Tag: vaccine

Fully Vaccinated? No Mask Needed with Exceptions

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Fully Vaccinated - No Masks with Exceptions
Photo by Ani Kolleshi on Unsplash

CDC’s Updated Mask Guidance for Fully Vaccinated People

On May 13, 2021, the CDC updated their Interim Public Health Recommendations for Fully Vaccinated People.  The CDC states the science shows that breakthrough COVID-19 illness in fully vaccinated individuals is limited and most breakthrough infections resulting in asymptomatic or mild disease. Hence, fully vaccinated individuals do not need to wear a mask indoors and do not need to socially distance, “except where required by federal, state, local, tribal, or territorial laws, rules, and regulations, including local business and workplace guidance.”
 

What is the Definition of Fully Vaccinated?

Full vaccination occurs ≥2 weeks after a person has received the 2nd dose of the Pfizer or Moderna vaccine or ≥2 weeks after a person has received the Johnson & Johnson vaccine.
 

What Can Fully Vaccinated People Stop Doing?

  • Stop wearing masks and social distancing, except as “required by federal, state, local, tribal, or territorial laws, rules, and regulations, including local business and workplace guidance.”
  • Stop testing before or after travel or self-quarantine after domestic travel
  • Stop testing before leaving the U.S. for international travel (unless required by the destination)
  • Stop self-quarantining after arriving back in the U.S.
  • Stop testing following a known exposure, if asymptomatic, with some exceptions for specific settings
  • Stop quarantining following a known exposure, if asymptomatic
  • Stop routine screening testing, if feasible

Where Are Masks Still Required for All?

Please keep in mind these CDC Guidelines do not apply in medical offices yet. Medical offices are places of higher risk. 
Other locations where mask use is still required are hospitals, other medical facilities, nursing homes, prisons, homeless shelters, and public travel.  In addition, it is still recommended that masks be worn in environments where there is a dense population, for example, at concerts.
 

What about Travel?

“All travelers are required to wear a mask on all planes, buses, trains, and other forms of public transportation traveling into, within, or out of the United States and in U.S. transportation hubs such as airports and stations.”
 

What about International Travel?

  • Fully vaccinated travelers do not need to get tested before leaving the U.S. unless required by their destination.
  • Fully vaccinated air travelers coming to the United States from abroad, including U.S. citizens, are still required to have a negative COVID-19 test result or documentation of recovery from COVID-19 before they fly to the U.S.
  • International travelers arriving in the U.S. are still recommended to get a COVID-19 test 3-5 days after travel regardless of vaccination status.
  • Fully vaccinated travelers don’t need to self-quarantine in the U.S. after international travel.

What If I’m Fully Vaccinated, Symptomatic, & I Get COVID-19?

The risk of breakthrough infection is very low for fully vaccinated people.  However, if this occurs, the fully vaccinated person who has COVID-19 symptoms should:
  • isolate themselves from others
  • be medically evaluated for a COVID-19 infection
  • get tested for COVID-19 infection
  • inform their doctor that they are fully vaccinated

What If I’m Fully Vaccinated, Asymptomatic, & Am Exposed to Someone Who Has/Might Have COVID-19?

The risk of breakthrough infection is very low for fully vaccinated people.  Isolation, quarantining, work restrictions, and COVID-19 testing are not required after exposure to someone who either has or is suspected of having COVID-19.  However, it is still necessary for them to self-monitor for 14 days after the exposure.
 

What If I’m Fully Vaccinated, Asymptomatic, Am Exposed to Someone Who Has/Might Have COVID-19, & I Work in a Prison or Homeless Shelter?

COVID-19 testing is required.  However, isolation, quarantining, work restrictions are not required after exposure to someone who either has or is suspected of having COVID-19.
 

What If I’m Fully Vaccinated, Asymptomatic, & Not Exposed to Someone Who Has/Might Have COVID-19?

Fully vaccinated people without COVID-19 symptoms, without known COVID-19 exposure “should be exempted from routine screening testing programs, if feasible.”
 

What If I’m Not Fully Vaccinated?  

The CDC recommends continued mask use and social distancing for anyone who is not fully vaccinated.  Masks are recommended for those children and adults, ages 2-years-old and up who are not fully vaccinated. Discuss your concerns about the vaccine with your doctor. Please consider getting a COVID-19 vaccine.  It is life-saving for the person vaccinated and the people around them.
 

When Will Fully Vaccinated People Be Able to Stop Wearing Masks in Your Office?

We will be able to relax some of our office’s mask requirements for fully vaccinated individuals, once the Overall New Percent Positivity is consistently (at least 2 weeks) <5% in BOTH Pasco & Hillsborough counties, as we serve both of these counties in Florida. New Percent Positivity refers to the percent of the population that has tested positive for COVID-19 for the first time in the past two weeks.  
 
Currently, as of 05/12/21, Pasco County’s Overall New Percent Positivity has been below 5% for two days. Hillsborough County’s Overall New Percent Positivity is 6.26%.  In addition, Pediatric Overall Percent Positivity has continued to increase through May 2021. Pasco’s Pediatric Overall Percent Positivity is 13.4% and Hillsborough’s is 14.7%. The Florida Department of Health does not release Pediatric New Percent Positivity. As always, we are watching these numbers very closely.
 

Do Children Still Need to Wear a Mask in Your Office?

Children ages 2-years-old and up and their parents who are not fully vaccinated against COVID-19 need to wear a mask throughout their office visit.  COVID-19 vaccine is not available for children 2 to 11-years-old at this point.  Trials are ongoing for children ages 6 months to 11-years-old.  The trials are expected to yield results in September 2021.  Please stay tuned.  We will keep you posted as updates occur.
 

How Can I Request to Not Wear a Mask in Your Office?

Fully vaccinated individuals that show their COVID-19 vaccination status as fully vaccinated will not need to use a mask in our office. For those who are uncomfortable sharing their vaccine information, mask use will be necessary throughout the visit.
 

How Can I Get More COVID-19 Updates?

Please feel free to search this blog for general non-COVID-19 health updates like car seat safety.  COVID-19 information changes daily.  We are happy to serve our community and others in this rapidly changing world we currently live in.  Please consider following us on our Small World Pediatrics Facebook page for frequent updates.  We also have weekly Facebook Live Videos on Sundays at Noon focusing on COVID-19 discussions where this week we discuss many updates and answer questions, including but not limited to the CDC’s mask guidance for fully vaccinated individuals.

Flu Season Severe 2017-2018

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fight the flu, severe flu, vaccine prevention, vaccine, vaccine, prevention, symptomsFlu Season Today?

As of the end of December 2017, the flu season is officially moderately severe.  The flu is widespread in 46 states.  This is up from 36 states in the previous week.  The U.S Centers for Disease Control and Prevention (CDC) research reveals that flu hospitalization is about 3 times higher than it was in the same time period in 2016.  In addition, the flu season started earlier this year than it did in 2016.  During the same time period in 2016, only 12 states had reported widespread activity, as compared to 46 states this flu season.  This pretty much matches what I’ve been seeing in our office in Florida.  About 3 weeks ago, we began to diagnose multiple children with the flu every day.

Why is this Flu Season Severe?

This season’s dominate flu strain is an Influenza A strain, H3N2, which is a particularly severe and causes more symptoms than other strains typically do.

What Are Flu Symptoms?

Flu symptoms typically include a fever and nasal congestion at a minimum. Other symptoms may include weakness, nausea, vomiting, diarrhea, headache, body aches, and more.

What To Do If I Think I Have the Flu?

If you are feeling sick with flu-like symptoms, you may want to consider going to see a doctor, especially within the first 48 hours of your illness.  Your doctor may be able to prescribe an anti-viral medication against the flu, Tamiflu, which is effective in preventing worsening symptoms of the flu by stopping its replication.  However, if you’ve been sick with the flu for more than 48 hours, Tamiflu is not effective.

I Have the Flu.  Now What?

Follow your doctor’s instructions.  Drink plenty of fluids.  Rest.  Stay home.  Do not go to work, school, religious gatherings, or other community gatherings or events.  By going out, you increase the risk of spreading the flu.  In addition, as the flu weakens the immune system, if you go out, you place yourself at risk for contracting a secondary bacterial infection, such as pneumonia, sinusitis, or an ear infection.

How Do I Prevent Myself From Getting the Flu?

Good old-fashioned hand washing is helpful, as flu droplets may linger on countertops and other objects. Hand washing prevents many other common infections as well (https://drsilvatotstweensandteens.com/2013/01/new-norovirus-highly-contagious-virus.html).

The good news is that the CDC reports that this season’s flu vaccine strains are a good match to the live flu virus strains that are circulating (http://bit.ly/2CLWaCZ).  That means the flu vaccine is providing good protection against the flu by preventing the flu so far.

The best course of action is to make sure you and your children get the flu vaccine.  It’s not too late.  No one knows exactly when the flu season ends.  From the looks of it, it will probably continue for another few months.  There is still time to protect yourself.  Get the flu vaccine at your doctor’s office, health department, school, or pharmacy today.

Flu Deaths | Prevention with Vaccine

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Flu Deaths | Prevention with Vaccine

The 2012-2013 Flu season started & peaked earlier than it typically does with cases documented as early as September  2012 and peaking in December 2012.  In addition, The past Flu season brought had a higher death rate for both seniors and children.   149 documented children’s death occurred due to Flu.  This is about 3 times higher than the average season.  In addition, seniors over the age of 65 were hit hard as evidence that they accounted for more than half of the hospitalization rates in the U.S.
 
While it is summertime, it is important to think about Flu shots now.  Typically, physicals are done in the summertime.  That is also the perfect time to receive the Flu vaccine.  Your child will be protected before the season & before they are exposed to other children when school restarts.
 
For more information about the recent Flu season, disease, and vaccine, please go to http://bit.ly/14sECUM and https://www.cdc.gov/flu/weekly/usmap.htm
 

Flu Illness High in U.S.

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Vaccine

The Centers for Disease Control and Prevention (CDC) have a U.S. weekly surveillance report.  As of last week, the rate of death due to flu with pneumonia reached a level above what is considered an epidemic threshold.

In addition, 9 out of 10 U.S. regions showed elevated levels of influenza-like illness.  47 states have a reported widespread level of the flu.

What can you do to prevent yourself or your family from getting the flu?

Get vaccinated.  The vaccine has been available since late last August, so it may not be as readily available. However, nowadays you have more locations where you can get the vaccine.  You can go to your doctor, your child’s pediatrician, a local pharmacy, or the health department.

Good old-fashioned hand washing is helpful, as flu droplets may linger on countertops and other objects.

Lastly, it may sound simple, but stay away from people who are coughing or appear to have cold symptoms. What looks like a cold one day, may reveal itself to be the flu on the next day.  Flu is contagious from 1 day before symptoms develop & 5-7 days after flu symptoms start.

The CDC’s U.S. weekly influenza activity map & weekly surveillance report are available. For more information on the flu, go to http://www.cdc.gov/flu.

 

Chicken Pox Lollipops | Unsafe & Illegal

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Chicken Pox Lollipops

Chicken Pox Lollipops?

For many years, before the chicken pox vaccine was available, parents used to have “chicken pox parties.” The idea was to get it over with,as you knew it was only a matter of time before your children became infected with the chicken pox. Now, apparently, some parents are taking this to a new level. Chicken Pox Lollipops? There is a Facebook Page titled, “Find A Pox Party.” This multi-state group of parents favors “natural immunity.” In so going, they purchase and sell chicken pox laced lollipops. The concept is simple and dangerous. A child that is acutely infected with chicken pox licks a lollipop. You buy the lollipop. You give that lollipop to your child. Your

child gets infected with chicken pox. However, the consequences are not simple; in fact, they can be deadly.  Pediatricians do not recommend these parties. And we definitely are against these chicken pox lollipops. We recommend disease prevention, period. Any intentional injury or disease is unacceptable.

 

Natural Immunity

 

Anyone who knowingly infects their child in the name of “natural immunity” while not being aware of the dangerous and deadly consequences, needs to become better informed. I hope that that the information in this blog post will educate many and thereby prevent disease. Parents may think, “What are the chances of that happening to my child? It almost never happens.” Remember, it only takes one time, one disasterous infection, for a parent to live a live filled with regret.

 
First of all, it is important to know that prior to the vaccine, chicken pox used to kill 100 children in the U.S. every year. The chicken pox vaccine is the safest manner in which you can prevent your child from getting the disease.
 
 

Chicken Pox Infection Complications

 

Secondly, it is important to be educated regarding the possible complications that can arise from a chicken pox infection. Most people think it is only a simple skin infection that itches a whole lot; then goes away. Many complications can arise from chicken pox. Chicken pox can cause a myriad of complications, including, but not limited to shingles, cellulitis, osteomyelitis, seizures, cerebellar ataxia, meningitis, encephalitis, pneumonia, hepatitis, conjunctivitis, retinal vasculitis, secondary blindness, and a whole slew of secondary bacterial infections, including MRSA.

 
 

Sharing Chicken Pox Lollipops Equals Sharing Many Unknown Diseases

 
Another thing to consider is the chicken pox lollipop is carrying that infected child’s medical history. That child could have had mono, AIDS, and many other diseases that are easily spread when there are open sores and/or saliva in their mouth. Simply put, the chicken pox lollipop is filled with the unknown and could be deadly.
 

Illegal – Federal Crime

 

Lastly, this news has gotten federal attention. Please be aware, that this is a federal crime on two counts. It is illegal to send any disease via U.S. mail or private mail. Also, it is illegal to alter or tamper with consumer products. Candy is a consumer product.
 
 

More Chicken Pox Disease & Vaccination Information

 
The American Academy of Pediatrics have in depth articles teaching more about the chicken pox disease and the chicken pox vaccine.

Kids Pneumonia Vaccine

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Kids Pneumonia Vaccine

Only 37% of children between the ages 14 and 59 months have received the 13-valent pneumococcal conjugate vaccine (PCV13).  This alarming statistic was released on November 4, 2011 in the U.S. Centers for Disease Control’s Morbidity & Mortality Weekly Report.
 
PCV13 replaces the 7-valent pneumococcal conjugate vaccine (PCV7).  Current recommendations include that: 1) children receive a primary series of PCV13 and 2) children between ages 14 and 59 months who have previously received the PCV7 as their primary series, receive a supplemental dose of PCV13, in order to prevent invasive pneumococcal disease (IPD).  Essentially, PCV13 protects children against an additional 6 strains of pneumococcus infection.
 
Pneumococcus is a bacterial infection that can cause invasive diseases, such as pneumonia, sepsis, and/or meningitis, which can result in severe illness and/or death.  Parents are usually familiar with & doctors typically refer to this vaccine as one of the “pneumonia” vaccines.
 
If your child is less than 5 years old, please ask your kids’ doctor if they are due for PCV13.  It could prevent illness & even save their lives.  For more information regarding kids and this pneumonia vaccine, PCV13, please go to http://www.cdc.gov/vaccines/vpd-vac/pneumo/default.htm#vacc.

Whooping Cough (Pertussis) Increase

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Whooping Cough (Pertussis) Increase
According to the Centers for Disease Control (CDC), last year, more than 21,000 people in the U.S. were diagnosed with whooping cough. This is the highest rate of whooping cough that the U.S. has seen in approximately 50 years. Currently, there is a whooping cough epidemic in California. Last year, in California, there were 8,300 cases of whooping cough and 10 babies died. Nationally, there were 26 deaths attributable to whooping cough.

Whooping cough, also known as Pertussis, is a highly contagious bacterial infection. Once infected, it starts with symptoms that seem to be consistent with the common cold. However, within 10 to 12 days, it progresses. It can lead to weeks or months of coughing, the sounds of which are constant and horrifying. It can also result in many devastating complications, such as pneumonia, dehydration, blindness, hearing loss, brain damage, seizures, or death. Infants have the highest risk of dying from this disease.

Those at highest risk, generally are those who have not yet be able to receive a high level of protection after receiving 3 doses of the pertussis vaccine. These include, but are not limited to:

* children who have not been vaccinated,

* children with delayed immunizations,
* children who are less than 6 months old

It is recommended that all children receive that whooping cough vaccine. This is offered as part of the Diphtheria-Tetanus-acellular Pertussis (DTaP) combination vaccine for children at ages 2, 4, 6, and 12-18 months old, with a booster at 4 to 5 years old. Additional recommendations are for children’s primary caregivers (moms, dads, grandparents, etc.) to receive the Tetanus-diphtheria-acellular pertussis (Tdap) vaccine.
 
I recommend this for all of my patients, their parents, and the older kids (teenagers) at home. Funny enough, dads hate the idea of receiving any vaccines. I never thought I would hear so many grown men cry, “But doc, do you know I hate shots? Do you know the last time I got shots?” My usual reply is, “Yes, I understand. No one likes them. Since, it’s been so long, you are probably not protected against pertussis. Just remember, you’re not doing this for yourself; you’re doing this for your baby.”
 
An excellent resource for more information is  https://bit.ly/3bFV8fe. Jeff Gordon, of NASCAR, is their latest supporter. Past supporters have included actress, Jennifer Lopez. Watch her touching public service announcement on You Tube at http://www.youtube.com/watch?v=3LsuJi33B2U (see right). Also, watch one family’s story on You Tube at http://www.youtube.com/watch?v=3akJVesMdvs&NR=1.
 

As always, consult your doctor with any questions you have about this disease and/or its prevention.

Vaccine Injury Compensation Program

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Vaccine Injury Compensation Program

The VICP was established as part of the National Childhood Vaccine Injury Compensation Act in 1986.  In essence, this provides families with financial compensation for injury proven to be caused by a vaccine.  It also protects vaccine manufacturers from lawsuits due to injuries caused by childhood vaccines, as long as every step in the manufacturing process was executed in the manner best known at the time.

The case in which the U.S. Supreme Court ruled was Bruesewitz v. Wyeth, Inc. (No. 09-152, S. Ct.).  The Bruesewitz family’s daughter suffered from seizures and has permanent developmental delay, after receiving a third DTP vaccine when she was 6 months old.  After losing their case in “vaccine court” (under the VICP), the Bruesewitz family sued Wyeth siting a 1998 DTP vaccine design flaw.  They claimed that Wyeth had prior knowledge about the design flaw, but decided to place it on the market regardless.  The Bruesewitz family filed a lawsuit against Wyeth directly with the claim that design-flaw was not protected by the VICP.  Of note, 65 other children were injured by the vaccine in the same vaccine lot that their daughter received.  Subsequently, the lot was pulled from the market.

In a 6-2 ruling yesterday, the U.S. Supreme Court upheld a ruling by the Third Circuit Court.  Justice Antonin Scalia wrote, “Provided that there was proper manufacture and warning, any remaining side effects, including those resulting from design defects, are deemed to have been unavoidable. State law design-defect claims are therefore preempted.” In other words, the Supreme Court decided that the VICP is still the only way in which families can receive compensation for any vaccine injury their child may experience; they cannot sue the vaccine manufacturer directly.

It is important to note that this ruling does not make claims that vaccines do not ever cause harm.  It merely offers protection so that lawsuits will not bankrupt the vaccine manufacturers causing them to pull out of the market.  If a withdrawal from the vaccine market would occur, it would be considered a public health issue with devastating consequences.

For example, prior to the existence of the Haemophilus influenza (Hib) type b vaccine in 1987, approximately 20,000 U.S.  children became infected with Hib meningitis, pneumonia, epiglottitis, or other invasive Hib disease.  Approximately 1,000 U.S. children died per year as a result of invasive Hib disease.  Per the Centers for disease Control (CDC), “the incidence of Hib disease in infants and young children has decreased by 99% to fewer than 1 case per 100,000 children under 5 years of age. In the United States, Hib disease occurs primarily in underimmunized children and among infants too young to have completed the primary immunization series.”

Of note, here are a few excellent sources regarding vaccine information:
http://www.cdc.gov/vaccinesafety/index.html

Health Care Personnel & Flu Vaccine

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Health Care Personnel & Flu Vaccine

This September, the American Academy of Pediatrics (AAP) issued a statement that they support all healthcare personnel receiving a mandatory annual flu vaccination. The National Patient Safety Foundation (NPSF), the Infectious Diseases Society of America (IDSA) and The Society of Healthcare Epidemiology of America (SHEA) are other organizations that are also are in favor of such a measure.
 

 

Does your provider receive the Flu vaccine annually? You may be interested in knowing that bit of information. After all, if an unprotected health care provider becomes ill with the disease, that provider is now a source of the illness and can infect patients and other office staff members without having any intention of doing so.
 
Currently, the Flu vaccine is a voluntary vaccine for all health care personnel. However, the risks are different for the health care provider versus the patient. If a health care provider gets infected with the Flu, he/she will most likely infect many other patients before he/she is even aware that he/she has the illness. In my case, this could have devastating effects for the children I examine, especially those with chronic diseases such as asthma. Hence, very year I make sure to get the Flu vaccine. Getting vaccinated is the best way to protect myself, my patients, my family, and friends from contracting the Flu.
 
There is a Centers for Disease Control and Prevention (CDC) report that stated that last January, approximately 35% of health care workers get Flu vaccinations. Nurses have some of the lowest rates of Flu vaccination.

It’s Just the Flu, Isn’t It?

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Swine Flu aka H1N1 Flu has everyone up in arms. Some people are fearful of the disease, others of the vaccine. Every day, after I examine their sick child, loving parents ask me, “Is it the Flu? Is it the bad one?” And if it’s not Swine Flu, I hear, “Oh thank God; it’s not Swine Flu.” I also hear, “I don’t know. It’s just too new. I’m afraid. Besides, we never get the Flu shot; we never get the Flu.”

So what do you do? Get the vaccine.

It’s safe. It wasn’t made any faster than any other annual Flu vaccine. The difference is that the strain is known; it’s specific. Instead of 3 potential strains, it’s the H1N1 strain.

Here are the facts. Since April 2009, The Centers for Disease Control and Prevention (CDC) has noted 200 Flu related pediatric deaths in the United States. 171 of those deaths were documented as H1N1 Flu, one of those deaths was due to Flu B, and the other 28 were non subtyped Flu deaths. Let’s put that in perspective. In the 2007-2008 Flu season, there were 88 Flu related pediatric deaths in the U.S. Making this season clearly worse. And the season isn’t even close to the end.

The reality is that millions around the world will get the Swine Flu. Few of your children will die from it. However, many of your children will get the disease. Your child will have to stay home from daycare or school. You’ll lose work. You will wonder if your other children, family, friends or even if you will get the disease from them. Many of you will spend many sleepless nights worrying whether or not your child will be okay. And even after they’re better, you will fear the secondary infection that’s just around the corner. The Flu weakens your immune system leaving you susceptible to other bacterial infections, like pneumonia.

There’s one question you need to ask yourself. Do you really want to sit there thinking you could have prevented this moment?

Go your Pediatrician’s office. Get the Seasonal Flu & Swine Flu vaccines today.

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