and good evening.

Thank you so much for watching HealthLine on PBS for Wayne.

I'm Mark Evans, your host.

Thank you for watching.

And we invite you to participate in our program this evening.

We have a telephone number on your screen as I speak 866- (969) 27 two zero.

We'll be taking your live calls throughout the program for the next half an hour.

And we don't stop down because we're for commercials because we are public television, you know.

All right.

So our very special guest tonight he's been on the show before but it's been a while.

Dr. Tony Equina, a pediatrician great to see you again, Mark.

>> Thanks for having me on.

Absolutely.

And we have a very important subject, very relatable especially this time of the year and that is vaccines and fighting all these nasty infections you can get during the wintertime.

So we want to address that and you are a pediatrician but you are more than welcome more than willing I should say to answer questions regarding seniors and everybody in between.

>> Absolutely.

Bring it on.

Yeah, because vaccines just are not for kids and they're not necessarily vaccines.

But we're going to talk about RSV flu and covid during the program which are the three primary things we have to be concerned about this time of the year.

So we'll go ahead and get started.

I want to know what does this time of a year what is it about this time of the year?

>> It makes us more prone to some of these viruses.

Well, it's Follmer and you know, when that temperature starts to drop and those leaves start to turn color is beautiful for sure but it does mean that viruses are right around the corner and this is what we call respiratory season.

This is when some of the most dangerous viruses circulate and they circulate fast and they are very contagious and once they wind up in a community watch out because if you're not protected there's a really good chance you're going to wind up with one of these viruses.

>> Yeah, fortunately I didn't get sick enough to to go to a doctor because I have had what I'm getting over with right >> I don't know if you can tell by my voice you look great.

I think I look great, sound awful but I'm a great but yeah I was very sick last week and I finally got over the hump so luckily I didn't have to have any medications.

In fact my doctor and the doctor's office recommended I just let it ride out and if it got worse of course to get it checked out and pay some attention to it.

>> So but anyway we want to get started here RSV especially for infants and you know, of course that affects the seniors as well.

>> But has RSV been around or is this something fairly new like covid?

>> Great question.

It's been around for years and decades and who knows how long until they've actually identified it.

>> It stands for the respiratory syncytial virus RSV and it's got an annoying loud name and it is an annoying loud virus and like I said, it is extremely contagious.

We've been dealing with RSV as pediatricians forever and we know again as soon as those turn change colors it's going to be a long respiratory season and we're going to be ready again to treat a number of children and young infants with RSV and the deleterious consequences that come with it.

RSV is boy that is a dangerous virus.

It infects about two thirds of all children before they turn to and what's worse than that is still hospitalized children.

About two to three percent of all children that do get RSV will be hospitalized with that virus.

>> Is the shadow of death possible for the RSV boy, it for most children it is an annoying cough congestion that is going to last for weeks.

Again, a very rare but complication is hospitalization about two to three percent of those children.

Death is a possibility.

We have seen it.

It's very rare but for all of these cases it is going to really wind up with a weeks of illness and those hospitalized children are going to be hospitalized for at least four or five days and that means a parent that's going to have to take time off work to care for them so you can see how this adds up over the course of an entire population of of Americans where boy, we're going to be really struggling to take care of our most vulnerable population once it hits a community and it is highly contagious, extremely contagious.

It lives in what we call droplets.

And so any child that rubs their nose then leaves it on a surface is going to be touched by another child who rubs their nose and leaves it on a surface so you can see the chain reaction and how it spreads rapidly like wildfire through a daycare and then through the home.

You know, when I did a pediatric residency in medical school, I was around a lot of sick kids.

It wasn't until I had my own kids who went to daycare that I really started to get sick over and over with RSV and flu and all of these annoying viruses.

>> Well well I guess that and we're going to talk about this fairly new vaccine by Fortius.

>> We'll talk about that in just a couple of minutes.

But the RSV vaccines that are available this season, that would be one of them before this.

>> And what else is there?

>> Well, there's been Fordice there is a vaccine called a Brize vote for pregnant moms and then there's another RSV vaccine for the elderly.

And again you can see the smile on my face and you can feel the excitement because for once and this is the first time in my career and I've told other other all of my patients other pediatricians agree with me this is one of the greatest medical advancements that we've had since I've been a pediatrician because it is preventing probably the most annoying dangerous viruses that is that is really affecting children year after year.

It's so commonplace we kind of just know it's coming in for the first time ever we might halt RSV in its tracks and this is a game changer for me as a pediatrician but more importantly for families and parents of young infants who are most likely going to contract this virus now.

>> And this of course is a vaccine.

You would take this before you would come down with RSV.

>> That's right.

Yeah.

And as a pediatrician, prevention is my game.

You know, if I can prevent an illness from happening boy, that is the greatest treatment in my medicine bag.

>> Would it help if a pregnant mother, a pregnant woman take the the virus?

>> I should say take the vaccine.

>> Would that help the baby before it comes along?

Yeah, great question mark.

So we can now tackle RSV from three different layers.

Absolutely.

I'm pregnant Mom who can get this vaccine after she's thirty six weeks pregnant two weeks before delivery will pass those antibodies along to the baby and the baby doesn't have to get the medicine at all for bombs that had their babies like over the summer and their child is under eight months old.

They can also get this antibody treatment where with one shot antibodies will be available for the baby to protect it against RSV preventing hospitalization by about 70 percent.

This is a game changer never before could we get antibodies to last for an entire season.

So with just one poke a child can be protected and this is a big deal.

And one point of clarification, Marc, vaccines are again as a pediatrician.

Prevention is my game and vaccines are really important.

They are safe.

They are effective.

This medicine is not technically a vaccine, is it?

It's an antibody treatment.

This is new.

>> So with one poke the antibodies that fight the off the virus, the viruses can help can will prevent that.

We call that passive immunity which is a really novel form of treatment.

>> OK, how long you know we were talking about the by Faunus am I pronouncing that correctly?

>> You're doing great.

OK, have they been working on this for a while.

>> Yeah this isn't this has been in the pipeline for a long time so everybody really gets nervous when the new medicine comes out.

But this this medicine has been studied for gosh over seven, eight years and the safety is just off the charts with this probably about maybe one percent will have an adverse reaction to the bay for this and ninety nine percent of those reactions are very mild redness around where the vaccine where the shot went in.

So it is a very safe and like I said a very effective vaccine that's been studied very at length and a lot of a lot of children now is that's something that a parent or even a senior citizen should ask about when they go see their doctor.

>> Oh please.

Yeah.

Whenever we have a new medicine we expect a lot of questions and that's what we're here for because frankly as a medical provider it's my job to make sure that these medicines that we're giving are safe and effective because it's my name on the line.

So we're going to be looking at these very closely as well and I have my full seal of approval that this medicine is safe and it's going to really keep a lot of infants healthy and save a lot of headaches and sleepless nights for parents.

>> I can tell that you're very passionate and very happy about this.

>> I am.

Yeah.

A lot of people will ask me would you recommend it for your own children?

Well, my children are nine and 11 but I do have two young nephews that were just born and I recommended for both of them and they both received the medicine.

>> There's no affects any type of negative effects of getting these vaccines.

>> Yeah, like I said, they're very mild in nature.

You know, it's really just kind of local irritation might be the most severe but most ninety nine percent won't have any reaction at all.

>> All right.

Just a break here for a second and let our viewers know in case they just tuned in.

We're talking to Dr. Tony Jacana, a pediatrician and we're talking about vaccines for winter whether you're I'm sorry if you're a child or an older person, please give us a call.

I don't if the younger kids are able to call us or not but definitely grandparents parents please give us calls and this could also affect you not only your children.

So the numbers on your screen it's 866 (969) 27 two zero.

So we'll get back to RSV I'm sure later in the conversation.

But we're going to go to the next one which is flu.

Everybody knows what the flu is.

Everybody I think probably to my knowledge has had the flu at one time or another, one degree or another and flu has been around for a long, long time.

In fact, the turn of the century back in the early nineteen hundreds there's a flu epidemic.

>> I think it became a pandemic to a certain degree.

Yeah, that's right.

The Spanish flu and it killed millions and millions.

It was a global pandemic.

I mean it really kind of put covid to shame at the time when you think about them in perspective with each other and gosh, you know we still have big outbreaks of flu that are extremely dangerous.

When I was in residency that was the H1N1 virus, remember and that that flu was a killer.

>> It was a killer.

I remember starting residency and being in the emergency room and seeing children die from influenza and that really imprinted on me that flu isn't something that you just kind of hum wave off.

This is something that impacts thousands and thousands of children every year and it kills thousands every year.

>> Yeah, there's a commercial on TV and I don't even know the name of it and I can't see it because we are a public television if I didn't know it but it's the wolf in sheep's clothing, the sheep's outfit and you know I'm the flu and I'm not you know and trying to downplay the effects and so forth.

>> But you know, it really is a very effective commercial because it seems like people kind pass it off like it's so I'll get the flu, I'll get over it.

But what is the determining factor whether or not you're going to be really sick with the flu versus just have a touch of it?

I mean what degree can people get this?

>> Yeah, it's a great question because everybody's going to react differently to viruses and the truth is we really don't know which children or adults might be impacted more and might have more serious morbidity and mortality when you get one of these viruses.

>> When I was a resident at the Children's Hospital, I had a healthy 16 year old need to be on aggressive respiratory support because of influenza.

Some even unfortunately died because of and when you see that when you know that boy, any amount of prevention is going to help and listen even if you're not if you're feeling very confident and you feel like you're not going to get sick from flu to a degree of hospitalization, remember too this is a service that we're doing for each other.

>> If you have compassion and love for your community and for each other, vaccinating yourself is a really wonderful gesture that you can do for your brother, your neighbor, your loved ones to help prevent them to help prevent the community from spreading these dangerous viruses and causing swell ups of hospital beds requiring aggressive treatment for these viruses that many times can be prevented.

>> And how is the flu transmitted?

>> Flu is transmitted usually through respiratory particles.

So if you're in a room you're coughing and a respiratory particle exits your mouth then there's a good chance that that particle goes through the air and it goes through your mucosal surfaces and infects you.

>> Well, that's pretty much the same way as RSV.

>> Yeah, RSV is a little bit more annoying because it lasts on surfaces even longer.

So there again that's that's how those kids will pick it up on their hands, rub their nose and pass it along to somebody else.

>> I see.

And what about covid regarding this conversation?

Yeah, covid is again that's one of these respiratory droplets where hopefully if we mask up and and wash our hands a lot we're going to prevent a lot of a lot of that disease and frankly we were quite, quite effective at doing that when our schools had to mask up and be aggressive at preventing covid they were able to keep their doors open.

They did an amazing job of that which by the way we saw practically zero RSV admissions that year or influenza admissions it wiped out all of them.

So yes, you can protect yourselves with using masks and washing your hands and being aggressive just like a lot of viruses.

All right.

We do have a call coming in from Steve who prefers to be off the air and that's fine.

We'll put your voice on the air or we'll just read your question is asking how does the flu vaccine affect an individual's natural immune system?

>> This is a great question.

I actually get this question a lot and the fact the fact is that vaccines work with your natural immune system.

>> So the analogy that I like to give is instead of giving the influenza virus to you, we're just giving just a little piece of the influenza virus.

>> If I was a virus it'd be like taking my toe and injecting it into so that you can recognize that toe so that when that virus comes along it can see that toe and say now I'm ready for you without actually getting an illness.

But it's your natural immune system that is reacting to that particle to develop immunity to it.

So you know, a lot of people say well, it's not natural to get a vaccine.

It's absolutely natural, just a much safer way to get your immune system to recognize a dangerous foreign pathogen without getting the disease itself.

This is fantastic.

This is science and we love it.

And again, this is our game.

This is the game that we love to play is when we can get ahead of these illnesses and prevent them instead of having to treat them after the fact.

>> And there are some people and I've had this discussion off the air and in fact just out in public where people think that if they get a flu shot it's going to take care of them for a long, long period of time.

>> They don't have to even worry about it next year.

But we've talked about RSV how important is it to get inoculations or vaccines at least once a year for these two ?

>> Well, nobody likes to get that poke in the arm every year, but it is important because the immunity will wane and it will change from year to year.

>> So the truth is we don't know which influenza of influenza variants are going to be circular every year we learn a lot from what's going on in the southern hemisphere.

Remember right there just finishing up their winter.

>> So the vaccine from this year is about effective usually around fifty or 60 percent this year it might be a little bit less.

>> That is the data we're seeing but what what I do remind everybody is 30 percent, 40 percent, 50 percent whatever is better than zero.

Yeah.

And if we can have any little chance to prevent an illness and do it safely and as effective as possible sign me up.

>> All right.

Well sign me up to in fact my insurance company is not hassling me.

I won't say that but I get emails and I get texts almost every day.

>> They would much rather pay for you to get the vaccine than to pay for your hospitalization and guess what?

So who would we all this is what drives up health care prices and it's a headache for everybody.

So yeah, let's do everybody a favor, get our flu shots and let's drive health care prices down and keep us all healthy.

>> Well, you know, we were talking about we kind of lightly touched on strains.

I mean there's not one particular strain of RSV or the flu.

I mean can you give me any type numbers how many different types of strains that we can possibly can be dealing with?

>> Yeah, we use these antigens on the flus to kind of determine and label them.

They are called H and antigens .

So H1N1 was one one variant and there's a lot of different numbers.

So flu's a really tricky one.

It's a little bit of a guessing game where our epidemiologists, the people that really study how how these viruses circulate, they're kind of guessing which concoction to come up with when they give you that flu shot.

Sometimes they do a great job, sometimes not as well H1N1 they didn't have H1N1 in that flu shot and you had to get a second poke just to get coverage for that.

This was a long time ago back in 2009.

But that was one that was one example where it was just a miss this year again it's going to be it's going to be protective sometimes it's better than others but boy, it's our best shot and we should all take it well, pun intende I'm with you.

>> No, we should absolutely do we suspect that this year this winter is going to be worse than any other winters?

>> We don't know.

>> My my hope is that with this RSV vaccine that we are going to see what we've never seen before which is a where our pediatric units aren't just saturated with infants infected with RSV and then sometimes doubly infected with influenza and even covid we call that the triple pandemic when we took off our masks for the first time in twenty twenty one and then that winter boy all of those viruses circulated which we hadn't seen in a while and our immune systems just weren't ready for it and boy did we see a big surge and a lot of those viruses at weird times do we saw RSV circulating in the summer and so again when we kind of when we try to manipulate things by protecting ourselves with things like masks, it did it did lead to a big surge in the months to come.

>> So hopefully every year we protect our infants with this RSV vaccine and again game changer for those young moms and dads that have young ones vulnerable to that virus.

>> And I know just from just keeping my ear to the ground on this medical situation as far as RSV flu, those seem to be very much highlighted versus covid we're going to be talking about covid too during our conversation.

>> Sure.

But it seems to and I don't mean to demean it or to to rank it low, but it seems like it's just not as prevalent as the RSV or the flu are.

>> We have a pretty good handle on covid right now.

Well, I think we're all still a little gun shy, right?

We all remember the damage that covid did.

Millions of Americans died with that.

We know the damage that influenza and RSV can do thousands and thousands of of healthy adults will get infected with flu every year and the same with RSV.

So it's hard to rank which one is going to be more dangerous to the than the other.

>> We're really fortunate right now covid hospitalization numbers have been pretty steady and a lot of that is because our bodies have kind of adapted a little bit and we've been getting these booster shots for covid the last covid shot came out about a week or two ago to cover the most recent strain.

So if you haven't had your covid booster, here's another opportunity to give yourself a layer of protection.

>> All right.

So babies is there concern for covid as much as there is for even senior citizens always you know, we definitely have seen kids get sick with Koven and have dangerous reactions to covid like Mihkel Didas which is something that we definitely saw and rarely.

But in my clinic for me, boy, I'm always worried about RSV and flu and then covid something too that's fresh in my mind and it's OK to get double shots or you can do triple shots right?

Absolutely, yeah.

In fact all of these vaccines work in a little different way and there is no problem at all and getting these these vaccines at the same time.

>> All right.

Would you recommend that as a doctor?

>> Oh again prevention if it's safe and well studied.

Yes, I'm in and these vaccines have been well studied and I feel very confident that they are safe.

>> So it's not really necessary to go in and get your covid shot today and then maybe next week get your flu shot and then after that maybe get your RSV you can get them all three and not worry.

p>> Oh for me give them all at once.

You know I don't want to get a poke every time I get nervous every time and I don't want to go to a doctor's office and take up their time and as well as you know when you're at a doctor's office guess where the sick people are so right if we can do this all at once yes.

>> Sign me up.

That's one of the reasons why they didn't want me to come in when I end up getting back.

But thankfully let's talk about some symptoms.

We've only got about three minutes left in the program.

What delineates each one of these as far as the symptoms go RSV flu and covid?

>> Yeah, there's a lot of overlap.

I know RSV is coming because it is a congested kid that is having trouble breathing so their nose that they can barely take their bottles to drink because they're breathing.

They're trying to swallow through their mouths and their noses are clogged and they just can't swallow and breathe at the same time.

>> And these kids have a cough again that just won't quit.

They're up all night coughing and guess what?

The parents are going to be up all night to trying to be worried and taking care of their infant.

That cough is going to last for two weeks and the worst thing about RSV is there is no medicine for it.

The only treatment for vitamin E for RSV is what I call vitamin T which is time that and support with hydration sometimes a little bit of oxygen, IV fluids but really there aren't medicines that's going to help treat this like we do most of our diseases.

>> It's just time and waiting it out and boy is that frustrating.

>> Well it is and it's almost like when you have a common cold you got to just let it ride itself out.

>> Now are there possibilities down the road to come up with treatments for the for the RSV?

>> We've been trying for years and years and years and we've been ineffective.

It's really it's really unsettling that with all of our advancements we still don't have a treatment for RSV but now we have prevention and this is again such a game changer.

I'm so excited you're going to see me with a little extra skip in my step when you see me because for the first time ever we can prevent RSV.

Really I'm glad that we're talking about this now the flu many people have had the flu kind of sort of the same symptoms but sometimes it affects your gastronomical system, is that correct?

>> Yeah, it's a systemic illness and by systemic I mean it's going to affect everything you're going to have the headache.

You're going to have the fevers, the body aches and certainly the respiratory symptoms as well.

Flu pneumonia is very common and it can even affect your GI system as well.

So yeah, the whole thing is it can be affected by influenza and it can really you're going to feel terrible when you have influence and it sounds to me like RSV and covid symptoms are very similar.

>> Am I wrong?

>> It's hard to say.

You know, babies when they get covered it feels just like another cold, you know, most of the time and then at the same time you have some children that get covid and have these terrible systemic symptoms like card dieties and fevers for four or five days.

It's a very weird virus and it's one that we had a tough time grappling with.

All right.

Doctor, we have about 20 seconds left in a take home notes for our viewers this moment.

>> My take home is if you have a loved one that is eligible for this new RSV treatment, please, please encourage your loved one to get it.

You'll be saving me and my office staff a lot of headaches and and a lot of and really, really helping these young families with their vulnerable infants as well.

>> Thank you for sharing that at a very critical time of the year.

That's a very good topic to have Dr Tony Jacklin, a pediatrician and we'll have him back again very, very soon.

>> In the meantime, thank you for watching.

Thank you for your calls until next time.

>> Good night and good