Update from: Dr. Ruth McDonald, VP, Associate Chief Medical Officer (Hospital Operations) and Chief Medical Operations Officer, and Dr. Danielle Zerr, Medical Director, Infection Prevention
In recent weeks, there have been reports of myocarditis occurring after COVID-19 vaccination with Moderna or Pfizer vaccines, including in Europe, where the European Medicines Agency (EMA) recently requested data from Pfizer and Moderna on reports of myocarditis and pericarditis after vaccination. Washington state public health agencies and the CDC are aware of these reports.
Health care providers should do the following:
- Consider a diagnosis of myocarditis or pericarditis in any evaluation of chest pain following COVID-19 vaccination.
- Inquire about recent COVID-19 vaccination in any patient presenting with symptoms consistent with myocarditis or pericarditis.
- Clinical features of myocarditis and pericarditis include chest pain or pressure, shortness of breath, electrocardiogram (EKG) changes and elevated cardiac biomarkers.
- Elicit a detailed history including vaccination status and potential exposures to COVID-19. Patients should be tested for COVID-19 infection using a molecular (PCR) test.
- Report such cases promptly to the U.S. Vaccine Adverse Events Reporting System (VAERS): https://vaers.hhs.gov/reportevent.html).
- It is recommended that the evaluating (not administering) provider report the incident to VAERS so appropriate clinical details can be reported accurately.
- Report cases of myocarditis or pericarditis within two weeks of any COVID-19 vaccination to Public Health – Seattle & King County at 206-296-4774 including information on vaccine manufacturer, vaccination date, dose number as well as history of prior SARS-CoV-2 infection.
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As of Thursday, May 13, 2021, Seattle Children’s is offering appointments for the Pfizer COVID-19 vaccine to youth ages 12 to 15, in keeping with FDA and CDC guidance on lowering the age limit for the Pfizer vaccine.
Any individual wishing to make a vaccine appointment at Seattle Children’s must use our scheduling portal. Youth under age 18 must be accompanied by a parent or legal guardian to sign the consent at both the first and second dose appointments. They do not need to be a current Seattle Children’s patient to schedule a vaccine appointment.
Vaccine appointments can also be made through the Washington State vaccine locator. Please direct any questions about COVID-19 vaccines at Seattle Children’s to COVIDCommunitySupport@seattlechildrens.org.
Dr. Rusty Novotny is the director of Seattle Children’s Epilepsy Program.
How common is epilepsy?
Rusty Novotny
Dr. Novotny: About 0.6% of kids have active epilepsy. If you imagine an elementary school with 500 students, that’s about 3 kids.
The highest incidence of pediatric seizures is in the newborn period and then it drops dramatically; it’s lowest in adolescence and continues to gradually increase as a function of age. Febrile seizures (from fever) are most common in children between 6 months and 6 years old. We rarely see febrile seizures in kids over 6 years old in the absence of other underlying risk factors. This is great because it means that kids can “outgrow” the risk of a seizure recurrence with febrile seizures and certain types of seizures in epilepsy syndromes we see in children.
One in 10 people will have a seizure at some point in their life. Read full post »
A new algorithm helps PCPs know where to refer patients for concussion at Seattle Children’s.
- Neurology sees patients who have had ongoing headache for over two months, in the absence of a sports injury.
- Sports Medicine sees patients who experienced a sports injury concussion, are at least 6 years old and have not experienced any of the following: hospitalization for more than 24 hours, skull fracture, intracranial hemorrhage, focal neurological deficit or neurosurgery/brain surgery of any kind in the past.
- Rehabilitation Medicine sees all other concussion patients.
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We have been hearing from providers who are wondering if they could make exceptions to the age limitations on the COVID-19 vaccines and administer the drug “off-label” or under an expanded use exception. While it may be tempting to consider, and there are certainly high-risk scenarios in which it feels like it might be best for a child or adolescent to receive the vaccine as soon as possible, the regulatory status of this vaccine makes that inadvisable at this time. “Off-label” use is allowed for FDA-regulated products that have received full approval, but not in the case of products offered under an emergency use authorization (EUA). Read full post »
To address suicide as a public health crisis, leading experts and healthcare organizations have collaborated to develop All Patients Safe: Suicide Prevention for Medical Professionals. This interactive, online suicide prevention training is designed for medical professionals and client-facing staff in Washington state. It offers an engaging and informative option for providers to become better skilled at suicide prevention and includes perspectives of real patients coupled with practical skills to help medical providers transfer what they learn to their practice and community. Read full post »
Seattle Children’s is proud to report we have surpassed a milestone of more than 10,000 opioid-free outpatient surgeries at our Bellevue Clinic and Surgery Center.
Seattle Children’s is a national leader in efforts to reduce the use of opioids during outpatient pediatric surgeries, while maintaining or improving pain management and outcomes for patients.
Last spring we shared an interview about this innovative approach with Dr. Lynn Martin, an anesthesiologist and medical director of the ambulatory surgery center at Seattle Children’s.
Seattle Children’s researchers want to better understand how different play-based activities influence attention and language outcomes. Families with toddlers between the ages of 18 and 24 months with no serious medical conditions or developmental concerns, born at 37 weeks or more and 4 pounds, 7 ounces or more, and who are exposed to English as a primary language are invited to participate in this study. We are following COVID-19 safety protocols for in-person appointments. Read full post »
When Cassie Fannin was 19-weeks pregnant with her first baby, she couldn’t wait for the ultrasound that would reveal her child’s gender. During the appointment, she and her husband, Michael, were delighted as they watched their beautiful baby wiggling around on the ultrasound screen.
Six years ago, Cassie Fannin’s world was turned upside down when she found out her baby, Summer, had a life-threatening congenital diaphragmatic hernia. She was devastated, but a Seattle Children’s surgeon gave her hope and showed her she could handle anything for her daughter.
Cassie asked the technician, “Is it a boy or girl?”
But the technician’s previously cheerful expression now suggested something was wrong. “I’ll need to check with the doctor,” the technician said while hurrying out of the room.
Moments later, a doctor gave Cassie and Michael the devastating news that changed their lives. Read full post »
Provider Grand Rounds
Events are held from 8 to 9 a.m. via Webex. Access information is here.
May 6, 2021: Assessing Antibiotic Allergies in Children: What’s New and What’s Practical?
William E. Pierson Allergy Lecture. David Khan, MD, Program Director, Allergy & Immunology Fellowship Program, Professor, Department of Internal Medicine and Pediatrics, UT Southwestern School of Medicine. Read full post »
