As a primary-care pediatrician, I greatly appreciated Bob Young’s summary of the GOP health-care plan.
There is little surprise their proposed plans include eliminating Medicaid expansion and the individual mandate. However, the House bill also proposes radical decreases to Medicaid funding.
Medicaid is an American legislative success story. It came into law with bipartisan support, and 95 percent of kids nationwide have health insurance coverage largely thanks to Medicaid. In Washington state, one out of every two kids is insured by Medicaid. In my own practice, a sizable percentage of kids are insured through Medicaid.
I am certain that the electorate did not intend for the federal government to gut Medicaid, taking us far backward in providing medical coverage for Washington children.
Rupin Thakkar, M.D., Seattle
American Academy of Pediatrics
What’s the Latest with the Flu for Clinicians
Current Flu Situation
As of March 7, flu activity was still elevated in the United States and expected to continue for several weeks. The season so far has been moderate. The majority of states reported widespread influenza activity at this time. With 40 pediatric deaths from influenza reported so far this flu season, even one preventable death is too many. Flu-related deaths in children younger than 18 years old should be reported through the Influenza-Associated Pediatric Mortality Surveillance System. The number of flu-associated deaths among children reported during this 2016-2017 flu season will be updated each week and can be found at www.cdc.gov/flu/weekly.
It is important to continue to recommend influenza vaccination. Children 6 months through 8
years of age need 2 doses if they have received fewer than 2 doses of any trivalent or quadrivalent influenza vaccine before July 1, 2016. The interval between the 2 doses should be at least 4 weeks. This age cohort requires only 1 dose if these children have previously received 2 or more total doses of any trivalent or quadrivalent influenza vaccine before July 1, 2016. The 2 previous doses do not need to have been received during the same influenza season or in consecutive influenza seasons. See the American Academy of Pediatrics (AAP) policy, “Recommendations for Prevention and Control of Influenza in Children, 2016–2017”, for more information.
The Centers for Disease Control and Prevention (CDC) released a new Morbidity and Mortality Weekly Report (MMWR) titled, “Update: Influenza Activity — United States, October 2, 2016–February 4, 2017.” The report summarizes U.S. influenza activity for the dates listed.
More Influenza Illness Suggests Need for More Rapid Antiviral Treatment
Children clinically presumed to have influenza should be considered for early antiviral treatment, when indicated, independent of laboratory confirmation or receipt of influenza vaccine. This crucial approach can help minimize morbidity and mortality, particularly in young children, and those who are hospitalized or who have underlying co-morbidities. Antiviral treatment should be started as soon as possible after influenza illness onset and should not be delayed while waiting for a confirmatory test result because early therapy provides the best outcomes.
Treating high risk children or children who are very sick with flu with antiviral drugs is very important. It can mean the difference between having a milder illness instead of a very serious one that could result in a hospital stay. See the AAP policy or visit the CDC Antiviral Drugs Web page for information about how antiviral medications can be used to prevent or treat influenza when influenza activity is present in the community. A summary of antiviral recommendations for clinicians is available on the CDC Web page Influenza Antiviral Medications: Summary for Clinicians.
CDC Webinar: 2016-2017 Influenza Season Activity and Recommendations for Clinicians
On February 16, 2017, the CDC Clinician Outreach and Communication Activity (COCA) hosted a webinar titled “2016-2017 Influenza Season Activity and Recommendations for Clinicians.” During this webinar, clinicians learned about 2016-2017 influenza activity to date and heard an overview of CDC recommendations for health care providers including influenza vaccination and the use of antiviral medications for the treatment of influenza. An archived version of the webinar, a transcript, and presentation materials are available online.
Ready Wrigley Preparedness for Flu Season
The AAP worked with the CDC to develop and endorse a new Ready Wrigley Activity Booklet on influenza. Each book aims to build capacity in children’s preparedness by inspiring youth readiness and promoting individual resilience. The books are designed for children 2 to 8 years of age. The Ready Wrigley Activity Book series is produced by the CDC Children’s Preparedness Unit and CDC communication specialists.
For more information, see the AAP Red Book Online Influenza Resource page and CDC FluView. All AAP “What’s the Latest with the Flu” messages are archived. Members of the AAP also have access to Flu Vaccine Recommendations and Key Speaking Points.
Resolutions to protect the children and families of immigrants marked the top three resolutions selected by AAP leaders at the Annual Leadership Forum (ALF) last weekend.
The resolutions called for access to legal representation for families seeking safe haven, protections for children of migrants, and response to the executive order limiting immigration and entry.
Other top 10 resolutions addressed improving mental health access for children, advocating to national leaders to stand against hate crimes and other discriminatory behavior across the country, wider availability of epinephrine supplies in schools, and evidence-based firearm policy and research.
Following are the top 10 resolutions:
“I was happy to see so many of these align with the current work of the Board and with the Strategic Plan,” said AAP CEO/Executive Vice President Karen Remley, M.D., M.B.A., M.P.H., FAAP.
The top resolutions were voted on by 76% of the 199 eligible voting members present.
Leading up to the ALF, AAP members were able to comment on the resolutions online.
Look to the May issue of AAP News for additional coverage of the 2017 ALF.
“The American Academy of Pediatrics (AAP) opposes the Department of Homeland Security (DHS) proposal reported in the media that would separate immigrant mothers from their children when they arrive at the U.S. border.
“Pediatricians work to keep families together in times of strife because we know that in any time of anxiety and stress, children need to be with their parents, family members and caregivers. Children are not just little adults and they need loved ones to comfort and reassure them.
“Federal authorities must exercise caution to ensure that the emotional and physical stress children experience as they seek refuge in the United States is not exacerbated by the additional trauma of being separated from their siblings, parents or other relatives and caregivers. Proposals to separate children from their families as a tool of law enforcement to deter immigration are harsh and counterproductive. We urge policymakers to always be mindful that these are vulnerable, scared children.
“The American Academy of Pediatrics is ready to assist federal officials in crafting immigration procedures that protect children.”
by: Fernando Stein, MD, FAAP, President and
Karen Remley, MD, MBA, MPH, FAAP, CEO/Executive Vice President, American Academy of Pediatrics
ELK GROVE VILLAGE, IL (Feb. 16, 2017) – The American Academy of Pediatrics welcomes today’s decision by the 11th Circuit Court of Appeals to uphold a lower court ruling against Florida’s “physician gag law,” which would have stopped physicians from counseling families on how to keep children safe around firearms.
The ruling means important conversations may continue unfettered between physicians and families about protecting children from unintentional injury and death, and it protects the physician’s First Amendment right to counsel patients.
The court upheld the June 2012 decision of U.S. District Judge Marcia G. Cooke of the Southern District of Florida-Miami, who issued a ruling permanently enjoining the 2011 Florida law restricting physician speech on firearms counseling from going into effect.
“We are delighted that the constitution has been defended, particularly when it comes to the First Amendment.,” said Fernando Stein, MD, FAAP, president of the American Academy of Pediatrics. “Pediatricians routinely counsel families about firearm safety just as they offer guidance on seat belt use, helmets and parental tobacco use to reduce the risk of injury to children where they live and play. These are all topics that families should feel very comfortable talking about with their pediatrician.”
The law would have prohibited a simple conversation in the physician’s office that can save lives. Research has shown that when physicians offer guidance on gun locks and safe storage, appropriate to a child’s specific age and development, it is more likely that families will take those necessary steps.
“We are pleased with the 11th Circuit’s common-sense decision, which allows physicians the right to counsel families on firearms ownership and storage,” said Madeline Joseph, MD, FACEP, FAAP, president of the Florida chapter of the AAP. “This ruling will allow physicians to offer sound medical advice to families without fear of state interference or penalties.”
The Florida Privacy of Firearm Owners Act, which was signed by Florida Gov. Rick Scott in June 2011, violates the free speech rights of doctors and patients. It bans physicians from asking their patients routine questions and having a discussion about firearm safety and subjects physicians accused of violating the statute to harsh penalties usually reserved for egregious professional misconduct.
Soon after passage, the law was challenged in court by the Florida chapters of the AAP, the American Academy of Family Physicians and the American College of Physicians, as well as by six individual physicians. The lawsuit, Wollschlaeger v. Governor of Florida, argued physicians’ First Amendment right to free speech and patients’ First Amendment right to hear the physician’s speech were violated. A U.S. District Court judge agreed with the physicians’ lawsuit and issued a permanent injunction, which was appealed by the state of Florida.
Other medical organizations have also challenged the law. In November 2012, an amicus brief supporting the district court ruling to enjoin the law was signed by the American Academy of Pediatrics, the American Medical Association, the American Academy of Family Physicians, the American Academy of Child and Adolescent Psychiatry, the American Academy of Orthopaedic Surgeons, the American College of Surgeons, the American College of Preventive Medicine, the American College of Obstetrics and Gynecology, and the American Psychiatric Association.
The U.S. Court of Appeals for the 11th Circuit heard oral arguments in the case in July of 2013. Since the Florida legislation passed in 2011, at least 14 other states have introduced similar bills, but none have passed.
Medications and Mothers’ Milk is the worldwide-bestselling drug reference on the use of medications in breastfeeding mothers, providing you the most current, complete, and evidence-based information.
Extensively updated throughout, the 17th Edition includes hundreds of new drugs, diseases, vaccines, and syndromes. The appendices provide information on radioactive drugs and tests, and over-the-counter drugs.
Written by world-renowned Clinical Pharmacologist, Dr. Thomas Hale, and assisted by Dr. Hilary Rowe, this drug reference provides everything that is known about the transfer of various medications into human milk, the use of radiopharmaceuticals, the use of chemotherapeutic agents, and vaccines in breastfeeding mothers.
We would like to work with your association to promote this book to your members. We can offer your association discounting on quantities that are purchased for sale to your members.
More than 350 medical, professional and advocacy organizations signed on to a letter drafted by the Academy to President Donald Trump expressing “unequivocal support” for the safety of vaccines.
The 28-page letter cites and abstracts more than 40 studies on vaccine safety and effectiveness. Co-signers of the Feb. 7 letter represent every AAP chapter along with state and national medical, research and advocacy groups, including the American Medical Association, the March of Dimes and Autism Speaks.
“Vaccines protect the health of children and adults and save lives,” the letter states. “They prevent life-threatening diseases, including forms of cancer. Vaccines have been part of the fabric of our society for decades and are one of the most significant medical innovations of our time.”
As the new administration takes shape, the Academy and others wanted to be on the record early to demonstrate strong support for vaccines and the recommended immunization schedule.
The letter points out that despite successes, outbreaks of vaccine-preventable diseases still occur. “As a nation, we should redouble our efforts to make needed investments in patient and family education about the importance of vaccines … to increase the rate of vaccination among all populations,” the letter concludes. “Put simply: Vaccines are safe. Vaccines are effective. Vaccines save lives.”
A letter from Dr. Alex Malter, Alaska’s esteemed Medicaid Medical Director, on mandatory lead screening for 1 and 2-year-olds on Medicaid in Alaska: “The Department of Health and Social Services is updating its regulations to clarify that lead screening is required for all children enrolled in Medicaid at 12 and 24 months of age. The attached letter from the Division of Healthcare Services provides more detail about the requirement, and provides a contact phone number if you would like more information.”
Congratulations to Jennifer Scoble, MD who will serve as the Alaska’s AAP Chapter Champion for newborn hearing. Dr. Scoble feels strongly in this program and writes, “The early detection and intervention of hearing loss is important to me because I have a personal background and professional interest in neurodevelopment, particularly as it pertains to the NICU graduate, but including all children. We have an opportunity to make a big difference in the lives of children with hearing loss by detecting it early and intervening as soon as possible.”