Setting the record straight on COVID-19 vaccines and infertility

With so much misinformation about COVID-19 vaccines, parents, especially of teenagers, find themselves confronted with some challenging questions that they may not know how to answer.

Among teenagers’ top concerns about the vaccines is whether or not they cause infertility later in life.

“It’s unfortunate this rumor is swirling around because there’s zero evidence of this occurring. It’s a theoretical risk that’s never been shown in any animal model to exist,” said Dr. Shad Deering, a maternal fetal medicine specialist at The Children’s Hospital of San Antonio.

This idea that the vaccines cause issues with fertility originated from a doctor who recognized something on the COVID-19 spike protein – on the virus itself, that was similar to a protein found in human placentas. The doctor thought that the vaccine might make antibodies against that protein and could affect placentas and pregnancies.  But COVID-19 vaccines don’t even cause that protein to be produced, and there have been studies of placentas of women who received the vaccine and there are no differences between them and women who didn’t get the vaccine.  According to Dr. Deering, unfortunate conclusions were quickly made, and soon after the information went viral and exploded on social media.

“There are inherent risks with anything we put in our bodies, from vitamin supplements to coffee and even chicken nuggets and we don’t know how those substances will affect us 10-20 years from now. In the case of the vaccine, the benefits of getting it greatly outweigh the risks,” said Deering.

Dr. Shad Deering, a maternal fetal medicine specialist at The Children’s Hospital of San Antonio, points to research showing there is no link between COVID-19 vaccines and one’s ability to have children afterward.

Teenagers may question the safety of the vaccines because of how quickly they were rolled out. 

Deering said the mRNA technology isn’t new – it’s been around for years.  In fact, Dr. Katalin Karikó, the scientist who was instrumental in developing ways to use it in medical treatments, has been working with mRNA since the 1990s. Additionally, the COVID vaccines now available were thoroughly tested before they were administered to the public and since they were introduced there has been ongoing research showing the vaccines are safe and effective.    

“The process was sped up because we needed an answer to help curb the pandemic. I think most of us are used to hearing vaccines take four to eight years to develop, but if you think about it, does it really have to take that long? With this vaccine, all of the red tape that researchers usually face was taken away which sped this vaccine up significantly while still keeping all of the safety protocols in place,” said Deering.

While the connection between COVID-19 vaccines and infertility is unfounded, the risks associated with being pregnant and contracting the virus are, in fact, real, which is why the medical community is strongly encouraging pregnant women to get vaccinated. 

“There are few things more difficult than seeing a pregnant woman, and sometimes her baby if it happens when too early in pregnancy, die from a disease that could have been prevented with a vaccine,”  said Deering.

There is also a chance that seemingly healthy young people are at risk of developing severe issues after they contract COVID. For example, The Children’s Hospital of San Antonio has seen cases of adolescents and teenagers developing myocarditis (inflammation of the heart) after a COVID infection.

“What it comes down to is getting COVID-19 and the possibility of becoming severely ill and dealing with the long-term effects of the virus versus getting the vaccine which carries minimal short-term. While we know the vaccine doesn’t cause infertility, what hasn’t been studied are the long-term effects of actually getting COVID-19,” said Deering. “Parents, especially teens, need to take the time to arm themselves with trustworthy information sources so they can help debunk some of the myths.”

The Children’s Hospital of San Antonio offers the Pfizer vaccine free of charge to members of our community who are 12 and older. Sign up for an appointment at this link. Once arriving at this link, select specialty: COVID-19 Vaccination. Under COVID-19 Visit Type, select Onsite Pfizer Vaccination Dose 1. Then click on the blue bar with SEARCH in the middle to find available appointments. We provided COVID vaccines in the Goldsbury Center for Children & Families located at 333 North Santa Rosa St., first floor, San Antonio, Texas 78207.  

Walk-ins are welcome on Tuesdays and Thursdays from 9:00 to 11:00 a.m. and 1:00 to 4:00 p.m. Experienced personnel provide the vaccines plus emergency attention is nearby in case of any immediate allergic reaction. If you have questions or concerns, please talk to your pediatrician about the vaccine.

Should Your Kids Be Color Blind?

Ruchi Kaushik, MD, MPH, Medical Director, The Children’s Hospital of San Antonio Complex Care Clinic; Assistant Professor, Baylor College of Medicine

Are your children oblivious to what is happening in our world today? The peaceful protesting of the deadly interactions between law enforcement and persons of color is an historic moment in our country. Undoubtedly, whether you have talked about it at home or not, if they have access to an electronic device, your children know what’s happening. As a parent, it’s important for you to frame current events with the values you want to instill. You must remember that you will always be their favored and most trusted source.

Raising three little girls is no easy task, and I spend countless hours preparing them for issues that may arise in their worlds. I recently stopped at the grocery store and asked my two older daughters to run in quickly and grab a few things. My teen turned to my pre-teen and said, “We have to be on our best behavior and not call attention to ourselves. Don’t ever forget that we are brown.” We have talked about race in our home before, but apparently it was time to hold another family meeting.

How you approach the issue will differ according to your child’s age and to whether your family is white or made up of people of color.

1. Secure your own oxygen mask before securing your child’s: Are you OK? How are you coping? Take a moment to care for yourself. Your child will remember your reaction and emotions far more than your words. I, personally, found it very painful to watch the video of George Floyd’s death and reached out to pediatrician friends who reminded me of the good work we do to advocate for children and that hope is not lost.
2. Check-in with your children: It might be helpful to learn what your child already knows and how they feel about it. Be an active listener and validate their emotions. It is absolutely okay and correct to state out loud that racism is real and the pain that people feel from being mistreated because of their race is real. This conversation will likely be more detailed with older children.
3. Emphasize safety and security: Remind your children they will be OK. With the country’s reaction so visible, children will be most concerned with what will happen to their world. Feeling safe in their home is particularly important for younger children.
4. Take a news break: Young children will benefit from a break from current events.  Spending quality time together as a family will provide reassurance and security.  When you are watching, be sure to watch together and discuss what you see with your child. Be sure to avoid graphic images and sounds. Older children and teens will need help understanding what is true and what is not on the internet and in social media.
5. Listen, ask and answer questions, and teach empathy: When you ask open-ended questions and actively listen and validate their answers, you are role modeling this behavior for your children. Every child’s experiences will be different, but teaching them to be open to others’ perspectives encourages empathy. Explain to your child that just because she hasn’t experienced discrimination doesn’t mean that other children haven’t or that it is not real. A willingness to listen to others and attempt to feel their pain brings us closer as a community and allows us to heal together.
6. Know the Signs:  Children don’t often come out and tell you that they are having difficulty coping with a tragedy.  Rather, they often have difficulty with sleep, problems in behavior, vague physical symptoms such as headaches, changes in appetite, or emotional problems such as depression or anxiety.  Be sure to keep an eye out for these issues and bring them up to your pediatrician or a mental health professional if you have noticed them in your child.

For more information, age-appropriate recommendations, and resources, visit this HealthyChildren.org article written by national American Academy of Pediatrics experts Drs. Nia Heard-Garris and Jacqueline Douge. Dr. Heard-Garris recently participated in the CNN/Sesame Street Racism Town Hall.

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How to Prepare for Your Telemedicine Visit

Ruchi Kaushik, MD, MPH, FAAP, Assistant Professor of Pediatrics; Medical Director, Complex Needs Clinic

The widespread illness and loss of so many Americans is an absolute tragedy. But one great advancement that has come as a result, and that many of my colleagues and I hope will stay, is the growth in the use of telemedicine. It is a safe, effective, efficient, and convenient method to communicate with your child’s doctor for a variety of health issues. I’d like to share some of my own experiences, both as a leader in telemedicine in our institution and as a parent whose child was seen by one of our specialists over video.

Is it telemedicine or telehealth? Or are they the same?

In a telemedicine video visit, your doctor communicates with you in a two-way video and audio call. Telehealth visits can be for many types of health care delivery, such as physical therapy or medication education.

Telemedicine visits can be by phone or by video. We definitely prefer the video because it gives us the opportunity to see your child so we can get as close to an in-person visit as possible.

Examples of platforms used today for telemedicine visits include Microsoft Teams, Webex, Skype, FaceTime, or Doxy.me. The Children’s Hospital of San Antonio uses Zoom.

Before Your Visit

Before you engage in a telemedicine video visit, be sure to call your doctor to see if the type of visit you need can be done by video. A few other things you will need to participate in such a visit include:

• Electronic device (smart phone, tablet, computer)
• Reliable internet access
• Zoom (either the app or on your internet browser)
• Patient portal account with The Children’s Hospital of San Antonio

Once you schedule the appointment, our staff will send you a link to the Zoom meeting as a message on your patient portal account. Staff will also call you a few minutes before the appointment time to “check-in” your child. Then they will transfer the call to the nurse who will ask you essentially the same questions she asks you when you go to an in-person visit.

Keep your phone near you. My child’s specialist wasn’t too busy (surprisingly!) on the day of her appointment, so they called me a little early to see if we could start before our scheduled time. I definitely appreciated that!

During Your Visit

A few tips to having the best experience:

• “Arrive” on time. It gives us the opportunity to focus on your child for as long as possible!
• Make sure you are on mute and that your video is on.
• Place yourself in a room with few distractions (noise, pets, other children) if possible and safe.
• If you have questions, be sure to write them down ahead of time so you don’t forget during the visit.
• Bring your child! Yes! We definitely need (and want!) to see him.
• Don’t be surprised if we ask to look around your home a bit. There is so much we can learn about your child’s health from their environment.
• Know that you are safe. We take your privacy and safety very seriously and assure you our Zoom connections are secure.

As a parent, I remember sitting on the couch with my 11 year-old daughter wondering if the doctor was going to ask me to show him her belly. And I realized that I wasn’t too comfortable with doing that over a video. We will not ask you to show us parts of the exam that may not be appropriate for video and if there is anything you are uncomfortable doing over video, please let us know. Again, your child’s comfort and safety are our priority!

I have really enjoyed telemedicine video visits, both as a doctor and as a parent. And at this time, it may be ideal for a variety of types of appointments. Be sure to call your doctor to check and see if it is right for you and your child.

To schedule an appointment, check out of webpage https://www.christushealth.org/childrens/services-treatments/primary-care and give us a call!

In the Room or Via Zoom?

Ruchi Kaushik, MD, MPH, FAAP, Assistant Professor of Pediatrics, Medical Director, Complex Care Clinic

Today it seems as though the news is coming at us from so many directions and changing by the hour. It can be hard to know what is and isn’t recommended by health care professionals. And although your regular family trips to the grocery store or Fiesta Texas are not advisable, The Children’s Hospital of San Antonio assures you that if you need to make an appointment for your child to see the pediatrician, you can feel absolutely safe doing so.

We are currently seeing patients in person and via telemedicine video visits. Depending upon the type of appointment you schedule, we can help you decide which is best.

Well Child Care Check-Ups (Physicals)

You should continue to bring your child in for well-child care checkups. When we see your child for their checkups we assess several growth and development outcomes:

• Height, weight, and BMI, paying close attention to underweight and overweight
• Developmental milestones, with referrals to therapies as needed
• Immunizations
• A complete physical exam

We are conducting well-child checkups in person. We screen all patients for COVID-19 symptoms by phone and again with a temperature check when they enter our buildings. Any patients with a positive screen are not seen in our pediatric primary care offices.

Sick Visits

At this time, we are doing our best to see most of our patients with illness, and particularly those with COVID-19 symptoms, either by telemedicine video visits or “curbside” (depending upon the clinic location). We will likely offer you a telemedicine video visit, if your child has any of the following symptoms:

• Fever
• Cold symptoms (runny nose, cough, sore throat)
• Difficulty breathing
• Nausea or vomiting
• Diarrhea

Follow-up Visits

You may need a follow-up visit for your child for a chronic problem or for medication refills (e.g. ADHD, asthma). Some of these may require a reliable vital sign (weight, height, blood pressure) or laboratory testing. Call your pediatrician to ask whether an in-person visit is needed or if you may see them by telemedicine video visit.

The Children’s Hospital of San Antonio is devoted to keeping all of our children and families healthy and safe. We want to see your child and for you to feel safe when entering our clinics. For more information or to make an appointment, please visit https://www.christushealth.org/childrens/services-treatments/primary-care to find your pediatrician.

The Sky is Not Falling! Talking to your kids about COVID-19

By Sky Izaddoost, MD, The Children’s Hospital of San Antonio Primary Care – Stone Oak

It’s been about a month, y’all! The kids have been home for a month. Seriously. I said a month.  While our lives have changed, so have the lives of our kids. My 5-year-old thought she didn’t get dessert last night because of “the COVID” (really it was because she didn’t eat enough of her veggies). Yes, COVID-19 has made an impact on our kids regardless of age. The kids miss their friends. Mine haven’t left our neighborhood in weeks. But worst of all, they hear us talk. They hear us say that people are sick. They hear us say people are dying. They hear our anxieties of how to pay the bills when paychecks are getting cut. They know more than you think, but they react differently than we do.

Some kids can tell you how they feel when given the opportunity to talk. Some kids have nightmares. Some kids shut down all together and refuse to talk. It’s up to us as parents to start this conversation and help our kiddos with stress during this pandemic.

So let’s get started. First, find out what they know about COVID-19. If you ever played telephone as a kid, you know that facts get twisted when they are passed from person to person. Talk to your kids about what they know and help reduce their stress by dispelling some rumors that may not be true. A child with anxiety about getting sick will benefit from reminders that they are staying home to avoid getting sick and to stop the virus. Really, y’all are superheroes at home. You are welcome to wear a cape.

Second, a routine y’all! Your kids are used to doing the same thing every day at school or daycare. Set up something similar at home. While it may seem odd to have to wake up, get dressed and not go anywhere, it returns them to a sense of normal.

Wake up by 8 a.m. Get dressed, brush teeth, fix hair, wash face, and eat breakfast. Just like a normal day. Then get schoolwork done. Make sure you set an afternoon goal or surprise to make getting schoolwork done easier. You could make a fairy lantern, create a scavenger hunt for parents, volcano science experiment, tickle war, or bake something. Also, set aside time for exercise – at least 30 minutes a day or work in an hour if you can. Have your kids help make lunch and eat lunch together as a family. 

Add some self-care elements to your routine. Beyond just exercise, pull out that old yoga mat and try some moves with the kids. My kids love to relax in a bath with a fancy bath bomb. Extra points because they made the bath bomb themselves. (Amazon for the win!) Think about ways you relieve stress for the kids during the regular school year and modify them to current conditions. Eating out relieves stress. So, have a picnic.  The weather has been awesome lately. Just make sure to put on the sunscreen and insect repellent based on age.

Practice social distancing. Honestly, I prefer the term “physical distancing.” Let your kids talk to their friends via Skype, Zoom, or FaceTime to keep them involved in each other’s lives. Give bonus time to talk about schoolwork! Kids can play games on Skype like Scattergories, Heads Up, charades, and have dance parties. Another thing you can do is set up a scavenger hunt where each parent provides a list of items and kids have to run around their respective houses with their devices finding two matching socks, or something shiny, or a superhero in a book.

Finally, this is stressful for adults – just as much as it is for our children. Every day there is something new for us to worry about. Take time to have conversations with your kids about everything that is going on. Reassure them of all the things you are doing to keep them safe. And remember to stay positive. San Antonio is an amazing city and our citizens and heroes are rising to the occasion.

So thank you to all of our health care workers, grocery store workers, delivery truck drivers, and all essential personnel for keeping us together and keeping us safe.  And thank you to the stressed-out parents at home who are keeping the kids and our community safe by staying at home with grace. Wear your cape proudly San Antonio. And send us some pics!

Dr. Sky practices at The Children’s Hospital of San Antonio Primary Care – Stone Oak. We are accepting new patients and taking extra precautions at all of our clinics to keep children and their parents safe and healthy. We carefully screen all patients by phone and during each visit, separating our days into morning well visits and afternoon sick visits, minimizing waiting room time and practicing safe social distancing and masking. We also have the ability to do video visits, allowing families to talk with a doctor without leaving home whenever possible. To learn more about our services and locations, find us at https://www.christushealth.org/childrens/services-treatments/primary-care.

How to Approach Your Child’s Behavior Issues When You Can’t Leave the House

By Courtney Smith, MD, FAAP, The Children’s Hospital of San Antonio Primary Care – Dominion Crossing

If you are noticing more tantrums from your toddlers, more attitude from your teens, or rising frustration within your family as a whole, you are not alone. Because of stay-home guidelines, many parents and children have been forced into a “new normal,” now doing school and work from home or shifting into new roles within the family. Add a grumpy, defiant, or exhausted child to the mix and it’s easy to feel like you are drowning.

First, let’s start with some behavior basics. While at times it may seem like your child is pushing your buttons just to test you, most children are not being intentionally disobedient. We know that behavior in kids is an outward manifestation of what is going on within that child. Think of behavior as the tip of the iceberg, or the part you can see above the water. However, the bulk of the iceberg lies below the water and keeps the ice afloat. That part is made up of things like anxiety, fear, sleep deprivation, and other factors that ultimately shape the behavior. Many of those underlying factors are hard for children to identify or talk about, but looking at the cause of behavior change is key to redirecting and reshaping that behavior.

So how do we address the causes of unwanted behavior? Anxiety and fear are important drivers of behavior. Toddlers and younger children are often very dependent on a predictable schedule. There aren’t many things under their control, so knowing “what comes next” is important. Creating a predictable routine can often help decrease anxiety about the unknown and reduce tantrums. For older children and teens, routine is also important, but watching the COVID-19 pandemic unfold is enough to create high levels of anxiety. Talk to your kids. Ask them what they think about the events going on and what they understand about them. You may be able to correct misinformation and reassure them at the same time. Let kids know it’s OK to be frustrated or worried and show them outlets to express those emotions rather than ignoring those feelings.

Healthy meals and exercise are important for growing brains. It’s hard for kids (and adults) to keep their cool when they are hungry or just need to move!  While eating out or going to the playground may not be an option right now, there are a lot of activities you can do as a family to work those muscles and prevent hunger from driving that difficult behavior. Sleep is also important, and just because kids may not be waking up as early for school, staying up all night watching movies or playing games can have major consequences when it’s time to do homework or school assignments the next day. Daily schedules should include meals, wake up time and bedtime as well.

Lastly, help kids connect with one another and family members who they may not be able to see in person right now. Kids can feel isolated just like us, especially when they are used to being at school and extracurricular activities. Create virtual meetings among family members, share a meal together via Facetime, or involve friends or family members for “virtual” story time. Write letters or send words of encouragement to others and show your kids the importance of thinking about others during times of crisis.

So next time you find yourself ready to pull your hair out because of your child’s behavior, take a moment to think about the causes behind that behavior. And if you need some help (which we all do sometimes), reach out to your pediatrician! We are here for you, and many of us are navigating those toddler tantrums and teen angst right alongside you.

Dr. Courtney Smith practices at The Children’s Hospital of San Antonio Primary Care – Dominion Crossing. We are accepting new patients and taking extra precautions at all of our clinics to keep children and their parents safe and healthy. We carefully screen all patients by phone and during each visit, separating our days into morning well visits and afternoon sick visits, minimizing waiting room time and practicing safe social distancing and masking. We also have the ability to do video visits, allowing families to talk with a doctor without leaving home whenever possible. To learn more about our services and locations, find us at https://www.christushealth.org/childrens/services-treatments/primary-care.

We are here for your family!