Wednesday, November 25, 2009

Vaccine Numbers for 2009; Update on H1N1 Vaccine

We just completed our annual report to VFC summarizing the numbers of vaccines we have given. I thought you all might be interested in some of these factoids:

-- From January 1, 2009 to November 21, 2009, we gave a total of 20,077 vaccines. (This excludes H1N1 vaccine, but includes seasonal influenza vaccine.)

-- 15, 296 of those were vaccines that we purchased, and 4,781 were provided through the government program, Vaccines for Children (VFC).

-- We have given 3,762 seasonal influenza vaccines this year (that includes some for last flu season and some for this flu season). We still haven't received all of the 3,500 doses of seasonal influenza vaccine that we pre-ordered.

-- We have given about 1,000 doses of H1N1 vaccine, mostly to patients who are high risk (asthma, other chronic illnesses) and the infants and toddlers under age 2 years. We are starting to receive regular, if small, shipments of H1N1 vaccine.

OUR CURRENT POLICY FOR H1N1 VACCINES:

If your child is in a high risk category, including chronic illness (asthma, diabetes, chronic kidney disease, congenital heart disease, immuno-compromised), children under two years of age, or family members of infants under 6 months of age, we will try to get you in as soon as possible.

If your child is not in a high risk category, but you would like him or her to receive H1N1 vaccine, call and we will schedule an appointment in our regular flu shot clinic.

PLEASE BE AWARE THAT THERE IS A CHARGE OF $18 FOR THE H1N1 VACCINE THAT WILL BE REQUIRED AT THE TIME OF REGISTRATION. WE WILL NOT BILL YOUR INSURANCE FOR THIS VACCINE.

Tuesday, November 24, 2009

Recalls

  • Stork Craft has recalled over 500,000 cribs. The support bracket can break, causing the mattress to fall. You can find out more information here.
  • CSI: Crime Scene Investigation Kits have been recalled because the white fingerprint powder in the kits contains asbestos, which can be harmful if inhaled or ingested. This product is part of a class-action settlement. You can visit www.csitoyssettlement.com for more information.
  • Bunk Beds from Big Lots, sold from May 2008 to February 2009 with model number WP-9108-1 or WP 9108-2, have been recalled because the support slats can break and cause the bed to collapse. Call 866-244-5687 or visit www.biglots.com for more information
  • Hungry Figures and Magnets have been recalled because sewing needles have been found in the stuffing. Call 866-288-3891 or visit www.weightwatchers.com or here

Monday, November 23, 2009

True Colors

U of U? BYU? Where does your loyalty lie? This rivalry week we are hosting a food drive to support the Utah Food Bank. Bring a can of food to your next visit, and support your favorite team. Or, you can donate a dollar and we will purchase the food for you.

Go.....Cougars!
Go.....Utes!

Thursday, November 19, 2009

Fever Fighter


With all the bugs out there, chances are you've had a kiddo with a fever recently. A few fever tidbits:
  • If your baby is under 2 months old, a temperature over 100.4=a trip to the office and most likely the emergency room. Babies this young are at increased risk for urine, blood or brain infections so these things need to be ruled out. That said, even with the higher risk most of the time it is just a virus.
  • Taking the temperature rectally is the most accurate. But if your little one is not so little anymore, a forehead thermometer is a good second choice. If you use the armpit method you can add a degree for a more accurate reading. Make sure the room isn't too cold if you're using an ear thermometer, and you haven't just given a cold drink if you are using the oral thermometer.
  • For babies over 6 months, the number itself doesn't matter as much as how your child looks. I would be much more worried about a child with a temperature of 100 who looks awful than a child with a temperature of 104 who is running around playing.
  • We like to see children with fever because of what they represent (ear infection, urine infection, strep, virus, etc) not because the fever itself will be harmful to your child or their brain. I once had a patient with a temperature of 107 for a week! He was a-okay.
  • Tylenol and Motrin will help bring the fever down and make your child feel better. You can alternate them every three hours (Tylenol at noon, Motrin at 3, Tylenol at 6, Motrin at 9, etc). Just make sure you give them the correct dose.
  • Fluid, fluid, fluid. Keep 'em hydrated.
  • With H1N1 the medicine is most effective within 24-48 hours from the start of the fever, so if you're going to bring them in try to make it within that window.
Good luck! And, remember, if you're worried we are always happy to see you and your sicklings.
Post-edit: The original post had an incorrect schedule for the Tylenol/Motrin dosing. This has been fixed.

Thursday, November 12, 2009

Croup is Raging!

So, your little angel (?) goes to bed happy as can be, then at the lovely hour of 3:00 a.m. wakes up out of the blue breathing harder than Darth Vader and barking like a trained seal. What's this all about?

Croup. It's back and raging right now. Croup is caused by several respiratory viruses (most commonly parainfluenza virus, but also RSV, influenza A, and other cold viruses). It is most common among children ages 2-4 years of age. For some reason, children with these viruses can have a significant amount of swelling in the larynx (voicebox) region. This gives them a constricted, whistly breathing pattern called STRIDOR that you will notice more with breathing in than breathing out, and more when they are breathing fast (crying or physically active). They may also get very hoarse or lose their breath altogether. In severe cases, the children can develop significant respiratory distress, with loud breathing both in and out, trouble swallowing, and retractions (the skin of the neck or under the ribs pulling in with breathing).

Typically kids will have tight breathing and croupy cough for the first 3-4 days (nights!) of the infection, then their cough will loosen up and become more productive, like a regular cold. It may take another week for their cold to go away.

You can usually treat croup at home unless it is severe. We recommend the following home treatments for your croupy child:

-- Run a cool mist humidifier or a steam vaporizer near their bed when they sleep. (If you use the vaporizer, be careful that they don't burn their fingers on the steam.)
-- If your child wakes up with stridor or severe cough, take him/her into the bathroom and run the shower on hot with the door closed. Sit with your child in the steam for twenty minutes or so, until the tight breathing starts to improve.
-- Another treatment for stridor that works well is to take your child outside in the cold night air. Be sure to bundle up, because you will need to stay outside from 15-30 minutes until the stridor improves.
-- If these things don't work, take your child to an emergency room for a special breathing treatment with racemic epinephrine. This will open up their throat, but it will require several hours of observation afterwards.

We can see your child in the office if he or she has stridor. Treatment with a steroid called dexamethasone (Decadron) will often help open up the airway.

Croup typically does not have fever with it, but the past week we have been seeing a lot of fevers (102-103) with croup. We should check your child if he or she has croup with a fever that lasts more than a day or two.

Summary of Influenza Weekly Update

The State Health Department sends out a weekly influenza activity report. A couple of interesting items from today's report:

-- Influenza Like Illness rates have FALLEN this week from 5.9% of visits the previous week to 4.7% this week.

-- Influenza-associated hospitalizations rose by 103 this past week, to a season total of 623 (there is some lag time in reporting hospitalizations, however).

-- 100% OF SPECIMENS SENT FOR CONFIMRATORY TESTING WERE H1N1 (PANDEMIC) INFLUENZA STRAIN. This means that there is no seasonal influenza activity yet.

-- There have been 14 deaths related to H1N1 influenza this season. There were no new deaths reported this past week.

Here is a link to the Influenza Report.

tv


A new study came out that showed children who are exposed to television before age three tend to be more aggressive. They included both active television watching, and just having the TV on.

Does this mean we should NEVER have the TV on? Maybe. Is that realistic? Not in my house. Do your best to limit your child's exposure and try to read to them at least once a day.

You can read more about the study here

Flu Finder

Google has recently introduced a tool to help you get a flu shot. They have a new site where they keep track of who has vaccine and who doesn't, among retail clinics. I'm not sure how updated they keep it, but it might be worth checking into.

Flu Vaccine Update November 12

Today we received a shipment of seasonal flu vaccine for VFC only for all ages.

Regular
6-35 months only

H1N1 we are out of supply but hope to receive more at some point.

Keep checking back

Wednesday, November 11, 2009

H1N1 Update November 11

At the close of clinic today we are out of H1N1 vaccine.

VFC
We are out of all flu vaccine.

Regular
6-35 months only

We hope to receive more H1N1 vaccine, we will keep this updated with the lastest vaccine supply.

Update H1N1

As of today we only have 35 doses left of H1N1 and will only be giving them to the children 4 years and older with asthma, heart disease or diabetes.

Please keep checking back!

Tuesday, November 10, 2009

Flu Update, November 10

H1N1
We have 75 doses of H1N1, which are only approved for children over 4 years old. These doses will be given to those children with asthma or other medial conditions such as diabetes, heart conditions, etc. There is an $18 administration fee with this vaccine that will be collected at the time of the visit.


VFC
Small (and going fast) supply of all seasonal flu vaccine.

Regular Insurance
6-35 months

Thanks for your patience!

Thursday, November 5, 2009

Correction, November 5th

Apparently we are NOT getting more flu supply on November 6th. We are very sorry for the confusion.

Tuesday, November 3, 2009

Flu supply update, November 3

Here's what we've got:

VFC
Under 2 years old
Flumist (for those without asthma)
Injectable for under 3 years old
Injectable for over 4 years old
*So, if your child is between 3-4 and has asthma, we do not have vaccine. Otherwise we have all ages.

Regular insurance
Under 2 years old

We are hoping to get another shipment on November 6th for both seasonal flu vaccine and H1N1. CALL AHEAD before coming in.

Monday, November 2, 2009

H1N1 vaccine clinics at SL County Health Department

The Salt Lake Valley Health Department (SLVHD) will take appointments Tuesday for H1N1 vaccination clinics. Clinics will take place Wednesday, Thursday and Friday at four clinic locations.

The public may begin making their appointments Tuesday starting at 9:00 a.m. until all available time slots are filled. Appointments can be made either online or by calling the SLVHD Vaccination Hotline at (801) 743-7280 (details below).

“We are excited to announce this shift in how we offer H1N1 vaccine in Salt Lake County,” says Gary Edwards, director of SLVHD. “We anticipate appointments will better serve those at highest risk and help to avoid the long lines seen at previous clinics.”

Starting Tuesday (11/3) at 9:00 a.m. appointments can be booked:
Online via: www.slvhealth.org
Direct web link: https://www.securedata-trans12.com/ap/saltlakevalleyhealthdepartment/index.php?page=10
SLVHD Appointment Hotline at (801) 743-7280
Open from 9:00 a.m.-1:00 p.m., or until all time slots have been reserved.

Individuals who secure an appointment will be given a half hour time slot and clinic location for vaccination. All clients with an appointment will be screened at the clinic to confirm eligibility.

Those eligible to receive the H1N1 vaccine:
Pregnant womem
Those who live with or care for children younger than 6 months of age
Health care or emergency medical personnel with direct patient contact
Children age 6 months to 24 years of age
Those under the age of 64 with chronic medical conditions associated with higher risk of medical problems from influenza
The vaccine is provided at no out-of-pocket cost to individuals at SLVHD clinics, however those with health insurance are encouraged to bring their card. Individuals without health insurance will still receive the vaccination at no cost

SLVHD clinic locations taking appointments for vaccination Wednesday, Thursday and Friday

Salt Lake City Public Health Center
610 South 200 East
Salt Lake City, Utah 84111

Southeast Public Health Center
9340 South 700 East
Sandy, Utah 84070