It is important to keep in mind that any “cold” or upper respiratory tract infection can cause wheezing. Enterovirus D68 is not any different. This virus tends to cause more people to experience difficulty breathing than a typical virus. There is no way to know in advance whether or not your child will develop wheezing when they get cold symptoms. Therefore, the best approach is to monitor their symptoms and call our office if your child develops wheezing or shortness of breath. If your child has asthma and begins to wheeze, then it is appropriate to treat the symptoms by giving asthma medications as prescribed. Our office should be notified if your child is not responding adequately to asthma treatments. Our doctors are available 7 days a week to check your child in the event that they do need to be seen and we can help you determine whether or not a visit is necessary if you are unsure.

At Pediatric Associates we are always trying to make the experience in our office better for you and your child.  To that end we have had many changes at our office this year.  We thought we should make our patients are aware of these changes.

One of the most significant changes has been that we have changed our billing company.  We chose our new billing company because they are more customer service oriented than our prior company.  Please make a note of the name and number of our new billing company:  A-Stat Medical Billing 401-723-5533.  Please call them if there are any questions with your billing statements.  In addition you will find our new office billing policy and HIPPA privacy policy attached to this email.

Near the end of the summer we launched our patient portal through our electronic medical record.  If you have not had your child’s account activated you can call and request activation or activate it when you come into the office. Through the portal you can view your child’s next appointment day and time.  You can request refills, referrals and routine physical appointments on the portal.  Soon you will be able to view lab results and immunization records.  You can also send non-emergent questions to the office through the portal.  Please call the office for sick visit appointments.

In the past month we have also started performing pre-visit screening and developmental screening online through a program called CHADIS.  Once again we are asking families to make an account and register each child.  Then before their next well visit log in and fill out the questions assigned based on your child’s age.  Teens should also fill out a self-report questionnaire so if your child is thirteen or older he or she can log on and fill out his or her own questionnaire as well.  The information on creating an account is attached to this email or a link can be found on our website.

The State of Rhode Island Department of Health has introduced a new requirement for 7th grade immunization.  For September of 2015 students will be required to have the first dose of Human Papilloma Vaccine before 7th grade school entry.  The requirement is being implemented incrementally so that in 2016 2 doses will be required for 8th grade and in 2017 3 doses will be required for 9th grade. As the most recently introduced vaccine we know that many parents have questions about this vaccine and the reasoning behind requiring it.  Please find attached a question and answer sheet that covers the most common concerns about the HPV vaccine.  If you child will be in 7th grade next year you will be offered the vaccine at their next well visit.  If your child will not be in the office for a physical before September 2015 please call the office to schedule an appointment to start the vaccine series.  Likewise if your child has already started the vaccine you can call for an appointment to complete the three dose series.

We will continue to keep you informed as we make changes in the future.

Answers to parents questions about HPV vaccine

Why is a shot for a sexually-transmitted disease required for school?

While Human Papilloma Virus (HPV) can be sexually-transmitted that is not the only way it can be transmitted. HPV is actually a skin infection and can be spread by any skin to skin contact.  HPV is the cause of cervical cancer and the majority of head and neck cancers.  Cervical cancer is the most common cancer in women and head and neck cancer is the third most common cancer in men.  The HPV vaccine should actually be thought of as a cancer prevention shot.  Someone who is infected with HPV has 434 times the normal chance of developing one of these cancers.  By comparison, someone who smokes 2 packs of cigarettes for 20 years has a 10 times the normal chance of developing cancer.  HPV vaccination is a public health campaign to reduce cancer deaths in the future.

Why require it at the young age of 11?

The HPV vaccine is a designed to prevent HPV infection.  Therefore, for maximum effectiveness the three doses should be completed before a young person has initiated any sexual contact.  Studies have shown that children 13 and under who complete the HPV vaccine series have a two to three times better immunity to HPV than those who complete the series after 14 years old.  Studies have also shown that one-third of students have had sexual intercourse by the end of 9th grade and two-thirds have had sexual intercourse by the end of 12 grade.  Waiting until high school may be too late.

My child is not sexually active, why do they need this shot now?

The analogy has been used to compare HPV vaccine to bike helmets.  When do you tell your child to put on their bike helmet 1) Before they get on their bike 2) After they are riding their bike 3) When there is a car headed towards them or 4) After they have already been hit by the car.  A person does not have to engage in sexual intercourse to transmit HPV any type of sexual activity or experimentation can transmit the virus.

Wouldn’t giving my child the vaccine be giving them permission to have sex?

When you give your child a tetanus vaccine are you giving them permission to stick themselves with rusty nails?  Use vaccination as an opportunity to discuss with your child your family’s values surrounding sexual activity.  You can also have a discussion about the multiple other sexually transmitted diseases which the vaccine does not protect them against.

Is the vaccine safe and effective?

All the studies have shown HPV vaccine to be as safe and effective as all of the other routine immunizations.   The majority of the side effects seen are injection site pain and fainting after injection.