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COVID-19 Vaccine For Children Ages 5-11 · The SHEA Podcast

0:08
SPEAKER_00: Welcome to the Rapid Response Podcast brought to you by the Society for Healthcare Epidemiology of America, Shay, promoting the prevention of healthcare associated infections and antibiotic resistance, and seeking to advance the field of healthcare epidemiology and antibiotic stewardship.
0:25
SPEAKER_00: I am Dr.
0:25
SPEAKER_00: Karen Raven, Chief of Pediatric Infectious Diseases at Namora's Children's Hospital, Delaware, and I will be serving as today's podcast moderator.
0:34
SPEAKER_00: Discussion on the podcast does not reflect Shay's perspective, but facilitates communication of multiple perspectives and experiences as we go through this challenging time together.
0:44
SPEAKER_00: Shay is excited to launch this episode of the podcast, COVID-19 updates, What We Know Now.
0:51
SPEAKER_00: Today's discussion will focus on the COVID-19 vaccine for children ages five to 11 years.
0:57
SPEAKER_00: Our speaker today is Dr.
0:58
SPEAKER_00: Eric Ball, general pediatrician with the Choc Primary Care Network in Orange County.
1:03
SPEAKER_00: He serves on the boards of the American Academy of Pediatrics in California and the California Immunization Coalition and has a strong interest in immunizations and vaccine policy and advocacy.
1:15
SPEAKER_00: Thank you for joining us today.
1:17
SPEAKER_01: Nice to be here.
1:18
SPEAKER_01: Thanks for having me.
1:19
SPEAKER_00: Great.
1:20
SPEAKER_00: Let's jump right in.
1:21
SPEAKER_00: So one of our first questions is Can you tell us a little bit about your background in pediatrics and the work that you've done during the pandemic?
1:29
SPEAKER_01: So I've been a primary care pediatrician for about 16 years now in Orange County, California, so Southern California.
1:36
SPEAKER_01: And I was just doing regular outpatient pediatrics when at the end of 2015, 2016, we had several cases of measles in my practice.
1:46
SPEAKER_01: So we were kind of the epicenter of the Disneyland measles outbreak during that year.
1:50
SPEAKER_01: And that really sparked my interest in immunizations and immunization policy.
1:54
SPEAKER_01: So we were seeing large amounts of unvaccinated people in our community, and they tended to cluster in these small pockets, and we were seeing measles and other infectious diseases spread through them.
2:05
SPEAKER_01: So when I saw this, I decided I want to be more involved.
2:08
SPEAKER_01: So I got more involved with my local and now national chapters of the American Academy of Pediatrics and have been working on vaccine advocacy, vaccine policy, and vaccine communication ever since.
2:19
SPEAKER_00: That's great.
2:20
SPEAKER_00: I know of that outbreak very well for sure, and my background in infectious diseases.
2:26
SPEAKER_00: And I think you and I are pretty close in timing as far as when we started in practice and stuff.
2:31
SPEAKER_00: So we've kind of had similar experiences along the way.
2:34
SPEAKER_01: One of the difficult things about COVID for us right now is you know, the vaccine has been out for almost a year in adults, and it is reminiscent of the measles outbreak that we saw.
2:43
SPEAKER_01: So it's essentially a vaccine-preventable disease.
2:46
SPEAKER_01: And it's tragic now that we're still seeing so many people die because of the misinformation and disinformation out there, and they're not getting vaccinated.
2:53
SPEAKER_01: And as a pediatrician, this is something we've been dealing with forever.
2:56
SPEAKER_01: And so I feel we're in a good position to try to get the good word out there about vaccines to try to combat disinformation and misinformation and make sure that our kids get vaccinated against COVID.
3:06
SPEAKER_00: Yeah, definitely.
3:08
SPEAKER_00: I think as pediatricians, we certainly can speak to vaccines, I would say almost better than anybody out there.
3:14
SPEAKER_00: So the big news right now, of course, is that both the CDC and FDA have approved the Pfizer vaccine in children ages five to 11 years.
3:22
SPEAKER_00: So can you tell us a little bit about this vaccine for kids 5 to 11?
3:27
SPEAKER_00: Kind of how does the dose compare with the dose for older kids and adults and if there's any other differences between the vaccines?
3:33
SPEAKER_01: Yeah, so this has been incredibly exciting.
3:35
SPEAKER_01: As we talked about, this vaccine for adults has been out for almost a year.
3:39
SPEAKER_01: And most of our families who have younger children have really been struggling because it's really hard for them to let their kids live a normal life, knowing that they're still susceptible to this potentially deadly disease.
3:49
SPEAKER_01: And so for almost a year, I, who am totally fully vaccinated and boosted, have felt a lot more comfortable going out in public, hanging out with my friends, doing things like that.
3:59
SPEAKER_01: Whereas if you have a seven-year-old kid, you have to be really still cautious about it.
4:02
SPEAKER_01: So it's really exciting that we now have an approved vaccine for kids five to 11.
4:06
SPEAKER_01: So it's a smaller dose.
4:08
SPEAKER_01: So the dose of the Pfizer vaccine that I received was 30 micrograms.
4:11
SPEAKER_01: They're going to receive 10 micrograms.
4:13
SPEAKER_01: So a third of the dose.
4:14
SPEAKER_01: The dose is smaller because kids' immune systems are better.
4:18
SPEAKER_01: And what they did when they were studying the childhood dose was they actually looked at the different doses and then kind of monitored the immune response.
4:25
SPEAKER_01: And they found that kids, even with a third of a dose, got as robust of immune response that I got, say, with a 30 microgram dose, which is great.
4:33
SPEAKER_01: So you can give them less vaccine and have still a good response.
4:38
SPEAKER_01: So they'll receive 10 microgram dose, two doses over a minimum of three-week period.
4:42
SPEAKER_01: So the same thing as with adults.
4:44
SPEAKER_01: And the formulation is completely different.
4:46
SPEAKER_01: So in our office, we received our vaccine.
4:49
SPEAKER_01: It comes in a different vial, it has a different concentration, it has an orange top instead of a purple top so that we don't get it confused.
4:57
SPEAKER_01: And it actually lasts a little bit longer in our refrigerator, which is excellent because we're really relying on pediatricians and family practitioners and local healthcare leaders to be able to give this vaccine to kids.
5:10
SPEAKER_01: And we're not focusing so much on big super centers like they were doing when we introduced the vaccine for the older folks.
5:16
SPEAKER_00: Yeah, great.
5:17
SPEAKER_00: So as far as the vaccine, are the side effects similar to what we saw in older adolescents and adults?
5:24
SPEAKER_01: Yeah.
5:24
SPEAKER_01: So the studies that came out with the five to 11-year-old group were really, really encouraging.
5:29
SPEAKER_01: So the side effects are what we expect.
5:31
SPEAKER_01: They're what I encountered.
5:33
SPEAKER_01: So, you know, the usual thing, sore arms, some redness, especially after the second dose, you can feel a little crummy the next day, potentially have a low-grade fever, a little muscle aches, things like that.
5:44
SPEAKER_01: There were actually very few to no like bad side effects with the vaccine and the thousands of kids who received it in the clinical trials, which is really, really reassuring.
5:53
SPEAKER_01: And in my experience, we've been vaccinating our 12 to 17-year-olds here in my office for gosh, since May, I believe.
6:00
SPEAKER_01: The side effect profile has been very tolerable and very similar to what we see in all the other vaccines.
6:05
SPEAKER_01: And if it's anything like the other vaccines that we give, I know that kids tolerate these things much better.
6:10
SPEAKER_01: I've had a recent tetanus booster vaccine, and my arm was so sore for like several days and it really hurt a lot.
6:16
SPEAKER_01: And you know, we give this to kids multiple times a day, every day, and they don't complain as much as I complained.
6:22
SPEAKER_00: Yeah, they're definitely more resilient than we are, for sure.
6:25
SPEAKER_00: What about the concerns about vaccine-associated myocarditis that we've seen in some of the older teenagers and young adults?
6:32
SPEAKER_00: How does the risk for this compare in the younger age group?
6:35
SPEAKER_01: Right.
6:36
SPEAKER_01: So that's a good question.
6:37
SPEAKER_01: The biggest like adverse effect that we've seen with the older people getting vaccines is myocarditis, which is inflammation of the heart.
6:45
SPEAKER_01: It was seen primarily in older in my world, but kind of young men.
6:50
SPEAKER_01: So men generally like 16 to 30 was the peak age for it.
6:54
SPEAKER_01: So a lot of people outside of my age, where I see as a pediatrician, and they were worse with the Moderna vaccine rather than the Pfizer vaccine in most studies.
7:03
SPEAKER_01: So what was shown was that there was a small group of them which were having myocarditis, usually a few days after their second dose.
7:10
SPEAKER_01: It was almost always short-lived, lasted a few days, went away completely on its own, and these adults got better with no sequelae.
7:17
SPEAKER_01: An important thing to know, or a few things to know.
7:20
SPEAKER_01: So one is that the amount of myocarditis we see in little kids, so five to 11-year-olds, just in general, is lower than it is in adults.
7:27
SPEAKER_01: So we should expect that the myocarditis risk in this younger age group should be lower just because they're younger.
7:33
SPEAKER_01: Number two is they're getting a smaller dose of the vaccine, a third of the dose.
7:37
SPEAKER_01: So we would expect that we would see lower side effect profile in this group.
7:41
SPEAKER_01: And then further, in the clinical trial that led to the approval of the vaccine, there were zero cases of myocarditis, even though they were looking for it.
7:48
SPEAKER_01: You know, we expect adverse effects with any vaccine.
7:51
SPEAKER_01: Myocarditis, you know, has been the one that we've seen the most with with this vaccine, but again, largely in a different age group.
7:58
SPEAKER_01: I'll close with saying that myocarditis is a huge risk with COVID disease.
8:03
SPEAKER_01: So, as everyone knows, COVID causes a lot of inflammation in the body.
8:07
SPEAKER_01: It's how it does a lot of its damage.
8:08
SPEAKER_01: And when people get COVID, particularly this age group, this young men age group, they have a higher risk for myocarditis.
8:15
SPEAKER_01: In fact, the risk for myocarditis with the disease COVID is dramatically higher.
8:19
SPEAKER_01: In some studies, 15 times higher than it is with your risk of myocarditis with the vaccine.
8:25
SPEAKER_01: And especially in this young group, we expect that to be consistent.
8:28
SPEAKER_01: Even in the highest risk group, you take like a 25-year-old man, the risk of myocarditis is somewhere between six and 10 times higher with the disease rather than with the vaccine.
8:37
SPEAKER_01: So if a parent is worried about myocarditis, the best thing they could do is vaccinate their kid.
8:42
SPEAKER_01: Because if their kid gets COVID, they have a higher risk of getting myocarditis.
8:46
SPEAKER_01: So the vaccine will protect their children against myocarditis.
8:50
SPEAKER_00: Yeah, I think that's a really great point.
8:52
SPEAKER_00: You know, really comparing the risk-benefit ratio between the vaccination on one hand and then getting the disease on the other.
8:59
SPEAKER_00: So clearly in this case, vaccination wins out on all fronts.
9:03
SPEAKER_01: I think one of the things that I try to get across to my patients when I see them is that the choice isn't really between getting the vaccine and not getting the vaccine and moving on with life.
9:14
SPEAKER_01: It's getting the vaccine and getting COVID.
9:16
SPEAKER_01: I truly do believe that most people who do not get vaccinated will get sick with COVID at some point.
9:22
SPEAKER_01: So you have to weigh the risks and benefits of any effect of the vaccine versus the risk and benefit of getting the disease itself.
9:29
SPEAKER_01: And myocarditis is a great example of this.
9:31
SPEAKER_01: So again, much safer to get the vaccine than to kind of take your chances with getting the disease.
9:36
SPEAKER_00: Excellent.
9:37
SPEAKER_00: One of the other things that we've been hearing a lot about, been a lot of misinformation about the potential impact of the COVID-19 vaccination on fertility.
9:46
SPEAKER_00: And unfortunately, this has resulted in some parents wanting to avoid vaccination, you know, of their children.
9:52
SPEAKER_00: So can you speak about that issue?
9:55
SPEAKER_00: And is there an impact of the COVID-19 vaccine on fertility?
9:59
SPEAKER_01: Gosh, this is really, really out there.
10:02
SPEAKER_01: There is so much misinformation and disinformation, especially on social media, about this.
10:07
SPEAKER_01: It's really, really common for me to talk about this with families.
10:10
SPEAKER_01: Before I talk about fertility issues, I just want to briefly talk about misinformation versus disinformation.
10:16
SPEAKER_01: So when parents come in and tell me they've read something or they've heard something, often it's misinformation.
10:21
SPEAKER_01: Misinformation is information that is spread around that is wrong, but there's no malice, right?
10:26
SPEAKER_01: It's so that so I have a lot of families, they will read something on the internet and then they will post it and spread it to their friends.
10:32
SPEAKER_01: They don't mean to do harm to these people, but they're just spreading around bad, non-scientific information.
10:38
SPEAKER_01: Then there's disinformation.
10:40
SPEAKER_01: There's a lot of disinformation on the internet as well.
10:43
SPEAKER_01: Disinformation is things that are purposefully done to try to, in this case, give vaccines a bad name, often for financial gain or some other gain from the person who puts out the information.
10:54
SPEAKER_01: There's a lot of providers who will sell alternative therapies, ivermectin, things like that, and will put out disinformation about the vaccine because that helps drive their revenue, for example.
11:07
SPEAKER_01: So they say, don't get the vaccine because if you get COVID, you can take my medicine or you can buy these vitamins and that will prevent you from getting COVID.
11:14
SPEAKER_01: It works just as well as the vaccine.
11:16
SPEAKER_01: So this is disinformation.
11:18
SPEAKER_01: It's a little more worse in my mind because these people have actually a motive to misinform the population.
11:24
SPEAKER_01: So with that being said, let's talk a little bit about fertility issues.
11:28
SPEAKER_01: So there is zero evidence that the vaccine causes any issues with fertility.
11:32
SPEAKER_01: It has been incredibly safe and it's actually been studied for a long time now with fertility.
11:37
SPEAKER_01: So a few points.
11:39
SPEAKER_01: One is in the initial studies that came out that looked at the safety and effectiveness of all of the COVID vaccines, people got pregnant.
11:47
SPEAKER_01: So people they weren't studying pregnancy, but people who were in the vaccine trials, tens of thousands of people, some of them got pregnant.
11:54
SPEAKER_01: They had their babies fine, it wasn't a big deal.
11:56
SPEAKER_01: There's been lots of studies that have done since then, which have actually looked at pregnant people who had the vaccine and pregnant people who didn't have the vaccine.
12:03
SPEAKER_01: And there was no difference in pregnancy losses, fertility, anything like that in either group.
12:08
SPEAKER_01: Further, we're almost a year into our vaccination program.
12:10
SPEAKER_01: I had my first COVID vaccine, December 2020.
12:14
SPEAKER_01: So when I see new babies in my office now, the vast majority of the parents have had their vaccines, right?
12:20
SPEAKER_01: So if this caused infertility, theoretically I wouldn't be seeing any moms who had their vaccine.
12:24
SPEAKER_01: And sure enough, most of them have had their vaccination.
12:27
SPEAKER_01: In fact, the same percentage have had their vaccinations as the same percentage as any other random person in the population.
12:33
SPEAKER_01: So it's clear at this point that there's no fertility issues with the COVID vaccine.
12:37
SPEAKER_01: Ironically, this is a very old anti-vaxxer trope that we've been seeing over and over again.
12:43
SPEAKER_01: We saw it a lot with the HPV vaccine.
12:45
SPEAKER_01: In fact, I still hear it with the HPV vaccine.
12:48
SPEAKER_01: And this is a very common thing because it plays on like a primal fear in parents, right?
12:52
SPEAKER_01: That you're going to mess up your kids' future if you give them this vaccine.
12:57
SPEAKER_01: The problem is there's no science behind it and it's completely false.
13:00
SPEAKER_00: Thanks for clearing that up for everybody.
13:03
SPEAKER_00: I think that's a really key issue.
13:05
SPEAKER_00: There's, and I like the distinction that you made between disinformation and misinformation.
13:09
SPEAKER_00: I think that really sends that point home.
13:12
SPEAKER_00: So can we give the COVID-19 vaccine at the same time as other vaccinations, like influenza?
13:19
SPEAKER_01: Yes.
13:19
SPEAKER_01: So it is totally safe and okay to give with other vaccines.
13:23
SPEAKER_01: My parents about a month ago received their COVID vaccine booster shot in their left arm and their flu shot in their right arm.
13:30
SPEAKER_01: And we're doing that routinely in our office now.
13:32
SPEAKER_01: We are still vaccinating 12 to 17 year olds.
13:35
SPEAKER_01: Most adolescents get vaccinations at their office visits, be it a meningitis vaccine, HPV, pertussis, or whooping cough booster vaccine.
13:44
SPEAKER_01: We give the COVID vaccine in conjunction with that.
13:47
SPEAKER_01: So it is safe to do.
13:48
SPEAKER_01: The only downside about giving it at the same time is if you have any side effects, right?
13:52
SPEAKER_01: So say you have a fever or your arm is sore or whatever, you don't know which of the vaccines you receive might have caused those symptoms.
13:58
SPEAKER_01: But otherwise, they are safe to be done together.
14:00
SPEAKER_00: Do you think there's a risk of, you know, if you get multiple vaccines, they're going to have worse side effects?
14:05
SPEAKER_01: I don't think so.
14:06
SPEAKER_01: I mean, it is cumulative, right?
14:08
SPEAKER_01: So if you get a tetanus shot in one arm and a COVID shot in the other arm, you might have a sore right and left arm instead of just a sore left arm.
14:15
SPEAKER_01: But otherwise, it should be okay to do it.
14:18
SPEAKER_01: I actually, especially during the wintertime, I try to limit a number of visits that my patients make into my office or into a pharmacy because this is where sick people are.
14:27
SPEAKER_01: And so to have someone have to come back here every week to get a different shot just exposes them to germs in our waiting room in the community.
14:34
SPEAKER_01: And so I find it's better just to get it all over with and move on.
14:38
SPEAKER_00: I think especially when we're dealing with younger kids too, I think they would appreciate that as well.
14:42
SPEAKER_00: Just get all those jabs out of the way at one visit.
14:45
SPEAKER_01: Correct.
14:46
SPEAKER_01: And I also don't think that, especially, and this kind of is talking about other kinds of vaccines as well, but I don't think a baby, for example, really minds getting two shots versus three shots.
14:55
SPEAKER_01: I don't think it makes a difference to them.
14:57
SPEAKER_01: But getting one shot every week, I think that's not great.
15:00
SPEAKER_01: And it kind of like, if you think about it, doubles the side effects because every two weeks now you can have a fever, feel crummy, that sort of thing.
15:06
SPEAKER_00: And I think, you know, given what we experienced during the pandemic, with a lot of our patients being delayed in their vaccinations due to not being able to access their healthcare providers, you know, I think it's it's incumbent on us as pediatricians to really make sure that all our kids are getting immunized, that they're, you know, on schedule and the right time.
15:25
SPEAKER_01: Correct.
15:26
SPEAKER_00: So you are a big advocate.
15:28
SPEAKER_00: You've worked a lot with vaccine advocacy.
15:31
SPEAKER_00: So, how can other healthcare professionals, how can we address vaccine hesitancy concerns that parents express?
15:38
SPEAKER_01: It's a lot of listening, a lot of kind of addressing parental fears.
15:41
SPEAKER_01: Everybody who's hesitant about vaccines generally is there for a different reason.
15:46
SPEAKER_01: I have a lot of long conversations in my office.
15:49
SPEAKER_01: And my first thing I do is I always kind of try to find out where they are.
15:53
SPEAKER_01: So a lot of parents, they just want to know like, is this okay?
15:56
SPEAKER_01: Right.
15:56
SPEAKER_01: So it's a five-second conversation.
15:58
SPEAKER_01: They're like, I think I want to get the COVID vaccine.
16:00
SPEAKER_01: What do you think?
16:01
SPEAKER_01: And my response is always like, it's a really good idea.
16:03
SPEAKER_01: I vaccinated my own children.
16:04
SPEAKER_01: And then the conversation is over and they get vaccinated.
16:07
SPEAKER_01: There's some people who want to answer specific questions.
16:10
SPEAKER_01: So we talk about the myocarditis issue, the fertility issue, and all these other things that they've read.
16:15
SPEAKER_01: And then there's some parents who are very resistant to it.
16:17
SPEAKER_01: And they often will tell me right off the bat, I've had patients over the past few weeks who I walk in the room and before I even say hi, they're like, I'm not doing the COVID vaccine.
16:24
SPEAKER_01: And I'm like, okay, I wasn't going to do that right now.
16:27
SPEAKER_01: But it opens a conversation for me.
16:29
SPEAKER_01: And I think the important thing is just to have that conversation.
16:32
SPEAKER_01: And the conclusion of the conversation does not need to be the kid getting vaccinated.
16:36
SPEAKER_01: I don't need them to leave the office getting vaccinated.
16:39
SPEAKER_01: If they do, it's great.
16:40
SPEAKER_01: But what I want to do is start a conversation and have the parent thinking about it.
16:44
SPEAKER_01: I'm a trusted source of information for most of my family.
16:47
SPEAKER_01: So for a lot of these people, I've had relationships with them for 10, 15 years.
16:51
SPEAKER_01: And I think that the fact that they keep coming back to me means they trust me for my medical advice.
16:56
SPEAKER_01: They trust what I did for my own children.
16:58
SPEAKER_01: And so for me to be able to, you know, say a few lines about why I vaccinated myself, why I vaccinated my own kids, that's something that they can think about, take home, and then they can weigh that with all of the other information that they're getting inundated with.
17:12
SPEAKER_01: And hopefully, because of that relationship, they're going to come back and get their kid vaccinated at a certain point.
17:17
SPEAKER_01: Quick story was I had a kid a few weeks ago who was, I think, five years old, and we had talked about the COVID vaccine.
17:23
SPEAKER_01: And she was one of these, like, I'm not going to do it, like, don't even ask me about it, kind of people.
17:28
SPEAKER_01: We talked for maybe five minutes about it.
17:30
SPEAKER_01: It wasn't very in-depth.
17:31
SPEAKER_01: I didn't think I was going to get anywhere.
17:33
SPEAKER_01: And she sent me an email through our electronic health record this morning and wanted to know how she can get signed up to bring her kid and to get vaccinated.
17:42
SPEAKER_01: Now, I don't know what changed in the past two weeks, but I know that the fact that I opened up that conversation certainly helped.
17:48
SPEAKER_01: And so I'm excited to have them come in and get vaccinated.
17:51
SPEAKER_01: And then the important thing after that is that that mom will now tell her friends that her kid got vaccinated and nothing bad happened, right?
17:58
SPEAKER_01: And so you get this kind of domino effect.
18:00
SPEAKER_01: Because just like misinformation is contagious and spreads around communities, good information is as well.
18:06
SPEAKER_01: And so we encourage our families to post photos of their kids getting vaccinated on Facebook, let other families know that they're doing this to protect their kids and their community.
18:14
SPEAKER_01: And so every one or two kids that leaves here vaccinated can lead to a few more down the road.
18:19
SPEAKER_01: And that really helps with community immunity and eventually will help us get out of this pandemic faster.
18:24
SPEAKER_00: Yeah, I think that's an excellent point.
18:26
SPEAKER_00: And you know, I like that emphasis on being able to have a conversation with your trusted person, particularly your healthcare provider, your pediatrician.
18:35
SPEAKER_00: You know, I think the studies have shown that we, particularly as pediatricians, but healthcare providers in general, if we recommend vaccination for our patients and we bring it up, they listen.
18:45
SPEAKER_00: They do listen.
18:46
SPEAKER_00: And then, like you said, even if they don't act on it on in that visit, they're going to take that piece of information home and think about it.
18:52
SPEAKER_00: And, you know, we can we can have an impact on them for sure.
18:56
SPEAKER_00: So I know you've done a lot of work in advocacy.
18:59
SPEAKER_00: If you'd like to talk a little bit about some topics there and how you would advise kind of other healthcare providers how how everyone else can get involved.
19:07
SPEAKER_01: Yeah, like I think anyone else, especially those of us in healthcare, sometimes we get frustrated because we see the same problem over and over again.
19:16
SPEAKER_01: And we always think like, man, there has to be a better way.
19:19
SPEAKER_01: Like I'm just frustrated that like this kid's not vaccinated or these kids aren't wearing their bike helmets, or you know, this kid drowned in a pool without a fence around it.
19:27
SPEAKER_01: And so we think about there's kind of three ways I find you can help kids or help families or help people.
19:34
SPEAKER_01: So one is just those intimate one-on-one conversations, which are probably the most effective, but they're the most time consuming and you can only reach a certain number of people each day.
19:43
SPEAKER_01: Then there's community things.
19:45
SPEAKER_01: So I think getting involved in your community is really helpful.
19:48
SPEAKER_01: So, you know, I speak to school boards and schools quite frequently.
19:51
SPEAKER_01: I'm involved with my local American Academy of Pediatrics chapter.
19:55
SPEAKER_01: And this allows me to kind of work on kind of a bigger level than just in my office.
19:59
SPEAKER_01: And then as I've kind of grown as a pediatrician, I've started doing more legislative advocacy, which is kind of like one of the biggest levels you can do this, which is where basically we're helping to make policy to change things.
20:11
SPEAKER_01: So, one example is with the measles outbreak that we had, we found that there was a tremendous number of children in Orange County, in my county where I live, who were not fully vaccinated before they went to school.
20:23
SPEAKER_01: And our like vaccination rate for the measles momstrabella vaccine in my community was something like 70% or something, it was very low, whereas we need about like 90 to 95% vaccinated to avoid outbreaks of measles.
20:37
SPEAKER_01: And the reason for that was it was a very easy exemption that families had.
20:41
SPEAKER_01: So they just had to sign a piece of paper, they didn't want to give their kid the vaccine, and then they can go to school and move on.
20:46
SPEAKER_01: And I thought that this was not great.
20:49
SPEAKER_01: And we were seeing kids suffer because of it.
20:51
SPEAKER_01: And I have a lot of patients who are immune compromised or have special needs, who, if they get measles or they get the flu or they get COVID, like they can die.
21:00
SPEAKER_01: They're at higher risk.
21:02
SPEAKER_01: And parents who do not vaccinate their kids honestly not only put their own kids at risk, but put a lot of these other children at risk.
21:08
SPEAKER_01: And they have the right to go to school as much as my kids do.
21:11
SPEAKER_01: And so I, as a pediatrician, helped to lobby my legislators up in Sacramento, the capital of California, on a bill that was introduced by Richard Pan, who is a pediatrician and what state senator in California, that got rid of non-medical exemptions for vaccines.
21:29
SPEAKER_01: So we became the third state in the country where, unless there was a legitimate medical reason for you to be unvaccinated, you had to be fully vaccinated to go to school.
21:38
SPEAKER_01: And after that bill passed, our vaccination rate in my county went from like 70% to like in the 90s in a year or two.
21:46
SPEAKER_01: And that was because families wanted to go to school.
21:48
SPEAKER_01: And like we talked about with misinformation, most of these families are pro vaccine, but they've been inundated with a lot of bad information.
21:56
SPEAKER_01: And they kind of, in their own mind, have this balance of risk.
22:00
SPEAKER_01: Versus benefit.
22:01
SPEAKER_01: And when they get inundated with this bad information, they find that in their minds, it's going to be too risky to vaccinate their kids.
22:08
SPEAKER_01: So a combination of talking to them on an individual level, doing some community outreach and doing some legislative work, we can really help change the balance and really put the onus on the benefits of the vaccine are going to outweigh any potential risks of the vaccine.
22:23
SPEAKER_01: So I think that's been really helpful.
22:25
SPEAKER_01: So on a personal level, it's been really impactful for my patients and my community for me to be able to get out there outside of my office and do advocacy work.
22:34
SPEAKER_00: Yeah.
22:34
SPEAKER_00: I think it really demonstrates that there's opportunities for all of us to get involved with vaccine advocacy for sure.
22:40
SPEAKER_00: So how how has your practice been handling all the requests for vaccination?
22:44
SPEAKER_00: What's your plan to get all the uh five to 11 year olds in Orange County vaccinated?
22:48
SPEAKER_00: I don't know how many have out there, but probably quite a few.
22:51
SPEAKER_01: We have a lot of kids here.
22:53
SPEAKER_01: It's been it's been super, super exciting.
22:55
SPEAKER_01: So we're we've been flooded with requests and it's really cool because you know, the again, these families have been waiting a really long time for this.
23:03
SPEAKER_01: Vaccinating kids is different than adults.
23:05
SPEAKER_01: Kids are more comfortable in a setting like their pediatrician's office.
23:08
SPEAKER_01: And I think most parents want to get the vaccine here rather than at a pharmacy or a place where kids have never been.
23:14
SPEAKER_01: So we are trying our hardest to be able to open up our office to as many kids as possible.
23:20
SPEAKER_01: The caveat being this is the busiest time for a pediatrician.
23:24
SPEAKER_01: We're we're like, you know, entering the height of cold and flu season.
23:27
SPEAKER_01: We're still trying to get kids flu vaccines.
23:29
SPEAKER_01: We are short-staffed like the rest of the world right now, and we're trying to accommodate as many patients as possible.
23:35
SPEAKER_01: So we are doing clinics.
23:37
SPEAKER_01: So we have clinics three days a week, one on Saturdays, and then after school on Monday and Thursdays in my office.
23:44
SPEAKER_01: We're trying to accommodate as many people as possible.
23:46
SPEAKER_01: We have an all hands-on-deck approach.
23:48
SPEAKER_01: We are having everybody who's trained give vaccines.
23:51
SPEAKER_01: So I am giving lots of vaccines personally.
23:54
SPEAKER_01: I worked all day on Saturday giving vaccines, and it was incredible.
23:58
SPEAKER_01: A lot of hugs, a lot of tears of joy, a lot of smiling, a lot of laughing.
24:03
SPEAKER_01: I've never seen so many kids so eager to get a shot before.
24:06
SPEAKER_01: It was really, really exciting.
24:08
SPEAKER_01: And we're trying to ramp up our efforts because our clinics are sold out or booked up for the next three weeks.
24:14
SPEAKER_01: So we're going to try to add in some more slots to try to uh accommodate as many people as possible.
24:20
SPEAKER_01: But it's been really remarkable.
24:21
SPEAKER_01: It's a good reminder of why it's great to be a pediatrician and the good that we can do here working with kids.
24:28
SPEAKER_00: Yeah, I have to say, you know, it's been pretty exciting to see how excited the kids are to come in to get this vaccine.
24:34
SPEAKER_00: Like a lot of them are saying, let's go, I want to get it done.
24:37
SPEAKER_00: They they wanted to get it done like, you know, five months ago.
24:40
SPEAKER_01: These kids have really suffered, you know.
24:42
SPEAKER_01: So not only the physical aspects of COVID, which has been terrible, and you know, more kids have died this year of COVID than die in the usual flu season.
24:50
SPEAKER_01: And we've hospitalized tens of thousands of kids, and you know, millions have been sick.
24:55
SPEAKER_01: I personally have hospitalized about a half dozen kids with it.
24:59
SPEAKER_01: And some who have long symptoms that I don't think are going to get better, that are that are persisting.
25:04
SPEAKER_01: So not only the physical things, but the emotional and the social aspects of this.
25:08
SPEAKER_01: So these are kids who have missed at least a year of school.
25:11
SPEAKER_01: These are kids who have had a hard time socializing in a safe way over the past year.
25:16
SPEAKER_01: And they've been watching everyone else get vaccinated and get back to life to some degree.
25:20
SPEAKER_01: And they haven't.
25:20
SPEAKER_01: And it's so exciting for them.
25:22
SPEAKER_01: I'm I'm thrilled that we're finally able to offer this to kids.
25:25
SPEAKER_00: Yeah, I think it was great news all around.
25:28
SPEAKER_00: And I think it's a great opportunity to, like said, really have an impact on the pandemic.
25:33
SPEAKER_00: So this part might be a little difficult to predict.
25:35
SPEAKER_00: I always say I don't own a crystal ball, but I could really like one.
25:39
SPEAKER_00: But do you have any guesses on when kids under five might get eligible?
25:43
SPEAKER_01: I'm not positive, but I know that the next group coming out, I believe, is ages two to five.
25:50
SPEAKER_01: And so it's a little harder with kids, right?
25:52
SPEAKER_01: Because the first thing you have to do is figure out the dose.
25:54
SPEAKER_01: So, you know, we had to figure out the 10 micrograms was the right dose to induce an immune response for the five to 11 year olds.
25:59
SPEAKER_01: And so once they figure out the dose for the two to five year olds, then they have to do the trial where they give it to some kids and they give a placebo to some kids and see how effective it is.
26:08
SPEAKER_01: My understanding is sometime after the new year, hopefully, I mean, it'd be amazing, January or February would be my best guess of when the next group of children should be available to receive their vaccine.
26:20
SPEAKER_01: So fingers crossed that that's when this is coming up.
26:22
SPEAKER_01: And then I think they're going down to as low as six months.
26:25
SPEAKER_01: So these will probably roll out over the next few months.
26:28
SPEAKER_01: I'm hoping.
26:28
SPEAKER_01: The five to 11 year olds that we're doing now is really huge because this is their school age population.
26:34
SPEAKER_01: And not that the little kids don't matter.
26:35
SPEAKER_01: We want to make sure they're vaccinated, we want to make sure they're protected.
26:38
SPEAKER_01: But what we see from, for example, influenza outbreaks every year is that these school age kids tend to drive that.
26:45
SPEAKER_01: And a lot of them spread this around in school, come home, get their family sick, and spread it in the community.
26:51
SPEAKER_01: So every kid that we can vaccinate is one fewer person who's a carrier for this virus.
26:57
SPEAKER_01: And every kid we vaccinate brings us one day closer to being done with the pandemic.
27:02
SPEAKER_00: Yeah, absolutely.
27:04
SPEAKER_00: All right.
27:04
SPEAKER_00: Well, I think we're about ready to wrap up our conversation.
27:07
SPEAKER_00: Do you have any final thoughts?
27:09
SPEAKER_00: Anything else that you want to share with our listeners?
27:12
SPEAKER_01: Yeah, I think the biggest thing, especially for parents, is if you are concerned, is talk to your pediatrician, talk to your family practice doctor, talk to a trusted healthcare provider who can tell you the truth and tell you the facts about the COVID vaccine for kids.
27:26
SPEAKER_01: One thing I always ask my own doctors is I say, what did you do?
27:31
SPEAKER_01: You know, so I love telling the story of why I vaccinated my two teenage children, why they were the first ones to get the vaccine as the day it was available.
27:40
SPEAKER_01: So feel free to ask your provider what they recommend and what they did themselves.
27:45
SPEAKER_01: And I would close with a statement that I saw on the internet, which I love, which is that the vaccine is safe, but COVID is not.
27:53
SPEAKER_01: And that's the best reason to vaccinate your kids.
27:56
SPEAKER_00: That's great.
27:56
SPEAKER_00: That's a great thought to leave everybody with.
27:58
SPEAKER_00: Well, thank you so much for taking time out of what I'm sure is a busy day in your office.
28:04
SPEAKER_00: You got to get back out there and vaccinate all those kids.
28:06
SPEAKER_00: So thanks so much for joining us.
28:08
SPEAKER_01: Thanks for having me.
28:09
SPEAKER_01: I appreciate it.
28:11
SPEAKER_00: So thanks again to Dr.
28:12
SPEAKER_00: Eric Ball for sharing his perspective and experiences.
28:16
SPEAKER_00: This podcast can be accessed on Shay's Online Education Center, Learning CE, under the Rapid Response Program, where you'll also find resources such as the Shea COVID-19 town halls.
28:28
SPEAKER_00: This concludes today's episode of the Rapid Response Podcast.
28:32
SPEAKER_00: And thank you so much for tuning in with us today.