Pediatrician’s Advice About H1N1 – Follow-up

Several weeks ago, I posted a letter from our pediatric office regarding the H1N1 virus, the hysteria surrounding it, and some advice about the vaccine. It got a lot of hits, so I thought I would post the follow-up letter that we received about a week and a half ago for your perusal. Hopefully, this will continue to take some of the edge off this relatively mild virus. As with the first time, the italics represent a direct quote from the letter written by Diane Holmes, M.D. and Kenneth Polin, M.D.

We are now into the seventh month of this outbreak, and fortunately, the overall severity of this infection has not increased.  The media reports the most severely affected patients without regard to the significant numbers who are not very ill and recover easily.  According to Center for Disease Control estimates, almost 6 million individuals have been infected, generating approximately 20,000 hospitalizations.  By those statistics, an individual with H1N1 disease has less than a 0.3% chance of even being sick enough to be hospitalized.  Please try not to fall prey to the media-based hysteria.  They are only giving the part of the story that draws viewers.

As we talk with our pediatrician friends in the area, we are all frustrated both with the lack of vaccine and the limitations of administration.  The entire H1N1 vaccine supply in the US is channeled through the federal government and subsequently through state and then local health departments.

Unfortunately, their efficiency is not always up to the standards we would like.   With all our staff working as hard as possible and with some of our nurses and doctors putting in extra time to just vaccinate, we have been able to give slightly more than 2,000 doses of the vaccine so far.  We understand your frustration if your child is not yet in that group.

Please understand that all pediatric patients are now considered in the priority group for the vaccine.  Even if we had enough vaccine for everyone (and we certainly do not) and our personnel did nothing but vaccinate all day, every day, it would still take more than 12 days to give the vaccine to everyone who wants it.  We absolutely want to vaccinate as many children as possible, but we need to also continue seeing sick children and give other essential vaccines.  One additional avenue to obtain the vaccine for your child is to bring him/her along with your other child’s scheduled visit.  We are happy to accommodate you if the proper vaccine is available that day.  Just ask the secretary to pull out the charts for the other child(ren), too, when you check in.

Another area of frustration is in trying to make practice adjustments keep in compliance with changing CDC guidelines.  This might result in inconsistent information at times being given to you by our staff.  We can only continue to try to do our best.

Please know that we take all pediatric illness very seriously.  Symptoms of flu (cough, congestion, fever, muscle aches, sore throat) do not routinely need to be seen in the office or the Emergency Department.  If at any point, however, you have concerns about your child’s illness (especially any fever lasting longer than 72 hours, any breathing compromise, child looking progressively sicker, child unable to drink) you should have your child seen. One frequently asked question is “What is the fever number that we should worry about?”  In children over 6 months of age, there is no “worry number.”  Always evaluate your child’s situation in context and trust your parental judgement.  A child with a 104 fever who is droopy but alert, breathing easily and able to drink is much less concerning than the child whose fever is 101 but is not alert, has respiratory issues, doesn’t have good color or is getting dehydrated.

Many thanks to those of you who have expressed appreciation to our office staff and our nurses recently for all their hard work during this very stressful time.  Your kindness and understanding is truly appreciated.

As always, we are trying to be as responsive to your concerns as possible.  Together, we will get through this.

Be Well!

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