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Swine Flu vaccine - request appts now

November 7th, 2009
It’s been little more than a week since we started scheduling H1N1 appointments and all of our high-risk children have been taken care of. The doctors at PHA are very grateful to our wonderful staff who has been working very extended hours to get this done. We are also grateful to our PHA families who have cooperated with us as we prioritized vaccine to the most vulnerable of our children.
 
Most of our original shipment of vaccine has been used and we are waiting for more from the state. Anyone age 2-25 years of age who would like to get the vaccine should e-mail us at general@phapc.com. We will contact you to make an appointment as the vaccine becomes available. When you e-mail us, please include the names of your children and a day-time phone number where you can be reached.
 
We do not know which form of the vaccine the state will send, so if you want your child vaccinated please be open to the mist or the injectable form. Once your child is in the office a clinical decision will be made based upon your child’s medical history and current vaccine availability. It is likely we will get more of the H1N1 flumist than of the injectable. The flumist is the thimerisol-free live-attenuated nasal vaccine. It is just as effective as the injectable vaccine with a similar side effect profile.
 
For children under two years of age, we still do not have the thimerisol-free vaccine.  We hope to have more information next week and will send a separate e-mail about it.
 
Please do not call us with questions about the swine flu vaccine as they are overloading our phone lines, our staff and our doctors. Our views are simple - we believe the H1N1 vaccine is safe and effective. We believe it will prevent the swine flu which in a small percentage of children can cause severe complications. When assessing risk vs. benefit we believe it is best to give the vaccine. We have given it to our own children (where appropriate) and we would like to protect your children as well. Having said that, it is important to keep things in perspective. More children will die this year from car and bike accidents than from the swine flu.
 
Thank you so much for your patience during this very busy time.  Our staff and doctors are all working hard to take care of your family. Fortunately, your children make it all worthwhile.

 

Thank you for trusting us with the care of your family.
 
Sincerely,

Your doctors at PHA 

 

 
Filed under: FLU INFO, Vaccines Comment (0)

Flumist Q & A (applies to H1N1 and Seasonal)

November 3rd, 2009
FLUMIST Q & A 
Is the flumist a live virus?
Both the seasonal and the H1N1 mists are Live Attenuated forms of the flu virus.  This means that the virus is weakened tremendously and engineered not to multiply above 90 degree temperatures.
 
Can my child get the flu from the flumist?
The flumist is engineered not to grow above 90 degree temperature which means it can not multiply in the human body.  It has been tested in mulitple settings, including families with children on chemotherapy, and the flu virus has not been transmitted to anyone.   

 

Is the flumist safe?

 

The flumist has undergone extensive testing and millions of doses have been administered.  It is now approved down to age 2 years. 
 
What are the side effects of flumist?
Flumist has the same side effects as the injectable vaccine - mild fever, achiness, cold symptoms - except that flumist doesn’t make your arm hurt.
 
Does my child need to avoid contact with anyone after the vaccine?
The only limitation involves people who have recently received a bone marrow transplant. Other than that there are no limitations after the flumist.  Your child may be around babies, pregnant women and people on chemotherapy. 

 

 
Would you give it to your child? We would and we have!!

 

Filed under: FLU INFO, Illness, Vaccines Comment (0)

Swine flu available for high-risk over 2 years

October 28th, 2009

We have received our first H1N1 vaccine shipment from NYS.  They sent us the H1N1 flumist, a small amount of the injectable H1N1 vaccine and none of the thimerisol-free vaccine for the children under two.

 

***All questions and appointments for the H1N1 will be done by e-mail. Please read this entire e-mail for details.  Thank you in advance for your patience and cooperation. ***

  

We believe the swine flu vaccine is important and safe for your children. Your doctors at PHA are giving it to our own children when appropriate. As supplies are somewhat limited, we will not spend any time in this e-mail trying to convince anyone to take it.  If you want to read more about our thoughts on the swine flu and its vaccine, click here.  If you would like to get your child the vaccine, read on.

 

Our nurses, doctors and administrative staff will be putting in extra hours for special H1N1 sessions.  This will allow us to give the vaccine to large numbers of our patients while still leaving room in our daily schedule for sick children.  Even with everyone working extra, we will not be able to accommodate everyone who wants the vaccine in the first week or so.  Our first priority must be to vaccinate the most vulnerable among us. Therefore, for now, we will only make appointments to administer the H1N1 vaccine as follows:

 

Injectable H1N1 vaccine will only be given to:

Patients with cancer, diabetes, heart disease, immune problems.

Patients with asthma who have been on steroids within the last year (flovent, pulmicort, orapred, advair, asmanex, symbicort, QVar.) 

 

H1N1 mist will only be given to:  

Children between two years and five years of age.

Children of any age who have a sibling under the age of six months in the home.

Children of any age whose mom is pregnant.

Parents of a baby under 6 months of age.

(Please note- the H1N1 mist can not be given if a seasonal flumist, or an MMR or a Chickenpox vaccine has been given within the previous 21 days.)

 

Pregnant women and children under two are considered high-risk as well, but the state did not send us the appropriate vaccine for these groups.  Pregnant women are advised to get it from their doctors if possible. NYS does not know when it will have vaccine for these groups, but we will send out an e-mail when we have more information.

 

If your child has a seasonal flu shot appointment in the next week, we recommend that you convert it into a swine flu vaccine appointment as swine flu is the predominant strain in our community at this time.  The seasonal flu shot can be postponed till later in the season. Just notify us by e-mail that you would like to do this. If your child has a check-up you can discuss administration of H1N1 with the doctor at that time.

 

Swine flu vaccine and seasonal flu vaccine can be administered at the same time - as long as both are not in the mist form.  However, due to shortages we have limited amounts of the injectable vaccine (seasonal and swine) and will only be able to give the mist form to most of our patients. Therefore, for most children, both will not be given at the same time. If your child is high-risk please talk to your doctor when you are in and an individualized decision will be made.

 

If your child is not in one of the above groups, please have patience.  We will do our best to get to everyone as soon as possible.  Thank goodness the vast majority of children who do get the illness will recover quickly and completely. And please remember that car accidents pose a greater risk to your child than does the swine flu.

 

If your child had a flu-like illness last Spring here is the scoop.  The CDC recommends that your child get the H1N1 vaccine because you can not be sure that your child had the swine flu.  However, it is likely that your child has some immunity to the H1N1 virus.  If your child is high-risk get the vaccine.  If your child is lower risk, take comfort that he probably has some immunity.

 

Children under 10 years of age will need a second H1N1 vaccine in one month. That booster can be given as a mist or a shot, regardless of the type used for the initial vaccination.  We can not guarantee that the booster vaccine will be available in one month as our supply chain is determined by the state. We do believe that as the season progresses more vaccine will become available and  one dose is better than none.

 

In accordance with requests from the health department, PHA will not collect co-pays for the H1N1 vaccine during this public health emergency. Your insurance plans will be billed a small administration fee. Most health insurance plans will waive co-insurance as well. Parents who receive H1N1 will be charged a $25 out-of-pocket administration fee.

 

Appointments for swine flu vaccine will only be made via e-mail. (Anyone who calls will be asked to e-mail us.) If your child is in one of the high-risk groups, please send us an e-mail requesting an appointment.  Include your child’s name and which risk group he falls into. Appointments will be in the evenings and on the weekends. Remember that the H1N1 mist can not be given within 21 days of the seasonal flumist, or the MMR or the Chicken Pox vaccine. Please do not request an appointment if your child is not high-risk.  Even if an appointment is mistakenly given to you, once you are in the office and your chart is reviewed, you will be sent away.

 

Please do not call us with questions about the swine flu vaccine as they are overloading our phones, our staff and our doctors. We are happy to take part in the nationwide effort to vaccinate our children from this disease. We are happy, as well, to provide our educated opinion of the vaccine which we have posted on our website.  However, restating our opinions to individuals on the phone interferes with our ability to provide the best care for your children.

 

Thank you so much for your patience during this difficult time.  Our staff and doctors are working longer and harder to give your family the care it needs. We will try to keep smiling.  We hope you will too.

           

 

 

 
Filed under: FLU INFO, Illness, Vaccine Safety, Vaccines Comment (0)

Do I need to limit visitors?

October 14th, 2009

For the first two month of life if your baby gets a rectal temperature greater than 100.5 you will need to take him to the hospital. So you need to do your best to keep your baby from being exposed to germs.

Try to follow these rules:

·         any one who touches your baby should wash his/her hands. 

·         Sick people should stay away (even grandma and grandpa.)

·         Children get sick much more often than adults, so iunless they are yours.don’t expose your baby to them.

·         Stay away from crowds if possible.

 

 

Filed under: Newborn questions Comment (0)

PHA Vaccine Policy

October 14th, 2009

 

Vaccine Information
Vaccines play a very important part in the development of your child’s immune system. They teach your child’s body how to fight infections that can be extremely dangerous, even fatal. The doctors of PHA follow the American Academy of Pediatrics vaccine recommendations and feel strongly that vaccinations are a vital part of preventive health care. 
 
All of our vaccines for children under three years of age are thimerisol-free.
 
While we are committed to vaccinating all PHA patients, we allow some flexibility for some vaccines. 
It is important that the DPT, HIB, Polio and Prevnar primary series be completed in the first 6-8 months. 
Hepatitis B is usually not a disease of the newborn period and this vaccine series may be postponed. 
We do not recommend postponing these vaccines, but are willing to accommodate parents in this regard if all the other vaccines are completed by 8 months. 
Parents who elect to postpone any vaccines will be required to sign a “Vaccine Refusal” form. Please keep in mind, however, that Hep B vaccines are required by the state and it may require “extra” office visits and copays to complete the series in a child who is no longer an infant.
 
The Rotavirus series is optional, but if given, needs to be completed between 2 and 8 months.  
The MMR vaccine is recommended at one year.  The company no longer makes the individual measles, mumps and rubella components, so separating them is not an option. Delaying the vaccine is not recommended because it delays protecting your child from three potentially dangerous diseases.
Hep A is recommeded in the second year of life.  It is currently not required by NYS.
Flu vaccines are recommended for all children 6mos to 18 years of age.
Vaccination for DPT, HIB, Prevnar, Polio and MMR must be completed by two years of age.
 
If you have decided that you will not give your child any of the childhood vaccines, then clearly our philosophy and yours do not match and you should find a pediatric group more in line with your thinking.  
 
Vaccine Schedule
 
Children under one year of age will receive the following vaccines: DTP (Diptheria/Tetanus/Pertussis), HIB (Haemophilus Influenza B), Prevnar (Pneumococcal), Polio (IPV), Hepatitis B (HEP B), Rotavirus

Children between one and two year of age will receive:
MMR, Varicella, Hepatitis A (HEP A), DTP booster (Diptheria/Tetanus/Pertussis), HIB booster (Haemophilus Influenza B), Prevnar booster (Pneumococcal), Polio booster (IPV)
Children between four and six years of age will receive:
MMR, Varicella, DTP booster (Diptheria/Tetanus/Pertussis), Polio booster

Children who are 11 year old or older will receive:�
TdaP booster (Diptheria/Tetanus/Pertussis) as required by NYS for all 11 year-olds in 6th grade, Menactra (Meningococcal Vaccine), HPV (Human Papillomaviurs) - for girls, Varicella booster where appropriate.

For more information on the vaccines your child will be receiving, please use the links to the CDC’s Vaccine Information Statements (VIS). The VIS will be given to you at every office visit when a vaccine is administered.

Important Links for Vaccine information

Immunization Action Coalitionhttp://www.immunize.org/
1573 Selby Avenue, Ste. 234
St. Paul, MN 55104
E-mail: admin@immunize.org
Tel: (651) 647-9009 Fax: (651) 647-9131

 

 

Vaccine Information Statements http://www.immunize.org/vis/#English
Centers for Disease Control and Prevention
1600 Clifton Rd, Atlanta, GA 30333, U.S.A.
Tel: (404) 639-3311 / Public Inquiries: (404) 639-3534 / (800) 311-3435
http://www.cdc.gov specifically for vaccine information: http://www.cdc.gov/node.do/id/0900f3ec8000e2f3
American Academy of Pediatrics Vaccine Initiatives http://www.cispimmunize.org/
Allied Vaccine Group http://www.vaccine.org/
 
Within the recommended childhood vaccines, some are more important than others. DPT, HIB, Prevnar need to all be given in the first 6 months.  If you would like to delay Hepatitis B or Polio, we will work with you, though these vaccines are required by the state and it may take “extra” visits as your child gets older to complete the vaccine series.
Filed under: Vaccines Comment (0)

Swine Flu - questions answered

October 14th, 2009

Swine flu (H1N1) swept through Long Island in June then disappeared.  Other parts of the country and areas in upstate NY are currently dealing with outbreaks of swine flu, so it may be back here sooner than we’d like. Here are some reminders about swine flu and the strategies to deal with it.
What is swine flu (H1N1)? - it is a type of influenza A.
How is it different from seasonal flu? - Its genetic base comes from pigs, unlike the seasonal flu which comes from fowl.
How is it similar to seasonal flu? - its symptoms are the same - fever, cough and achiness.
Why is there so much hype around swine flu? -because it is genetically a new type of flu, no one has any immunity to it.  Therefore, it has the potential to make a lot of people sick. When lots of people get sick at the same time, even if the illness is not severe, it affects lots of things - hospitals, schools, the work place, availability of medicines. In addition, it seems that hospitalizations for the swine flu have included many more children than we see with the seasonal flu.
What about vaccines? - Flu shots are the single best way to avoid getting the flu.  The swine flu vaccine should be very effective because the vaccine was made after the flu was already here (unlike the seasonal flu vaccine which is made a year in advance based on scientists best prediction of expected flu strains.)
Will PHA recommend the Swine Flu Vaccine? - Yes

Is it safe to take a vaccine that hasn’t been tested? - flu vaccines have years of use, testing and follow-up behind them.  The swine flu (H1N1) vaccine is made the same way as the seasonal flu vaccine.  Scientists take certain parts of the flu virus and grow it in eggs and make it into a vaccine. Next year the swine flu vaccine will likely be incorporated into the seasonal flu vaccine.

Will PHA be giving the swine flu vaccine? - Yes.  We started vaccinating our high risk patients as soon as we received our first shipment of vaccine.  We are now accepting e-mails with the names of any child age 2-25 years who would like the vaccine. We will schedule appointments as the vaccine becomes available.

What else can I do to prevent the flu?- most of us get the flu when we take our hands which have been contaminated by another person, and touch our mouth, nose or eyes.  If you make a concerted effort to keep your hands away from your face, and to wash them before eating and after potential exposure to sickness, you will dramatically increase your chances of staying well!

Filed under: FLU INFO, Illness, Vaccines Comments (10)

New MD joins PHA Family

October 14th, 2009

We are very excited to announce that Maggie Chalson, M.D. is joining the PHA family starting November. Dr. Chalson joins PHA with a wealth of experience in all areas of private practice and a special interest in obesity and the importance of healthy lifestyle choices.  Her addition allows us to add an extra doctor for those busy Mondays (and other times), as well as to expand our Friday hours until 7PM.  Having another doctor at busier times will allow us to reduce wait times and return phone calls faster.

Dr. Chalson PhotoDr. Chalson’s easy-going and approachable manner fits perfectly into the PHA philosophy. She has spent the last four years as a private-practice pediatrician in Queens and her skill is apparent as she interacts with parents and children alike.  While taking care of all ages of children and all aspects of pediatric care, Dr. Maggie has distinguised herself by her success with obese teens. “It is not about a diet,” says Dr. Chalson.  “It’s about a lifestyle change that will follow these children for their whole lives.”  Dr. Chalson helps motivated teens set specific goals for change in lifestyle, behavior, and dietary choices and then meets with them monthly to discuss their progress.  Dr. Chalson has appeared on New York Channel One News to discuss the remarkable challenges facing these patients.  She plans to share her expertise in this area with the patients at PHA. Click here to read two accounts of one teen who flourished under Dr. Maggie’s attention.
http://www.ny1.com/Default.aspx?SecID=1000&ArID=82524

Dr. Chalson grew up on the south shore of Long Island graduating from Lawrence High School.  Her undergraduate years were spent at Tufts where she was a dual major in English and Biology with a concentration in medical history. Returning to New York, Dr. Maggie received her Medical Degree from Stonybrook University with recognition in the humanities. She continued her medical education at prestigious Mount Sinai Hospital in Manhattan where she developed her special interest in treating obese patients.

Dr. Maggie’s pediatric education took another step forward as she and husband Jon welcomed baby boy Asa in Spring 2009. In addtion to spending time with “her boys,” she loves to spend time at the beach, to cook and to travel. Dr. Maggie is looking forward to meeting all the wonderful families at PHA.  Please join us in welcoming her and ask for Dr. Maggie at your next appointment.

Filed under: Uncategorized Comments (3)

Tylenol Recall

October 2nd, 2009

Tylenol has voluntary recalled several lots of suspension due to potential problems with manufacturing.  No child has become ill from getting Tylenol.

Click below to check out the affected lot numbers.  If you have given your child Tylenol from these bottles, and your child seems fine, do not worry.  If your child is sick, please call our office.

If you have any of the affected Tylenol in your home, please discard it.

 

 

http://www.tylenolprofessional.com/assets/TYLENOL_Letter_091809.pdf

 

 

 

 

 

 

 

 

 

Filed under: Health Advisories, Medications Comment (0)

Seasonal Flu Recommendations 2009

September 28th, 2009

Seasonal Flu vaccine Recommendations for 2009 are:
- Children with chronic illnesses, asthma, diabetes, heart disease & their family
- All children 6 months to 18 years of age with an emphasis on children under 5 years old
- All family members of a baby age 0-24 months - so if you are expecting a baby between
now and March, this means you!
- Children with an immunosupressed family member
- Children with history of pneumonia or multiple ear infections
- Pregnant women
- Adults over the age of 50 years.
- Anyone with a vacation or important celebration scheduled during flu season.
- Healthy children and adults who do not want to get the flu.

Most children and adults need one flu shot for the flu season.
Children under age 9 who have never had flu vaccine need two shots, one month apart.
All of our vaccine for children three and under is thimerisol-free. Flumist is thimerisol-free.
People with egg allergy or a previous adverse reaction to a flu shot should not receive flu vaccine.

Filed under: Vaccines Comment (0) Article tags:

My baby has the hiccoughs

June 7th, 2009

My baby hiccoughs every time I feed her.  What should I do?

Hiccoughs are normal in newborns.  At the beginning your baby will likely get hiccoughs every time she feeds.  This is because as her stomach expands, it irritates the nerve that supplies the diaphragm.  As your baby matures - a few weeks to months, the hiccoughs will disappear.  Most babies with hiccoughs show no distress with them at all; so there is nothing to do, but watch and wait.

Filed under: Newborn questions Comment (0)
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