Transcription:
Talking Through Pediatric COVID-19 Vaccines

Scott Webb: Welcome to UK HealthCast from the University of Kentucky Healthcare. I'm Scott Webb. And today, we're discussing the new UK Healthcare Pediatric Vaccine Clinic with Dr. Dan Grantz, he's a Pharmacist with UK Healthcare and Dr. Lindsay Ragsdale, she's the Interim Chief Medical Officer for Kentucky Children's Hospital.

So I want to thank you both for being on. We're still involved, if you will, at least, in this pandemic, COVID-19, and, you know, adults were vaccinated and then older kids. I was just mentioning, you know, my kids are a little bit older, so they've long since have been vaccinated. But now, kids 5 through 11 can be vaccinated. And this is a really, you know, relevant and timely topic. So, as we get rolling here, Dr. Grantz, which vaccine will be offered by the UK Healthcare Peds Clinic?

Dr. Dan Grantz: Yeah. So this will be the Pfizer BioNTech product and the concentration of it's a little bit smaller than the adult though. So it's a 10-microgram dose and it's a 0.2 mL amount that we inject into the arm.

Scott Webb: And Dr. Ragsdale, which medical organizations have endorsed the vaccine for children? And how did they reach that decision?

Dr. Lindsay Ragsdale: I think there's been so much thought to go into thinking about how do we make sure we can safely give a COVID vaccine to children. Pfizer applied for an emergency use authorization through the FDA and that was granted. And then, you know, there's lots of steps in trying to make sure that we have safety.

So the CDC Advisory Committee on Immunization Practice thoroughly vetted all of the data. So, they dig into every single patient in their trial and really overwhelmingly in that committee said absolutely the risk are low, the safety is really good and the benefits are huge for kids in this age range. And the CDC endorsed as an institution the emergency use authorization. The American Academy of Pediatrics, Gynecology and Obstetrics, so really many medical organizations have endorsed this vaccine. And you know, it's been based on a lot of really sound data. They did it in a fashion that was really closely observed and had a lot of oversight, so a very sound process.

Scott Webb: Yeah. And I'm sure that's a comfort for everybody who is going through this process, who may have been vaccinated themselves. And now, they're trying to reason their way through this and understand and make sure that, you know, all the due diligence and everything, you know, all the I's were dotted and the T's were crossed before getting their younger kids vaccinated. And, you know, COVID appears to be less of a threat to children than the older population, you know, generally speaking. So as folks are thinking about this and whether or not to get their younger kids vaccinated, why do you believe they should?

Dr. Lindsay Ragsdale: Yeah, you're absolutely right. I think kids in this age range have been less affected by COVID-19 compared to adults. However, I will say they're not 0% affected. So, we really have seen kids in this age range get sick, be hospitalized. There have been serious consequences and even some kids have died in this age range. So it's really impossible to tell at this point, which child is going to get infected and which isn't. I mean, there are some Illnesses that put kids at risk, a higher risk for COVID-19 infections, but we really don't have a way to protect kids completely. I think mask and social distancing has only got us so far.

And this past surge from the summer until September, October, we have seen an enormous increase in the amount of kids that we have admitted to children's hospitals. Even here in Kentucky, our Kentucky Children's Hospital has seen a six-fold increase in children being admitted to our hospital compared to the whole pandemic in the year before. So this is a serious effect on kids this age range and we would like to protect them. I mean, this vaccine is our best shot at protection.

Scott Webb: Yeah, doctor, I think you're so right. Those of us who are parents, or even if you're not a parent, obviously, we want to protect our children. And there's only so much that masking and hand-washing and distancing can do. And the vaccines have been fully vetted as you've said and most of the major organizations endorse the vaccine, the COVID-19 vaccine, for younger children. So I think naturally, I and others may have this question for you, what have the studies shown about the risks involved with vaccinating younger children against COVID?

Dr. Lindsay Ragsdale: Yeah. I appreciate questions like this, because it really speaks to our parents' duty. I mean, I'm a parent myself, have kids in this age range. Asking questions and really making sure that we're making good decisions I think is really helpful, and so I encourage people to ask questions.

You know, the data looks really good. Pfizer's trial in this age range had thousands of kids enrolled. The safety was really good and the protection was 90.7% effective in really preventing symptomatic COVID. And the side effects were mild. What they saw mostly was soreness on their arm. If So, if they got the injection on their arm, a sore arm. Some kids had some mild headache or just feeling fatigued, but that was really quickly resolved on its own. So after a day or two, they felt completely back to themselves. But they had a really good immune response. So, this is kind of best of both worlds. It's a third of the adult dose. So the side effects seem to be more mild, but their immune response was great. These kids' bodies are really healthy, so they had a great response to COVID, which is what we really want to see.

I think there have been some concerns in the media about myocarditis and, you know, that is really an inflammation of the heart from some kind of immune response. But what we've seen is, in this age range, the five to eleven in Pfizer's trial, there were zero cases of myocarditis. And so we're really trying to think of risk and benefit. The risks are low to get this COVID vaccine, but the risk of a COVID infection are very high. You can actually get myocarditis from COVID infection itself. So that if a child in this age range gets COVID-19, their body can really get inflamed and react to that infection and can have myocarditis. So really those risks are higher than if they get the vaccine. I think that this has been thoroughly vetted and the safety and efficacy are really, really good.

Scott Webb: Yeah, they really are. And I'm glad we're doing this and really emphasizing these points. And maybe it's just too soon, I sort of want to ask you about long-term side effects, especially in children, but it's probably too soon to know, right?

Dr. Lindsay Ragsdale: You know, some things are too soon, at least in this age range because we're just now rolling them out The CDC has a side effect tracker that every family can enroll their child in. And they're looking at a population base, so, you know, after we are vaccinating hopefully millions of kids, there's 28 million kids in this five to eleven-year-old age range in the US, so we can see really at a population base.

But I think the good news is this was already rolled out to twelve-year-olds and up. So we have this very, very large population of adults and adolescents that we've already vaccinated. And the safety is very, very good for that. So that's reassuring, that we already have this big population of patients that we've already vaccinated and really the trial has already shown us that it was safe in the 3000 children that were enrolled in Pfizer's trial. So we will keep an eye on it closely. I think the CDC is very interested in putting out the data about side effects so that people feel more comfortable over time.

Scott Webb: You know, we've talked here about long-term side effects. Any sense so far on the short-term, other than, you know, Dr. Ragsdale had mentioned some headaches and things, do you have any sense of short-term side effects that children might experience?

Dr. Dan Grantz: I believe a lot of the side effects that we experienced with this vaccine are a kind of flu-like symptoms in the sense that they're going to feel tired, maybe sleepy. And then as their body mounts that immune response, they might have a runny nose for example or they might feel run down. And the good news is because it's a vaccine and your body's using its own immune system to respond to that, you actually overcome that pretty quickly. And because the vaccine is such that it's not the live actual COVID virus, your body can overcome that within about 24 to 48 hours, as opposed to several weeks or days that it could drag on.

And I know, just to kind of piggyback off of what Dr. Ragsdale said too, I get a lot of questions about infertility, where parents are sort of scared about the long-term effects or maybe even short-term effects in some cases of infertility for their children. And I just wanted to point out that right now, those claims have been scientifically disproven. I think that's why the GYN group and oB-GYN groups have stepped in and kind of made some statements about this as well. So I just wanted to make that point around this.

Scott Webb: They really have. You know, the incidence of colds and flus and things over the past year and a half or so with everybody or most people wearing masks and, you know, paying more attention to hand hygiene and distancing, you know, people just haven't been getting sick as much. But of course, now that the kids are back in school, that's probably going to change and we could do a separate podcast on the flu vaccine. But I wanted to ask you, how long has the UK Healthcare Pediatric Vaccine Clinic been in the works and which experts have been involved in its development?

Dr. Dan Grantz: Yeah. So that's been a great collaboration between the UK Children's Hospital, our UK Healthcare Pharmacy Teams, and actually our Information Technology teams. Once we learned that Pfizer was getting close to getting this product to market, we really ramped up our discussions in September. We've had daily calls. We've had weekly kind of conference calls to bring in other people within our teams to organize this. And I'll let Dr. Ragsdale expand on that, but we've also worked with the state as well.

Dr. Lindsay Ragsdale: Yeah, I agree with Dr. Grantz. This has been an amazing collaboration. I think this is a great example of really multidisciplinary care. Really what the core of this was is how can we help kids get vaccines in a safe and child-friendly environment, and that was really our central goal from the very beginning concept. So, we have involved specialists from our children's hospital, child life specialists, which have been really key to this. They are professionals that help kids adapt to medical intervention They can help them feel comfortable in the hospital setting and clinics. And for us, we're bringing lots of children in to one environment and giving them all vaccines.

Understandably, kids are lots of times nervous about getting a shot and there's some needle phobia and some worry about getting shots. So, really, from the moment they walk in, this is all about engaging the child in what's going to happen, making sure they feel prepped and engaged. We actually have a treasure map that helps them know what's going to happen next. And they go all the way through our clinic space and to the end to get a prize. And so then they are already engaged in the process. The parents have told us thank you so much. This has been the best vaccination experience they've ever had. And I think that this just speaks to how we should care for kids in healthcare, that engaging them in the process that they know what's happening to their body, because eventually they're going to become adults and we want them to seek care for themselves in the future. So, this has been really key to the central goal to our team. And it's been really amazing to see the kids come through and they've been really, really excited. And, you know, I think they've shared with us they're tired of being scared. They're tired of being scared about COVID-19. It's all everybody talks to and their whole lives have really been up-ended School feels different social environments feel different so they're ready to feel not so nervous anymore

Scott Webb: Yeah, it

sounds really cool even for an adult. I kind of want to go there myself. Can you tell folks exactly where to find the clinic?

Dr. Lindsay Ragsdale: It's located at 245 Fountain Court in Lexington. It's on the first floor. You'll see signs. It's open Monday through Friday, 1:00 to 7:00 PM and Saturdays 9:00 to 5:00. We're specifically targeting time after school. We want to make sure that this is family-friendly and thinking about their timeframes. They can register online at ukvaccine.org. And, you know, that website is really designed to give lots of information and also how to register their children for appointments.

Scott Webb: It's just so cool and so nice to hear that you've removed as many of the barriers as you can. You know, putting it there on the first floor and making it this really cool kid-friendly environment, and making the hours convenient for kids so they can go after school and on the weekends. You guys have really, you know, thought of everything. And, dr. Grantz, what's the process like, you know, when we get there? Maybe you can just kind of take folks through it, a little low sort of audio virtual tour. You know, when we walk through those doors, what's this going to be like?

Dr. Dan Grantz: So as they arrive, they'll be there with their parents. They'll come into the building and they'll be received there by a registration desk. So at that point, we have staff

members who are going to try to,

you know, give them some information and connect with them. There is a process to check in, so they will be asked their name and birthday and that sort of thing.

. Once we take that information, we'll give them the treasure map. We'll explain to them what's about to happen. And we have some signage to get you back into the cubicles, the cubicle farm, so to speak. So once they go through that first step of check-in and then we have wayfinders, who will help direct them to the right location.

The whole process takes about 30 to 45 minutes, but really the longest part of that is really the waiting. So after we administer the vaccine, in one of these areas, they will have to wait for 15 minutes for monitoring. And we have staff onsite to make sure that they don't have an allergic reaction or any serious side effects.. that usually occurs right away if we were

going to have a serious

reaction. And then, once they've completed that and just to describe the space in terms of ease of use, we've got some areas designated for

families.

So if I'm bringing maybe five or six children, we have a way to separate them out and give them a big enough space. And we actually have people who can help them, sort of handlers so to speak, to help with the children as we get the

s kind of organized.

If you have more than one child being vaccinated at that time, we can accommodate that as well.

And then, from there,

the fun part is

actually the treasure chest. So once they've completed all of their assignments and made it through to the end, they are going to get a sticker. They'll also be able to pick a treasure chest, a toy or a sticker. And so once they're complete,

they'll

be able to leave. And we can accommodate handicapped children.

Dr. Lindsay Ragsdale: I would love to add on about our sensory room. You know, we've really been thoughtful to make sure that we can offer vaccines in a safe and welcoming environment to kids that might need additional support. So our sensory room has things on the floor and lights on the wall and a special light machine that can help with distraction, calming. . We have a child life specialist on staff here that can come in and meet the child and family and find out what has worked for them in the past. We have a kind of freezy spray that some kids are calling Elsa spray, that they can spray on the arm before they get an injection. We have a vibratory handheld device you can actually hold up to the arm that can help your brain's distraction from the pain impulses of the injection.

So, we've really been thoughtful all the way through about how to help kids that might need extra support. And those rooms have been really key. And the child life specialists can actually come to any booth in our vaccine site. And we have heard from families that that's been a very helpful support. We're training all of our staff to make sure that we're listening to kids and their parents about what might be most helpful. How do you hold the child? What do they want? To really talk to them, and that's really been a great environment for them.

Scott Webb: Yeah, it sounds like it. And as I said before, I would like

to go there myself. Who doesn't like a treasure hunt, treasure

map?

So cool. And UK Healthcare always at the forefront with things like this. So no surprise, that you know, you would have conceived of this and thought of everything and really listening to parents, listening to the kids as well, getting their feedback.

And

Dr. Grantz, as we wrap

up here, I think most parents would want to know, will there be any followup with our children after they've been vaccinated? Is there any need for that? And if so, what's that

process like?

Dr. Dan Grantz: Yes, there is a process. Of course, just like the adults, we need the children to get their booster shots. So what we've done on the website is there's a place for you to, once you leave, you would go back to the website and register to schedule that second appointment. When you do, you'll get a confirmation email, but then as you get closer to that date that you're due because you need them to wait about three weeks after they get the first dose before they need the booster. So around 16 or 17 days, they'll get an email that will allow them to go through the scheduling process again., It's the same process

they went through the first

time. So it should be easier for them the second time around, but we are preparing to give vaccinations at this location for both the first dose and the booster doses down the road for them.

Scott Webb: That's great.

And Dr. Ragsdale, I'm going

to give a last word to you.

You know, we've given everybody

I think really good reasons

sound

scientific

and

some fun reasons to have their children the younger children vaccinated Now that they're

eligible I just want to

hear it from you Final takeaways for parents who are sort of confused by things or on the fence Just not sure whether it's the right thing for their child. Why do you recommend that the younger children be vaccinated now that they're eligible?

Dr. Lindsay Ragsdale: Absolutely. We are encouraging families that are on the fence to talk to their pediatrician or a trusted provider to get the facts. I think it is confusing, what all has been published out there, especially online, and just making sure that you get the real facts of safety and efficacy. This is a safe and effective vaccine. I think that we want to protect our kids from serious illness related to COVID and we also don't want them to unknowingly infect others if they were to happen to be COVID-positive. And so really this is a way for us to protect children in this age range and also the loved ones that they are in contact with, that may be more at risk for a serious outcome.

So we do really want to encourage families that are on the fence to please talk to a trusted provider. It is a safe and effective vaccine and we are encouraging people to try to really look into the facts. This is a clinic that will be open. So, we do have appointments available. We'd love for you to come and bring your child through. I think it has been an overwhelmingly enjoyable experience for families and we'd like them to come back for their second dose as well.

Scott Webb: Yeah, I couldn't agree more and that's such a perfect way to end. And I really hope that UK Healthcare and others will consider things like this for adults as well. We might be more likely to get our flu shots and our COVID booster shots, if we could also go on a treasure hunt. I'm just saying, you know, once a kid, always a kid.

So this has has been so fantastic to learn about this. We hope that everybody signs their kiddos up,

and gets in there and gets vaccinated and we can get on the other side of COVID, you know, sometime relatively soon. Thank you both for your time today and you stay well.

Dr. Lindsay Ragsdale: Thank you.

Dr. Dan Grantz: All right. Thank you so much.

Scott Webb: Please visit our website for more information regarding the COVID-19

vaccine at ukhealthcare.uky.edu/covid19/vaccine

And that wraps up another episode of UK HealthCast from the University of Kentucky Healthcare. Please remember to subscribe, rate and review this podcast and all of the other University of Kentucky Healthcare podcasts. I'm Scott Webb. Stay well.