This Saturday, November 21, 2009, from 7-10 AM we will be administering the H1N1 injectable vaccine for high risk children (see below for definition of high risk) between the ages of 6 months and 5 years of age. It will be given out on a first come basis and there is limited availability. You may use the main entrance of the office. Children who are 5 years old can receive the vaccine only if their school is not offering it. School age children must receive the vaccine through their individual schools. No other vaccine other than the H1N1 injectable will be offered at this clinic. Healthy children ages 2-5 years of age will not be offered the injectable vaccine and should not be brought to the clinic. The reason for the early hours is that we are working around our normal Saturday schedule to make the injectable vaccine available before the holiday.

High risk children who are unable to receive the intranasal vaccine include:

•Children less than 2 years of age;
•Children with a medical condition that places them at higher risk for complications from influenza, including those with chronic heart or lung disease, such as asthma or reactive airways disease; children with medical conditions such as diabetes or kidney failure; or children with illnesses that weaken the immune system, or who take medications that can weaken the immune system;
•Children younger than 5 years old with a history of recurrent wheezing;
•Children receiving aspirin therapy;
•Children who have had Guillain-Barré syndrome (GBS), a rare disorder of the nervous system, within 6 weeks of getting a flu vaccine,
•Children who have a severe allergy to chicken eggs or who are allergic to any of the nasal spray vaccine components.

Children who are severely allergic to eggs may need to receive the vaccine through their allergist.

Let us also clear up some misconceptions, misunderstandings, etc.

1. We are in contact with the health department almost daily. The supply of vaccine is what it is.

2. We are administering the vaccine according to a strict protocol given by the health department. We don’t make the rules, but we need to abide by them.

3. We are discouraged by the DOH to administer the second H1N1 dose to children less than 10 years old until after January 1, 2010. This is to assure that all children can get at least one dose of the vaccine before the start of the new year. The good news is that first dose appears to be more effective than originally thought.

4. People who live in Massachusetts and come to our practice are eligible to receive the H1N1 vaccine according to the same guidelines we use for residents of Rhode Island. We cannot give it to school age children who are scheduled to receive it through the school system. Massachusetts is slowly starting to offer it through the schools, but on a much slower pace than Rhode Island. However, RI will be offering a special vaccination clinic for RI residents who attend Massachusetts’s schools for children K-12 on Saturday, December 12, 2009. You must preregister at www.health.ri.gov by 4 PM on Wednesday, December 2, to attend this clinic.

5. At the present time, we can only offer the flu vaccine through our Lincoln office.

AS A REMINDER, PLEASE READ THE FOLLOWING:

With the onset of H1N1, our office (as well as other physician offices) has been inundated with calls and appointments.  We are seeing over 100 children a day in the office, approximately 1/3 of which are add-ons. Judy, our nurse, is answering in the range of 50-75 phone messages a day (and that is a conservative estimate). Our front office staff have been extremely busy in answering calls and with moving patients in and out. Our physicians are busy as well returning phone calls, seeing patients, and handling emergencies. This does not take into account that every family being seen in the office has additional questions about the flu, which lengthens each office visit. In order to provide timely care in the most efficient manner, we ask your cooperation in reading and complying with the following reminders and suggestions:

1. When leaving a phone message, leave one phone number that we can reach you at. We will make one attempt to call you back. It is helpful if you can be brief and to the point in your concerns and questions because of the volume of calls we are receiving.

2. Have your caller ID turned off. We use our back lines to return phone calls. We leave our other phone lines open for new patient phone calls. If your caller ID is on, it will greatly delay our ability to call you back as we reserve the right to keep our back-lines private.

3. Evening and weekend phone calls are for emergencies only. If you have questions about H1N1, please call Monday-Friday during the day.

4. Please do not call on nights and weekends for prescription refills. Our policy states that we also require a 2-3 day notification for refills in general.

5. Referrals are not able to be done on Mondays. Our policy states that we need a one week notification for referrals, so please plan accordingly.

6. If your child has recently become ill, use common sense in initiating treatment. If it is a common cold or even the start of the flu, we will only tell you to do the obvious: treat the fever, increase fluids, rest, etc. We ask that unless there is a compelling reason for your child to be seen, to give it a few days first and see how your child does. We are trying to conserve appointment slots for the children who are most sick and in need of being seen. We do have to triage phone calls at times to accomplish this, so we ask for your patience and cooperation.

7. As an office, Tamiflu is only prescribed for good reason. We do not give it to otherwise healthy children who have the flu with no other complications.

We will continue to update the website in a timely fashion as we get new information and vaccine supplies. We again thank you for your patience and cooperation.

LPA