Friday, October 30, 2009

Are We Discriminating?

As you have noticed in my posts about influenza vaccines, we split out insured children from Medicaid/CHIP children. One parent called in to tell us we were discriminating against insured children.

So I thought I would explain why we separate them out. We purchase vaccines from suppliers. Those vaccines are then given to our patients, and the vaccine charges are billed to the insurance company. Vaccines are very expensive; the charges for a typical well baby check are $300-400 in vaccines alone.

For that reason, the government has a special program called Vaccines For Children, or VFC. The government purchases vaccines for this program and distributes them through selected sites, which includes Southpoint. The government has strict rules about who we can give these vaccines to. They are only to be used for uninsured patients, children on Medicaid, children on CHIP, or Native Americans/Inuit. If we violate this policy we will not be able to participate in the program.

We often have discrepancies in the vaccines available for insured versus uninsured patients; usually our insured patients have all vaccines available, whereas our VFC-eligible patients often do not. It just happens that VFC sent us a recent shipment of seasonal flu vaccines, which we had been out of for several weeks. Our seasonal flu vaccine supply is gone, since we have given out almost 4,000 doses already this year. We are still working with suppliers to see if we can order more, but it is in very short supply nationwide.

Wednesday, October 28, 2009

Flu Vaccine update, Wednesday Oct 28th

We are out of H1N1 vaccine today. We are hoping to have some nasal doses within the next two weeks.

We have injectable flu vaccine for insured children 6-35 months only. We have no nasal flu vaccine for insured children.

For Medicaid and CHIP (VFC program) we have seasonal flu vaccine and some nasal flu vaccine as well today.

Many of you have scheduled flu vaccine appointments for your children in advance. Since we are having a very difficult time getting flu vaccines from our suppliers, you may be called to reschedule. I WOULD RECOMMEND CALLING OUR OFFICE THE DAY BEFORE OR DAY OF YOUR APPOINTMENT TO CONFIRM THAT WE WILL HAVE VACCINE AVAILABLE, or at least checking this site.

We are sorry for the inconvenience of having to double check even after you've scheduled an appointment. It reminds me of the Seinfeld episode when he "reserves" a rental car only to find that they are out of rental cars, and he tells the clerk that she obviously doesn't understand what a "reservation" is! In the best of all worlds, we would have all the flu vaccine that we need, when we need it. Apparently we don't yet live in that world.

Monday, October 26, 2009

What Flu Vaccines Do We Have Today?

We are sorry to announce that we are currently out of nasal vaccine (Flu Mist) for the seasonal flu. We are several shipments behind and are working with the supplier to try to get some vaccine, although it doesn't look promising.

We still have some thimerosal-free vaccine for seasonal flu for children under 3 years of age. We do not have any injectable vaccine for children 3 years and over.

We have a few doses of injectable H1N1 vaccine, which we are saving for infants ages 6-23 months, and children with high risk medical conditions such as asthma or diabetes. We are expecting to have nasal H1N1 vaccine for children 2 years and older (without asthma) within the next two weeks.

If you have scheduled an appointment in our flu shot clinic, please call the day of the appointment to check to see if we have vaccine available. Our vaccine supply has been very undpredictable this year.

Please be patient with our front desk and nursing staff as we try to find ways to get all of our patients protected against the strains of influenza this year. It is quite a challenge, but we are committed to doing our best to help you protect your family.

Wednesday, October 21, 2009

How Long Do I Have To Wait In Between Flu Shots?

There has been some confusion (including me!) about how long to wait between flu shots. We reviewed the MMWR/CDC guidelines and contacted the State Health Department to confirm the rules. Here they are:

1. You should wait 28 days after a LIVE vaccine (FluMist seasonal, Nasal H1N1, MMR or Varicella vaccines) to receive another LIVE vaccine.

2. You can give INACTIVATED VACCINES (injectable seasonal flu vaccine, injectable H1N1 vaccine, all other common childhood vaccines except MMR and Varicella) anytime after a LIVE vaccine.

3. You can give LIVE vaccines any time after an INACTIVATED vaccine.

4. WE CANNOT GIVE BOTH NASAL SEASONAL FLU AND NASAL H1N1 AT THE SAME VISIT. There is insufficient data to show whether or not they are effective when administered together.

So..... it may be a little tricky to get both seasonal flu and H1N1 flu for your kids in a timely manner, if they are 2 years or older and are getting nasal vaccines. We are hoping to get more injectable vaccine for both seasonal and H1N1, which would give us more options.

SO WHAT DO I RECOMMEND? If your child (2 years or older) has not had any flu shots yet, I would prioritize getting the H1N1 vaccine first, since that is at epidemic levels right now. ( Our other doctors might have a different opinion on this, so feel free to ask them.) We hope to have nasal H1N1 vaccine within the next two weeks in the office. We do have nasal seasonal flu vaccine right now, and should be getting some more injectable seasonal flu vaccine in the next few days. There is no seasonal flu activity yet in our area. It is hard to say when it will start, but it often starts after the Thanksgiving holiday.

Friday, October 16, 2009

H1N1 Vaccine, 10/16

We have received a limited number of doses of the H1N1 vaccine in the shot form. This will be available on a first come first serve basis for the following groups of patients:

  • Children ages 6 months to 2 years
  • High-risk patients, meaning those with asthma, immunodeficiency or living with those who are immune compromised

We do not know if we will get more vaccine, but there is currently still vaccine available at the State Health Departments.

Wednesday, October 14, 2009

Jump ‘n Jive Doorway Jumpers Recalled

Graco has just recalled their Jump 'n Jive Doorway Jumper because of a design flaw that could expose children to a small part choking hazard. You can find out more information here.

H1N1 and Regular Flu Update

Southpoint Pediatrics has applied to become a center to distribute H1N1 vaccine for the state of Utah, and we just received word that in two weeks we will receive the vaccine. We will continue to update the blog as we get more information.

We are seeing more and more cases of H1N1 (swine flu) in the office, so it is a great idea to get vaccinated. Right now the only place to receive the vaccine is at the State Health Department.

As far as regular flu vaccine, we have all ages and all insurances EXCEPT those over 3 years old who have asthma with regular insurance (we currently only have Flu Mist for patients over 3 with regular insurance, and Flu Mist is not approved for children with asthma).

In other news, phase one of the construction is completely done and we are working out of our new rooms. Phase 2 is well on its way, so hopefully the transformation will be complete soon!

Thursday, October 8, 2009

Flu shot update

We received a new shipment of flu vaccine, so now we have vaccine for children 6-35 months who have regular insurance. We also have vaccine for all ages for those with VFC (any type of Medicaid or self pay). We are still waiting for vaccine for children over 3 years old with regular insurance. Hopefully soon.

Wednesday, October 7, 2009

Somebody Looks Fabulous!-- Dr. Buchanan on TV

Check out this link to see our famous Dr. Buchanan getting his H1N1 vaccine today!

Wasatch Pediatrics Looking for I.T. Director

I know we have several parents of patients who work in IT and Networks. Our current director is moving on to a new company, so we will be interviewing. Here is the ad that will appear in newspaper and internet sources:

Director of I.T. for Medical Practice

Will direct all technology needs of medical practice. Design, support, configure, and implement network infrastructure for integrated practice management and EHR system. Minimum of 5 years progressively responsible experience in information systems, with two years in ambulatory health care setting. Experience with VMware, phone systems, SAN, terminal services support, CISCO routers and Microsoft Operating Systems. Must be able to work comfortably with physicians, technical vendors, software company, and large staff. Ability to present in large groups and interact well on all levels, provide training and support, and make technical recommendations for network. Will be required to manage I.T. staff effectively and deal with people. Flexibility in work schedule is needed to assure optimal system function. To be considered for this fulltime immediate opening, submit resume by October 12, 2009 to jsauric@wasatchpeds.net.

H1N1 Influenza vaccine information

Some nasal spray doses of H1N1 vaccine are available today at Salt Lake County Health Clinics.

Several of our patients have called to say that they were unable to get the vaccine because they had received seasonal flu nasal vaccine (Flu Mist) within the previous 28 days.

There is a general rule about vaccines that you must wait 28 days after receiving any live-virus vaccine (Flu Mist/nasal influenza, MMR, Varicella) before you can receive another live-virus vaccine.

The CDC has been encouraging us to vaccinate all children with seasonal flu vaccine as soon as possible, even though this may interfere with receiving H1N1 vaccine if they receive the nasal live virus vaccine (FluMist).

If you have questions about your child's vaccines, please call us at 801 565-1162.

We have applied to be a vaccination center for H1N1 vaccine. We are waiting to hear from the Utah State Health Department about when we will receive vaccine, and other details such as cost, etc. As soon as we know, we'll let you know.

Monday, October 5, 2009

Flu Shot Update, Monday October 5th

Good Morning. We have been having some supply issues (big surprise) with seasonal flu vaccine. There is plenty of vaccine, but the manufacturers are having trouble shipping it because of the big shipments of H1N1 vaccine that are going out right now.

Here is where things stand at our office:

For regular insurance patients: We are out of seasonal flu vaccine for infants under 2 or for any children with asthma until later this week. We do have the nasal spray "FluMist" vaccine, which can be used for 2 years and up but not for asthma patients.

For Medicaid and CHIP patients, who qualify for VFC vaccines: we currently have all kinds of flu vaccine.

We still don't have any word on when we will get H1N1 vaccine in our office, but are expecting to hear any day now.

Meanwhile, H1N1 flu is circulating at mild to moderate levels in the community right now, along with Parainfluenza (croup) and Group A Strep (strep throat).