FAQs on the mRNA vaccine for pediatrics
Information on Melatonin use in pediatrics
Doc Talks with Dr. Fazilat
Flu vaccine and prevalence
Information to partake in a blood sugar monitoring study in honor of Diabetes Awareness Month
Pfizer COVID19 vaccine for ages 5-11: Please schedule with Alex!
COVID is mild for most kids. So why get vaccinated?
Vaccination will prevent many infections, disruptions to schooling, hospitalizations and rare but severe complications of the disease. More than 8,300 kids aged 5 to 11 have been hospitalized with COVID-19 because of serious illness. According to a CDC analysis, the number of children and adolescents admitted to the hospital increased nearly fivefold over the summer months amid the delta surge. 
In addition, more than 5,200 children and teens have developed MIS-C, or multisystem inflammatory syndrome in children, a condition linked to COVID-19 that often leads to ICU admission. The median age of kids getting MIS-C is 9 years old. 

We cannot predict which kids will have severe COVID-19 or MIS-C. In one CDC analysis, roughly 30% of kids hospitalized with COVID-19 had no underlying health conditions that would have put them at increased risk. 50% of 12 - 17 yr olds have been fully vaccinated! That's more than 11 million kids who have had both of their doses of COVID-19 vaccine. The vaccines continue to be monitored very closely. In fact, the Centers for Disease Control and Prevention (CDC) say that COVID-19 vaccines are getting "the most intensive safety monitoring in U.S. history."

Was this rushed? Not at all. There were no shortcuts. Once we knew what virus was causing the pandemic, everyone worked together. The COVID-19 vaccine works similarly to other vaccines your child has had. All safety processes were followed and none were rushed.Over 10,000 children 6 months and older were in the studies and now over 8 million children have been vaccinated. There have been over 52,000,000 doses provided in the US and every side effect is being studied and followed.

Resources to Answer your Questions:
  • CHOP's Dr. Paul Offit discusses all of the pediatric side effects of the COVID19 vaccines that have been reported to date. He does a phenomenal job addressing every concern that could possibly be raised and does not ignore any reported side effects. Please share this with friends who are unsure of whether or not to get the vaccine. I list it below.
  • Healthy Children
  • NPR FAQ
  • Mayo Clinic FAQs

Too busy to read? Schedule a Call with ME!
I can address any question in person or via email.
Vaccine education center from Children's Hospital of Philedelphia with Dr. Paul Offit (click link to register and listen!)

Over 10,000 children over 6 months of age have successfully completed trials with mRNA vaccine. The phase 1 trials are the largest in the history of vaccines. In addition, we now have numerous well controlled, large population, real life studies showing one thing:  The vaccine is MUCH safer when compared to COVID19 infection for BOTH children and adults.  For children there were 250,000 infections in the past week.  Of adolescents who had to go to the hospital, 1/3 required the ICU, intubation or ECMO.  1/3 of these severe patients had no risk factors. 

Vaccine Side effects should not deter you.  In fact, they make the argument for getting vaccinated.  Every side effect is more severe and MUCH more prevalent with natural infection.  Listen for yourself.  I broke down this talk in hopes to help combat the myths and misconceptions around the vaccine.  While some worry that we are only one year out from the pediatric trials you have to consider the risk of pediatric long haulers syndrome and other long term problems from getting infected.  

Time stamps in Minutes: 

Minute 1:50- Myocarditis from the vaccine.  After vaccination 1 in 20,000 ppl were found to have a self resolving, 1-2 day myocarditis (16-29 yo’s have the highest rate).  Not surprisingly, the virus causes a more serious myocarditis at a much higher rate.  Several studies show that approximately 1 in 43 people who were infected were found to have myocarditis when they were screened by echo, EKG or otherwise.  See the studies in the presentation.  In addition, myocarditis is present in MIS-C.  This is a rate of 1/1000 to 1/3000 of this infected.  Vaccine myocarditis heals in 1-2 days without long term consequence.  Viral myocarditis can kill.  The vaccine prevents viral myocarditis. 

Minute 5:45- Thrombosis - Severe is cerbral venous thrombosis and the numbers show the vaccine has much lower incidence than that after infection. 

Minute 7:00-  Guillan Barre Syndrome- VERY low rates compared to what is induced by real infection.  

Minute 9:19- Addresses the comment  “The Vaccine Is Not Necessary for children”
There are over 4500 MIS-C cases in children and over 36 MIS-C related pediatric deaths, psychological factors discussed 
Minute 10:55 - “Reduced Fertility” myth began by a physician who wrongfully compared a protein sequence with that of a placental cell and tried to petition the European union with the falsehood.  This association was easily disproven.  Studies clearly show that the vaccine protects and greatly IMPROVES outcomes for pregnancy.  Numerous studies and statistics (vSafe study) show this. There was no evidence showing any negative effect on pregnancy.  Birth rates have not been affected since the start of the pandemic. 

Minute 13:20-  mRNA CANNOT alter our DNA. There is no reverse transcriptase enzyme to make DNA and no integrase enzyme to insert the DNA into our DNA.  There is no chance DNA is being altered.  Analogy to spider man is made. 

Minute 14:45- Pregnant women infected by the virus are 3 times more likely to need ICU, Intubation, Mechanical ventilation, and ECMO.  COVID19 Vaccine IS RECOMMENDED for pregnant women.  Without the vaccine there is a 1.5 fold increased risk of death from COVID19 infection.  Initially the vaccine was “allowed” for pregnant women.  Then the studies were able to happen with these women getting the vaccine.  This showed no change in pregnancy and livebirth outcomes between unvaccinated and vaccinated. Vsafe studies have followed every pregnancy on the vaccine. 

Minute 17:00- The Vaccine can make people Magnetic. Ingredients are reviewed to explain how this is impossible.  Commentary by scientists, physicists, and physicians- very entertaining!

Minute 19:12- Spike protein is a toxin.  Sham doctor- Byram Bridle “PhD”- uses a very poorly done and non relevant study where abnormally high levels of spike protein were inserted intra-tracheal into mice. There was no real comparable scenario to the vaccine and humans.

Minute 21:20- COVID19 Vaccine Kills People “according to VAERS”.  The was per a reporter on FOX who was also vaccinated.  Numbers are reviewed and there is no change in death rates for people vaccinated.  No one is sure where he got this information.

Minute 23:22- Vaccinated Teachers are Dangerous to Students. From a poorly informed teacher in Florida. Concept she bases her theory on is that the vaccine is transmitted through air. But this would mean any protein your body makes is transmissible to others.  Hemoglobin, lactic acid, etc.

Minute 24:45- Plandemic- Multiple Falsehoods listed and discussed when needed. 

Minute 26:00-  Q and A
26:20 Flu Vaccine recommendations 
29:00 Booster dosing may not be necessary for preventing hospitalization but may help mild to moderate symptomatic infection and will help immunocompromised.  B cell memory is intact one year out.  People in the hospital are just not vaccinated period.  It is not dependent on a booster. Panel advising on booster dose rejected it.  
34:00 Why the delay in getting results for pediatric studies.
34:40 Adverse reactions with flu vaccine does not predict adverse reaction to COVID19. 
36:00 Has anyone died from the vaccine.  Not from mRNA.  There was possibly a case report of a cerebral vascular event after AstraZeneca viral vector vaccine. Cerebral vascular events happen from the real virus at much higher numbers. 
38:50 Ivermectin is not a medically endorsed treatment.  It has no proven role.   There was a trump following that wanted to use this. Its best use is for horse deworming. It has harmful side effects so do not give this to patients. 
40:21 After infection when can you get vaccinated. 
44:00 How to explain mRNA to people who don’t understand cells. 
It is DIABETES AWARENESS MONTH!

Preventing obesity, Type 2 Diabetes and Metabolic Syndrome is one of my passions in pediatrics. If you want a call or visit to discuss your child's diet and lifestyle, please email me or schedule one with the office. Like always there is no fee for this!

If you are interested in improving your own health, dropping some pounds, and learning how to control your blood sugars, consider signing up for ZOE. You can use my code to participate in a blood sugar monitoring trial where you will be shipped a continuous blood sugar monitor that is easy to use and tracks your blood sugar 24/7. Many elite athletes use these and you will get an opportunity at a minimal fee of 40 dollars a month. This is conducted with scientists from Massachusetts General Hospital, Stanford Medicine, Harvard T.H. Chan School of Public Health, and King’s College London. 
Check out Doc Talks Episode 18: Dr. Vivi and Dr. Fazilat discuss common pediatric eye concerns:
1. Lazy eye (amblyopia)
2. Crossed Eye (strabismus)
3. Stye (acute vs chronic)
4. Blocked tear ducts (nasolacrimal duct obstruction)
This is a series of live talks with trusted local specialists. Learn More About Dr. Fazilat here.

Watch live on Facebook  and Youtube (hit subscribe!). All Past Episodes are on Dr. Vivi's webpage or Instagram.
FLU SHOT THIS YEAR?
Flu is in OC and our case total is over 50.  You can track numbers here. Since we are not sure how COVID19 and Flu may exacerbate one another, you should get vaccinated soon. COVID19 can be given any time before, after or with the flu shot.  Since we are monitoring reactions to COVID19 closely we recommend getting the flu shot separately.  However, it is not a problem to give them at the same time since most children have very little reaction to the first dose of COVID19.  

People at increased risk for severe influenza: 
  • All children < 5 years of age
  • Children with chronic pulmonary diseases (such as asthma and cardiovascular diseases)
  • Immunosuppressed children (primary or secondary due to medications, or due to HIV infection)
  • Women who are pregnant during the influenza season
  • Children and adolescents who are receiving long-term aspirin therapy
  • Children in nursing homes and other long-term care facilities
  • American Indians/Alaska Natives
Are you kids up before the crack of dawn thanks to Day Lights Savings?? Do you want to know more about Melatonin? 

MELATONIN: It is a hormone produced by the brain that plays a role in sleep. Every child reacts differently to melatonin, so talk to you doctor first before using. 

SIDE EFFECTS: blood pressure changes, drowsiness, sweating, vision problem, nightmares, joint and belly pain. It also lowers the threshold for seizures in “at risk” children. 

Perspective on the safety of melatonin in kids varies widely but for short-term use, it appears to have a wide safety margin. I do not recommend long-term use in children due to the lack of research on long term safety. 

More importantly, good sleep habits can go a long way in helping kids get a good night’s rest. 

DOSING: Max dose should only be 3 mg for children less than 88 lbs 40kg and 5 mg for children more than 88 lbs /40 kg. Not everyone responds to melatonin so don’t increase above these amounts before you switch brands or discuss with your doctor. It is a hormone (!) so lower doses are sometimes more effective than higher doses. 

To help get your kids in bed at a certain hour, dose 30-60 minutes before the desired bedtime. 

I often am comfortable adding in melatonin after the age of 3 and only at 0.5 mg. It is then possible to increase by 0.5- 1 mg every 3-5 days to the maximum dose or until the desired affect is achieved. Some children may need a dose several hours before bed. If you are using it for more than a week you need to talk to your Pediatrician or a sleep specialist. 

What brands are approved by US standards: Pure Zzzs, Natrol, and Zarbees. 

This is a great link by a Yale Sleep Specialist
Don't forget we want to see you! If you need your annual exam don't delay. We are looking for you. We are also here for any of your needs! RAPID Antigen TESTING KITS can be purchased through us or via Walmart and Amazon.
What is circulating?
Lots of things! Hand foot mouth (enterovirus), Adenovirus, Croup, Rhinovirus and RSV.

Here is more on Rhino and RSV:
Rhinoviral symptoms present 12-72 hours after exposure and last 7-11 days, but may persist for longer.

Transmission: direct contact or aerosol particles from a sick person. Transmission can happen a few days before the sick child has symptoms, peaks day 2-7, and may last as long as 3-4 weeks. Site of entry - the nose and eye. The virus attaches to respiratory epithelium and spreads locally.
Highly contagious behavior: includes nose blowing, sneezing, and physically transferring infected secretions onto environmental surfaces or paper tissue. Contrary to popular belief, behaviors such as kissing, talking, coughing, or even drooling do not contribute substantially to the spread of disease.

Infection rates approximate 50% within the household and range from 0% to 50% within schools, indicating that transmission requires long-term contact with infected individuals. Brief exposures to others in places such as movie theaters, shopping malls, friends’ houses, or doctors’ offices are associated with a low risk of transmission. Because children produce antibodies to fewer serotypes, those who attend school are the most common reservoirs of rhinovirus infection

Respiratory syncytial virus (RSV) is here and serious for infants. If you see any blue coloration around your child’s mouth, retractions over their torso or hear wheezing get help immediately. Otherwise call your doctor to get checked if your child was exposed. Beyond reactive airway disease, RSV can lead to ear infections in as many as 40% of cases. Remember, it's still important for anyone experiencing any COVID-19 symptoms such as a runny nose, fever, cough, headache, sore throat, loss of taste or smell to get tested.
RSV can spread when
* An infected person coughs or sneezes
* You get virus droplets from a cough or sneeze in your eyes, nose, or mouth
* You touch a surface that has the virus on it, like a doorknob, and then touch your face before washing your hands
* You have direct contact with the virus, like kissing the face of a child with RSV
People infected with RSV are usually contagious for 3 to 8 days. However, some infants, and people with weakened immune systems, can shed the virus after symptoms, for as long as 4 weeks.
RSV can survive for many hours on hard surfaces and lives on soft surfaces such as tissues and hands for shorter amounts of time.
People of any age can get RSV, but infections later in life are generally less severe. People at highest risk
* Premature infants
* Young children with congenital (from birth) heart or chronic lung disease
* Young children with compromised (weakened) immune systems due to a medical condition or medical treatment
* Adults with compromised immune systems
* Older adults, especially those with underlying heart or lung disease
In the United States and other areas with similar climates, RSV infections generally occur during fall, winter, and spring. The timing and severity of RSV circulation in a given community can vary from year to year.
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