I’m a pediatrician. Here’s what I want you to know about vaccines.

By Dr. Katherine Williamson, a CHOC pediatrician

dr-katherine-williamson
Dr. Katherine Williamson, a CHOC pediatrician

Proper vaccination is important for all people, but especially infants and babies. When children follow the recommended immunization schedule outlined by the American Academy of Pediatrics (AAP), they are better protected against potentially life-threatening diseases.

During the COVID-19 pandemic, your CHOC pediatrician’s office is a safe, physically distant environment to keep your child and family safe while still delivering high quality preventive care.

As a pediatrician during COVID-19, I get a lot of questions about baby vaccination and vaccines for children. Here are the most common questions I’ve gotten about vaccines during COVID-19– and why maintaining your child’s immunization schedule is more important than ever.

Can I delay my child’s vaccines during COVID19?

Getting vaccinated on time is important because even though we have the threat of COVID-19 to contend with, all the diseases that we can prevent easily with vaccines are still a threat. These diseases — such as whooping cough and measles — are ready to emerge at any time that we don’t have the majority of our kids vaccinated.

Recent data released by the World Health Organization and the Centers for Disease Control and Prevention showed that measles deaths worldwide reached the highest level in 23 years last year. Although no measles deaths were reported in the U.S., the number of measles cases nationwide were at their highest point since 1992. Public health experts have linked the increases in measles cases to insufficient vaccine coverage.

If we don’t keep our kids protected against measles and other fatal diseases, the risk for further emergence is going to be very high. While we are waiting for a COVID-19 vaccine to stop the pandemic, it is up to us to keep our kids safe and prevent any future epidemics by using the tools we already have to prevent disease.

Do I really need a flu shot every year?

It’s important that each member of your family get their flu shot every year. This is especially true this year, amid the COVID-19 pandemic. Since both influenza and COVID-19 can have overlapping symptoms, it may be difficult for doctors to determine which virus is behind your symptoms based on a clinical exam alone, according to pediatric infectious disease experts at CHOC.

These overlapping symptoms may include, but are not limited to:
Fever or chills
Cough
Shortness of breath
Fatigue
Sore throat
Runny or stuffy nose
Muscle pain or body aches
Headache

Learn more about why getting a flu shot is more important than ever this year.

Are vaccines safe?

Vaccines are one of the most important things we can do to help protect our children’s health. Vaccines and proper handwashing, more so than all other interventions, have proven to be the most safe and effective ways to prevent disease.

What is the proper vaccine schedule?

The current immunization schedule outlined by the AAP and Centers for Disease Control & Prevention has been researched and proven to be the most effective and safest way for children to be vaccinated against potentially fatal diseases. It’s important to know that no alternative schedule has been shown to be as safe and effective.

Is it better to do multiple vaccines at one time or space them out?

The safest way to keep your child safe from vaccine-preventable diseases is to get all their vaccines on time. There is no advantage to spacing them out, and instead the longer you wait, you increase the risk of them catching one of the preventable diseases before you protect them.

The amount of antigen (protein) in each vaccine is so tiny that your immune system can process multiple vaccines at one time and build an antibody “army” to protect your child for each of those potentially fatal diseases. In fact, the amount of antigen (protein) in each vaccine is 100,000 times less than if your child has a common cold, so there’s no concern about overwhelming their immune system when they get their vaccines.

What can I do to make my child more comfortable while receiving a vaccination?

Studies have shown that preparing your child for vaccinations should ideally include three components: explaining what will happen, how it will feel, and strategies for coping with any related stress or discomfort. Here’s more tips on how to make shots less stressful.

This article was updated on Nov. 16, 2020.

Why getting a flu shot is more important than ever this year

It’s important that each member of your family get their flu shot every year. This is especially true this year, amid the COVID-19 pandemic. Since both influenza and COVID-19 can have overlapping symptoms, it may be difficult for doctors to determine which virus is behind your symptoms based on a clinical exam alone according to Dr. Jasjit Singh, pediatric infectious disease specialist at CHOC.

dr-jasjit-singh-choc-childrens
Dr. Jasjit Singh, a pediatric infectious disease specialist at CHOC

“Access to testing for both viruses will be essential to determine the cause of the illness and help inform care decisions,” Singh says.

These overlapping symptoms may include, but are not limited to:

  • Fever or chills
  • Cough
  • Shortness of breath
  • Fatigue
  • Sore throat
  • Runny or stuffy nose
  • Muscle pain or body aches
  • Headache

Dr. Singh adds, “Influenza season and the ongoing COVID-19 pandemic present an overlapping utilization of the same resources, including personal protective equipment (PPE), hospital beds and equipment. It’s essential that we all do our part in curbing the spread of influenza this season to limit any potential strain on these resources.”

There is also growing concern among providers that people could become infected with both viruses at the same time, according to Dr. Singh.

“This year more than ever, it is important to get a flu shot to offer as much protection as possible from influenza ,” says Dr. Singh

In this Q&A, Dr. Singh answers some other common questions parents have about the influenza vaccine amid COVID-19.

When is the best time to get a flu shot? Is it possible to get the flu shot too late?

The Centers for Disease Control recommends people get vaccinated against influenza by late October, before the influenza season starts. However, it is not too late to get your flu vaccine.  Anyone who has yet to receive their annual influenza vaccine should still get vaccinated. Your annual influenza vaccine can protect you from getting infected with influenza, and importantly, can also help prevent serious outcomes, including hospitalizations or death.

What time of day should you get a flu shot?

There is no specific time of day that makes a flu shot more or less effective. Choose a time that is convenient and available for you and your provider.

What are the side effects of getting a flu shot? 

Some patients experience low grade fever, muscle and joint aches, headaches or nausea.  You cannot get influenza infection from the flu shot, but some patients can experience mild “influenza-like symptoms” for up to two days after receiving the vaccine. Some patients also experience redness and swelling around the injection site. Here are some tips for making shots less stressful for kids.

How can I protect my family from influenza this year? How can I protect my family from COVID-19?

Besides getting an influenza vaccine, washing your hands – properly and often – is the single best way to protect yourself against influenza. Here’s advice from a pediatrician on proper hand-washing.

To further protect yourself and your family from the flu this season, remember these tips:
Stay home when you’re sick, and stay away from others who are ill
Cover your nose and mouth when you cough
Get enough sleep
Eat a well-balanced diet

With no COVID-19 vaccine currently available, the best way to prevent this illness is to avoid being exposed. It’s also important to take preventative steps:
The CDC recommends the use of cloth face coverings in public for those over age 2
Practice physical distancing
Avoid large gatherings, particularly indoors
Avoid close contact with people who are sick.
Avoid touching your eyes, nose and mouth.
Stay home when you are sick.
Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing or sneezing.
The CDC recommends laundering items including washable plush toys as appropriate following the manufacturer’s instructions. When possible, use the warmest appropriate water setting for the items and let them dry completely. Laundry from an ill person can be washed with other people’s items.
Check out this list of how to prepare your household for a potential COVID-19 outbreak.

Featured image c/o the American Academy of Pediatrics & SELF magazine.

Stomach Flu vs. Influenza

Many people talk about the “stomach flu” when they’re feeling sick to their stomachs. It isn’t the same as influenza or the flu. Stomach flu is an illness called gastroenteritis, which is usually caused by a virus. The seasonal flu, or influenza, is a virus in the upper respiratory system. Each year from October to May, millions of people all across the U.S. come down with the flu.

Stomach flu (gastroenteritis)

Someone with the stomach flu may have the following symptoms:

  • Stomach cramps
  • Diarrhea
  • Fever
  • Nausea
  • Vomiting

He or she will usually feel sick for a day or two and then feel better. Unfortunately, there is no vaccine or cure for the stomach flu or gastroenteritis. Here’s how you can make the stomach flu go away:

  • Get lots of rest
  • If you’re throwing up, avoid solid food. When you feel up for reintroducing food, start with bland items like bananas, rice, applesauce or toast.
  • Sip fluids, such as water, or try a popsicle.
  • To avoid dehydration, sip small amounts of beverages that contain electrolytes.

Seasonal flu (influenza)

When people have influenza, they usually feel worse than they do with a cold. Most people start to feel sick about two days after they come in contact with the flu virus. They might have:

  • Fever
  • Chills
  • Headache
  • Muscle aches
  • Dizziness
  • Loss of appetite
  • Tiredness
  • Cough
  • Sore throat
  • Runny nose
  • Nausea or vomiting
  • Weakness
  • Ear pain
  • Diarrhea

Sometimes, influenza can turn into pneumonia. This is especially dangerous for babies, or kids and adults with pre-existing health conditions. If you think your child has influenza, see a doctor.

How to treat the flu

Most kids with influenza will get better at home. Make sure your child:

  • Drinks plenty of fluids
  • Gets plenty of sleep
  • Takes acetaminophen or ibuprofen to relieve fever and aches.
  • Wears layers that are easy to remove. Children might feel cold one minute and hot the next.

Fever and most other flu symptoms often go away in about five days, but kids may experience a lingering cough or feel weak. Children should be kept home from school or daycare until they have been fever-free for 24 hours.

Tips for keeping your kids safe from the seasonal flu:

There are several things you can do to help your family avoid the seasonal flu.

  1. Get a flu shot. It’s better to get vaccinated later in the season than not at all. The Centers for Disease Control recommends annual influenza vaccinations for everyone 6 months and older.
  2. Practice proper hand washing. Besides getting a flu shot, proper hand-washing is the best way to prevent the spread of illness, including the seasonal flu.
  3. Stay away from people who have a fever. Ask friends, family and caregivers who have had a fever or chills within the past 24 hours to stay away from your child. Likewise, keep your little ones home from school or daycare for 24 hours after they’ve had the same symptoms.

6 Ways to Keep Your Kids Safe from the Flu

Flu season is here. We spoke to Dr. Katherine Williamson, a CHOC pediatrician, about how to keep your kids safe from the flu.

Dr. Katherine Williamson
Dr. Katherine Williamson, a CHOC pediatrician

#1 Get the flu shot

Make sure that each member of your family gets the flu shot every year. The Centers for Disease Control recommends annual influenza vaccinations for everyone age 6 months and older. Vaccinations are especially important for those at increased risk for flu complications, including pregnant women. Encourage family members and caregivers around your child to get the flu shot. Of the more than 170 pediatric deaths from the flu during the 2017-2018 influenza season, 80 percent of those did not receive a flu shot.

#2 Practice proper hand washing

Remind your child that we always wash our hands for at least 15 seconds (always with soap, and always with vigorous rubbing) after using the restroom, before and after eating, after playing outside, and after sneezing, coughing or touching your face. Aside from getting the flu shot every year, proper hand washing is the best way to prevent the spread of illnesses including the flu.

#3 Stay away from people who have a fever

Ask friends, family, or caregivers who have had a fever or chills within the past 24 hours to stay away from your child. Do not send your child to school or daycare for at least 24 hours after they experience a fever or chills.

#4 Teach proper cough etiquette

Teach your child to cover his nose and mouth when he coughs. Parents should model good behavior.

#5 The importance of sleep

Sleep! The best immune system boost you can give your child is good sleep at any age. The right amount of sleep for your child is however much sleep he/she needs when he/she can wake up naturally without an alarm clock or mommy clock waking them up. For some kids this is 8 hours, while other need more than 10.

#6 Healthy eating

Healthy vegetables, fruit, and protein. You are what you eat! Eating processed sugar-filled foods can decrease your immunity by inhibiting your body to fight against diseases. Offer your kids healthy foods without the option of choosing the less healthy snack. They will eat when they are hungry, and when they are hungry, make sure it is healthy options that are available.

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Should I Take My Child to the Pediatrician, Urgent Care or Emergency Department?

By Dr. Sarah Kay Herrera, a CHOC pediatrician

At CHOC, we know that parents want to be confident they’re giving their child the best care. In order to do that, you need to know where to bring them when they’re sick, but the problem is there are so many options: Do I bring them to the pediatrician’s office? Urgent care? Emergency department? This can make you feel overwhelmed and confused – especially with cold and flu season just around the corner.

We believe parents should have peace of mind they are getting their child the best care. We know it can be scary, stressful and sad to have a sick child. That’s why our Primary Care Network has 16 convenient locations throughout Orange County and beyond. CHOC Hospital in Orange offers the only emergency department in Orange County that’s just for kids. At the Mission Hospital Emergency Department, in partnership with CHOC at Mission Hospital, kids and families have access to pediatric-trained nurses, physicians and specialists.

To help you make decisions about where to go for care, consult this guide:

1. Pediatrician

Your pediatrician’s office is not only a place for check-ups, but your primary resource for sick visits as well. Your child’s pediatrician is the doctor who already knows your child’s medical history.

  • You will need to set an appointment for a sick visit, which could include symptoms like fever, runny nose, cough, ear pain, headaches, sore throat, rashes or abdominal pain.
  • If your child is experiencing a chronic lingering issue such as abdominal pain or headaches, it is best to see your pediatrician as they can provide ongoing care and find a pattern in the symptoms, which is important for more complex illnesses.

Here’s a helpful guide of what to bring to the pediatrician’s office.

2. Urgent care

  • Urgent care offices are usually open after business hours, which is typically after 5 p.m. and weekends.
  • Most are walk-in clinics and do not take appointments. This means you can usually expect long wait times. This is the best place to go for acute illness such as fevers, ear pain, runny nose, cough, sore throat, vomiting, diarrhea, minor falls, and stitches.
  • Sometimes your pediatrician or an urgent care provider may decide your child is too ill to go home and they may send you to the emergency department for further treatment or testing.

Emergency department

  • In some cases, it’s best to go straight to the emergency department for apparent life-threatening events, which could include rapid and fast breathing, head trauma, trauma with loss of consciousness or vomiting, motor vehicle accidents, severe abdominal pain or dehydration.
  • An infant less than 28 days old with a fever of 100.4 degrees or higher is considered an emergency and should be taken directly to the ED.
  • Here’s a helpful checklist of what to bring to the emergency department.
  • Not all urgent care clinics and emergency rooms take care of children on a regular basis. It is best to go somewhere that specializes in children’s health. Pediatric-focused facilities have specialized training and equipment to offer the best care for your child.
  • Most pediatrician offices have a phone triage line to help parents decide which place may be best for their child.