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Background: The influence of pediatricians on parental acceptance of COVID-19 vaccine for children has not been well studied. We designed a survey to estimate the impact of pediatricians' recommendations on caregivers' vaccine acceptance while accounting for participants' socio-demographic and personal characteristics. The secondary objectives were to compare childhood vaccination rates among different age groups and categorize caregivers' concerns about vaccinating young (under-five) children. Overall, the study aimed to provide insight into potential pro-vaccination strategies that could integrate pediatricians to alleviate parental vaccine hesitancy. Methods: We conducted an online cross-sectional survey study using Redcap, in August 2022. We enquired COVID-19 vaccination status of the children in the family (≥five years). The survey questionnaire included socio-demographic and personal characteristics: age, race, sex, education, financial status, residence, healthcare worker, COVID-19 vaccination status and side effects, children's influenza vaccination status, and pediatricians' recommendations (1-5 scale). Logistic regression and neural network models were used to estimate the influence of socio-demographic determinants on children's vaccine status and build predictors' ranking. Results: The participants (N = 2,622) were predominantly white, female, middle-class, and vaccinated against COVID-19 (89%). The logistic regression model was significant vs. the null (likelihood-ratio χ2 = 514.57, p < 0.001, pseudo-R2 = .440). The neural network model also demonstrated strong prediction ability with a correct prediction rates of 82.9% and 81.9% for the training and testing models, respectively. Both models identified pediatricians' recommendations, self-COVID-19 vaccination status, and post-vaccination side effects as dominant predictors of caregivers' vaccine acceptance. Among the pediatricians, 70.48% discussed and had an affirmative opinion about COVID-19 vaccine for children. Vaccine acceptance was lower for children aged 5-8 years compared to older age groups (9-12 and 13-18 years), and acceptance varied significantly among the three cohorts of children (χ2 = 65.62, p < 0.001). About half of the participants were concerned about inadequate availability of vaccine safety information for under-five children. Conclusions: Pediatricians' affirmative recommendation was significantly associated with caregivers' COVID-19 vaccine acceptance for children while accounting for participants' socio-demographic characteristics. Notably, vaccine acceptance was lower among younger compared to older children, and caregivers' uncertainty about vaccine safety for under-five children was prevalent. Thus, pro-vaccination strategies might incorporate pediatricians to alleviate parental concerns and optimize poor vaccination rate among under-five children.
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Objective: Vaccination is an important measure for the prevention of coronavirus disease 2019 (COVID-19). In the present study, we aimed to evaluate parents' attitudes toward vaccinating themselves and their children. We also searched whether information about the multisystem inflammatory syndrome in children (MIS-C), a severe complication of COVID-19, could change parents' decisions on vaccinating their children. Method(s): A questionnaire form consisting of sociodemographic features, COVID-19 vaccination practices, and knowledge about MIS-C was applied to parents of children attending Bezmialem Vaklf University Hospital from March through June 2022. Factors affecting vaccine hesitancy were evaluated. Result(s): Among 383 parents, COVID-19 history was present in 248 (64.8%), and 165 (43.1%) were hesitant to vaccinate themselves. The number of cases where both parents had received at least one dose of COVID-19 vaccine was 256/354 (72.3%). The most common reasons for vaccine hesitancy were vaccines being new in 53/165 (32.1%) and fears of side effects in 95/165 (57.6%). Parents' hesitation toward vaccination of their children with the COVID-19 vaccine was highest for the 0 to 6 age group (78.9%) (73.6% in the 6-12 age group, and 47.3% in the 12-18 age group). In total, 365/383 (95.3%) parents did not have an opinion about MIS-C. After information was given, 62.5% of the 302 participants who opposed vaccinating children under 6 years changed their decision to have their children vaccinated. Conclusion(s): Although routine childhood vaccinations were performed in 99% of children, more than half of parents were hesitant to vaccinate their children with the COVID-19 vaccine. The majority did not have an opinion about MIS-C. Briefings by pediatricians about complications of COVID-19 will help avoid vaccine hesitancy. Copyright © 2023. Thieme. All rights reserved.
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Purpose of Study: Individuals with neurodevelopmental disabilities (NDD) encounter the healthcare system more frequently than their neurotypical peers, but most systems have not adapted a patient-centered approach to train staff and design spaces that are optimized for individuals with NDD. Certified Child Life Specialists (CCLS), Developmental-Behavioral Pediatricians, and a board-certified behavioral analyst at the Center for Excellence in Developmental Disabilities (CEDD) at the UC Davis MIND Institute partnered with nursing teams from the UC Davis COVID Vaccine Program to develop a dedicated Vaccine Clinic that addresses common barriers to vaccination for individuals with NDD. The program included training for vaccine program staff, and COVID vaccination and vaccine education for individuals with NDD in a safe, inclusive setting. Methods Used: MIND Institute staff obtained input from CEDD Community Advisory Committee and community partners to develop clinic protocols and dissemination strategies. Vaccine program staff received training about NDD and a website and video describing the clinic were created. After patients scheduled an appointment, they were contacted by CCLS who completed a structured intake interview that addressed each patient's likes and dislikes, sensory sensitivities, preferred method of communication, and history of previous experiences with medical procedures. Prior to the vaccine appointment, Child Life staff shared a social story with the families that provided a visual description of each step of their visit to the MIND Vaccine Clinic. Team huddles were completed the morning of vaccine clinic. Summary of Results: 321 doses of the COVID-19 vaccine were scheduled to be administered to individuals with NDD ages 5 to 67 years (225 M, 91 F, gender nonconforming 5). 8 appointments were either canceled or the individual did not attend. We were able to safely administer 310 (99.3%) doses. Conclusion(s): Strategies were developed to address common barriers to vaccination, some of which are more common in individuals with NDD, including sensory dysregulation, history of medical trauma, and concerns about how a novel vaccine might impact a patient's specific medical condition. A structured intake, staff training, daily huddles and a quiet dedicated space, longer appointments and dedicated parking were key elements of clinic success.
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INTRODUCTION: To maintain high vaccination rates, vaccination interventions should be targeted according to interests such as parents' knowledge, attitudes, beliefs, and vaccine hesitancy. METHODS: This research was conducted between June 2020 and April 2021 using a questionnaire about optional vaccines (OVs) in Turkey. RESULTS: A total of 241 physicians participated and 14 physicians were excluded due to insufficient data. Finally, a total of 227 physicians, including 115 pediatricians and 112 family physicians, were included in the study. The mean age of pediatricians and family physicians was 33.42 ± 8.25 years and 35.46 ± 11.09 years, respectively. There was no significant difference between pediatricians and family physicians in terms of age and gender (p > 0.05). Nearly half of all physicians (49%) stated that they do not have sufficient knowledge about OVs. Pediatricians (64%) stated that they have sufficient knowledge at a higher rate than family physicians (37%) (p = 0.000). Physicians who declared having sufficient knowledge informed families about OVs more frequently than those with insufficient knowledge (p = 0.000). Pediatricians provide information about OVs more frequently than family physicians (p = 0.001). Rotavirus and meningococcal vaccines were the most frequently recommended vaccines. CONCLUSIONS: Rotavirus and meningococcal B were the most recommended OVs. About half of the physicians participating in the study stated that they did not have sufficient knowledge about OVs. Physicians with sufficient knowledge of OVs recommend OVs more frequently.
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There are a lot of questions regarding the differentiation and diagnosis of ophthalmic diseases by a doctor of first contact. The article in the form of questions and answers presents a multidisciplinary discussion of a pediatrician and an ophthalmologist in relation to anatomical and physiological approaches to the formation of diagnoses, those conditions that are accompanied by the symptom of "red eye". The authors discuss algorithms for diagnosis, and modern approaches to the treatment of red eye syndrome. Clinical criteria for acute conjunctivitis of various etiology are presented. Considered modern approaches to the diagnosis and treatment of eye lesions using local antibacterial agents in various forms of releases, different combinations of active substances, including the drugs Floxanext, Tobrotsim-Next-Sombi and Tobrotsim-Next.Copyright © 2021, Professionalnye Izdaniya. All rights reserved.
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OBJECTIVE To explore the elasticity of the primary health care (PHC) private offices in Greece during the pandemic crisis, and to identify the features that make an independent private practice resilient to unfavorable situations. METHOD A survey of clinical and economic activities was conducted among general practitioners, internists and pediatricians working in private practice in Thessaloniki. The participants were questioned about their practice during the first (March to May 2020) and second (October to December 2020) phases of the COVID-19 pandemic. Statistical analysis of the data was carried out. RESULTS A significant drop in visits was reported during the pandemic, while telemedicine consultations increased. Profits were reduced, with variation depending on the size of the office and the specialty of the doctor. Most physicians received some sort of financial aid from the government, but overall, the consequences of the pandemic were not catastrophic for their private practice. CONCLUSIONS PHC private offices in Thessaloniki survived the difficulties caused by the pandemic, despite a loss in income. The private practitioners adjusted to the new policies that were implemented during this health crisis.Copyright © Athens Medical Society.
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Introduction: COVID-19 pandemic brought multiple negative consequences that go beyond the direct damage caused by the disease and that affect health systems as well. Complaints of attacks against health care workers became frequent and concerning. The objective of this survey was to characterize the frequency and type of violent behavior against front-line professionals in Latin America. Material(s) and Method(s): A cross-sectional electronic survey was carried out between January 11th to February 28th, 2022. Different health care workers from Latin America who have been delivering care at least from March 2020, regardless of whether they assist or not patients with COVID- 19 were included. A non-probabilistic snowball sampling was performed, and the survey was Results: The survey was responded by 3,544 participants from 19 countries (Figure 1);58.5% were women, and the mean age was 41.9+/-11 years. The 70.8% were doctors, 16% nurses, 3.4% physiotherapists, and the remaining 9.8% had other functions within the health team. About 85.1% of physicians were specialists: 33.9% were cardiologists, 14.4% were intensivists or emergency physicians, 10.9% had some surgical specialty, 7.7% were pediatricians or related subspecialties, and the remaining 33.1% had other specialties. The 36.3% and 28.8% worked in public and private practice respectively, the remaining worked in both. Direct and regular care to COVID-19 patients was provided by 74.7% of all contestants. Among the participants, 54.8% reported acts of violence: 95.6% suffered verbal violence, 11.1% physical violence, and 19.9% other types. 39.5% of respondents experienced it at least once a week. The acts of violence involved patients' relatives (32%), or patients together with their relatives (35.1%). The victims rated the stress level of these events with an average of 8.2+/-1.8 points (scale from 1 to 10). Approximately half of the health personnel who suffered an assault experienced psychosomatic symptoms after the traumatic event (Figure 2). Among the victims of violence, 56.2% considered changing their care tasks, and 33.6% abandoning their profession. However, only 23% of the health personnel attacked stated that they had made some type of legal action regarding these acts. In a logistic regression model, doctors (OR 1.95, p<0.01), nurses (OR 1.77, p=0.001), and administrative staff (OR 3.20, p<0.01) suffered more violence than other health workers. Women more frequently suffered violence (OR 1.56, p<0.01), as well as those who worked with patients with COVID-19 (OR 3.59, p<0.01). Conversely, a lower probability of violence was observed at older ages (OR 0.96, p<0.01). Conclusion(s): We detected a high prevalence of violence against health personnel in Latin America during the current pandemic. Those caring for COVID-19 patients, younger staff, and women were found to be more vulnerable. It is imperative to develop strategies to mitigate these acts and their repercussions on the health team. (Figure Presented) .
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BACKGROUND: SARS-CoV-2 vaccination of all age-eligible populations is an important part of the COVID-19 pandemic response. In Ontario, vaccination coverage in 5-to-11-year-old children has remained lower than in other age groups. We sought to understand pediatricians' perception, practices, and barriers to SARS-CoV-2 vaccination in children, particularly children aged 5-to-11 years, to inform interventions and promote capacity of pediatricians as vaccinators and vaccination promoters. METHODS: This is a descriptive, cross-sectional study consisting of an online self-administered questionnaire distributed to 1,313 pediatricians in Ontario. Descriptive statistics, including Chi-square or Fisher's exact tests, were performed. RESULTS: In total, 152 Pediatricians responded (11.6% response rate), from February 17, 2022 to March 17, 2022. 78% of respondents were general pediatricians and 22% were pediatric subspecialists. Median years of practice was 17 (8-31), with 68% female, 32% male. Most pediatricians thought it was unlikely that children aged 5-to-11 years would become seriously ill from acute COVID-19 caused by Delta (66%) or Omicron (80%). 92% were very likely to recommend the COVID-19 vaccine for children aged 5-to-11 years. COVID-19 vaccine was perceived as safe, with higher safety perception in children aged 5-to-11 compared to 12-to-17 years (p < 0.0001). COVID-19 vaccines were thought to be effective in reducing hospitalization or severe illness, and reducing SARS-CoV-2 infection, with higher perceived effectiveness against Delta compared to Omicron (p < 0.0001). 97% felt confident counselling caregivers of children aged 5-to-11 years on the COVID-19 vaccine. Few pediatricians did not feel confident in accessing resources for health professionals (6%) or for patients/caregivers (12%). CONCLUSIONS: Most surveyed pediatricians were very likely to recommend COVID-19 vaccination for children aged 5-to-11-years, perceived COVID-19 vaccines as safe and effective, and felt confident in their COVID-19 vaccine counselling for children aged 5-to-11 years. However, there remains areas for further training and capacity development.
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COVID-19 Vaccines , COVID-19 , Humans , Male , Child , Female , Child, Preschool , Cross-Sectional Studies , Ontario , Pandemics/prevention & control , COVID-19/epidemiology , COVID-19/prevention & control , SARS-CoV-2 , Pediatricians , VaccinationABSTRACT
Introducion. COVID-19 in children is a relatively mild disease. Though a more serious condition characterized by systemic infl ammation does occur in children in a Kawasaki disease-like form named multisystem infl ammatory syndrome (MIS-C). MIS-C in children is a less common pathology. Case Report. A clinical case of multisystem infl ammatory syndrome in children (MIS-C) temporally associated with SARS-CoV-2 infection in a previously healthy preschool-age girl is presented. The disease had an incomplete Kawasaki disease-like form corresponding to this syndrome in children and adolescents as defined by WHO and CDC criteria. Conclusion. This clinical case draws the attention of general practitioners and pediatricians to the peculiarities of this type of syndrome diagnosis and management.Copyright © 2021 Croatian Paediatric Society. All rights reserved.
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Cardiological problems in children are a common reason for consultations on duty. Cur-rently, due to the pandemic caused by SARS-CoV-2 virus, it is necessary to limit unnec-essary contacts and any consultations should be justified. On the other hand, there are cardiological conditions that may be dangerous to the child's health, because among the trivial reasons for consultations, there may be significant irregularities that require detailed diagnostics and treatment. For this reason, a family doctor or a paediatrician should make a thorough initial assessment taking into account whether a cardiological consultation is necessary. If so, does it have to be performed urgently, or can it be a planned examination.Copyright © 2021, Wydawnictwo Czelej Sp. z o.o.. All rights reserved.
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By September 2022, approximately 2. 88 million doses of COVID-19 mRNA vaccine had been administered in Japanese children, and 9 cases of vaccine-related anaphylaxis had been reported. Of these, 2 cases were determined to be definite anaphylaxis by expert review, for an incidence rate of 0. 7 cases per million doses. This is equivalent to the incidence of anaphylaxis from adverse reactions to existing vaccines. If anaphylaxis occurs, pediatricians should administer an intramuscular injection of adrenaline, the first choice of treatment for anaphylaxis. The allergen contained in mRNA vaccines is likely to be polyethylene glycolPEG. Therefore, we must be cau-tious in our decision to vaccinate individuals with a history of allergic reactions to PEG-containing agents. However, since no clinical test has been established to confirm allergic reactions to PEG prior to vaccination, efforts are being made to identify high-risk patients by questionnaire. It is necessary for each facility to clearly state how to respond to anaphylaxis and share information among staff so that treatment can be reliably administered in the event of anaphylaxis.Copyright © 2022, Dokkyo University School of Medicine. All rights reserved.
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By September 2022, approximately 2. 88 million doses of COVID-19 mRNA vaccine had been administered in Japanese children, and 9 cases of vaccine-related anaphylaxis had been reported. Of these, 2 cases were determined to be definite anaphylaxis by expert review, for an incidence rate of 0. 7 cases per million doses. This is equivalent to the incidence of anaphylaxis from adverse reactions to existing vaccines. If anaphylaxis occurs, pediatricians should administer an intramuscular injection of adrenaline, the first choice of treatment for anaphylaxis. The allergen contained in mRNA vaccines is likely to be polyethylene glycol(PEG). Therefore, we must be cau-tious in our decision to vaccinate individuals with a history of allergic reactions to PEG-containing agents. However, since no clinical test has been established to confirm allergic reactions to PEG prior to vaccination, efforts are being made to identify high-risk patients by questionnaire. It is necessary for each facility to clearly state how to respond to anaphylaxis and share information among staff so that treatment can be reliably administered in the event of anaphylaxis.Copyright © 2022, Dokkyo University School of Medicine. All rights reserved.
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By September 2022, approximately 2. 88 million doses of COVID-19 mRNA vaccine had been administered in Japanese children, and 9 cases of vaccine-related anaphylaxis had been reported. Of these, 2 cases were determined to be definite anaphylaxis by expert review, for an incidence rate of 0. 7 cases per million doses. This is equivalent to the incidence of anaphylaxis from adverse reactions to existing vaccines. If anaphylaxis occurs, pediatricians should administer an intramuscular injection of adrenaline, the first choice of treatment for anaphylaxis. The allergen contained in mRNA vaccines is likely to be polyethylene glycol(PEG). Therefore, we must be cau-tious in our decision to vaccinate individuals with a history of allergic reactions to PEG-containing agents. However, since no clinical test has been established to confirm allergic reactions to PEG prior to vaccination, efforts are being made to identify high-risk patients by questionnaire. It is necessary for each facility to clearly state how to respond to anaphylaxis and share information among staff so that treatment can be reliably administered in the event of anaphylaxis.Copyright © 2022, Dokkyo University School of Medicine. All rights reserved.
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Introduction: Prepubertal vaginal bleeding outside the neonatal period is always abnormal and is very alarming to both parents and physicians. The variable etiologies of vulvovaginitis are the most common causes of vaginal bleeding during the prepubertal period. We report a series of three cases observed during covid" period of 2020-2022. Case report: two patients 8 and 9 year -old girls, were refered to pediatric secondary center due to of external vaginal bleeding. Hormonal levels were pre-pubertal and bone age was not advanced. Both girls were hospitalized and sellar X-ray and pelvic MRI were done during further course, not revealing the etiology of bleeding. Six months after the first bleeding, they were reffered to a pediatric gynecologist where foreign bodies (grass seed) were found during vaginoscopy. Third patient, a 3-year- old girl, was examined by her pediatrician because of heavy bleeding. Hormonal analysis and bone age were not suggestive of precocious puberty. Additional analyses revealed elevated alpha fetoprotein level (>5000 IJ,), which led to the diagnosis of yolk sac tumor in vagina wall, which was then confirmed by vagionoscopy and biopsy. It is important to perform vaginoscopy in premenarchal girls with repeated vaginal bleeding because in patients older than five years, a common reason for vaginal bleeding is foreign body but in younger patients, the primary goal is to exclude a malignant tumor.Copyright © 2023
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The course of COVID-19 in pediatric patients is usually mild or asymptomatic, but with the dominance of new virus variants, more children become symptomatic and require hospitalization. Since the end of 2021, a significant increase in the percentage of children infected with SARS-CoV-2 has been observed. This paper aimed to update the recommendations on the management of a child with COVID-19 in outpatient and inpatient settings. The current possibilities of prophylaxis, diagnostics, and antiviral treatment were discussed, indicating the limited availability of therapy for children. The mainstay of COVID-19 treatment in most pediatric patients is symptomatic and supportive treatment, as well as measures aimed at reducing the spread of SARS-CoV-2 infection.Copyright © 2022, Wydawnictwo Czelej Sp. z o.o.. All rights reserved.
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Objective. The aim of the study was to intercept early problems and difficulties in onset and stabilization phases of breastfeeding, in a population of healthy full-term newborns - during the COVID-19 pandemic - through a Clinical Governance Project, supported by the Department of Neonatology and Pediatrics, which introduced a speech therapist, as part of the professional team acting synergistically with neonatologists, pediatricians, pediatric nurses, midwives and gynecologists. Materials and Methods. Over a period of two months (2020), n = 72 newborns, 38 males and 34 females, were recruited (mean age:1.3 days) in the Departments of Neonatology and Obstetrics and Gynecology of Castelli Hospital, ASLRM6. Lingual frenulum neonatal screening (Martinelli, 2015) was administered to all the newborns and the frenulum was classified as normal, doubtful or impaired. Breastfeeding difficulties were evaluated and speech therapist counseling was performed, to support early onset and stabilization of breastfeeding. Results. Lingual frenulum screening resulted normal in 36 (50%), doubtful in 20 (28%) and impaired in 16 (22%) of total newborns. An alteration of both lingual and upper labial frenulum was found in 16 (22%) of the newborns studied. n = 23 newborns (32%) showed alterations able to hinder breastfeeding: these cases were successfully managed by helping the mothers to change the breastfeeding position, adopting a rugby hold position. Conclusions. According to our preliminary results, speech therapist counselling, in the critical COVID-19 pandemic, allowed early detection of lingual frenulum alterations, and their impact on the onset of breastfeeding. We found that altered lingual frenulum was associated with breastfeeding difficulties: in these patients, speech therapist intervention resulted useful in managing early breastfeeding problems.
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Background Changes to paediatric services during the Coronavirus disease 2019 (COVID-19) pandemic potentially challenged children's fundamental right to health. As COVID-19 has presented with greater morbidity and mortality in adults than in children healthcare resources including staff were diverted from paediatric services to support adult care. Infection- control measures were also implemented including hospital visiting restrictions and reduced face-to-face paediatric care. Objectives We investigated paediatricians' perceptions around the impact of changes to paediatric services during the first wave of the COVID-19 pandemic on children and young people (CYP) to develop recommendations for maintaining their care during subsequent pandemics. Methods A multi-centre service evaluation was conducted through surveying consultant paediatricians working within the North Thames Paediatric Network a cohort of paediatric services in London. Results Forty-seven consultant paediatricians across six National Health Service trusts completed the survey. Lower quality of paediatric care due to redeployment was reported (61%;n=28) alongside consequences of visiting restrictions for CYP's mental health (79%;n=37). Fewer hospital attendances of CYP were linked to caregivers' fear of COVID-19 infection-risks (96%;n=45) and government 'stay at home' messages (89%;n=42). Although 52% (n= 24) relayed that care accessibility had improved with virtual formats inequities for those with reduced technological access or skills were noted (83%;n=38). Risk of harm to children with complex needs disabilities and safeguarding concerns was reported due to reductions in face-to-face care. Paediatricians largely perceived that the prioritisation of adults during the pandemic had compromised children's right to health (81%;n=33). Conclusion Consultant paediatricians raised concern around poorer quality and accessibility of paediatric care during the pandemic's first wave and resulting harm occurring to children. In future pandemics children's welfare must receive greater consideration and support. Recommendations for future practice are provided based upon our findings including maintaining face-to-face consultations with vulnerable and disadvantaged children.