Elm Street Pediatrics

New and Improved Website

2010-08-08T18:59:00.002-05:00

Greetings! We at Elm Street Pediatrics are thrilled to announce that we have updated and improved our website, www.elmstreetpediatrics.org. As of now, we are moving our blog to our website homepage, where it can now be found amongst lots of other fascinating and useful information. Please follow our blog over to our new home, and please also let us know how you feel about the change. We hope you will be as excited about it as we are. Thanks and enjoy the rest of the summer!!

- esp

Almost Summer 2010 !

2010-05-23T10:52:00.003-05:00

As we get closer to the end of the school year there seem to be many pressures on parents, children and doctors alike. This can lead to significant stress, and many may notice behavior issues surfacing. The 1-2 week break between school end and summer camps starting can be a great time to rest up and loosen the daily schedule.
For those with teens, please monitor parties and get-together times. Alcohol use though illegal is common, and a little forethought and parental control can hopefully avoid tragedy.
We offered a parenting work-shop last week in the office. Those who came found it helpful. If there is another format you would prefer- for instance- earlier in the evening with child minding please let us know.
Updating the website- we are in the process of doing this. We aim to make news more easily accessible and up to date.
Schedule your sports physicals and school physicals as soon as possible. While we aim to see all our patients when one is needed, rather than them need to go to a CVS or Walgreen's walk in clinic, we are more relaxed and less rushed in June and July than in the second half of August.
While some colleges do not require a physical we really recommend it. We have a wealth of advice, both medical and psychological to give, as well as doing the physical itself. We enjoy seeing our young people all the way through college, as long as they feel comfortable too.
New parents- an updated Tetanus vaccine- the Tdap is recommended, if you have not had one in a few years. While the hospital seems to take care of new Mothers often the Dads are overlooked. This vaccine prevents both Tetanus and Pertussis, otherwise known as whooping cough. This disease has surfaced again over the last few years, and while to older children it is mild, though prolonged cough, to newborns it can be fatal. We do carry this vaccine, while your internist may not, and can administer to you. We will provide papers for you to submit to insurance.
Please tell your friends, who might be pregnant, that we do offer free prenatal 'get to know you' visits with all the doctors. Just call the receptionist.
Dr Nelson is out of the office until June 24th
Dr Goodman will be away June 25th - July 7th

March News from Elm Street Pediatrics

2010-02-28T12:03:00.005-06:00

It is only 3 weeks to the official start of Spring, but as those of us who have lived in Chicagoland for a while now are aware, winter seems to hang around for several more months, along with many winter illnesses.

We are continuing to see many children with nasal congestion and wheezing, most of which is due to the respiratory syncytial virus. This usually affects preschoolers, and can be concerning in infants under 6 months. It usually presents with nasal congestion and low grade fever, but soon may progress with a wet chesty cough and some respiratory distress. Sometimes we are able to diagnose in the office with a nasal swab, and this does help us to be able to predict the course. Ear infections and very occasionally pneumonia can be associated. It is important to watch whether a child is having difficulty breathing, and to make sure that fluid intake is adequate. Usually the acute phase of the illness lasts 3-5 days but the cough can really linger for 2 weeks. An appointment is always recommended if you are worried.
Also there seems to be still a significant number of children with gastroenteritis. This typically starts with vomiting and usually is followed by diarrhea within a few days. If the vomiting is persistent please always call the doctor on call, as younger children can become dehydrated quite quickly. Small sips of clear fluids containing sugar, preferably pedialyte in younger children, are recommended -even if your child is not too interested in drinking. Do not worry about eating for a few days. Once again watching the urine output is very important. As mentioned in previous blogs these are usually viral illnesses, that will get better with supportive care, and do not need antibiotics.
The new Prevnar vaccine has been licensed. This vaccine will cover 13 antigens as apposed to 7 in the current vaccine. One important serotype - or variety of pneumococcus that is resistant to amoxicillin is included in the new vaccine. The Prevnar vaccine is usually given at 2, 4, 6, 12-18 and 24 months. Pneumococcus can cause ear infections, sinusitis, pneumonia and meningitis, among other illnesses. We hope to have supplies of the new vaccine within a month
We will continue to offer 'Walk-in hours' everyday through March- including THURSDAYS - please give us your feedback about this service, and any recommendations are always welcome. As usual if you show up before 10am being seen is guaranteed, and if we are not too busy we are flexible with this time. Dr Miki continues to see children for check-ups starting at 9 am on Thursdays.
Dr Nelson will be back in the office starting March 18th.

End of January Office Update

2010-01-27T13:20:00.003-06:00

1. Infections going around...

RSV: we are seeing LOTS of RSV around. RSV stands for Respiratory Syncytial Virus. It causes fevers for 4-6 days, congestion, cough, and ear infections. It can also cause wheezing in certain kids, and can occasionally lead to pneumonia. It most often affects younger children under age 3, though we have seen it in some toddlers/ preschoolers/ school aged kids as well.
Gastroenteritis (the stomach flu): we are seeing lots of kids with vomiting, many with diarrhea as well. In general these are caused by viruses, and do not require antibiotics. It is important to monitor hydration status for these kids. Signs of dehydration include dry lips, lethargy, significantly decreased urine output, and fast heart rates.
Influenza: we have not seen much influenza this month. It typically worsens in February and March. We suspect that there will be a resurgence of H1N1 Influenza this winter, so it is still a good idea to get immunized or receive a booster if you have not already done so.

2. Office Information...

Walk-ins: we continue to offer walk-ins starting at 830 AM throughout all of January and February. We hope this helps you as we try to provide easy access to us during the difficult winter months.
Blog: we will continue to update our blog with information as we have it. Thanks for reading.

Stay warm and stay healthy!
- esp

Happy New Year 2010!

2010-01-10T18:32:00.002-06:00

Happy New Year to everybody! We are sorry we havent posted any info in awhile, but we do plan on providing information here on a monthly basis, so stay tuned!

What we are seeing in the office:

we have seen a nice decrease in the amount of H1N1 influenza seen in the area
if history holds true, we should start to soon see an increase in Seasonal influenza
we have started to see RSV, which is a fever/ runny nose/ cough/ wheezing/ ear infection illness that tends to affect younger children under age 3
we are also seeing lots of gastroenteritis, also known as "stomach flu"

Vaccine reminder:

we do have H1N1 vaccine, and as a reminder, a second (booster) dose is recommended for all children aged 9 or younger who received the first dose of vaccine
the booster should be given 3-6 weeks after the first dose was given

Please stay tuned and stay warm!
We will be providing updated information again soon in the near future!
And... Happy New Year!!!

-esp

H1N1 Recalls, Holiday Hours, and Booster Info

2009-12-15T23:52:00.004-06:00

H1N1 Vaccine Recalls

Some of you may have read or heard on the news that certain lots of Thimersol-free H1N1 injectable Vaccine given to patients ages 6 mos-35 mos were recently recalled
None of the Nasal Mist was recalled
We are happy to say that we did not have these lots at Elm Street Pediatrics, so if you received the vaccine at our office, this does not affect your child!!
In addition, please note: the recall did NOT happen because the vaccines were unsafe in any way, but rather due to questions of their effectiveness; thus, do not let this news worry you about the safety of the vaccines your child received

H1N1 and Influenza Booster Info

As noted previously, we are currently offering booster doses for both the H1N1 and Seasonal Flu vaccines
All children under age 10 are recommended to receive boosters of the H1N1 vaccine, ideally 4 weeks but as soon as 3 weeks after the first dose
All children receiving the seasonal flu shot for the first time under age 9 are also recommended to get a booster shot at least 4 weeks following the first dose
In order to make scheduling smoother and easier, please do NOT call to schedule the booster until your child is due to receive it... we cannot schedule all children for boosters several weeks in advance as our flu clinic schedules are not set that far ahead of time!!
Thanks for your understanding with that issue!

Holiday Hours:

A reminder of our holiday hours:
Thurday Dec 24 and Thursday Dec 31: 8:30 am-1:00 pm with walk-ins from 8:30-10 am
Friday Dec 25 and Friday Jan 1: closed for holiday, but available via pager/ on-call as needed
Saturday Dec 26 and Saturday Jan 2: open as regular Saturday hours starting at 9:00 am

Thank you!
Happy holidays!!
Stay Warm!!!

-esp

Boosters Galore

2009-12-10T19:47:00.002-06:00

Good news from Elm Street Pediatrics regarding Flu vaccines....

H1N1 Vaccine

First dose and booster doses now available for the following ages: 6 mos-35 mos, 4 years and older
For kids aged 36 mos-4 years old (i.e. 3 year olds) please discuss with one of the physicians to determine the best approach
For the booster: it is ideally given 21-28 days after the first dose; also, if the first dose was a mist, it is preferred that the second is a mist -- likewise if the first dose was a shot, it is preferred that the second is a shot -- however, if for availability reasons it is necessary to get the other form of vaccine, that IS acceptable
Please call the front desk to schedule

Seasonal Flu Vaccine

The seasonal flu vaccine is available for ALL kids 6 months of age and older on a first come, first serve basis
Please call the front desk to schedule

What illnesses are going around now??

We are still seeing H1N1 Influenza circulating in the community
It is true that we are seeing less H1N1 flu than we had seen in previous months
December is typically the beginning of Seasonal Influenza
We are starting to see seasonal Influenza this month; this typically peaks in February and extends into the spring months, however every season is slightly different.

The AAP has launched a new website for parents, with tips and links.

If you are interested: http://healthychildren.org/

A special thanks to all the extra work put in by our front office and nursing staff during this busy time, as we try to vaccinate everyone as quickly as possible...

Thanks for reading!

Happy holidays!! Our Holiday hours will be posted next week.

Please don't hesitate to call with ANY questions, comments, or concerns!!!

- the doctors at Elm Street Pediatrics

H1N1 Vaccines, New Thursday Walk-In Hours, and Other Notes

2009-12-01T12:51:00.000-06:00

H1N1 Vaccine Update: Kids Between ages 6 mos and 35 mos old

We have H1N1 vaccine for children of this age!
If your child has not been scheduled for this vaccine yet, you may call and schedule them with the front desk
Booster doses for this age group are available as well, and will be until we run out of vaccine; this second dose is recommended 3-4 weeks after the first dose is given
The CDC estimates that for children of this age, 30% of children are fully protected after 1 dose of vaccine, while approximately 95% are fully protected after the second dose of vaccine

H1N1 Vaccine Update: School-Aged Kids

The Winnetka School District has announced its vaccination plan for kids ages kindergarten-8th grade: http://www.winnetka36.org/newsfeed.php?ID=6619
We do recommend the H1N1 vaccine for this age group
As a reminder, booster doses are recommended 3-4 weeks after the first dose is given for all kids under age 10
For children not in the Winnetka School District, a reminder that vaccine is available through Skokie, as mentioned previously in this newsletter

Office Hours/ Walk-Ins

In the past, we have not offered walk-ins on Thursday mornings, and have opened the office at 9 AM on those days
During this busy winter season of December and January, we have adjusted our hours as follows: we have added walk-in hours from 8:30-10 AM on Thursdays
Thus, we will now offer walk-in hours starting at 8:30 AM every day Monday-Friday during December and January on a trial basis to see if this is helpful for you all -- our patients!!

Seasonal Flu Vaccine

We anticipate getting our next shipment of this vaccine sometime this week, so we hope this will be available soon
We will update this blog once it is available!!

Well Visits: A reminder

Just as a reminder, the schedule for well-child visits, as recommended by the American Academy of Pediatrics is as follows
infants: 1 month, 2 months, 4 months, 6 months, 9 months, 12 months
toddler: 15 months, 18 months, 2 yrs, 2.5 yrs, 3 yrs
after age 3: once yearly every year through age 18 (this has changed from previous, and is different from what was formerly posted on our website!)

H1N1 Vaccine Update -- Turkey Edition!!

2009-11-24T17:04:00.000-06:00

As of this morning, we are pleased to report that we have H1N1 Vaccine available for patients aged 6 months - 35 months.

We are currently giving the FIRST dose of this vaccine to those patients who have not yet had it
We have a clinic scheduled for Monday, Nov 30 to begin administering these doses
The vaccine is available to all patients in this age range
Please call the office to schedule an appointment for your child if they are of this age

Regarding booster doses in this age range, as a reminder, it is recommended to receive a booster dose of the H1N1 vaccine 3-4 weeks after the first dose. This will hopefully provide more complete coverage against the virus.

We believe we will be administering the booster doses in the near future
However, we are currently ensuring each child has had their Primary, or FIRST, dose before we begin offering booster doses
Please stay tuned to this post for updates on when we do in fact begin scheduling for the booster doses for this age group

For older children, we have only a few doses remaining. We are reserving them for high-risk patients, including those with asthma, heart disease, a newborn at home, or other high-risk situations (see previous posts for details). If your child falls into this category and has not received their FIRST dose of vaccine, please call the office to discuss scheduling them for the vaccine.

Thanks and Happy Thanksgiving!!!

H1N1 vaccine update, pre-thanksgiving edition

2009-11-20T09:47:00.000-06:00

A few updates from Elm Street Pediatrics:

Sadly, we have now given ALL of our 390 doses of H1N1 vaccine. All doses were given to those patients and families in the high-risk group, including asthmatics, those with heart disease, pregnant women, etc.
With over 3000 patients in the practice, we apologize that we logistically could NOT vaccinate everyone who wanted to do so. We did our best to vaccinate all of the patients with the highest risk profiles as directed by the CDC. We were also limited in that we only had flu shots for ages 4 and up, and limited flu mist supplies for ages 2 and up; thus, we were unable to vaccinate those between 6 mos and 2 years -- nor could we vaccinate kids under age 4 with asthma or history of wheezing. Again, we apologize for this!
We do not know when we will receive our next shipment, but we promise to update this site as soon as we have it.

H1N1 vaccine may be available through the Skokie Health Department in December for all patients in the priority risk groups, as long as you are an Illinois resident.

Clinic dates there: Dec 3, Dec 6, Dec 9, Dec 12
Location: Oakton Park, 4701 Oakton St, Skokie IL
To make appointments: visit www.skokie.org
Priority groups are: all children/ adolescents/ young adults (ages 6 mos-24 years), pregnant women, adults (ages 24-64) with chronic health issues, healthcare workers
This clinic will offer boosters to children under age 10 as well. Remember, the booster should be given 3-4 weeks after the first dose is given.

Once again, the Thanksgiving Week Holiday Schedule:

Monday: regular hours, 8:30-5:00
Tuesday: regular hours, 8:30-7:00
Wednesday: shortened hours, 8:30-2:00
Thursday: office closed, physician available via pager at all times
Friday: shortened hours, 8:30-2:00
Saturday: regular hours, 9:00-1:00

Thanks and bear with us!

Boosters and Turkeys

2009-11-16T22:54:00.000-06:00

Influenza H1N1 Vaccine Booster Doses:

there have been many questions about who needs a booster vaccine for H1N1 influenza
for children age 9 years old or less, it is recommended to receive a booster (second) dose of the vaccine 3-4 weeks after the first dose
this booster dose is in order to achieve maximum efficacy (to make sure the body's immune system is maximally prepared to fight off infection if exposed to the H1N1 influenza)
however, even if only 1 dose is given (in cases where the second dose is not given as recommended), the vaccine will likely still be at least partially effective, and maybe completely protective --- this information is different from what some families have been led to believe --- thus it is NOT true that without the booster dose, the vaccine is completely useless and ineffective....
so what does "partially effective" mean?? in most cases, completely effective means preventing any illness from developing... partially effective likely means a less severe illness than would have occurred without any vaccine, often of shorter duration
currently, we do not have enough vaccine in our office to offer booster doses to any children for the H1N1 vaccine, and we apologize that this is the case
we cannot offer these booster doses because we have not yet received our complete ordered shipment of H1N1 vaccine from the Cook County Department of Public Health
if and when we do receive our remaining shipment (which we still hope will happen later this month or early next month), we will begin offering booster doses at that time once all primary doses have been given
as always, please feel free to call us and ask any questions about this or anything else....
.... but please understand that unfortunately, we currently CANNOT schedule any patients for booster doses for the H1N1 vaccine

Thanksgiving Week Holiday Schedule:

Monday: regular hours, 8:30-5:00
Tuesday: regular hours, 8:30-7:00
Wednesday: shortened hours, 8:30-2:00
Thursday: office closed, physician available via pager at all times
Friday: shortened hours, 8:30-2:00
Saturday: regular hours, 9:00-1:00

*** As always, we are available at any time all week by paging the physician on call at 847-501-4040. Please don't hesitate to page us with any issues...

Thanks for reading! Happy holidays and safe travels to all during this holiday period. Please call us with any questions or concerns...
-esp

Priority List for H1N1 Vaccine

2009-11-14T16:44:00.000-06:00

The past week was very exciting for us at Elm Street Pediatrics. We were able to begin administering doses of the H1N1 vaccine to those patients and families in the high priority, or Tier 1, group. We apologize that at times there were some long waits in the office to receive the vaccine, but the demand is high and we are doing the best we can to vaccinate everyone in a timely manner.

That said, we are continuing this upcoming week with scheduling of the H1N1 vaccine for out Tier 1 families. IF YOU ARE IN THE TIER 1 GROUP, AND WE HAVE NOT CONTACTED YOU ABOUT RECEIVING THE VACCINE, PLEASE CALL OUR OFFICE AND REQUEST AN APPOINTMENT SO THAT YOU MAY RECEIVE IT. We have done our best to identify those of you in that category; however, if we overlooked you or your family, please call to let us know so we can schedule you for the vaccine! Please note that we have not yet started vaccinating any children younger than age 2, as we have not yet received those vaccines in our office.

The vaccines we have received are the following:
* Inactivated shot for people over age 4
* Live nasal mist for people over 2 years of age
* THUS: we do NOT yet have any vaccines for patients age 6 mos-2 years old, and we are NOT able to vaccinate asthmatics under age 4, as they are ineligible to receive the nasal mist vaccine

Tier One patients are as follows:
* Pregnant women (must receive the inactivated vaccine -- not the nasal spray)
* People who live with and care for those less than 6 months of age
* Children 6 months to 4 years of age
* Children 5 to 18 years of age with chronic medical conditions that increase the risk for influenza-related complications (asthma, heart disease, diabetes, etc)

In addition, recent government-sponsored trials have shown the vaccine thus far to be both safe and effective; see the following for details:
http://www.flu.gov/news/blogs/2009niaid.html

Thanks and hope you are enjoying the surprising weather!!!
-esp

First Shipment of H1N1 Vaccine Arrives at ESP!

2009-11-10T14:30:00.000-06:00

Word of mouth travels quickly around here, but in case you have not heard, it is true that we have received our first shipment of H1N1 vaccine. Here are the details:

- we have received a partial shipment of our supply
- the doses we have received are not for children under age 2 years
- we will begin by vaccinating our high risk patients, and will call those families to schedule the vaccine; this includes: asthmatics, heart disease, diabetes, autoimmune disease, chronic lung disease, families with infants under 6 months of age at home, pregnant women who have not received the vaccine from their Ob/ Gyn and who are recommended by their Ob/ Gyn to receive it
- if you believe you are a high risk patient but have not heard from us to schedule, please call us to discuss

** we have not begun vaccinating patients or families who are outside of this high priority grouping, but will update this post when that does occur; we will also update this as soon as we receive further shipments of vaccine, hopefully in the next few weeks

THANKS FOR YOUR PATIENCE AND UNDERSTANDING IN THIS DIFFICULT TIME!
- esp

No H1N1 Vaccine Yet at ESP -- Though May Be Available Through CCDPH

2009-11-07T08:17:00.000-06:00

As all of you well know, we unfortunately have still not received the H1N1 Vaccine. Although we were initially told when we ordered it that we would have our doses in early November, this does not appear to be the case. We know you are all worried and frustrated, and we are as well. We have contacted various sources in the media to express our anger, and there was a brief article detailing our concerns in the Chicago Tribune today, if you are interested.

http://www.chicagotribune.com/health/chi-flu-vaccine-anger_glantonnov07,0,3003622.story

More importantly, however, is the fact that we are still not sure when we will receive the vaccine. We would like to again emphasize that if you have the opportunity to have your child vaccinated against H1N1 at school or a public health office, we recommend that you do so!! It is also possible that some of the local area pharmacies will receive the vaccine before we do, and that you will be able to get your child the vaccine at these locations. Like us, however, they were told they would have their doses by now, and they do not either.

It is still possible, as detailed in the last newsletter, to attempt to schedule an appointment to receive the vaccine through the Cook County Department of Public Health. Some of our patients have been able to get vaccinated this way. Once again, to do this, please use the following resources (note that although we are located in the NORTH district, it may be faster to call one of the other district numbers to schedule -- that is a tip i received from one of our savvy patients!):

http://www.cookcountypublichealth.org/files/Fludocs/h1n1%20vaccine%20flyer_10-29-09.pdf

As always... thanks for reading and stay healthy!!!
- esp

Update: H1N1 Flu Vaccine

2009-10-30T10:38:00.000-05:00

As of today, the Cook County Department of Public Health has started scheduling H1N1 flu vaccines for next week for Cook County residents. To schedule for them, please call the following phone number: 847-818-2860, and then hit option 1 followed by option 1. For details please see this link:
http://www.cookcountypublichealth.org/files/Fludocs/h1n1%20vaccine%20flyer_10-29-09.pdf

For non-Cook County residents, please see the following link through the Illinois Department of Public Health:
http://www.idph.state.il.us/h1n1_flu/sf_vaccine_locations.htm

We still anticipate receiving the vaccine in our office in the next 1-2 weeks. However, if you are a high-risk family (child under 6 months, asthma, heart disease, other chronic illness), you may want to try to schedule to receive it at one of the Cook County Department of Public Health Locations through the above phone number.

Some pharmacies in our area have also told us they will be getting the vaccine next week, and they will be scheduling clinics at their locations as well, so please call them for further information. It is possible that these pharmacies will receive the vaccine before the Elm Street Pediatrics office receives it. This link has some information regarding those locations as well (scroll to your town to see those pharmacies):
http://www.idph.state.il.us/h1n1_flu/vaccine_locations/sf_vaccine_locations_cook.htm

H1N1

2009-10-29T11:04:00.000-05:00

Unfortunately, we at Elm Street Pediatrics still do not know the answer to the most-asked question this month, "when are you getting the H1N1 vaccine?". Unlike other vaccines, which we purchase and therefore can predict when we will receive them, the H1N1 vaccine was produced with government monies. Thus, the government decides who gets it and when... which is why some schools and public health departments have received it before us, the private offices.

We have been told we may be receiving the vaccine in early November. We hope this is the case, and promise to update this newsletter as soon as we do have it. At that time we will be scheduling clinics to administer the vaccine, first for high-risk patients and then according to supply and demand.

As many of you know, we have seen an increase in the amount of H1N1 influenza in our community this month. Please see previous posts for details regarding symptoms and treatment. As a result, our office staff, nurses, and physicians have seen a significant increase in number of phone calls received. We are doing our best to get back to you as soon as possible; however, please do not hesitate to call back if your call is not returned in a timely fashion.

Finally, there was in interesting post on NPR this past week regarding the spread of viruses. If any of you are interested, the link is: http://www.npr.org/templates/story/story.php?storyId=114075029.

As always, stay healthy and enjoy the fall colors. We would especially like to welcome back Dr Susan Nelson, who has returned to the office this week... it is wonderful to have her back. Thanks for reading!

- esp

Yet Another Influenza Vaccine Update

2009-10-22T10:45:00.000-05:00

What are We Seeing at Elm Street Pediatrics??

As many of you are aware, the past few weeks have seen an increase in the number of cases of H1N1 influenza seen in our office. So yes, the H1N1 influenza is here and we are seeing it. However, the seasonal flu has, for the most part, not shown up yet. It typically does not appear until December or January. We expect this to be true this year as well. What this means, is that virtually anybody confirmed of having Influenza most likely has H1N1, since that is the only strain of influenza currently in circulation in Chicago.

Do We Have the H1N1 Vaccine Yet??

No. We have not yet received any H1N1 vaccine. We hope and expect this to happen in the next 1-2 weeks. Keep checking back here for updates.

When Can the H1N1 Vaccine Be Given? What if I just got the Seasonal Flu Vaccine??

The seasonal flu vaccine comes in 2 forms, live (nasal) and inactivated (shot). The H1N1 vaccine comes in the same two forms, live (nasal) and inactivated (shot). Like other live vaccines, such as MMR and Varicella, 2 live vaccines must be separated by 4 weeks (unless they are given on the same day, which is allowed). The exception to this is that the H1N1 nasal live vaccine can NOT be given on the same day as the seasonal live nasal vaccine. So if you just had the live seasonal vaccine (nasal), you must wait 4 weeks before getting the nasal H1N1. However, you can get the inactivated shot any time. And vice versa. And there is no minimum interval between H1N1 shot and seasonal flu shot.

How long to wait between doses of the H1N1 or seasonal flu vaccines?

The ideal time frame between initial dose and booster dose is 4 weeks, though as little as 3 weeks is acceptable. For children under age 10, the CDC currently recommends both an initial and a booster dose of the H1N1 vaccine. Whether this will actually be possible will depend on how much vaccine is actually shipped to our office and the Chicago area.

What If I can get the vaccine for my child at school?

We recommend that if you want your child to be vaccinated, and can receive it somewhere other than our office, that you go ahead and do so. We do not know for sure when we will get it, or how much we will get. So if your school offers it, please take them up on the offer.

How much does the H1N1 vaccine cost??

The H1N1 vaccine itself is provided free from the government. As with any shot, there are charges associated with the administration fee. If the office visit is for the H1N1 shot ONLY, you will NOT be initially charged a co-pay. However, it is POSSIBLE that you may be billed for the copay after the visit, depending on how the insurance company processes the administration charge.

What are the symptoms of H1N1??

The symptoms we have most seen are very similar to the seasonal flu. We are generally talking about the "respiratory flu", not the "stomach flu", though there can be vomiting with H1N1. Other common symptoms are fever (often high fevers), body aches, muscle aches, cough, runny nose or congestion, abdominal pain, nausea, and diarrhea. Some less common symptoms include wheezing, hoarse voice or stridor, calf pain or tenderness, and ear pain.

********
THANKS TO EVERYONE FOR READING OUR NEWSLETTER!!

We will continue to update it weekly, as well as when we receive the H1N1 vaccine, so keep checking back here for updates in the coming weeks!!! As always, feel free to call the office with any additional questions...

-esp

MORE FLU VACCINE INFORMATION!

2009-10-15T15:10:00.000-05:00

1. Seasonal Flu Vaccine

As a reminder, the seasonal flu vaccine is in short supply, due to manufacturers shifting their production plans. They had to make H1N1 vaccine quickly, and so they temporarily halted production of some of their seasonal Flu vaccine. Thus the shortage.
We currently have a limited supply of the seasonal Flu vaccine, and are restricting remaining doses to high-risk individuals. This includes younger children aged 6 mos-2 years, children with asthma, and those with other chronic diseases.
We will be receiving more supply of the seasonal flu vaccine next month, so if you have not received it yet, there is still time!! Remember, the seasonal flu does not appear typically until December or January, and has not appeared yet this year either. Getting vacccinated this November or December should provide more than enough time to build up immunity for the peak flu months of January, February, and March.

2. H1N1 Flu

As many of you know, we have started to see confirmed cases of the H1N1 (swine) flu in the north shore of Chicago. This has led to much parental concern, and many questions about the vaccine availability.
Unfortunately, we still have not received our shipment of the H1N1 Flu vaccine. We hope to have it in the next 2-3 weeks. When we do receive it, as noted in previous posts of this newsletter, it will be given to high-priority patients first, followed by healthy children after that. If your child is high-risk (asthma, family members of infants 0-6 months old, other chronic medical conditions), please call the office to have your child's name placed on the priority list -- that way we can call you when the vaccine is available and be sure to reserve doses for your family.
Additionally, some schools may have the vaccine available before we do at the office. If you would like your child to receive the vaccine, and it is offered at the school, we encourage you to sign them up for it as we do not know for certain when we will have it, or how many doses we will have. We will continue to update this post weekly as we have new information.

Thanks and stay healthy!

-esp

INFLUENZA VACCINE UPDATE

2009-10-08T18:01:00.000-05:00

October 7, 2009

Who Should Get Them?
As always, the seasonal Flu vaccine is recommended for all children ages 6 mos through 18 years.
It is especially important for children with asthma, heart disease, or other chronic medical conditions to get this vaccine.
It is also important for infants under age 2 and children under age 4, as they are a high risk group, as well as for caregivers and family members of infants under 6 months of age.

When Should They Be Given?
The typical Seasonal Flu season usually begins in December or January, so it is recommended to get vaccinated by the middle of December if possible.
The H1N1, or Swine Flu, season is different and has already appeared. We ARE seeing cases of this in the north shore area as of October, 2009.
Thus, the H1N1 vaccine is best given as soon as its available for the best protection.

What Forms of Flu Vaccine Exist?
There is an injectable "shot" that can be given to those above 6 months of age. This is NOT for individuals with severe egg allergy.
There is also a nasal spray "Flumist" that can be given to those above 2 years of age. This is NOT recommended for those with immune system problems or with asthma or recurrent wheezing.
Neither vaccines should be given to anyone who has had an allergic reaction to flu vaccine in the past, or who has had Guillain-Barre Syndrome.

What Is Available At Elm Street Pediatrics For Seasonal Flu Vaccines?
For the Seasonal Flu, we currently as of October 2009 have adequate supplies of the Flumist to vaccinate all children who are able to receive it.
We also have injectable Flushot for those children who cannot get the mist, either due to age <2 years old or due to asthma or other chronic medical conditions.
However, like most other offices, our deliveries of the Flushot have been delayed due to the concern about H1N1 vaccine. Thus, we currently have a shortage of the injectable flu vaccine and are reserving the current stock of Flushot for those who cannot get the mist. Next month, in November, we expect to get the remaining doses of the Flu shot and it will be available at that time for the families who want it. Because the seasonal Flu does not start until December or January typically, this is ample time to receive the vaccine.

What Is Available At Elm Street Pediatrics For H1N1 Flu Vaccines?
Good question. We currently have not received our supply of this vaccine.
It is recommended that children under age 10 receive 2 doses, the second given 4-6 weeks (minimum 3 weeks) after the first. Children over 10 years old need only one dose.
Immunity develops approximately 10 days after the vaccine is given.
We anticipate being shipped the first doses by the middle to end of October and will update the blog every Thursday with details.
It will be given on a priority basis according to a Tier System:
Tier 1: pregnant women, healthcare workers, families with infants <6 mos old, children aged 6 mos-4 yrs, and children aged 5-18 yrs with asthma or chronic medical conditions
Tier 2: healthy people aged 5-24 yrs, people aged 25-64 yrs with chronic medical conditions
Tier 3: all others

As the H1N1 Flu is currently being seen in our area, this vaccine will be given out as soon as we receive our shipment.
For details about this vaccine and lists of who gets it first, and for information about treatment, please see the links below.

http://cdc.gov/h1n1flu/vaccination/acip.htm
http://cdc.gov/h1n1flu/antiviral.htm

September 'Back to School' Newsletter

2009-09-09T09:43:00.000-05:00

Welcome to our first Newsletter.

!! HAPPY FALL 2009!!

We will attempt to keep this current and not too complicated

Hopefully all children will be back at school by this Friday September 11th!

We start flu clinics this Saturday September 12th, then most Tuesdays through October 10th. Please call to schedule an appointment!

Flu vaccines: there are 2 flu vaccines available this fall. One is for the seasonal flu, which is recommended for all children ages 6 months through 18 years, and is currently available at our office. It can be given either after a well-check visit or through scheduling a nurse visit or at one of our flu clinics. The second is for the H1N1 flu, and is currently in trials being tested by the CDC. We anticipate having this vaccine available in October or November.

UPDATE on H1N1--- so far, this is just the 'flu and possibly milder than the regular seasonal flu. We saw many cases in the Spring, and undoubtably there will be a resurgence this fall; however it seems that it is generally a mild illness and the recommendation currently is not to treat otherwise well children with antiviral medication. As well as protecting the child, immunizing children also decreases the spread of the disease. Children tend to be the main vector for spreading respiratory diseases.

The regular vaccine does contain thimerisol as does the flumist- the live attenuated nasal vaccine. There is a mercury/thimerisol free vaccine available, and we often will have it, based on availability. Despite claims to the contrary and after massive research thimerisol has not been shown to be detrimental.

Vaccine for H1N1 - will be available late October early November. It is going to be provided by 5 different manufacturers and there will only be an administration fee. However there will be a strict protocol as to who is eligible especially at the begining, when the supply is limited. Talk to your doctor if your child has special needs. Those in the first tier include, in order, pregnant Mothers, health care workers who have direct patient contact, people who care for those under 6 months. After this come children 6 months to 4 years and those ages 5-18 with chronical medical condtions.

There are several interesting and well-written pages with information about the H1N1 flu and vaccine. Please click the following links for details:

http://www.cnn.com/2009/HEALTH/09/01/parents.h1n1.flu.guide.gupta/index.html?iref=newssearch

http://www.cnn.com/2009/HEALTH/08/20/h1n1.flu.kids.trial/index.html?iref=newssearch

Dr Nelson will be overseas from September 22 and will be back in the office October 26th-she will be available by email, please call the office for details.