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COVID-19 FAQ and Resources for Physicians & Providers

Updated November 3, 2021

FAQ and resources

Children's Mercy is committed to providing answers and information related to COVID-19. Answers to frequently asked questions are categorized by topic and updated on an ongoing basis below.

COVID-19 vaccine frequently asked questions

 

If you have a general question about COVID-19 that is not answered below, please email us at physicianservices@cmh.edu. We are working with our Infectious Diseases team to provide answers and will return your email within one business day.

Our hope is that the one-third of parents who are really excited about the vaccine and have already rushed out and gotten it for their kids, along with their pediatricians, will help nudge that hesitant group along. Soon, over 1 million children in the 5- to 11-year-old age group will have already received vaccine, and over the next few weeks will have received two vaccines, which will allow us to provide even more reassurance on how kids are tolerating the vaccine. As we accrue more data in kids, let’s continue this conversation with hesitant parents and answer their questions. Ask them, what is their biggest concern about the vaccine?

There’s really not much to be allergic to in the vaccines. It looked like there were more allergic reactions at the beginning of the adult vaccine rollout last winter, but a lot of those reactions were actually panic related, which was understandable. It comes down to about four to five allergic reactions per 1 million people. There are some different fats, lipids, salts and sugar in the formulation people can react to, but it’s very rare.

The pediatric formulation is the same formulation as the adult and adolescent formulation. However, we’re preparing the drug a little differently so we can achieve the dose that’s right for a younger age group.

Pfizer recently asked the FDA to authorize boosters for all adults, but at this point, we just don’t know. The hope is that the vaccine will have a long-lasting effect and that we won’t need to be giving boosters six months from now. This may eventually become an annual vaccine, just like for influenza, but only time will tell.

Kids who are 11 at the time of their first dose should get the 10-microgram dose. If they turn 12 in the midst of their dosing timeframe, then ultimately, the 30-microgram dose would be preferred for 12-year-olds. That said, if they get the 10-microgram dose, they are considered fully immunized. It’s not considered incorrect or wrong dosing. It is allowed per the packaging insert from Pfizer and from the FDA on their fact sheet. You really can’t go wrong. If you inadvertently give the higher dose to someone in that younger age group, you can count them as fully vaccinated.

You can reach out to us at physicianservices@cmh.edu with any questions you may have. We have experience registering with Missouri and Kansas state registries, so we can help you through the lengthy process. There is quite a bit of information that needs to be gathered and submitted to the state if you need help collecting and submitting that data. We also can help you navigate all the resources out there. There is information on the FDA, CDC and state websites and we can talk through which resources you need. Both Missouri and Kansas have a state website for vaccine providers that outlines the essential resources you need to get your clinic up and going and the resources you need to provide to patients. We can also get creative. You can send staff to one of our clinics and we can talk through the process, or we can meet you in the pharmacy. We can also do a video call and walk through the process.

Ask the parent, "What is your biggest concern?" What we hear often is we don’t know the long-term safety of the vaccine. So, let them know you understand why they might be concerned about that. There has been a lot of discussion around long-term safety in the news and on social media networks. Tell them what you know about the safety of vaccines. When someone is going to have a reaction to a vaccine, it nearly always happens within the first two weeks of vaccination, and certainly within the first four weeks. That’s why when they did the trials, they monitored people for up to two months. This provided a long cushion of time to help researchers better understand what to expect in terms of safety events and reactions from the vaccine. That helped them make sure they caught any reactions that occurred.

Even though people have talked a lot about long-term safety, we don’t see safety events or big adverse reactions to vaccines happening beyond that initial timeframe. So, we don’t have long-term concerns about the safety of the vaccine. What we see are those short-term adverse events, whether that’s a local or systemic reaction to the vaccine, or something rarer and serious like anaphylaxis. Or it might even be a rare but potentially less serious reaction like myocarditis, which potentially resolves quickly.

So, be sure to stop and ask the parent to explain what they understand, then ask them what other questions they have about the safety of the vaccine.

The use of mRNA is another technology used to create the COVID-19 vaccine. This technology was created more than a decade ago and has been used in other prototype vaccines (e.g., MERS virus), thus it was already known that a vaccine using mRNA technology could produce an immune response. It was also known that it could be quickly mass produced. This is what made it a good option for a COVID-19 vaccine. This vaccine is made up of the gene that codes for the spike protein inside of a lipid nanoparticle layer. Once the spike protein is made in the cell, it goes to the cell surface and triggers an immune response. The viral vector vaccines (e.g., AstraZeneca and J&J) use a modified version of a different virus (e.g., adenovirus) that is unable to replicate, but is able to bring the spike protein gene to the human cell to make the spike protein and induce immunity. Other vaccine technologies include proteins conjugated to a polysaccharide antigen (pneumococcus, Hib), killed virus (polio), toxoid (diphtheria, tetanus), subunit (pertussis), and live virus (MMR).

For any requests regarding the vaccine or storage, please review this process and then email us at: COVIDVaccineStorageHelp@cmh.edu.

Yes! Please complete this form if you are interested and we will connect you with the ideal contact to help set up a time.

The antibodies produced from COVID-19 infection are robust and oftentimes high titer for a period of time. If you have a significant infection versus if you had asymptomatic or mild infection, your antibody titer is generally higher. However, what we know now is that in people who are vaccinated, the types of antibodies differ from those who had infection. We look for something called a neutralizing antibody, an antibody that’s able to neutralize or kill the virus. Antibodies that you make from the vaccine are really good neutralizing antibodies. Antibodies from infection are a mixture; neutralizing antibodies aren't as high as they are if you're vaccinated. We want to be able to fight off COVID-19 infections. The vaccine gives us a better chance of fighting off future infections if a child gets exposed.

Newly released FDA guidance authorizes undiluted, thawed Pfizer vaccine vials to be stored in the refrigerator for up to one month based on recently submitted data. (Previous guidance was five days.)

This isn't new technology. This technology has actually been around for over a decade. It’s been used in cancer treatments, specifically the mRNA technology. It has also been used to create a vaccine for the Middle East Respiratory Syndrome virus. We had animal data on it before we started use in humans. All of this is important for people to understand. In addition, we have found that all the COVID-19 vaccines that are authorized in the United States are safe for people. There has been a lot of press about the vaccine and blood clots. The fact is the risk of developing a blood clot from having the COVID-19 infection is a hundred times higher than it is from having the vaccine. 

The risk of anaphylaxis is between 2-5 per million people vaccinated in the U.S. It is similar to other vaccines and about the same as your risk of getting hit by lightning in a given year, which is about one in a million. For kids we don't have the actual breakdown of that data yet. What we do have is the pharmaceutical companies noting anaphylaxis rates are similar to adults. It is a very low-risk situation that we’re talking about. What has been shown in the literature is that the vast majority of people have an anxiety attack that is mistaken for anaphylaxis.

As far as emergency management of a reaction, anaphylaxis is going to be airway obstruction and EpiPen is ideal to have on site. We recommend at least two EpiPens for any vaccine clinic. If you have significant anaphylaxis and the airway is completely obstructed, you could administer a second EpiPen if necessary. On the standing order from the state of Missouri, it does list your emergency medicines that they recommend to have which are EpiPen and Benadryl. Not everybody has Benadryl. Our vaccine clinics carry oral Benadryl, but not all do. Most vaccine clinics only have an EpiPen. You do not need an AED for anaphylaxis because typically anaphylaxis does not cause you to flip into a shockable rhythm. As long as you have an EpiPen available for any potential anaphylaxis – the airway obstruction for anaphylaxis – you should be prepared.

You cannot charge for the vaccine. However, you can submit to insurance for reimbursement of the administration fee.

Please refer to the CDC information regarding the second vaccine, if not administered within six weeks. 

If they have a mild URI, feel free to give the COVID-19 vaccine, as you would any other childhood vaccine. We would not recommend a child receive the vaccine if they are febrile.

If a patient has an acute COVID-19 infection, they should not get the vaccine until after the isolation period. Once this is finished, then they can receive the vaccine.

If they received monoclonal antibody because they fell into a higher-risk group and they're on the older age spectrum – the adolescent – then the recommendation right now is 90 days. Right now, the CDC is still recommending waiting for that 90-day period if they received monoclonal antibody.

The CDC guidelines regarding masking are for the general public – not the health care setting. We must be respectful of people who are not vaccinated and be good role models for patients, families and visitors. We also need to be aware of the increasing infection rates caused by the Delta variant across Missouri and Kansas right now.

At Children’s Mercy, parents and families can remove masks while they are in the room alone with their children. However, they should wear a mask when members of the health care team are present. They also need to wear a mask when leaving the patient room and walking around the hospital.

General COVID-19 frequently asked questions

Reference answers to frequently asked questions from physicians and providers. 

View recommendations for a safe return to sport and physical activity after COVID-19 here. Other helpful resources include:

COVID-19 testing

Testing is available for those ages 2 months up to 22 years old. Families can self-schedule a COVID-19 test through Save My Spot at cmh.edu/covidtestAll testing is by appointment only.

See COVID-19 Testing at Children's Mercy for locations and additional information.

Results will be processed offsite and will be available within 1-2 days. If a provider or medical group is listed as the primary care or referring provider in the patient's Children’s Mercy record, they will be able to receive the patient's COVID-19 test results in My Patient Connections

If a patient is not already on the patient portal, they will receive a call from the Urgent Care Follow-Up NurseLine, (816) 960-3000. They can assist patients with a return to work or school note and a printed copy of the COVID-19 test results.

COVID-19 vaccine

Vaccine clinics are available for ages 5 years up to 22 years. See COVID-19 Vaccine at Children's Mercy for upcoming vaccine clinics, hours and locations. Appointments are needed.

Children’s Mercy is following the CDC guidelines for home isolation and return to work criteria which are available here.

Resources

The following resources have been identified for use in practices and with families. 

Children's Mercy resources

COVID testing - parent notification letter templates

Children’s Mercy has developed a letter for parents requesting confirmation of their child’s COVID-19 test results. The letter provides options based on the patient’s testing results and symptomatology. Letters are available in English and Spanish. 

Please consider leveraging these letters in your practice and customizing for your needs: 

Resources in the community during COVID-19

Many families in our community need extra support right now. Children’s Mercy has gathered resources for Kansas and Missouri families who need assistance with food, transportation, and other basics during the COVID-19 pandemic. 

Click here to access resources related to the following: 

  • Family toolkit: Social Distancing with a Plan
  • Food resources 
    • Children's Mercy free lunch program
    • Harvesters
    • School district nutrition services 
  • Transportation and lodging 
    • Free rides for essential needs
    • Resources for families with Missouri medicaid coverage
    • Resources for families with Kansas medicaid coverage
  • Mental health support
  • Helpful websites and hotlines

Community provider town hall 

A town hall event was held virtually on May 7, 2021 to provide community providers an update on vaccinating pediatric patients and how to offer a vaccine clinic in your office.

Watch a recording of the event

Related resources: 

Podcasts

The Children’s Mercy Pediatric Ethics Podcast Series

This series features Children's Mercy specialists and other pediatric experts from across the globe covering topics that are changing pediatric ethics.

Recent podcasts include: 

  • Ethics and Communication During a Pandemic 
  • Pandemic Ethics
  • Planning for COVID in Washington State
  • COVID and Child Abuse

Access the series

Transformational Pediatrics series

  • "Pediatric Provider Well-Being and the COVID-19 Pandemic" with Jennifer Bickel, MD, pediatric neurologist and Medical Director of the Children’s Mercy Center for Professional Well-Being. Listen now.

Pediatrics in Practice series

  • "Return to Play in the Pediatric Athlete After COVID-19 Infection" with Daniel Forsha, MD | Ryan Northup, MD | Amol Purandare, MD | Natalie Stork, MD. Listen now.

Other

Websites

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