The flu vaccine doesn’t cause the flu. Period.

by Jennifer Gunter MD

Child Receiving Flu Vaccination

Over 80 percent of children who died from flu last year were not vaccinated.

Flu vaccines are available, and so that means that the anti-vaccine brigade is out in force.


The Daily Mail published an anti-vaccine op-ed by a former reality TV contestant named Katie Hopkins. It was followed by a shorter counter argument by a doctor, but when you are given less than half the word count and are at the bottom of the page it is hard to mount an effective response. Hopefully the Daily Mail will give us an op-ed next week on how the earth is flat.

I noticed many responses to Ms. Hopkins on Twitter were from people who claimed that they previously caught the flu from the vaccine.

So one more time, for all the kids in the back: The flu vaccine does not cause influenza.

The flu vaccine is made with an inactivated virus that cannot cause illness or with a process using a recombinant technology that contains no virus at all.

The nasal spray, not recommended currently in the United States due to lower efficacy, also can’t cause the flu. It does have a live virus, but it is highly weakened and can’t cause infection.

Children should absolutely get the vaccine. In the 2016-2017 flu season over 100 children in the United States died from the flu. Over 80 percent of those who died were not vaccinated.

If you get sick right after the flu vaccine one of the following has happened:

  1. You have a cold, and you have mistaken it for the flu.
  2. You have the flu, but you were incubating it before the vaccine. The vaccine takes about two weeks to work.
  3. You have the flu and were unlucky enough to get a strain not covered by the vaccine.
  4. You have the flu, and it is a strain that is covered by the vaccine, but you did not get as sick as you would have without the vaccine.
  5. Nocebo effect. You expected something bad to happen and so your body produced symptoms.

If you aren’t sure, it is the flu let me tell you it isn’t the flu. With the flu, you really feel as if you are going to die. It’s that bad. I had it several years ago, and for two days I had to crawl to the bathroom. I was too weak to walk.

So let’s please put this myth to rest.

The flu vaccine doesn’t cause the flu.


Link to original article published in MedPage Today




Children and sports: Choices for all ages

by Mayo Clinic Staff

Children’s sports promote fitness, but not all children thrive in formal leagues. Help your child find the right sport and venue — school, recreation center or backyard.


Want to give your child a head start on lifelong fitness? Consider children’s sports and other kid-friendly physical activities.

With your encouragement and support, chances are a few sports will spark your child’s interest. Fan the flame by taking your child to local sporting events and sharing your own sports interests with your child.

Consider age-appropriate activities

Your child is likely to show natural preferences for certain sports or activities. Start there, being careful to keep your child’s age, maturity and abilities in mind.

Ages 2 to 5

Toddlers and preschoolers are beginning to master many basic movements, but they’re too young for most organized sports. Keep in mind that toddlers who participate in organized sports also typically don’t gain any long-term advantage in terms of future sports performance.

At this age, unstructured free play is usually best. Try:

  • Running
  • Tumbling
  • Throwing
  • Catching
  • Swimming
Ages 6 to 9

Click here to read the rest of this article from the Mayo Clinic

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Fever in children: 5 facts you must know



A recent issue of Pediatrics includes a new report detailing the need for doctors to improve patient teaching about fever and fever-reducing drugs.

Many parents fear their child getting a fever, or have “fever phobia.” I certainly can understand why. Kids can do crazy things when they get fevers. They don’t sleep well, eat poorly, and behave strangely. Some children can even have seizures due to a quick spike in body temperature. So it isn’t surprising that beginning as early as the pre-natal consultation, parents ask questions about what to do when their child gets a fever.

Concern about childhood fevers is long-standing in our history. Fever superstitions and ancient fever remedies are ribboned throughout all cultures. For example, Romans would trim the fingernails of those affected with fever. Using wax to attach the fingernail clippings to a neighbor’s front door was thought to transmit the fever to that household. Note: Do not have ancient Romans as neighbors. And, even today, I will occasionally see children whose elders have used a method called cupping to literally suck the fever out of them.

So, here are 5 fabulous facts about fever. Some of these statements may be exactly opposite what our mothers have said about fever. The goal of this post is not to discredit grandma, but to decrease fever phobia and treat fever correctly. And with the right information, maybe the next time our pink-cheeked kiddos come to us with warm foreheads, we might not be so eager to jump to our medicine cabinets.

Please note: The following facts are NOT true for infants under the age of 3 months. Please talk to your pediatrician about newborns with fever.

1. There is no “number” on a thermometer that requires a trip to the Emergency Department.Nope, not even 104F degrees. With very specific exceptions, kids do not have to maintain a “normal” temperature during times of illness. Fever is a normal, healthy way for the body to fight common infections. Bacteria and viruses that attack our bodies love normal body temperature, but cannot successfully replicate in hotter conditions. Fever, therefore, reflects a robust immune system’s defense against these pathogenic attackers. The bacteria and viruses are the enemy, not the fever they cause.

So remember: fever is a symptom of illness, not a disease. Seeing a high number on the thermometer means your child’s body is doing its job to fight an infection.

2. The severity of fever does not always correspond with the severity of illness. So, what does that mean? A fever is generally defined as over 100F degrees. However, with few exceptions, the degree “number” over 100F really doesn’t matter. In fact, a fever of 101F degrees does not make more difference to me than a fever of 103F degrees.

I have kids running and playing in my office with high fevers. I have other children who look sluggish and sad with a reasonably mild fever. Every kiddo reacts to a fever differently. So regardless of the actual numerical value, look for signs of serious illness in your child. Observe his level of discomfort, level of activity, and ability to maintain adequate hydration. If you are concerned, call your pediatrician to discuss the next steps.

3. Fevers do not have to be treated with medication. Fevers help the body fight infection. Treating a fever is only necessary when you think your child is uncomfortable. The goal of administering antipyretic (anti-fever) medications is not to get a high temperature back to “normal.” They are simply medications to make your child feel better.

Fevers can make kids feel pretty lousy. Children can have altered sleep, unusual behavior, and poor oral intake. If these symptoms are upsetting to your child, please give a fever reducing medication. Treating fever does provide comfort, and may decrease the risk of dehydration.

As an aside, if you are coming to the pediatrician’s office because your child has a fever and her or she is uncomfortable, please give your child a fever reducing medication prior to coming to the office. You do not have to wait until the doctor “sees them with a fever.” A comfortable child is much easier to examine. And a good exam will often determine the cause of the fever, allowing for accurate treatment.

4. Half of you are dosing fever medications incorrectly. As many as one-half of parents do not administer the correct dose of fever reducing medication to their child. This includes both under-dosing and over-dosing. Medications should be dosed according to your child’s weight, not age. Always use the measuring device that comes with the medication. If you lose the dosing device, use only a standard measuring instrument (syringe, medicine cup) as a replacement. Household spoons and measuring spoons are not always accurate.

I often hear parents deliberately under-dosing their child. They say, “I didn’t really want to give him medication, so I just gave him a half-dose.”

A “half-dose” will do nothing. Don’t bother.

If you feel that your child needs medication, give the correct dose. If you have questions about your child’s dosage or the proper measuring device to use, call your pediatrician.

5. Fever does not cause brain damage. In a person with a normal functioning brain, and the ability to cool oneself, fever is normal response to infection. Every normal brain has a internal “thermostat” that will prevent a person’s temperature from getting high enough to cause brain damage. It is only when hyperthermia, or heat stroke, occurs when damage to the brain and other organs will occur. Hyperthermia happens in the rare instances when an individual’s brain cannot regulate temperature well (as in a rare case of brain injury) or when an individual is not able to cool oneself (as in a closed car on a summer day.) Fever due to illness in a normal child will not cause organ damage.

Natasha Burgert is a pediatrician who blogs at KC Kids Doc.

Babies often get overdoses of prescribed narcotics

By Fran Lowry

NEW YORK (Reuters Health)  – Infants and children being treated with narcotics routinely receive overdose amounts, according to a study presented in Denver this past weekend at the annual meeting of the Pediatric Academic Societies (PAS).

Narcotics are usually given to young children in liquid formulations, which are difficult for parents to measure correctly. Also, pharmacists may not account for the child’s weight when prescribing, said Dr. William T. Basco, Jr, from the Medical University of South Carolina in Charleston.

“Narcotics involve a large proportion of drugs that are most commonly involved in adverse drug events and we also know that parents have problems properly measuring liquid preparations, so taking those two factors together, we wanted to find out more about the frequency of potential overdoses in young children,” Dr. Basco told Reuters Health.

He and his colleagues identified the top 19 narcotic-containing drugs prescribed for children aged 0-36 months from a review of 2000-2006 South Carolina outpatient Medicaid data. They calculated the expected daily dose of the narcotic based on Centers for Disease Control and Prevention growth chart data to impute the weight of each child as the 97th percentile based on age and gender, and then compared that dose with the actual amount of narcotic dispensed by the pharmacy.

During that time, there were 149,791 prescriptions for narcotic-containing preparations, for patients with a mean age of 18 months.

“Most of these prescriptions were appropriate, for post-operative or post-trauma pain. Some were for antitussants, and I think that is an important point to emphasize,” Dr. Basco said.

Fifteen percent of the prescriptions contained an overdose quantity of narcotic, the research team found. The average excess amount of narcotic dispensed was 53% more than expected.

The researchers also found that the younger the children, the more frequent the overdoses. More than half (61%) of infants aged 0 to 2 months who received a narcotic got an overdose, compared with 35% of infants 3 to 5 months old, 17% of infants 6 to 11 months old, and 8% of children 12 months or older (p<0.0001).

Younger children also got larger overdoses. Compared to expected doses, actual doses were 90% higher in the 0 to 2 month age group, 53% higher in the 3 to 5 month group, 36% higher in the 6 to 11 month set, and 34% higher for babies 2 months and older (p<0.05).

In addition, the youngest infants were dispensed more than twice the expected quantity 20% of the time. In comparison, infants 3 to 5 months got more than twice the expected quantity 3.8% of the time, infants 6 to 11 months, 1.5% of the time, and for children 12 months or older, it was just 0.2% of the time (p < 0.05).

“Clinicians need to remember that the younger the child, even small deviations from the appropriate dose will make a big difference,” said Dr. Basco. “Giving 20% more drug when you are 5, 6, or 10 years old doesn’t matter as much, but when you are a 2-month-old, then it matters a lot.”

The sedative effects of the narcotics can cause young children to stop eating and drinking and become dehydrated. “Very few would die from overdose but that is possible, but the greater issue is dehydration and this is harmful,” Dr. Basco said.

He added that, ideally, all pediatric prescriptions should be based on the child’s weight.

“For inpatients, our hospital pharmacy will not send any drugs to the floor unless the child’s weight is on the order, but ambulatory prescriptions that you get at Walgreens or CVS do not consider the child’s weight,” Dr. Basco added.

Click here to read the rest of this article.

What is a concussion and what does it mean for a child?

by Christopher Johnson, MD

When it comes to football season,  it’s time to think about sports injuries. We frequently have children admitted to the PICU (or to what we call the intermediate or step-down unit) for observation, typically overnight, who have struck their head. They have had concussions. What is a concussion, and what does it mean for the child?

The term itself is centuries old, but even thirty-five years ago, when I was in training, the actual definition of concussion was a bit vague. What was usually meant was that the patient got hit on the head and either lost consciousness briefly or at least wasn’t quite himself for some period of time afterward. These days we’re more precise than that, but concussion is still a somewhat inexact term. This is mainly because of our ignorance of the subtleties of how the brain works.

The formal definition of concussion is a transient interruption in brain function. By implication, various scans of the brain, such as CT scans or MRI scans, show no abnormalities. Since all the imaging studies are normal, defining concussion is necessarily inexact. I’m sure one day we’ll have some kind of machine that detects the reason for the symptoms of concussion, but right now we don’t have such a thing — concussion is an entirely clinical diagnosis, meaning there’s specific no test for it.

There are several systems for grading concussions. Here’s how the American Academy of Neurology grades their severity:

Grade I: confusion, no loss of consciousness, symptoms last for < 15 minutes, has memory of the event
Grade II: confusion, may lose memory of the event but no loss of consciousness, symptoms last for > 15 minutes
Grade III: loss of consciousness and no memory of the event

The list of symptoms that can come from a concussion is a long one. Headache, dizziness, vomiting, and ringing in the ears are common. Various behavioral changes are also common, such as lethargy, difficulty concentrating, and irritability.

What are the effects of concussion on a child? Years ago we pooh-poohed the idea that mild concussions cause brain problems. For example, football players were sent right back into the game after experiencing a concussion. We now know that is dangerous. As a general rule, we don’t recommend any contact sports for at least a week (some authorities say longer) after all symptoms have cleared. This is because a repeat blow to the head, even a very mild one, can cause severe injury to a brain that has not fully recovered from the last injury.

What about long term effects of concussions? The overwhelming majority of children who suffer a concussion, especially a mild one, recover completely. But around a fifth or so of children who have had severe concussions continue to have problems many months afterward.

You can read much more about concussions at the federal Centers for Disease Control, the Mayo Clinic, and the respected Brain Trauma Foundation.

Christopher Johnson is a pediatric intensive care physician and author of Your Critically Ill Child: Life and Death Choices Parents Must Face, How to Talk to Your Child’s Doctor: A Handbook for Parents, and How Your Child Heals: An Inside Look At Common Childhood Ailments.  He blogs at his self-titled site, Christopher Johnson, MD.