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Time	Subject
00:24	Introduction
10:25	The role of pediatricians in vaccinations
12:46	How preparations for children’s vaccinations are going
19:11	How the dose for children is determined
21:12	Addressing hesitancy for vaccinating children
25:50	Considering flu shots in addition to the COVID-19 vaccine

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jocogov.org/coronavirus

Theresa Freed  00:00

COVID-19 vaccine eligibility expands to a new age group. On this episode, hear how children ages five through 11 can get their shots.

Announcer  00:08

Whether you live in or just love Johnson County, Kansas, JoCo on the Go has everything Johnson County, here's what's happening and what's coming up in the community you call home.

Theresa Freed  00:24

Thanks for joining us for JoCo on the Go, I'm your host Theresa Freed, a Johnson County resident and employee of Johnson County government. This week the Johnson County Department of Health and Environment is starting to vaccinate children ages five through 11 against COVID-19. On Tuesday, November 2, the Centers for Disease Control and Prevention approved recommendations to offer the Pfizer vaccine to this new age group. Last week on Thursday, November 4, the county held a Facebook live discussion featuring JCDHE Director Dr. Sanmi Areola and pediatrician Jennifer Watts with Children's Mercy Hospital. The discussion was facilitated by our own Director of Public Affairs and Communications, Jody Hanson. Here are some of that conversation on pediatric vaccines.

Dr. Sanmi Areola  01:07

Good afternoon, everyone. And as always, good to have Dr. Watts with us. Dr. Watts and her colleagues at Children's Mercy Hospital has been very integral to our efforts, testing, vaccinations in schools, childcare establishments. And now, I'm sure it's she's as happy as I am to see that we now have Vaccines for Children five to 11. That's been a big gap in our efforts to ensure that we have protection across our different age groups. And so we're very happy to sit to see that it's good to know that we have a vaccine that's gone through a very stringent process to ensure that its efficacy is at the level that we want to ensure that it's safe and that children can be protected. And that's what this vaccine has proven to be just like we saw in adult population, what we have seen is that it's highly efficacious in protecting children. And, and it's very safe. So the situation now is a little bit different than a lot better than it was in January when we started vaccinating and the adult population, we have more providers in the community. Dr. Watts is going to talk about their efforts regarding getting pediatricians to get ready be providers and get again, these are the people that you typically go to for your vaccines. And that's what we encourage you to do. Vaccines are available at a lot more than the health department a few other people now. So we wanted to do that. Finally, before I invite Dr. Watts to just share what they're doing is this is very important, very critical to get our children vaccinated. One of our primary goals, and that's what we've worked with, that Dr. Watson had him on, is to keep us unspoken. We want our children to learn. We want them to learn in person, it is the best way to learn. There are benefits to social interactions, and all the things that are associated with impulse and learning. And there's not a better way to get there than to get a high percentage of them vaccinated. But we've been pretty clear that our efforts to protect our children protect our vulnerable population is best done through a layered approach. There's not one magic wand. So we've been very clear that vaccination is good, but the wearing mask and others are more important. But especially because this population did not have they were not eligible for vaccine a it did add a layer of risk. And so again, for me pretty excited about the model we get just like we did we've done, we're going to try to get them out as quickly as we possibly can. Dr. Watts, you've been in the middle of this been in several meetings where you've talked through this, it's clearly at the heart of what you do. So they had to watch it and mercy does. Take it away. Let people hear from you.

Dr. Jennifer Watts  04:26

Yes, thank you. Thank you so much for having me. I know that you know this collaboration with Children's Mercy and the Johnson County Health Department has been phenomenal as is all the health departments in our region. This is this is a public health crisis that we've been dealing with from day one. And so the support from all the health departments has just been absolutely phenomenal. So thank you. Thank you for having me. And I will say you know when we get the word of the approval it's a celebration for us because we've been waiting for this for so long. We've wanted this to go through the appropriate channels. We've wanted this to go through all the necessary pieces that it took to make sure that this is a safe and effective vaccine, if this would have rolled out, you know, months ago, we'd still be happy, I'm not gonna lie, we'd still be happy. But the fact that it's gone through this process, and it has taken this time to get there, has made us ecstatic. That we know and we are putting forward a product that is safe and effective for our children. That's at the heart of everything that we do at Children's Mercy. And this vaccine is no different. You know, when 12 to 17 became eligible for vaccine, we were happy then, and we are happy again with five to 11. And when we hit the under five group, then it's going to be another time that we are very happy, we are fortunate in the sense that in the adult world, they only get one celebration, and we get three. So we are lucky in that sense. Because these are, these are definitely big days for us. And we have done a lot of work and trying to prepare our hospital as well as some of the community in order to provide vaccine to as many people as with like, if we see this in phases, obviously, we've got this large group of people that have been waiting for this day and want their children vaccinated, myself included, from you know, right out of the gates. And, you know, we want to try to get as many kids vaccinated as possible immediately. We also know that there's a large group of individuals that want to take time to look at the data to look at the information and make the best decision for their own family. And it may take them a little bit longer than some people to make that decision. But we hope that by providing some of the factual information to everybody that, you know, we can help that group come to the best decision for their family. And then we'll probably have some people that don't want to get vaccinated. And that group exists as well. And so we've tried to so far, we've tried to prepare for everybody, and in the best ways that we can. We have, we have vaccine clinics that we have opened for scheduling our first clinic, well, I guess I'll take a step back, we send on the state line. So we've got clinics in Missouri, we also have clinics in Kansas, which means we received vaccine from both the state of Missouri and from the state of Kansas. Our shipment in Kansas arrived the same day, as I believe Sanmi that you guys got yours is my understanding our mass vaccination clinics are on Saturdays. And then we are offering a small amount during the week, Monday through Friday. And during normal business hours, most of our vaccine efforts are trying to get to the masses as best as we can. That being said the most I mean, most childhood vaccines are given through your pediatrician offices. And so we actually prefer this even though we're standing up clinics to try to help with the volumes of people that want to be vaccinated. But we actually really like when you go to your pediatrician office and get your vaccine from them. You have a pediatrician for a reason. You ask your pediatrician, all kinds of things about your child's health. You go to them to get your childhood vaccines, but you also go to them when your child has a fever and you you want to know what's going on and want to do what's in the best interest for your child in regards to their health. So I think you most likely if you have children, you trust your pediatrician for all things health related when it comes to your kids and COVID-19 is no different. When it comes to questions for the vaccine. When it comes to questions about the illness of COVID-19 your pediatrician or your family practice doctor is your your general practitioner is your most trusted source of information for you. You've already established that relationship. And so first and foremost, we recommend a lot, you know a lot of people trying to go to their pediatrician offices for their vaccine. I do know there are quite a few pediatric practices in Johnson County that are offering vaccine. Some of them have started already. Some of them are making plans to start in the upcoming weeks. Everybody is at this a little differently. And we have worked with a lot of practices to try to help them get their clinics off the ground. But at the same time, there's a lot of people that want to get vaccinated today, and I love the enthusiasm, but there's no way we can get everybody vaccinated today that wants to be vaccinated. And so it's the balance of getting the vaccine from the state administering the vaccine in your clinic too. And so we do ask for a little patience to you know, get get these kids vaccinated as quickly as possible. But I certainly do know that there are a lot of pediatricians in the area that are celebrating with us. And they are launching their vaccination efforts to,

Dr. Sanmi Areola  10:05

um, thank you, I think you touched on quite a few themes that I'm going to ask you to talk about a little bit more. So we have a, for example, in Johnson County, in this age group, we have just under 56,000 children that would be eligible. So that's a lot of people.

Dr. Jennifer Watts  10:25

I think that, you know, pediatricians are at the core of your child's health, and you start from birth and seeing your pediatrician. And some people even go before their child is born, to meet the pediatrician and make sure that this relationship is going to be a solid relationship, it's a lot of trust to put into an individual when it comes to the health of your child. But that relationship builds I mean, there's a lot of things we do on the pediatric side, why you have to come in for your well child checks over and over, especially in the first year of life. Part of that is to get your childhood vaccines, but part of that is to, you know, to help you with some of the preventive care that is necessary and children. But a big portion of that is establishing that trust, and building that relationship with your pediatrician. And, and I think when it comes to kids health it that that relationship is one of the most important relationships that you can have with your child. And so I do think, you know, COVID-19, while there's a lot of information out there, and there's a lot of you know, it has become politicized over this time period. COVID-19 is no different. This isn't a this is a virus that affects your child, just like a common cold, just like flu, just like bacterial infections, it, it makes an impact on your child's health, the same as all these other illnesses. And so, when you turn to your pediatrician for other illnesses, it makes sense to go to your pediatrician for COVID-19 as well. Your pediatricians know a lot of the information about the vaccine, you know that information comes through the channels, it goes through the FDA, it goes through the CDC, and then the pediatricians have access to that data to and they can look at it and they can interpret it and you know, they know reputable sources versus not reputable sources. And your pediatricians are not going to give you false information because they have your child's health at their core to that's our job as pediatricians. And so I do think that that's probably one of the most trusted sources when it comes to your child's health that you can turn to answer some of the questions and concerns that you have.

Jody Hanson  12:46

So I guess talk through a little bit about the preparations that you're making right now and that your staff is making and maybe specifically what you're doing to make sure that these children are comfortable in the room where they're where they're getting the shots,

Dr. Sanmi Areola  13:00

However, the primary goal is to keep our children safe and keep our schools open, that this will become will move to the top of our priority. And that's what we have done, we have tried to anticipate how many of these 56,000 will actually want to take the vaccine and I think genuine throughout the three different groups, I would take it now. Some will wait until they get additional information and some will just not take it and some will take it after they talk to their pediatrician. So although I've spoken with more recently with a couple of people's like, Okay, I said, talk to your doctors or where are the doctors I've spoken to for doctors, they're all saying the same thing. Take the vaccine itself. And some people are going to take longer to convince them. But because right now we not only have three approved vaccines, J&J, Moderna, and Pfizer. Now we have booster shots and additional shots. And then we and some of those come in different from doses and the children. Children vaccine is 10 micrograms of active ingredients, which is a third of what the adults are getting. So it is important to do it in a way that does not allow for mistakes. It's also important to know that children react in different ways and Dr. Watts can talk through some of that when we started vaccinating 12 to 15 year old. The reactions that we got were a lot different from the adults. So that so the way that we are going to be given out the vaccine does require that we ensure that the process worked very, very smoothly. Opportunities for mistakes reduced but also make the kids comfortable with their parents. We are going to have nurses that are dedicated to just give him pediatric vaccines, we're still doing the other ones. But in terms of our capacity, this is where we're devoting most of our resources to a lot of calls from parents by phone, a lot of emails, people wanting to take it. And that's a good thing. And that's why that patience is important. But also to know that there are other venues to get the the shots and listening to a pediatrician tell you even what her preference is. I think I think that's, that's very important. So,

Dr. Jennifer Watts  15:34

Jody, when you talk about preparation at Children's Mercy, one of the big things I think we've done is tried to get information out to the public. On our website, you'll find a lot of materials about the vaccine. It has our vaccine schedule, too. But there's a lot of extra materials out there. If you have questions, we have a couple FAQ sheets on our website that answers some of the most common questions that we are receiving about vaccine. We have, we have all most of our documents translated into Spanish and English, we have information on the vaccine and nine different languages. If the most commonly spoken languages in our region, so we're trying to do our best to get factual information out into the community. We invite as many people to take a look at the information, take a look at the questions. And just look at it, discuss it within your family. And if you have questions about any of the information on our website, your pediatrician, because it's certainly able to address a lot of the information that is there. They have the same information that's on our website. But your pediatrician can definitely address any questions that you may have. When it comes to preparation of you know it for administering vaccine to kids. This is what we do. This is this is our thing. And we've been doing this for years, we continue to do it, we administer vaccines to children all the time. And so this is this is certainly where I think we shine. We do have a whole program called comfort promise that helps children become comfortable with receiving the vaccine, we have a few additional pieces in for pain control. And we do have certain methods and techniques for children with high sensory needs. That they can use and you know we can assist them with when they come through our vaccine clinics. Sometimes just being in a large room with a lot of vaccines going on in a mass vaccination setting can be can be challenging for some children. And so we do have, we do have certain spaces that we can utilize if needed for children with high sensory needs. I will say though, you know, I'm going to go back to your pediatricians office because that's where your child's comfortable going anyway. So that's definitely always something to keep in mind. If your child's comfortable there, though that would definitely be a priority. As far as the different dose in pediatrics, we dose things all the time, based on weight based on age, we are used to this system where most people need different doses. And so we do have all of our standard safety precautions in place to ensure that every child receives the appropriate dose for their age.

Dr. Sanmi Areola  18:28

Thank you for that information. And I know that Dr. Watts had sent out all this information about their website, also to a larger group yesterday. But you can also go to our website Jocogov.org/coronavirus, COVID-19-vaccine, and get also a lot of information. I don't know, Jody, we have also prepared FAQ's also there. I don't know that posted yet. So lots of information. But I guess the key message here is comfort of your kids. questions that you have going to the pediatrician, pediatrician offices where they're very comfortable is also, again, underscored here.

Jody Hanson  19:11

And I just happened to see a question on Facebook that fits in exactly to what Dr. Watts was just talking about. So I was gonna try to sneak that in really quick. So somebody was asking about the dose for children. Is it based on age? Is it based on weight? I didn't know if you could clarify that a little bit. And also, questions about if this has been approved by the FDA

Dr. Sanmi Areola  19:30

test, you know of products, vaccines or this is it's not something that just started with COVID It's something that we we have been doing and yes. So the dose does is very important. And yes, bodyweight consideration is important. But children their organ system is still great. All of those are taken into consideration and determining which so for a long time It's kind of been assumed in testing for, for this product that to have an older will be tested with certain assumptions and terrain younger than that we sign an assumption. So what's important in testing are the use of any product is to make sure that we they are effective. And we use them at the dose where we minimize the undesirable effect and maximize the desirable effect. So if it's effective 30 micrograms of active ingredient that's, that's what we want to use. And so that's been tested, this was tested in a few 1000 children found to be highly effective, over 90% effective risks that are that the benefits far outweigh. So the dose at which this is approved, is effective, it works and risk of adverse consequences are pretty low. So again, that's I don't have Dr. Watts has something to add to that.

Dr. Jennifer Watts  21:07

I don't have anything else to add, it's all age based.

Jody Hanson  21:12

What are you anticipating? And what are you hearing as far as levels of hesitancy for this among parents of children in this new age group five to 11? Who are who just become eligible, and then also maybe getting a little bit older? The 12 to 18 year old? What has that level of hesitancy been like?

Dr. Jennifer Watts  21:32

I think there's there certainly is a level of hesitancy how great it is, I think will be determined, right? I mean, a vaccine is only as good as the people that take it. So I think we will see the you know, what level of hesitancy there is, you know, after we can get this first round of vaccines into people's arms. There's definitely a lot of questions. So rightfully so that, you know, you always want the best for your child. And so a lot of people asking really good questions. And I'm glad to see the questions. And I'm glad that people are asking the appropriate questions. And that's part of why we put together the FAQ sheets on our website and tried to get a lot of that information out. But I do certainly think there is hesitancy, and that is to be expected. What I can tell you, you know, one of the biggest questions we get is, why do we need to get the vaccine in this age group are kids even affected with COVID-19. And even though it's certainly less than adults, you know, the severity is less than adults, kids in this age group, the five to 11 age group specifically, certainly do still get vaccinated still certainly get COVID-19 infection. We know that nationally, there's been over 2 million cases in this age group of COVID-19, over 8000 hospitalizations for the five to 11 age group. And we have had 94 deaths in this age group nationally. So I think that's something just to keep in mind that yes, it still does affect children. One death in a child of five to 11 is concerning. And so we, you know, that number while it is smaller than the adult population, 94 deaths in the age group of five to 11 is still a concerning number to me. This age group is also the age group that has the highest rates of MS see the multi system inflammatory syndrome in children. That's a that's a process that occurs after you've had COVID 19 infection. And this is the age group where we've seen the most cases of Missy, so it's certainly something that affects children in this age group. And definitely there's hesitancy around it. But I just wanted to emphasize, you know, the children in this age group do get COVID-19 infection. And so it is important to get yourself educated by factual information and reliable sources on the vaccine.

Dr. Sanmi Areola  23:54

And I think that that last sentence for, for us the have to answer these questions every day and deal with the inaccurate information that's out there. It's very important to get your information from the proper sources. And you heard about the infections that we've seen more recently, while the younger children account for what is it 22% of the population, about 27% of recent infections are occurring, those children know they don't die as often as older persons do, but every death in this population is too many, especially when there are things we can do to prevent that and taking the vaccine is a good first step to do that. Again, we cannot overemphasize, it's okay to have questions. If you have questions. Ask for answers from the right sources. And especially in this climate, there's just a lot of information out there. That can be confusing, too. People who don't deal with this everyday. So talk to your pediatrician, talk to people with expertise in this area, get the right information before you make the decision. Yes, just like we saw in the adult population, there's been a few studies out there in terms of the level of hesitancy to expect. But just like we saw in the adult population to, we are not having clinics where we are given 3000 shots daily anymore, but we are given 100 here, 50 here, and we keep improving on the numbers. And that's what I expect in this age group. And it's okay to take your time until you have your questions answered before you decide to get it. But as questions from the right sources, I think that's a very important part of this process.

Jody Hanson  25:50

Well, I know something else that's communicated this time of year is get your flu shot as we get closer to flu season, or maybe we're already there. So parents might be wondering if they can if their children can get their flu shot and their COVID-19 vaccination at the same time?

Dr. Jennifer Watts  26:07

The simple answer to that is, yes. Yes, you can get it at the same time. You know, in pediatrics, we get a lot of vaccines together. And initially, when COVID-19 came out, they you know, it was not recommended to give with other vaccines. And as we've gathered more data behind that, as a country, then, you know, we have found that it's safe to go ahead and administer concurrently with other vaccines. So 100% Yes, flu vaccine COVID-19 vaccine, both of them save lives, we strongly recommend both of them, and you most certainly can receive them at the same time.

Jody Hanson  26:45

Okay, thank you. So as it's as we're getting more doses, and parents can start making more appointments as more of those open up, I guess, just talk through the logistics, where should they go to make appointments and also maybe you could talk about if those children will need a second dose and that length of time in between doses to that would be good to know.

Dr. Sanmi Areola  27:06

All right, so for four appointments with the Johnson County Department of Health and Environment, it's go to our website. Jocogov.org/covid-19-vaccine, you can click on the link to make an appointment is also a two dose regimen similar to that of adults. You get the second dose three weeks after the foster so very, very important to keep that in mind. Again, even though we are assuming that everybody's aware. While there are positive news coming from other vaccines, Moderna, J&J, right now, this is available only through Pfizer. Actually, the other two are only still approved for 18 plus. So anybody younger than 18 is still taking that Pfizer. So you say is a second dose three weeks after the first dose?

Jody Hanson  28:00

Do you anticipate that the other vaccines will at some point offer you know be eligible or be available for children young or younger?

Dr. Jennifer Watts  28:08

We certainly we certainly hope so. And I know Moderna it will be most likely to be the next one on the market for pediatric vaccine, J&J. I'm not totally sure about

Jody Hanson  28:23

I think we're probably ready to wrap up. Is there anything else that each of you would like to add or put an exclamation point on if just to emphasize it a little bit more?

Dr. Jennifer Watts  28:35

I will say I think the summary points are it's safe and effective. Yes, we should do it. If you have questions, talk to your pediatrician. access our website if you need anything. If you have any questions, any concerns, get some get some good, good trusted information. Talk to your pediatrician about it. As far as scheduling. My last request is be patient. You know, this is a world where a lot of pediatricians are just now kind of coming into and so be patient with your with your pediatric practices. We will get everybody vaccinated it will take a little bit of time, but we will get everybody vaccinated, check back frequently with the offices and with our patient portal and with our phone number. And hopefully everybody will get vaccinated.

Dr. Sanmi Areola  29:23

Of those just underscoring the fact that you need please be patient with us. We are opening up appointments, but there are many, many people that want it the demand is high. Appointments are being taken up very quickly. We're working to look at opportunities to even add more appointments. And as we open those up, we'll let you know. If you have questions. You can also reach out to us we'll answer your questions. Reach out to reputable sources that you can trust their information before you make Your decisions, it's okay to have questions. It's okay. Really to be hesitant as long as one is seeking knowledge and seeking information from the appropriate sources. And finally, Dr. Watts and your team, we are very appreciative of what you have been done in the community. People just see you out there once in a while. They're not aware of the things that go on behind the scenes, very happy that you are entering Mercia, what you are doing in the community, helping to protect our children. This is a very big deal to have vaccines available to five to 11 year olds, in addition to the 12 to 15 that we already have. It's a big deal. We can have a lot of our children vaccinated. Of course, the vaccine is only good if we can get into the arms of people. But this is very important in ensuring that in person learning, our school environment are safer, even looking into the future. So thank you. Thank you for joining us

Theresa Freed  31:07

Get much more on COVID-19 vaccines in Johnson County by visiting jocogov.org/coronavirus. Thanks for listening.

Announcer  31:15

You just heard JoCo on the Go. Join us next time for more everything Johnson County. Have a topic you want to discuss? We want to hear from you. Follow us on Facebook and Twitter at JoCoGov. For more on this podcast, visit jocogov.org/podcast. Thanks for listening.