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COVID-19 Vaccination and Younger Children

Submitted by Dr. John Maddox, Pediatrician, Pentucket Medical/Haverhill

Now that those age 16 years and older are able to receive the COVID vaccine, pediatricians are fielding questions about when younger children will be next.

Vaccines typically spend years being studied for effectiveness and safety. That process was understandably expedited due to the lives being lost due to COVID illness. COVID’s is the first vaccine to ever be approved under the Emergency Use Authorization (EUA) process. As with any medical treatment, there is always a balance between benefit and risk. Every treatment carries some risk that must be considered in comparison to its benefit.

The risks of the vaccine for an individual age 65 and older are much, much lower than the risks of COVID. That math is very different for children under age 16, where the risk of death from COVID is one tenth of one percent.  Even the risk of the treatable multi-inflammatory syndrome (MIS-C) is 2 per 100,000 — which means that most pediatricians will never see a case. For children, we will have the luxury of time when evaluating the effectiveness and safety of the COVID vaccine.

Until most adults have been vaccinated, we need to continue general mask-wearing and social distancing. But children can safely return to their childhood, including in-person school, without delay. Immunizing children has always been an important piece of preventing infectious diseases and building herd immunity, but we can focus our attention now on vaccinating as many adults as soon as possible.

Walk-in Urgent Care Available at ExpressCare Riverwalk

Walk-in urgent care services are once again available at ExpressCare located at 370 Merrimack Street in Lawrence.

To support all our patients’ healthcare needs, we will continue to provide respiratory care and treatment safely in a dedicated, isolated space at our Respiratory Illness Clinic at the same location. Walk-in respiratory care is also available.

COVID-19 Vaccine Distribution

 

  • Given the large demand and limited supply of vaccines, Mass General Brigham is following Massachusetts’ phased plan and therefore in this phase is only offering vaccines to patients ages 75 years and older.
  • Please sign up for a Patient Gateway account if you not already done so. This will be Mass General Brigham’s primary means for managing the vaccination process.
    • Mass General Brigham will begin reaching out to eligible patients soon via Patient Gateway, email, phone calls, and text messages. We are in an ‘outreach only’ phase so patients will be notified when they have been selected. Please do not call Pentucket Medical with questions about your status.
    • Selection for “invitation” is random, but special consideration is being given to more heavily impacted communities such as Lawrence and Haverhill.
  • Pentucket Medical will begin vaccinating patients at Haverhill-Primrose beginning Wednesday, February 3.
  • Eligible patients can also find other locations and schedule a vaccine appointment through the Massachusetts web site. This resource should be considered in addition to ongoing Mass General Brigham efforts.
  • For additional information please click here.

How can I prevent my child from developing diabetes, which runs in my family?

By Dr. John Maddox, Pediatrician
Pentucket Medical/ Haverhill

There are two types of diabetes. Type 1 develops in childhood, but it is less likely to run in families. Unfortunately, based on current knowledge, there is not as much a parent can do to prevent type 1. Thankfully, this type is more rare. I’ll add that families that deal with type 1 are some of the most resilient that I have seen as a pediatrician.

Type 2 is more likely to run in families but is also much more preventable. Diabetes, as its core, is about not having enough insulin to help glucose get from the blood stream into the body’s cells to provide energy. The primary key to avoiding type 2 comes from good nutrition. All foods are eventually digested into glucose (also called blood sugar) as our fuel. Foods that are digested slowly allow our body’s pancreas to release insulin slowly, creating a gradual rise and fall of input and output that generates optimal health. Foods that are slowly digested (like an apple) have a low glycemic index; foods that are rapidly turned to sugar (like a potato) have a high glycemic index.

Fascinating new research reveals that a window of taste preference exists for infants ages 6-12 months. A baby might make a face the first few times peas or green beans are offered. However, with 8-10 days of persistence, we can successfully prime their palate for a healthier lifetime ahead.

Should schools be open or closed during COVID?

By Dr. John Maddox, Pediatrician
Pentucket Medical/ Haverhill

School staff and families are experiencing tremendous fatigue from the heroic work to maintain in-person education during the COVID pandemic. Millions of hours and millions of dollars have gone into mitigation efforts (like masks and distancing and ventilation).

Most schools use a hybrid model, with each student only in the building 2 days per week. Furthermore, close contacts are quarantined. These modifications significantly reduce the likelihood of COVID spread.

Given the benefits of in-person education and the health risks of COVID, decisions about if and when to temporarily shut schools are very complex — requiring wise judgment. It’s important to avoid being reactionary, when fear clouds fact. The fundamental question should be: “is having our school open right now making the pandemic here now worse?”

Massachusetts has its system of red, yellow and green communities, which marks the degree of caution each district should be using in its decisions. This is a particular challenge for urban cities, where both the rates of COVID and the harms of remote education are highest.

To use a baseball analogy, closing a school is like shifting the infield to double play depth when a runner is in scoring position with one out. It’s a tool that gets you out of a pinch. If this school year were a game, we’d be in the top of the 3rd inning. We need to encourage and reward good managers, who keep an eye on the long view and the final outcome.

Teens and Mental Health

By Dr. John Maddox, Pediatrician
Pentucket Medical/ Haverhill

Photo by Polina Zimmerman from Pexels

A recent personal experience with the sadness and shock of suicide weighs on my mind these days. Suicide is the 2nd leading cause of death in the US, among ages 15-24. Rates have increased by 41% over the past 17 years. Males have a rate three times higher than females. Dismal statistics like these can sometimes be numbing, which discourages the hopeful proactive energy we need to bring, in order to prevent future tragedy.

When listening carefully to people who have considered suicide, one element that comes up invariably is psychological pain. The pain of loneliness or unworthiness can be as real and unbearable as physical pain. We humans are built for connectedness: an antidote to isolation. The time and energy invested in relationships reinforces that each of our days matter. We are grateful for those who help us, and we take joy in the opportunity to help others.

World Mental Health Day is this Saturday October 10th. Read more about “10 Things Parents Can Do to Prevent Suicide”

En Espanol

5 Reasons Why Everyone Needs a PCP

A primary care physician (PCP) is always there for you, whether you have a common cold, need help managing a chronic condition, or are due for an annual checkup. These doctors tend to be the entry point for patients first entering the medical system, and developing a good working relationship with one is very beneficial to you and your health. Here are five reasons why you should have a PCP by your side.

1. Your Primary Care Physician Knows You

Having an established relationship with your PCP allows him or her to be familiar with you and your family’s medical history. This makes it easier for them to find patterns in your health and know how your body responds to certain illnesses.

2. A PCP is Your Entry Point to the Continuum of Care

Having a PCP is a great way to learn how to navigate the somewhat complicated medical system. They can refer you to specialists who may be more knowledgeable about a specific health issue. Through Pentucket Medical you have access to a network of primary care, medical specialists and urgent care services throughout the Merrimack Valley.

3. You Have Lower Out-of-Pocket Costs

A primary care physician co-pay is typically much cheaper than a visit to an emergency room. Having a go-to doctor who you can easily set appointments with creates a much lighter burden on your wallet, especially in the long run. Take a look at your insurance card to see the difference in cost between an office and emergency room visit.

4. A PCP Can Help You Reach Your Goals

Have goals like weight loss, eating better or general wellness? Your primary care physician can work with you to plan out how you can achieve your goals. Your doctor can recommend diets, exercise plans, and more to help you on your wellness journey.

5. You Can Receive High-Quality Preventive Care

In addition to providing care for acute illnesses and chronic conditions, your doctor can help you take measures to prevent their onset. Your PCP keeps track of your health over time, performs preventive services and screenings to catch diseases early, and offers advice to help you maintain a healthy and happy life.

Establish a relationship with a Pentucket Medical clinician today and start on the path to a healthier you. Our doctors offer same or next-day appointments, online scheduling through the Patient Gateway and an extensive list of accepted insurance plans.

cite: Baylor Medical Center

Sources:
U.S. News & World Report | How to Find the Best Primary Care Doctor
NCBI, U.S. National Library of Medicine | Contribution of Primary Care to Health Systems and Health

 

 

Kids and Screen Time

By Dr. John Maddox, Pediatrician
Pentucket Medical/ Haverhill

In every era, it seems that adults wring their hands over the new technologies to which their younger generations of children are exposed — the telephone, the TV and now the internet with all its many branches. New technologies obviously allow new capabilities and innovations for people of all ages, but pediatricians continue to try to tease out the good from the bad effects of “screen time” — as we counsel parents and youth about ways to prevent and correct some undeniable pitfalls of excessive use. Teens aged 13-17 spend an average of almost 9 hours per day using screen media. 45% of adolescents say they are online “almost constantly.” 54% of adolescents say they spend too much time on their cell phone.

Check out the following Family Media plan, relevant for all ages. If you think your child is using media too much, or becomes aggressive when you try to set limits on their media use, talk to their health care provider about your concerns, and ask for guidance on helping them cut back.
https://www.healthychildren.org/english/media/Pages/default.aspx#home

Mask Mythbusters: Five Common Misconceptions about Kids & Cloth Face Coverings

Submitted by Dr. John Maddox, Pediatrician, Pentucket Medical/ Haverhill

1.        Can wearing a mask make it harder for my child to breathe?

Recommended cloth face coverings do not block the exchange of oxygen or carbon dioxide.  The vast majority of children age 2 or older can safely wear a cloth face covering for extended periods of time; this includes children with many medical conditions.  Begin now having your child wear masks at home.  Start with short periods, when they are doing their favorite activities, and gradually increase the length of time, so they get used to it.  All schools will offer mask breaks.

2.       Can masks themselves spread germs?

Masks get damp over time, from the same respiratory droplets that spread COVID, flu and other germs, so face coverings should washed regularly.  It is important to have cloth face coverings that fit a child’s face well, so that they are not tampering with the mask.  You should perform hand hygiene before and after touching your face covering.

3.       Can a child with special health care needs, like the autism spectrum, wear a mask?

Some children will need extra attention to the way a mask feels and fits and smells.  Some kids will benefit from strategies like Social Story (see below), which help explain new situations with both descriptions and directives.  Schools are prepared for some students with special needs to be unable to wear masks full-time right away.  Occupational therapists and applied behavior therapists will work with students to teach them new and important skills.

4.      Should a kid wear a mask during sports?

Cloth face coverings help young athletes protect their teammates and themselves.  They also help protect the sports season.  Whenever safe and possible, athletes should wear a cloth face covering.  This includes on the sideline bench, in team chats and going to and from the field.  Exceptions include when they are actively exercising.

5.       Do masks really prevent the spread of COVID-19?

Cloth face coverings are one of the most effective ways to prevent the spread of COVID, flu and other germs.  Very early on in the pandemic, there was concern about having enough masks for health care workers, so widespread mask use was discouraged.  However, it is very clear now that states, communities, and schools that have contained COVID— despite imperfect social distancing, ventilation and hand hygiene— have used cloth face coverings to prevent spread, even in asymptomatic people.

 

https://www.healthychildren.org/English/health-issues/conditions/COVID-19/Pages/Cloth-Face-Coverings-for-Children-During-COVID-19.aspx

https://www.healthychildren.org/spanish/health-issues/conditions/covid-19/paginas/cloth-face-coverings-for-children-during-covid-19.aspx

https://drive.google.com/file/d/1R1lSbfZ8TRchbHCiK_4svK7WLH62lS

https://vkc.mc.vanderbilt.edu/assets/files/tipsheets/socialstoriestips.pdf

https://www.nytimes.com/interactive/2020/08/19/well/childrens-face-masks-comfort.html

Vaccine Appointment Scheduling

Mass General Brigham patients age 12 and older can schedule a vaccine appointment on our new scheduling website. Please note, any patient under 18 needs a parent or guardian’s consent which can be found here.

COVID-19 Information