No walk-in flu clinic for 11/14
November 13, 2009 by Kenneth Carlson, MD
Until further notice H1N1 influenza vaccines will be given by appointment only. Currently all available shot appointments are filled or being filled by those on waiting list. To get your child on a waiting list send an email to h1n1@childhoodhealth.com. At this time the waiting list is only for H1N1 influenza vaccine. We are having two of our nurses working full time to manage the list and administer vaccine.
We received two batches of vaccine making this week the best for vaccine shipments for our clinic. We are working to get it quickly into kids. The first batch was only for four years and up while second batch included vaccine that can be given to all children 6 months and older.
We did receive some nasal seasonal vaccine from the state for our patients on the Oregon Health Plan or uninsured (Vaccine for Children program). We still do not have more doses for patients on commercial health plans. The nasal vaccine can be given to patients 2 years and older without asthma or other serious chronic disease. We will start scheduling for seasonal flu vaccines once we have more doses available. No injectable seasonal vaccine is available at this time.
To help find locations for vaccine, google started a map at: Google flushot map
Influenza vaccine update
October 14, 2009 by Kenneth Carlson, MD
Things are changing rapidly!
H1N1 vaccines are dribbling in on a weekly basis and we are already used up the few doses we have received. We don’t anticipate having doses available for our Saturday clinic. We will post update once that changes. We have ordered several thousand dosages but are dependent on public health system on how and when they get distributed.
Seasonal influenza vaccine has currently run out. We are anticipating another 1000 dosages likely sometime next month. Many vaccine producers temporarily halted seasonal flu vaccine to allow for production of H1N1 vaccine. Fortunately seasonal influenza usually doesn’t become common January to March.
H1N1 (“swine”) influenza vaccine has arrived
October 13, 2009 by Kenneth Carlson, MD
Just this week we are beginning to have our initial doses of H1N1 vaccine arrive. Our first shipment included nasal vaccine. Injectable is anticipated to arrive this week.
We are continuing to have walk-in flu shot Saturdays from 9am to 12noon. Our staff are successfully keeping up with unprecedented volume and waits for families have been short.
Injectable H1N1 vaccine is recommended for all patients 6M to 24 years old.
Nasal H1N1 vaccine is for children age 2 to 24 years old without chronic illnesses like asthma. Nasal H1N1 and seasonal nasal influenza vaccines cannot be given at the same time and must be separated by one month. There are not restrictions on timing of either injectable vaccines and injectable vaccines can be mixed with nasal vaccine without problem.
Supply will be coming in small batches over the coming weeks. It is best to keep an eye on our web site or call clinic on Friday evening to see if we will have adequate supply for Saturday flu shot clinic.
Seasonal influenza vaccine is currently in short supply but we do anticipate another 1000 dosages to arrive sometime in November. Updates will be posted on our website.
Excellent review by Dr. Paul Offit at New York Times
Flu shots have arrived!
September 12, 2009 by Kenneth Carlson, MD
Beginning this week we now have influenza vaccines available for our patients. This includes vaccine those on commercial insurance, Oregon Health Plan, and uninsured. We have doses of injectable and nasal vaccine. Saturday influenza clinics begin this month. Just come to our clinic between 9 am and 12 noon. No appointment necessary. If your child already has an appointment coming up in the next 4-6 weeks we will be happy to get vaccine done at that time. Influenza vaccines are recommended for all of our patients over 6 months old. Supply is expected to be adequate. We increased our order this year substantially to prepare for coming flu season.
The vaccine currently available is the usual seasonal vaccine that includes protection against three strains of influenza. This does NOT include H1N1 2009 strain.
H1N1 2009 influenza vaccine is anticipated to be available in November. It will be available in injectable and nasal forms. The manufacturing process is identical to current seasonal influenza vaccine. It is not an “experimental” vaccine. It is recommended for children over 6 months old and will be most important for children under age 5 and those with chronic health conditions that put them at higher risk for complications from influenza. Dosing and schedule has not been finalized but will likely closely mirror current seasonal influenza vaccine schedule.
For latest information on influenza vaccine visit CDC Influenza Information Center
CDC Videos
Influenza Vaccine Update
September 2, 2009 by Kenneth Carlson, MD
We have been getting a lot of questions lately regarding influenza vaccine recommendations and availability. We have started to receive injectable and nasal vaccine for the seasonal influenza. This covers three strains of influenza. Our initial shipments come directly from the manufacturer and are for patients on commercial insurances. For patients on the Oregon Health Plan (medicaid) and uninsured the vaccines are purchased by the state and distributed to medical offices to administer. We anticipate this to arrive in the next several weeks. We will continue to dedicate Saturday mornings from 0900--1200 for influenza and other vaccines needed. Also if your child has an upcoming appointment in next 1--2 months we will be happy to take care of any vaccines at that visit.
Influenza vaccine is recommended for all children 6M and older. They are most important for kids under age 2, those around children too young to be immunized and children with medical conditions putting them at increased risk for complications from influenza (like asthma).
New this year is an additional shot for H1N1 2009 pandemic influenza that emerged last spring. The severity and spread of disease is not known at this time. Anticipation is that it will be the most common strain circulating since the strain has not been in the community in previous years and was seen to be the dominant strain in southern hemisphere (their winter) in recent months. The technology in manufacturing the vaccine is the SAME as regular influenza vaccine. It is NOT a new vaccine. What is new is the strain isolated to make the vaccine, but the process and ingredients used are the same as prior influenza vaccines. If the H1N1 strain had emerged earlier in the year it would have likely been incorporated into the regular seasonal vaccine (and may very well be what we see in winter 2010--2011). We do not yet know if children will need one or two doses to get the best protection.
The same recommendations exist for H1N1 2009 pandemic influenza vaccine (also known as “swine flu”) regarding who to give it to. This vaccine is not yet available and anticipated to come to offices in late October or November. This vaccine will be purchased by the government and distributed to medical offices and public health clinics to administer. We have applied to be one of those sites. There will be no direct cost of vaccine to families, thought administration fees may apply. These are usually covered by insurance.
At this time we still don’t know if children will need one or two of the H1N1 vaccine. We also don’t yet know about simultaneous administration of H1N1 vaccine along with seasonal influenza vaccine. These questions will be answered in coming months. We will administer this vaccine in our same Saturday AM shot clinics. We anticipate ample supply of both H1N1 vaccine and seasonal influenza vaccines for our patients.
We will continue to update our web site to keep you alert to changes in this important issue. For the latest information visit CDC Influenza site.
Vaccination is our best weapon to decrease the severity and spread of influenza this season!
MRSA update
August 31, 2009 by Kenneth Carlson, MD
Our clinic continues to follow the latest treatment recommendations for MRSA (methicillin resistant staph aureus). The type of staph that is occurring more commonly in the community is different from hospital MRSA that emerged 20+ years ago. That type of MRSA is resistant to nearly all oral antibiotics. Community MRSA that is commonly causing skin infections is still sensitive to a number of oral antibiotics. It is very common and our office probably sees 10-20 cases per week. We changed our prescribing pattern several years ago to target this changing bacteria. We culture abscesses when drained in our office to identify type of bacteria but always pick antibiotic that will target community MRSA (fortunately there still are several options). Draining the abscess is the most effective treatment for skin infections.
The vast majority of cases of MRSA we see are in the skin and the remaining percentage are in the bones. Kids with skin only infections are rarely ill and often do not even have fever. “Regular” staph actually infects bones and bloodstream more easily than community MRSA. The best prevention is frequent hand washing and avoiding sharing towels, washcloths and clothing. Keep open sores clean with soap, water and topical antibiotic. Seek medical care when pus forming lesions are seen on the skin for antibiotics and possible draining of the abscess.
Staph pneumonia is one of the causes of death from influenza. This occurs most often in children with underlying health problems but can also occur in healthy children. It is for this and other reasons we recommend influenza vaccination for all our patients over 6 months old. Flu shot clinics for seasonal flu will begin in September. H1N1 (swine flu) pandemic flu shot clinics will begin when vaccine is available, probably November.
Busy winter at the office
February 7, 2009 by Kenneth Carlson, MD
In recent weeks we are experiencing our typical seasonal increase in office visits that usually peaks in February. This year is no exception as we are having some of our busiest days in the history of our clinic. We are experiencing very high volume of phone traffic, at times overloading our phone systems. We will be adding capacity soon, but until then read on for some tips.
Tips to communicate with us in the busy winter months
- Call early in the day for urgent same day appointments
- For questions about symptoms consider visiting Legacy Emmanuel Children’s KidsCare for health advice
- For nonurgent calls consider calling later in the day or avoiding Monday (our busiest day)
- For routine prescription refills call the pharmacy directly. If they need to authorize more refills the pharmacy will contact us. (For medications that require paper prescription to be picked up please continue to contact our office by phone or online)
- Use our My Health Online service to send us messages through the internet securely (sign up in the office)
- If you are at our office for a visit be sure to make your next appointment prior to leaving the office.
Most commonly we see an increase in respiratory infections, including colds, bronchiolitis (often cause by RSV), and influenza (respiratory flu).
What this means for you is to remember to call early in the day if you are interested in same day appointment. We are typically filling all appointments by about 4pm each day. Also, feel free to review health topics on our website as well as in our print Red Book for common questions.
We thank you in advance for your patience during this busy time.
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