. Courtney a former pharmacist from Kansas City, Missouri. In 2002, after initially being caught diluting several doses of chemotherapy drugs, he pleaded guilty to intentionally diluting 98,000 prescriptions involving multiple types of drugs, which were given to 4,200 patients, and was sentenced to 30 years in federal prison
- The shortage of the flu vaccine in the United States during the winter 2004-2005 flu season.
- The British noir film The Third Man (1949).
When A.D.A. Alexandra Borgia is describing the cons the "career con-man" was involved in, she described a con where he bought totaled cars and reassembled them and selling them. "The chassis were so bad they were unsafe at any speed." A reference to the book "Unsafe at Any Speed" by Ralph Nader, who brought to light the reluctance of the auto makers to make cars safer because of the cost. It also brought to light the problems with the Chevrolet Corvair.