neither the el paso medical society its members nor pbs el paso shall be responsible for the views opinions or facts expressed by the panelists on this television program please consult your doctor [Music] although we know a lot more about covid19 there are still many things that we're learning every single day we are here this evening to discuss the emergence of more perilous and also transmissible variants of covet 19. the medical community would like very much to urge every person age 12 and over to get vaccinated we're not here to tell you what to do that's not what this is about i know people are tired of that however we are here to stress that it is an increased risk of severe disease and hospitalization for everyone who remains unvaccinated there are questions there are a lot of them and that's why we're here this evening it's a great time to call in and ask this is a live program so call with your questions the number is 881-013 this evening's program is underwritten by the american heart association we also want to thank the texas tech palo foster school of medicine for providing the medical students to manage our phones today we have madeline morris with us and so when you call in madeleine madeleine look up you're on camera hi madeline's going to be answering the phones and again she's a medical student so she kind of knows how to give the jargon our way and we will get those answered for you to the best of our ability and again there's there's a lot to be said um we have also the el paso county medical society who has been providing the show for many many years i'm catherine berg and you are watching the el paso physician [Music] we are talking about variants of the kovid 19 and also the vaccine vaccination sorry it's easy for me to say vaccinations that we are looking at in america in texas in el paso and then also around the world what's happening there but the important thing is that we are trying to urge people to get the vaccinations and we're going to talk specifically this evening about 12 years and over specifically 12 to 17. and with me we have dr glenn fennelly who will probably recognize him he was here uh not too long ago just a couple of months ago he is the chair of pediatrics at texas tech university health sciences center specializes in infectious disease and specializes in making vaccines which is kind of cool um he came to us from he's from new jersey came to us from new york and um he has been here for not too long but you are really really making an impact here and then we also have dr hassan salum i'm smiling i'm smiling so before i tell you what he does does for a living let me just show you what he brings he comes in and he brings his cookies he has this bag and i'm like what do you have in the bag props no i got cookies i said yeah right and and hold on and we have we have baklava that's somewhere else i just think the world of you and so i want to eat these but then i'll be spitting on everyone but dr salum um comes from us originally from syria and then he was in france and he was just going to come for a little while and he just never left and thank god for that because i'm going to i'm going to enjoy some of your food later on but he is a pediatrician with west wind pediatric clinic specialty also the president of the el paso pediatric society and chief of pediatrics at las palmas so we definitely have some experts here this evening and i want to just jump out of the gate dr fendley i know you've been here a little bit over a year um but talk to us about your background and i think that's so important i know we didn't get into that to almost halfway through the show last time and it really made sense so your work with vaccines and what we're looking at right now just kind of give everybody in the audience what you do and what you've been doing for the last several decades briefly when i was at the end of my uh general pediatric training in new york city that was during the time of an outbreak of measles back in 189 1989 to 1990. there were about 30 000 cases nationwide in the us and we saw dozens of cases and young infants that were too young to be hospitalized even though we have a vaccine to give to kids one and above so for me it taught me very rapidly that uh if there's measles anywhere everybody everywhere is at risk and we needed to do better in terms of perhaps immunizing across the lifespan so that's what got me thinking about better vaccines better ways to get it into kids earlier in life and how to do it in a safe and effective way an effective way and that that's so important too and bottom line we got to get it out there uh dr saloon so let's talk about you you are pediatric guy um what do you do all day every day and you were talking about you speak four languages so that's kind of nice um do you also bake different four different things actually at least being baked by dr masalum is my wife and was hoping to come with me she cannot make it but in the future she will happy to make it well thank god for that i'm looking forward to that looking forward to my doctorate as well nice yeah so all day every day what do you get to do again it's pediatrics but especially in this this day and age we are clinicians i have we have two practices we are busy practices we see roughly average 100 patient 100 patients a day 100 patients a day yes ma'am between two offices we are six providers though okay okay we have three physicians we have three uh foreign covet affected us before last year in may and june we were scared of patient coming to us and the patient coming for physical was care of us for that our business was to the nadir and we used to close at 12 o'clock and we go home oh wow and with the uncertainty fear anxiety all this factor affect business however right now i heard that we arrived to the trish hall if it passes 70 percent is vaccinated and the they say doctor actually knows about this you don't need mask anymore right now we're seeing roughly 100 mission a day okay and between this 100 mission we emphasize in preventive medicine and we encourage vaccines okay and we're going to i'm going to talk to dr fennelly and i were talking right before the show too i'd like to state um some numbers if we could to the best of your ability i know they're changing constantly but we have vaccination rates nationwide certain rates in texas and certain rates in el paso and we're we're doing pretty darn good so to the best of your ability where are we right now yes i think i think we have a lot to celebrate locally i think we did very well early on in the pandemic in terms of adherence with mask wearing believe it or not el paso was among the top in the country in terms of those rates more recently we broke the 70 first dose immunization uh we're one of only seven of them what could be considered a major city in the us they're 300 with populations over a hundred thousand so we're one of only seven we're at 72 percent nationwide we're maybe barely breaking 60 percent with first dose immunization statewide we're only at about 50 um full immunization so we're doing very very well where we need to do better is right now the vaccines have proved down to age 12 statewide we're only at about 26 first dose immunization again it's relatively new for that age group but we need to do and could do much better there and i agree and i'm going to talk to dr sulu in a minute about that what i would love to ask you um and also brag about el paso a little bit why do you think you and your colleagues i'm sure have kind of talked about this how is it that we have done so well i i've had different you know shows going on and and the way that we just put things in the place before the vaccine was even here i did a show back in october and they're already readying themselves of how we're going to distribute that but let's talk about that process of how el paso put it together very good so when i first arrived in el paso on august 1st of last year for me it was a pipe dream that the vaccine would even be available or approved shown to be effective by late calendar year the fact that we had it available before the new year was remarkable and what was even more remarkable was the way that the community banded together uh the the public hospital umc texas tech the hospitals of providence everybody banded together major vaccine drives and it was remarkable to see the long lines of people lined up i was so grateful when i was able to complete my series by early january and and to see all of my colleagues get it our staff there was enough vaccine available that we could prioritize get all the hospital workers first-line responders we brought in dental technicians we brought in fbi agents there were no plans for these agents so it was really a remarkable thing to see so i think again it was that community participation it had there was no charge for this people volunteered to give the vaccine uh so that i think is something that is perhaps unique to el paso and it's got us to where we are now see and this is why you can't leave us because we're cool here you know it's just the way we roll it's the way we roll so let's talk about uh pediatrics so we're looking at this great percentage of adults 18 and over and now we really are concentrating on those that are 12 and 17. what have been and all and i'll ask in a little bit too what all the controversy is and questions but what right now do you feel is holding back the age group from 12 to 17. to get their vaccinations i think in general there is hesitancy about vaccine in general before they covered vaccine some people attribute autism to vaccine which as physicians we know is not true some people think this vaccine is too new and that it is a new new some people thought if you get the vaccine you change right you become a monkey you become a dog and some people say they are going to be cheap in your body it means this misinformation makes the people a little bit anxious number one number two is the side effect and this reputation about some clotting of like estradiol vaccine some and efficacy as the gng vaccine and this is a new mrna vaccine which is new technology and people in general they have fear of new stuff yeah fear of the unknown you're right i think fair of unknown and we're doing as community our best as petition to educate people we spend a lot of time there we are vaccinated our children vaccinated we are not i haven't changed i haven't been a monkey i don't have a tail i am i look normal except my accent accept your accent yeah if you've got several languages in there that's good that's right and you're trying this to educate okay and i want to see what vector yeah i honestly want to ask you the exact same questions um and again it's been kind of proven that fertility i i hate to bring it up but everybody talks about fertility so i would like for you as a medical individual that's here both of you yes talk about that and then talk about all the other things that the myths are sort of around i almost felt like you know i would love to have the 20 myths about the maxine and then just bust them all right so this is that time to do so the headline of about the vaccines that have been approved and fertility is there is zero evidence that any of these vaccines can cause fertility mechanistically it's it's just not plausible early studies were done in animal models so called dart studies that address risk during pregnancy developmental and reproductive toxicity and a model based studies there's zero evidence that it impacts a pregnancy in the phase three trials there was one loss of a pregnancy but it happened out of about 24 women that were inadvertently immunized during that trial but it happened to be in the placebo group post-marketing there is zero evidence it's impacting pregnancy acog the official body that sort of is the expert or thought leaders on women's health and reproductive health the guideline here is that every woman should go through the process of being informed about the benefit and the side effects right but there is no barrier to immunization and that's not a requirement so whereas it is not officially approved as of yet because the full data isn't there there's no barrier and the risk of not being vaccinated during pregnancy exposes you to very high above the usual risk for severe covita so how are this this is a hard question so how when you're talking about the process of being informed that in itself is such a big thing because information now comes in all sorts of ways it's coming in through social media it's coming in through whatever your feeds are getting you've got 20 news channels on any given day how how would you suggest and this is for both of you how would you suggest that people get the proper information versus just what they're hearing from the you know the atmosphere here and there and i'll start with you where should people look number one we have to trust the organizations like the fda food and drug administration the cdc the advisory committees to the cdc on immunization practices they look at the evidence they look at the post emergency youth use authorization approval data on side effects and they're in the process of figuring out what is plausible what can be linked to the vaccine and what cannot be first and foremost we have to trust in those bodies and we have to trust in that data tomorrow will be a very important date in that regard in that an advisory committee to the cdc will be looking at some of the evidence around myocarditis in children and young adults that have been immunized it's plausible yes it looks like it may happen within four days of the second dose is it is it a causal we don't know yet we hope to have more information after this meeting after all of the evidence is looked at so we have to begin with the evidence we also have to i think the medical community we have to be clear where we get our information and we have to be careful what we say and repeat we have to stick with the evidence and i think families need to feel comfortable coming to us for guidance don't get guidance from your aunt don't get it from certain news outlets that are taking partial evidence and saying there's a risk again in the balance the risk of still being exposed to covet and getting severely ill are an order of magnitude higher than any hypothetical or theoretical risk of vaccination and there's a phenomenon and i don't know if we spoke about it specifically on this program other programs but there are certain communities and ours is one that you know the person that lives down the block is the one that knows everything and then that's you know in the thought process that they know everything but again if you're looking at websites one of the quickest things that i say instead of looking at a com look for something that says dot org that usually means that it's an organization that either is a non-profit they're not out to sell something to you it really is more of an information i do a lot of webmd information and if there's places that you want to throw out there by all means let me know but same question to you dr saloon when we're looking at how to get information out to people what are you telling your patients what are you saying to your parents your parents mean the parents of the patients that are coming in uh when you're looking at 100 patients a day what are some of the questions parents are asking you about the vaccines let me tell you real stories number one i agree with dr lee however i brutalize i make a priority i think number one is our primary care physician this was the primary care physician this was the bible for example in our case we have this baby since the baby was one year old until 18 or 21. and number two the mom she will tell you i look i look in google i watch the tv but i come back to you it means i think number one is pcb number two then cdc and fta and this uh very rabbitual has reputation source so the number one person to go to is whoever your doctor is right now ask that question you've already gotten an established relationship with them uh they know who you are they know your body so that would be the number one place to go and then yeah and the other story for example today i have two cases and yesterday i have one case yesterday i have 16 year old boy come to me for physical he has some concern about his private area and the mom jumped to me i'm not going to give him that vaccine because he could facility i spent time with him i don't now right today i have another case a mom she's a teacher she's very [Music] informed lady she's smart lady she reads a lot she told me you know look my daughter right now is 12 she's going to have her period next year i'm not going to give her the vaccine i see why she says because i heard the vaccine disturb the period makes the builder very strong very light a regular period and i educate her and she listened to me and i convinced her so she has the vaccine so you did good she won okay another child come to me as like dr glenn knows some people has anxiety adolescent and when you have anxiety you have chest pain and you have your heart goes fast and two last week they come to me that parent say look doctor salum do we give the vaccine to x and z i say of course she says but you know the heart rate is fast and did you hear about myocarditis and pericarditis and this study in oregon and this study in israel i i spent time with them and i was successful on all these cases they convinced them and they would get the rights right well that's that's good and actually i'm going to hop in really quick and i'll say this a couple of times throughout the program um if you are interested in having your child age 12 to 17 get the vaccine and we hope that you are um and again we're here to disband these myths that are out there and i i want to talk a little bit because i've hear i've heard about fertility too but i've not seen anything that's fact based on it so i'd love to see where where and how that came in the first place i don't even know if that's something that we can answer but um vaccinations are open and free drive through at um was it the civic center sorry that's the one thing i didn't right when we were looking that down so it's at the civic center we're looking at the civic center and it's 8 a.m to 7 p.m monday through friday so 12 year old to 17 year olds there needs to be a parent and or a guardian with them so 8 a.m to 7 p.m at the civic center monday through friday or 8 a.m to 4 p.m on saturdays so that's super duper important also we were talking about walgreens you can make an appointment there sometimes you can walk in i was at a walgreens today for something completely different i was getting a passport photo but there was nobody there so if that's the case give that a shot cbs give that a shot um if you have the primary primary doctors you can have that pediatricians you said not all of them have them but they're starting to get in that's correct okay and how is that how is that roll out now with private practices because i know for a while that was taking a while and it was it was being done so do doctors order a certain amount of vaccines is that how that's being done right okay so tell me that process we applied one year ago okay to be a provider okay and then the criteria uh thankfully it been the change initially they want the for example this pfizer vaccine has to be uh stored in -70 right right now they say you can keep it in the normal fridge for almost four weeks and the problem only the logistic problem one way as the vaccine to the dilution you have to do it within maybe four hours this is the reason we prepare the patient we have the list of the patient ready and we call them as a group okay and we give the vaccine we don't want to miss any doses absolutely absolutely some physician they say you have to order again and you need a password and username to get the the uh coming to use the shipment okay for that some people had already have it somebody but doesn't have it okay but the primary care right now they're very comfortable to give the vaccine only we need the patient when they promise to show up some people they say we don't we have only one car with the husbands other people i lost my phone i did not hear this as a little problem we have to address it with the patient before we open the right the vaccine so how many and and this is just a curiosity for me so how many come in a package i know you get a box but if you have a package of 10 vaccines that to unfreeze a certain amount at any given time is it like 10 at a time because i remember when i got my vaccine right it's it's five to six per vial okay but i mean the shipments are over a thousand eleven hundred right right currently but you can keep frozen like 10 vials at a time and then bring out those 10 vials at a time give you six doses okay okay nice you said so um we talked about some of the concerns but i do want to just ask because i want to so specifically and i'm about to have a coughing fit i can tell talk about where this myth of infertility comes from because that's the first thing i heard my daughter asked about that she's 24. i'd like to just throw out to the audience why that's out there and why and you may not know i mean it may be just something that's just thrown out there but again i'd like to stress that over and over again because that's the number one question i keep hearing yeah i i can't comment on where it comes from i can only comment that in the many decades i've been in pediatrics and some of my global health work uh this was a reason back in in the former yugoslavia that children were getting polio there were concerns in the breakup of that uh nation into into uh in particular the kosovo area um families there were propagating the this this claim that children would be fertilized if they got the polio vaccine as a result of that there was a polio outbreak throughout the midpoint outbreak there for decades so you know it took international organizations to come and reassure so this has been there forever it also has exist around polio vaccine in other nations um so it's sort of a trope in certain ways and i think there are many groups out there that that do promote these theories there again is zero evidence we have to stick with the facts and there are other stories i've heard like it will impact or delay menstruation even if you're exposed to somebody who's been vaccinated and this is this borders on an absurdity again sticking with the facts all of the approved vaccines these are not transmissible agents it's either a piece of rna or it's a actually a virus that can't replicate to make copies of itself so that's an impossibility so it's difficult to counter it i don't know where they come from but again we have to counter that fiction with the fact and and again i appreciate your point and it's remarkable to hear how you're able to persuade these families in our own practice we've heard the same stories you know males 12 13. the parents want them vaccinated the boys say i don't want to because i'm afraid i won't be first father all right right and again that's i'm glad that we we continue to bring this up i've got a question here from the audience and this is something i have not heard often about but i'm thinking about little ones once we get to the point where we're under the age of 12. but a question is from the audience is there an oral dose of the copit vaccine being developed um and and i don't know if that's something that is it right now i'm just thinking about injections that's all i've heard about and maybe doctor might know there are certain companies that have taken the the adenoviral vector approach and are looking at intranasal some promising early data i don't think it's gotten to the point of pediatric trials again most vaccines overwhelmingly with the exception of oral polio vaccine or a rotavirus vaccine are given inframuscularly it's a safe reliable way of doing it for the most part you're going to have a bit of discomfort with the coveted vaccines that's a bit more accentuated that pain but again it's absolutely safe we know the dose is getting in there it would be beautiful in time if we can do that but it's going to be much longer in terms of new route new formulation these vaccines we're talking about down to six months of life pfizer moderna that data is going to be available soon and we may have approval before the end of the calendar year down to six months of age so i hate to capitalize your time but you're you were talking the last time you were here too with fda original approval i know this is emergency use approval i get it when there is a vaccine that's introduced to the fda on average not covet related on average how long does that take for fda approval what processes that go through and the reason i'm talking about that is that with emergency use approval which we really needed i'd like to combine the two and explain that to the audience okay very briefly so what is eua or emergency use authorization it it was really this mechanism was established in the wake of 9 11 the terrorist attacks and it was meant as a way to rapidly approve biologicals vaccines treatments against potential bioterrorist agents for which none existed some were under development what has to happen there's sort of three or four steps first of all there has to be identification of a threat or a public health threat we were there pretty fast with kovitz yes the secretary of the health and human services has to recognize this they declare an emergency that gives the fda the authority to use this mechanism what's necessary you have to do studies you have to do large phase three studies that show efficacy and safety based on that data it you have to say this is likely to work it's probable it's work based on very rich clear and compelling data you also need to demonstrate that it's probable highly probable that it's safe within within the context of that study you need at least two to three months follow-up and then after you approve it the prediction is it's going to continue to be safe the other criteria is there's no other alternative here the only alternatives we had were hand washing face masking our medical practices being down to zero us not being able to see friends and family so again this is remarkable where we are right uh otherwise the process can take years however given how quickly things have moved the incredible response in terms of volunteers for studies right the numbers or the the the sort of power of these studies we probably will get to full approval for maybe moderna pfizer relatively soon okay and full approval is there anyone any country in the world right now um and i and i don't know the answer to this but is there any country in the world that um is not looking at going forward before full approval and i know that for a little while um in europe and it wasn't johnson johnson it was esther's thank you astrazeneca astrazeneca um so that was the one too and and then that was clear too so my point two is even though it's emergency use uh vaccinations that are approved there were still studies involved prior to the approval and i think that's so important to let people know because yes it happened fast but there were studies and it has been shown and that's so important and it's important also to look at what was the bar that was set the threshold that was set for effectiveness was 50 effectiveness and here we were at more than 90 for 90 95 which is remarkable on the adverse events side it wasn't much more than it was sort of if you will an amplified version of what would be anticipated from a measles shot or a dpt shot pain swelling a little bit more severe but it went away and it was self self limited there have been concerns that have come up and this is part of the the reporting that happens with any vaccine the the the the vaccine adverse event reporting system there's a lot of data coming at the fda that's collecting that that is being used and manipulated to a degree we need to know what's the denominator what's the population from which that's being reported and then looking backwards and saying is it plausible that there's causality with any of these we know on the other hand that we would be at a million plus deaths perhaps from covet in the u.s we would still have our wards filled we'd have 150 200 250 patients at university hospital alone if we didn't have the vaccine exactly so um i want to talk about boosters and i don't want to to end the show without doing that and i don't know exactly where to fit that in but there and i'm going to talk specifically about kids for a second because there was some confusion i'm just going to read this because it's easier for me to do it like this confusion arose from a false report service on social media saying that the spike protein on this coronavirus was the same as another spike protein called the sintin one that is involved with the growth of the attachment of the placenta during pregnancy this and that and the other i know that you're specializing pediatrics you were talking about um treating children a year you know a day old et cetera so i want to talk about this because again that was a social media report talk about pregnancy talk about newborns how is it as a pediatrician that you were talking to parents you're trying to educate and trying to let them know that these vaccines still are important but then there are these reports that come out that again are unfounded and they're on social media how how do you deal with that unfortunately can i see something about myth before they can absolutely yes this unfortunately a glue yes right yes that's true right for example right now when you go outside with your hair wet you're going to catch a cold yeah yeah right now exactly that's what i don't see everybody why he's sick because he catches he was walking barefoot i was invited in 2019 to international meeting in syria i was the keynote speaker there and then after we sit down there we thought a lady she came to me with a child five-year-old has worked and another lady came with another child has molluscum wart and molluscum is very common you know the word carmen or a word on your skin a word okay okay it's a little bit similar to what but it's softer a little bit than a award okay but also a skincare skin condition it's very common okay and wart is more rough than molluscum malluscum is a little bit more smooth and natural then i thought you know this two different rash and this virus and the grandma says no no he was counting the store in the night oh goodness and it happened to me accidentally three months ago a lady from mexican lady came to me with a grandma with molluscum i totally said virus is coming he comes from the dirt swimming pool and he's like no no doctor he wants a current exhaust and until now we cannot get rid of they last for generations and that's what dr fennelly was saying you know a lot of these uh questions are from vaccines the most important part of his intensity towards vaccine autism we cannot get rid of this myth that it doesn't give you autism is this a problem let me talk back about the spike when the vaccine comes it was some improvement in g5 towers in the world oh for cell towers yeah right g5 cell types okay this is a conspiracy and you will have a chip and the gf tower is going to watch you and then bill gates call you from uh from washington move your hand link to me move you mm-hmm combine it yeah and fortunately this spike protein in the uterus to make the placenta have nothing to do with the spike protein of the virus which makes the disease and the people attached other than amish actually it was we know that a lot a lot of women has a covet infection the baby become great no problem so we know at least and i've heard a couple reports on this so we know at least if there was a pregnant woman who has covid even if she still has coveted while giving birth that's correct the baby does not have covet the majority they don't have the majority okay and we see me we see every day maybe every day i see minimum or average five babies every day and the ones that covered was spiking in the past was as a peak time every day i have three or four covet positive baby all of them do great no problem feeding well thriving well breathing well no rash no problem they're doing very well actually i was reading the other day about this spike protein they see the uterus specifically the uterus doesn't have the ac2 and receptor oh there is yes and they don't have it for that most likely uterus and placenta are protective for the virus that's the reason we don't see a baby who is congenital right uh but maybe the virus come to the baby after being born right comes the hand from the nose or from the island it's another beautiful way biology works right the protection of somebody's pregnancy is this another myth and attached to the people and they talk about it this five g or c five come together with the vaccine they are attached to them anything spike right now they are it will be coronavirus yeah interesting yeah right no truth about it because maybe only three babies get sick with the vaccine the sick but they did very well in my practice when it was a peak we have 82 patients 82 children children okay has covered positive from parent or from the environment only to get sick okay getting sick meaning showing any symptoms no is that correct or not no no no hospital okay i have two okay one of them has this what we call it multi-system inflammatory yes exactly has the heart carbide has fever more than five-day and present three times in the emergency room with abdominal pain possible up in the subject then the third time i said the parent nice family i'm going to admit him troubling was 2 000. fraction ejection was 50 percent right we treat him very well he came back to follow the other day he's doing great another one come as a kawasaki like syndrome five euros complete cause like like syndrome and she did very well it means in my own practice i have 82 patients only two the little bit sick and these two they're doing great right now because it means hundred percent they did very well right and the newborn i'm not worried about it and my nurse practitioner actually was pregnant she told me this story she told me she came to me one time she's a beautiful lady she says look salute you're uncovered either you gain weight or you gain weight me i did two weights and she has a couple she wasn't sick for a few days the baby beautiful and she's beautiful is he doing great nice we have extra time in your hands you have a loved one at home you know life is good um dr fennelly i i'm gonna go to the boosters now only because i feel like we we are all celebrating right and we are all getting back to our new normal and and i and this is something too that we haven't studied yet but the studies are going on of how long the vaccines that the three of us have had now for several several months how long are those going to last us and again we're not again there are a lot of things that we know there are still some things we don't quite know right when do you see or your colleagues and what you've been reading and studying of when we all should receive the next vaccine is that a year is that two years what's the big discount so there are two considerations one is you know if the virus does not change at all how long does immunity last against the original strain upon which most of the vaccines have been based that alone it could last for a year or more perhaps we know also that the mrna vaccines do an excellent job if you get both doses of giving prolonged immunity we know also so slow down for the mrna so that would be the pfizer and the majorana okay so let's talk about that we want to talk about that i just want to separate those out for the audience so they don't know what we're talking about if you've had covet recovered by covert you probably would be protected for the first five six seven months but it would behoove you to be vaccinated because it's been shown that vaccination after infection will boost that protection even more there's also very encouraging evidence on the johnson and johnson or adeno adeno-based vectors that we can get good prolonged immunity the challenge now is becoming with some of the variants of interest that become variants of concern right will that immunity be effective against those it's too soon to predict whether it will be and when we will need to be boosted this is circles back to why i think this is one of the most compelling arguments for immunizing everybody the teenagers the children they're not totally without risk they can develop this msic they can be hospitalized they can die and that has to be balanced and they can transmit and they can that's the most important thing and in certain states it's been shown that the variants become the predominant strain in that population if unimmunized and the rates of infection and hospitalization go up 300 percent in a non-immunized population we've seen in other populations counties rural areas in the u.s where vaccination rates may not be much above 20 25 where you're seeing 700 increases in hospitalization probably due to the variants that are more transmissible and cause more severe disease there are so many questions around that that i'd like to ask and i don't even know where to start so variants are basically a mutation of something within the virus that makes it just a little bit more this or a little bit less that so when we're looking at and i remember when months ago like the india variant i know that's not what it's called but i'm going to refer to it as that's what everybody's referring it to so there's a variant there and it is spreading across the the world the visine of the visine the vaccines that we have now and we're looking at johnson and johnson pfizer moderna at this point it looks like those three vaccines are good for the indian india variant is that correct they're good although there's some probably some loss in effectiveness okay is it above 85 still perhaps and again for vaccinations you're looking simply for 50 and that's fda approval if you're looking at fifty percent approval or um um rate of f efficiency and not speak well but we got to 95 on these two so that's already above and beyond so i mean this gets without getting too much into the weeds on this this gets into the question of what do we need for herd immunity we still don't know that 70 to 90 percent that would mean 79 everybody in el paso including six month olds right right or the youngest we can immunize are fully protected so the variants introduce some doubt into that uh the vaccine may not work in three to five percent of people some people may not have a second dose so those are all the unknowns and still we're not vaccinating anybody below 12 which is about 10 to 15 of the population so those are the unknowns so the 50 was sort of just uh arbitrary that was the threshold that the fda felt let's we've done that with the flu vaccine the average you know seasonal flu vaccine may only be 40 to 70 percent effective so again we have a home run hit fortunately i think we're going to keep up with it in terms of this science so there are vaccines being developed that are using the surface proteins from the variants they probably will solve that problem so we're we're in good shape in terms of the disappointment is for the majority of the world where the hope is in the astrazeneca vaccine there was another mrna vaccine under development that would have been stable at higher temperatures a similar technology to monderna unfortunately it looks like it's less than 50 effective in the early phase 3 trial this would have been an affordable vaccine so this is what we're going to be faced with on a global basis in terms of continuing to try to control coping i don't know and we did not talk about this before the show so if i'm just throwing this on you forgive me but i know that we are at the point also now with our sister city and juarez and in mexico in general of the distribution of vaccines so there's there's the two issues there number one the distribution the receiving them and distribution and number two the hesitancy um with that population as well is there anything that you two know that might be new on any information with the distribution in mexico and that's we can be specific about what is because i know a couple of months ago we were having a hard time just getting vaccines there i mean what i can say is there there there i i know of attempts early on to try to say look we have some extra exactly moderna or fire vaccine here we'd like to distribute juarez there was no mechanism for that because of the approval process the the best avenue for mexico is to work through kovacs so kovacs is beginning to supply vaccine the u.s government i think has contributed half a million doses to mexico which is a start so i think that's going to have to be the pathway for areas like juarez as of right now looking into the future it would make a lot of sense if we could do this regionally in a bi-national area right across borders because like everything else like air quality water quality infectious agents were essentially one functioning cosmopolitan area but unfortunately those have been the barriers and is there and again i didn't ask before the show might we know what the vaccination rate in juarez is right now i do not know i do not know okay okay i know that was something that we're trying to tell you something yes because us as pediatric society and pediatrician el paso when we have a limited amount of ppe gloves and shield and the juarez was a lot worse and it was a lot of uh morbidity and mortalities a lot of people couldn't see we donate everybody donate maybe 10th what he had and we give it to her yeah and i i so for most of you you know this is i do this as a volunteer but my real job is the el paso community foundation that was one of the first things we're trying to do is to get ppe uh to areas that weren't hospitals you know to clinics to to pay and it was very very difficult to and then getting them across the border was a whole nother issue um so i again i wasn't sure where we sat on that doctor you were going to add something no i i guess you know just the the situation with the unaccompanied minors upwards of 4 000 plus at the fourth place shelter um after the vaccine against coffee was approved there wasn't quite a mechanism to immunize because the assumption is most of those children are supposed to be transited out of there within a certain amount of time and they wouldn't have that three-week window so unfortunately that was a missed opportunity so again there are a lot of missed opportunities in terms of uh populations and congregate settings in particular right and then the parent guardian situation yeah yeah like you said that's kind of that's a separate discussion but it's an important discussion yeah agreed agreed so uh and i dr fennel we talked a little bit about this on the last show but with boosters and flu shots going forward i remember us coming on the air i want to say is maybe august and we were talking about august september october it's time to get your flu shots um that that is something not to ignore right and so maybe in the future the flu shot and the kovid shot may be the same in and of the same we talked a little bit about i mean they could they could be given at the same time and the big change over the last few weeks has been that the cdc has said that you can co-administer vaccines so as pediatricians we need to give several vaccines that wants to keep up in general we're behind with vaccination i'm curious to hear how you're doing in your practice but in new york june through september of last year they were 80 off on measles mumps rubella vaccination rates compared to the previous year the good news now is there's no uh hesitation about giving both the coveted vaccine and other vaccines at the same time the assumption is they will not interfere with one another no reason that shouldn't be done with the flu vaccine right again in time we look forward to a time where we're getting our seasonal covet vaccines absolutely and so talk about your practice a little bit of like as well in our practice we seize any opportunity to catch up with vaccines actually with all vaccines all vaccines some people come for vaccine and one child needs four and the other child needs six zanzano's coming to me poor child he needs six can i and i agree we did we did not it was fear it was uncertainty people not shown do you think somebody is has no complaint have not come to physical uh when the media and elbaso uh pass out afraid several forty percent nobody will show up right even us we don't show up to our world for that we are behind but we don't let any opportunity uh with uh leave us in labs we don't we don't anybody come we try to catch up with all the vaccine and is this very important actually opportunity for us when somebody come for covert vaccine right now to catch up with all the vaccines and i think all the distribution doing this right now yes dr saloon i have to say i i was one of those people and i will put my tail between my legs and saying that but i still need to get my second shingles vaccine and so in my head too i'm thinking well don't get any vaccine because you're if you're going to get the covered vaccine you know and so again unfounded i'm listening to social media i'm listening to the lady down the street i still need to get my second shingles vaccine and so that should not be an issue but i'd like to bring that up so vaccines which is what else would be out there that's pretty common so shingles vaccine which is several years ago hp you know the hpv uh vaccine that should not be an issue um so are there any right now college don't calculate meningitis yeah right and we're trying to call them come here before you go to college otherwise to find a home for you it's difficult right you come to us we give it to you provided to you and a lot of them coming right now for the mini jets vaccine because it's the dorm and the college and they're showing up so making that very clear yes that it is fine to get other vaccines associated it absolutely is and it's essential i mean if we drop below a certain threshold with measles vaccination we drop below that 93 percent herd immunity among children 90 then we're going to begin to see outbreaks gotcha sorry i'm being i'm reading a question here from the audience i'm just going to read this cold hypothetically if we were to pay for the coveted vaccine how much would it cost for one person to get the vaccine sorry um the good thing is i i don't know i don't know if you all know the good thing is it's free it's free and the actual cost has been of what it's been offered to the u.s government we know for i think modern advisors somewhere in the range of 19 to 25 okay yeah and this is something to uh i don't know if we talked about the last program but when i got my vaccine in general they will ask for the insurance information and i think a lot of that is too to register you and make sure that you are in the system the insurance company knows you have been given this vaccine is that the reason why because it is free anyway and if you are covered by insurance or not the information is still something that you write down before you get the vaccinations insurance company pay administration fee i see okay yeah because you are using your time you are using injection you are using alcohol you are using documentation maybe this is a reason okay yeah and and i want to tell this audience that they are lucky in some certain part of world black market can avoid yeah it will be cool you know what do you talk about that 100 to the right yeah or maybe more and may not even be correct maybe it's not stored appropriately right maybe not transported appropriately maybe it's not giving appropriately and you don't know what you're getting they don't uh disclose what vaccine is this russian vaccine chinese vaccine right astrazeneca they don't are we having any of that issue in mexico right now i don't know i know uh look at that just that's the disclaimer beginning the show um and maybe to anyone who is who is listening and i'm going to repeat this actually i should have done it several times before the program was over i don't know why my flashlight's on but um vaccines again free for children ages 12 to 17. you can go to the civic center just drive through you don't have to have an appointment just drive through civic center 8 a.m to 7 p.m monday through friday ages 12 to 17 you will need a parent with you or a legal guardian with you but again it's free just hop in the car and go over there get every get all the kids from the neighborhood round them all up um 8 a.m to 4 p.m on saturdays and again with parent or guardian you can also get them if you can the best place really would be at your primary physician if you've got a pediatrician go there uh call them first to see if they've got the vaccines but as you said uh doctor slim that things are coming uh faster and faster that way yes can i mention something please please right now it's closed uh school is over yes and a lot of traveling and some people right now international travelers oh that was one of my questions yes i want to tell the people to have this evidence of vaccine with them number one number two if they need a test before the deporting in the plane is required has to be pcr tests because in our offices we have rabbit antigen test okay say that again pcr test what does that stand for a pulley chain reactive test a chain reactor okay yeah for for that this this this required within i think 72 hours okay for that they have to be aware that before they leave town to the airport to have in their markets that evidence of vaccination let's call it uh basketball right and to have the pcr they're done with a 72 hour and this required insurance okay i see that's where you're going okay so the rapid test uh is not acceptable by airplane okay yes is it because it is less less accurate on sensitive it's positive okay so positivity is very good but the sensitivity is not too good okay it means maybe you have if it's positive you have the disease if negative doesn't mean you don't have the disease so i'm going back home to germany in september so i'm already in my head thinking okay we have to take a test before i go i got to take tests when i get there um and at this point and they're certain countries still are a quarantined situation um we are this went fast so we are about five minutes before the show ends dr fennelly i would love for you to think about if we haven't talked about something you want to talk about yet or if you want to stress something more and i'm going to have the same question for you in a moment too what have we not covered yet that we'd like to cover and that was great that you brought up international travel i mean i think it's been comprehensive as of now i think i i view this challenge of getting more people vaccinated not so much as hesitancy but there are a lot of questions we have a lot of questions on the other hand i think everything's pointing in the direction of continued effectiveness of these vaccines and safety and i can't stress how important it is to stick with facts if if you are promoting false information to your friends in your social circle you're potentially doing tremendous harm you could save a life by reassuring by encouraging people to stick with the evidence and to get vaccinated and again to find out the evidence where are you sending people as a doctor yeah i think again the most authoritative if somebody wants to read it with their own eyes would be the cdc web website it's updated daily there's fantastic links through there so that's probably the most comprehensive most accessible and el paso strong is still uh if you want to look up el paso strong the search engine that's still giving that information that's local and national as well dr saloon what have we not covered yet that you'd like to talk about yes i want i think we were comprehensive i agree i want to remind the patient and the family please go to your pcp you want pcp you know him for a long time or her your general practice yeah yeah you trust them and you will pcp do something else me i don't feel embarrassed calling for help i got emphasis these guys i got some people out of town what we do right now what advice and since they trust you and you can't really relay this message to them if you said them great cdc and fda they got lost go to your pcp this was my advice and your busy business him and his children and his wife get the vaccine he's not going to harm you exactly and if for some reason you don't have your own doctor we do have clinics here in el paso yes uh they're everywhere texas tech has clinics and again good old-fashioned walgreens good old-fashioned cbs um and again i'm going to bring up the civic center one more time because and i feel like there's another place too but again el pasostrong.com or pasostron.org pardon me uh we'll give some information as well but 12 to 17 year olds that we're that's what we're trying to really get down right now the majority of people who are 18 and plus in el paso who want to get a vaccine have been vaccinated um at least one shot in and then the other one to come but 8 am to 7 pm monday through friday would be at the civic center for children that are 12 to 17 and then on saturdays 8 a.m to 4 p.m and again that's at the civic center super easy you just go in you drive up they may or may not ask you for insurance if you got insurance you can have it doesn't mean you have to have insurance that has nothing to do with it it's free completely free uh parent or guardian with you if you want to watch this program again if sometimes we just go a little bit too fast which i know we do there are several ways you can do that and we're streaming live on youtube i forgot to say that earlier um but if you are somewhere else or if you have to leave the television on your phone you can use uh youtube.com and then type in the alpaca position if you're looking specifically for this show this show is called variants of coded vaccine and new vaccines as well and again the variance is something that we've been talking about quite a bit and i feel like we can do a show just on that but not including the vaccines how many variants are out there mossy minnows right now hypothetically there are thousands yes please yes just i want to mention one more thing for the uh breast feeding is safe if you have a baby you have your breast feeding this continuously feeding we recommend the breast feeding breastfeeding continue with your plastic okay even if you have covered breastfeeding is safe and that's again where biology is beautiful because it doesn't let things pass that line wash your hand well put the mask and feed your baby okay excellent um again pbs el paso.org is where you can watch us again and all the other episodes and then the el paso county medical society epcms.com i want to say thank you again to madeline morris who has been dealing with all of our questions i want to say hello specifically to mario ramirez who has been helping us out for many many years here at pbs el paso and he is uh moving on but still going to be here to help us out so i wanted to say not a nod to you mario i know that you're in the back so this is specifically for you and we have brenda here counting us down we've got gracie in the back doing things and frank luna and every now and again they get some credit i'm catherine berg and you've been watching the el paso physician studio thank you [Music] [Music] you