Author: All Pediatrics

Our September calendar is now available for booking online.

Book your appointment directly from our website by clicking here.

You may also use the patient portal or Healow app.

It will be available over the phone starting on June 1st.

Things have been moving since my last update.  COVID-19 is still out there, of course, but the country’s weekly cases and death rate are finally back down to where they were in October. (To put that in perspective, we are still seeing over 300,000 new cases each week, and around 5000 deaths per week).  We still need to be sensible and wear masks in stores and try to socially distance, wash hands well, etc., but we can be more liberal about socializing, especially if all the adults have been immunized.   Thus, if the adults are immunized and healthy, visiting family such as grandparents can be back on, even if it involves a flight, in my opinion (but there are no 100% guarantees, of course).  I’ll be travelling myself later this month (but I personally am still holding off on indoor dining and movies).

I have been all in favor of going back to school, and look forward to camps with outdoor activities being open this summer.  The number of cases of children getting sick remains quite low, in particular for severe illness, and when they do catch COVID, it is almost always from family members, not classmates.  Beach vacations should also be fine; social distancing is not that hard on a beach, although it may mean being back a bit from the shore.

The big news is vaccinations, of course.  These have been game changers.  Most people do not have side effects, and when they do, they are almost always minor. Even the ones that have been publicized, such as blood clots, are small in number; the risk of a serious COVID infection if you skip a shot is orders of magnitude larger.

Should 16-18 year olds be vaccinated?  It’s not even close in my opinion.  Wherever you can get this done, do so.  We will be getting vaccines in our office very soon, and will start booking appointments. There may be some difficulty with the process as we roll it out at first, but please be patient as we work out the kinks.  We are told there will be ample supplies, so watch our website for further updates.

The next group up will be 12-15 year olds, for whom I expect approval shortly.  Again, I strongly encourage immunization for this cohort as well. I know that the physicians in the practice will be vaccinating their children this age.  I would do so for mine, but they are older and fortunately have already been vaccinated.

One note about the vaccines: until we have more data, it is recommended that no other vaccines be given within two weeks of the COVID vaccine, so if your child is due for others as well, you will need to schedule separate visits for those.  To lay out a time frame, if your twelve year old gets their required meningitis, tetanus and HPV vaccines on day 0, they would wait until day 14 for the COVID, then until day 35 (three week space between vaccines) for the second one, and then until day 49 if any more vaccines were needed.  If you wanted to do the COVID first, we can adjust the schedule for that as well.

Get vaccinated if you can, stay safe, and have a great summer!

Our August calendar is now available for booking online.

Book your appointment directly from our website by clicking here.

You may also use the patient portal or Healow app.

It will be available over the phone starting on May 4th.

Our July calendar is now available for booking online.

Book your appointment directly from our website by clicking here.

You may also use the patient portal or Healow app.

It will be available over the phone starting on April 15th.

ALL Pediatrics is excited to announce that we’ve partnered with Doctor Yum! The Dr. Yum Project is a 501c3 nonprofit. Their mission is to help families and communities overcome barriers to eating well.

https://www.doctoryum.org/

Learn more about their upcoming virtual program below:

Parenting for Wellness: Virtual Edition

4 Class Series on Thursdays in April
(April 8, 15, 22, & 29 at 8:00 pm Eastern)

Our June calendar is now available on the patient portal. It will be available to book over the phone starting 3/22.

We are still not out of the woods, but numbers are finally starting to drop consistently, now that the holidays are over. The one potential blip is the Super Bowl, and we will see in the next two weeks whether that has caused an uptick.

When I say the numbers are dropping, we still have to take this in perspective. Thus, this past week saw less than 500,000 new cases in the United States. and less than 15,00 deaths. The first number is comparable to levels in mid-October, and the second mid-December. By way of comparison, however, in mid-June, when much of the country was in more severe lock-down, we were seeing less than 200,000 new cases, and less than 5000 deaths, per week. We still have a long way to go.

In Prince William County, this past week saw us dip below 1,000 new cases for the first time since mid-November, but deaths are still recording similar numbers to last month, 10 or so per week.

After many fits and starts, vaccines are finally starting to roll out. There has been concern about the new variants of COVID, but so far, the vaccine is holding up, perhaps not with the efficacy for the earlier variants, but still looking quite useful. Further data will answer this question. It is not surprising that the vaccine is still promising; for example, the flu virus mutates each year, but we still retain some protection against it (part of the reason why one needs two vaccines the first year, but only one subsequently).

Speaking of the flu vaccine, you may have read of a study suggesting that getting the flu vaccine helps mitigate against COVID-19. I’ve read this study, and it is not the world’s strongest; it was published in a journal called Cureus, and I’m not sure a journal with a pun for a name is the most rigourous out there. However, it does offer food for thought. This year, flu will be minimal, due to mask wearing, social distancing, etc., but I expect it to be back with a vengeance next year. As I have commented on before, I expect that next year, during flu season, although I will of course be vaccinated, and plan on eating out and seeing some movies, etc., I see myself wearing a mask for shopping. Do not be surprised if you also see me wearing one in the office, at least when seeing older children who will not be put off by it; at my age, I suppose I should be more active at protecting myself.

A big question is whether schools should reopen. President Biden is pushing for this to be done, at least up to eighth grade. We now have an abundance of evidence that younger children are very rarely superspreaders, especially if asymptomatic. I believe we can all see that on-line learning just does not cut it for younger children, and that the experience of being in a school enhances learning, so I strongly support this. I also believe that teachers should be high priority for getting vaccines, but that it is reasonable to open schools even without mass vaccination (although there will of course be some breakthrough cases).

To put into perspective how mild (comparatively) COVID-19 has been for children: children make up around one-fifth of the population. There have been around 2,000,000 cases in children in the United States, with 200 deaths. If adults had had the same numbers, we would have expected to see around 10,000,000 cases, and 1000 deaths (instead of almost 30,000,000 case, and 500,000 deaths).
As always, until the numbers are down much more substantially, mask wearing, good handwashing, and social distancing, for your sake and that of your friends and family, please.

The NEW Lakeridge location of ALL Pediatrics is now open. We are no longer at the building on Old bridge Road.

The new location is

4500 Pond Way
Suite 220
Woodbridge, VA 22192

Our physicians, nurse practitioners and staff are grateful to have received the gift of the COVID 19 vaccine!  We owe a debt of gratitude to the scientists that worked tirelessly to develop this vaccine at an astonishing pace.

We want our ALL Peds families to know that we are recommending the vaccine to our grandparents, to our parents and to our friends.  We do not yet have studies to recommend the vaccine to children younger than 16 years of age.  Once the studies are completed, we will make a recommendation.

Many of you will have the opportunity to receive the COVID 19 vaccine in the next few weeks and months; we want you to feel confident that getting the vaccine is the right choice and the only hope to a path toward normalcy.

How the COVID vaccines work

•   The Pfizer and Moderna COVID 19 vaccines are both mRNA based vaccines
•  When someone receives an mRNA vaccine for COVID-19, it tells the person’s own cells to make the SARS-CoV-2 spike protein. The person’s immune system then recognizes the viral spike protein as foreign and produces antibodies to eliminate it.
• mRNA vaccines do not contain live virus and do not carry a risk of causing COVID 19.
• The mRNA doesn’t enter the nucleus of the cell where DNA is located. Instead, the vaccine mRNAs stay in the outer part of the cell.
• After being transcribed into protein just one time, the mRNA quickly degrades.
• The Pfizer and Moderna vaccines confer approximately 50% immunity 10 to 14 days after receiving the first dose of vaccine and up to 95% immunity after the second dose.  For the Pfizer vaccine, you will need a second dose 21 days after your first vaccine; for the Moderna vaccine, you will need a second dose 28 days after your first vaccine.
• We need 75-80 percent of Americans to receive the vaccines in order to attain “herd immunity.”

Allergies

•   The CDC considers any history of allergies as a precaution, but not a reason to avoid receiving the vaccine.  Individuals with allergies to medications, food, environmental allergies, insects, and latex have the same risk of having the same risk of having an allergic reaction to the mRNA COVID-19 vaccines as the general population.
• When you receive your vaccine, the vaccine site will monitor you for 15 minutes (30 minutes if you have a history of allergies) to ensure that any adverse reaction can be identified and addressed promptly.

Children and COVID 19 vaccine

•  The Pfizer vaccine is currently approved for people ages 16 and above.  The Moderna vaccine is approved for people ages 18 and above.  Clinical trials have started in children 12 to 15 years of age.  It will take approximately 6 to 9 months for these studies to show safety and efficacy.

Breastfeeding and Pregnancy

Women who are pregnant and are part of a high-risk group (frontline essential workers, healthcare personnel and those with preexisting conditions) may choose to be vaccinated.  Pregnant women were not included in the clinical trials due to historical restrictions on including pregnant women in clinical trials.  The American College of Obstetricians and Gynecologists (ACOG) recommends that COVID 19 vaccines not be withheld from pregnant individuals who meet criteria for vaccination based on recommended priority groups.

ACOG recommends COVID-19 vaccines be offered to lactating individuals similar to non-lactating individuals when they meet criteria for receipt of the vaccine based on prioritization groups. While lactating individuals were not included in most clinical trials, COVID-19 vaccines should not be withheld from lactating individuals who otherwise meet criteria for vaccination. Theoretical concerns regarding the safety of vaccinating lactating individuals do not outweigh the potential benefits of receiving the vaccine. There is no need to avoid initiation or discontinue breastfeeding in patients who receive a COVID-19 vaccine.

Please discuss any concerns that you may have with your health care provider.  We believe the benefits of the vaccine outweigh the risks and that receiving the vaccine is much safer than contracting COVID 19.

Please continue to wear your mask, wash your hands and socially distance!

Sources:

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/how-they-work.html

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/index.html

https://acaai.org/news/acaai-provides-further-guidance-risk-allergic-reactions-mrna-covid-19-vaccines

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/pregnancy.html

https://www.bfmed.org/abm-statement-considerations-for-covid-19-vaccination-in-lactation

Our April schedule is now open on the patient portal. It will be available over the phone starting Monday January 18th.