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What to Expect During Pediatric Visits During the Pandemic

By Jeffrey Boxer, MD, Beacon Pediatrics

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Dr. Jeffrey Boxer

We get many questions from parents of our pediatric patients. This guide is a great resource for parents to know when and how they can safely come into the office for scheduled appointments and exams.

Q: IS IT SAFE TO SEE MY PEDIATRICIAN DURING THE PANDEMIC?
The answer is yes. Your pediatrician’s office is open and taking extra precautions to make sure that you and your children are safe when you come in. That includes separate entrances and dedicated rooms for sick and well children. There is no waiting room: instead, patients are escorted directly into an examining room. Masks are required for all staff, children over 2 years of age, and their parents/guardians. There are specific hours when sick children are seen. Nurses and providers who are seeing sick patients do not see well children that same day. In addition to these precautions, rigorous sanitation and cleaning practices are being followed. Telehealth visits are available and even some drive-through testing is being offered.

Q: WHY SHOULD I BRING MY CHILD TO THE PEDIATRICIAN DURING THE PANDEMIC?
Newborn babies need to be assessed for feeding problems, weight, jaundice, and other issues that can be present. New parents often have many questions that need to be answered about their new baby.

Infants, children, and teens should have their growth, blood pressure, developmental milestones, speech/language, hearing and vision checked. They need to be checked for anemia and lead toxicity. 

Emotional and behavioral issues are important to address at all ages. These issues may be exacerbations of ongoing problems, or they be new due to pandemic induced social isolation, lack of structure, and/or boredom.
Illnesses and injuries should be evaluated and treated. 

Perhaps most importantly, infants and children need to be kept up to date on their immunizations.

Q: WHY IS IT IMPORTANT TO GET VACCINES DURING THE PANDEMIC?
Childhood vaccine rates have fallen dramatically during the Covid-19 crisis. With immunization rates decreasing, and with the reopening and loosening of pandemic restrictions, we fear that there could be outbreaks of vaccine preventable diseases like measles and whooping cough, presenting us with a second health crisis. Both the CDC and the American Academy of Pediatrics have recommended that well child visits and immunizations continue during the pandemic.

Q: ARE VACCINES SAFE?
Absolutely yes! Today’s vaccines are much more refined and are safer than any in history. Vaccines contain antigens, which are either live but very weakened (“attenuated”) viruses, killed (“inactivated”) viruses, or small parts of bacteria or viruses. These antigens prompt the body’s immune system to produce the protective antibodies that we are now hearing so much about during the present Covid-19 pandemic. With the improvements that have been made over the past few decades, the total number of antigens in all vaccines combined is less than what used to be in a single vaccine. A child’s immune system has no problem handling this small number of antigens. In fact, the number of antigens in all vaccines combined is but a raindrop in the ocean compared to the number of antigens that children’s immune systems encounter in their daily activities like eating, breathing and playing. We now have vaccines to protect children and teens from 16 different viruses and bacteria that otherwise would threaten their health.

Before a vaccine is licensed, it is tested in thousands of children. After licensing, the federal government continues to monitor the safety and efficacy of all vaccines.

Q: WHAT ABOUT TOXINS IN VACCINES?
In addition to antigens, vaccines contain preservatives and adjuvants that prevent contamination and improve effectiveness. These ingredients are present in minute quantities that have been proven to be extremely safe. In fact, we are all exposed to much higher levels of these ingredients in our everyday life.

Q: WHAT ABOUT VACCINES AND AUTISM?
In 1998 Andrew Wakefield published an article in a British medical journal (TheLancet) allegedly linking the MMR (measles, mumps, rubella) vaccine to autism in only 8 children. Ten of Wakefield’s coauthors later withdrew their names from the article and dozens of studies since then have disproven his theory. The Lancet has long since retracted the article. 

Thimerosol, a mercury-containing preservative that was previously used in many vaccines, became the next target of of some families with autistic children. Thimerosol was removed from all routine vaccines in 2001, yet the incidence of autism did not decrease.

It is natural and understandable to want to blame someone or something for causing autism in children. What we know is that vaccines save lives. They DO NOT cause autism.

Q: ISN’T NATURAL INFECTION BETTER?
Indeed, in most cases natural infection does impart better immunity. That is why most vaccines require several doses to be effective. However, the price one pays for natural infection is the risk of the complications of that disease. Measles can cause encephalitis.

Hemophilus influenza, meningococcus, and pneumococcus can all cause meningitis, etc. Vaccines are much safer than the diseases that they prevent We know that Covid-19 has many serious complications. Hopefully we will have a safe and effective vaccine for coronavirus in the near future. 

Q: WHY NOT DELAY OR SKIP VACCINES?
There is no proven benefit whatsoever and there is significant risk in not giving vaccines on time. Vaccines are started early to ensure that the youngest and most fragile are protected as soon as possible. Any parent who refuses to immunize their children is shirking their social responsibility.  They are not only putting their own children at risk for serious complications of preventable infectious diseases, but they are also allowing the spread of those diseases to those too young or too ill to be vaccinated. The result can be serious complication and even death for those who are the most vulnerable.

Q: ARE VACCINES REALLY NECESSARY?
The vaccine program in our country is truly a victim of its own success. Most parents have never seen a child with diseases such as measles, meningitis, whooping cough, or chicken pox. They have not seen seizures, blindness, brain damage and death from such illnesses.  As a practicing pediatrician for over 40 years, many of those years before we had all of the vaccines that we have today, I have personally had patients hospitalized, permanently damaged, and die from vaccine preventable diseases. I have never seen a life threatening or life changing complication from a vaccine. Vaccine preventable diseases still exist throughout the world, and if immunization rates continue to fall in the United States, they will reemerge here. 

Vaccines have saved hundreds of millions of lives worldwide, more than any public health intervention in the history of medicine. Ever!!! My colleagues and I firmly believe that vaccinating children, teens and young adults may be the single most important health promoting intervention that we perform as health care providers, and that you perform as parents and caregivers. 

Even during this most difficult crisis, it is important to bring your infants, children and teens to their physician, so that they continue to receive the ongoing quality health care that they need and deserve.

Q: WHAT ARE SOME RELIABLE RESOURCES FOR HEALTH AND COVID-19 INFORMATION?
Here are some reliable websites for parents regarding Covid-19, vaccines, children’s health, and parenting:
www.healthychildren.org (American Academy of Pediatrics)   
www.kidshealth.org (Nemours)
www.cdc.gov (Centers for Disease Control and Prevention)

 

Jeffrey Boxer, MD, FAAP, is a pediatric physician with Beacon Pediatrics, affiliate and is a member of Beebe Medical Staff. Dr. Boxer grew up in a small town in the Catskill Mountains of New York. He attended Colgate University and graduated with a degree in geology. He earned his medical degree from Upstate Medical Center in Syracuse. He started his medical career training to become a family medicine physician in Wilmington, Del., however during a pediatric rotation he decided to become a pediatrician instead. He spent three more years in Wilmington completing a pediatric residency. He went on to practice pediatrics for 37 years and served as Chief of Pediatrics at Monadnock Community Hospital for most of those years before moving back to Delaware to practice at Beacon Pediatrics, Rehoboth Beach. To learn more about Beacon Pediatrics or to make an appointment, call 302-645-8212.