[Music] foreign [Music] thank you for taking time from your busy day to watch this special presentation from the El Paso County Medical Society I'm Dr Joel Hendricks president of the El Paso County Medical Society and it is my hope that you will find our program of great interest educational and informative about the medical care provided by some of our best physicians in our country right here in the Borderland from all of us at the El Paso County Medical Society please enjoy tonight's program [Music] vaccines it's always a Hot Topic and still is with Cova vaccines taking most of the media attention over the last several years the focus has been steered away from other vaccines that are very important for everyday life for both children and for adults vaccines defend what matters that's the name of the program this program is underwritten by the Texas Medical Association as well as the Texas Medical Association foundation and UMC University Medical Center and also a big thank you as always the El Paso County Medical Society for bringing this program to you enjoy this episode foreign [Music] today it's all about vaccines but we're going to kind of chop it up in a couple of different pieces here we have Dr Joel Hendricks with us who is the chief medical officer for the University Medical Center he's also serving this year as the president of the El Paso County Medical Society and you started out as an OB GYN you have so much background to you um so you have some very specific vaccines that we're going to talk about and then we're going to move to a couple of other doctors that have other vaccines to talk about so vaccines vaccines vaccines why are they in existence and why are they so important thank you Catherine first of all I'd like to take this opportunity to thank you for your 26 years of doing this show ah this is this is a important medical education for our our community and you've been a part of that and thank you you have teased out from Physicians what what is important I appreciate that I appreciate you saying that really the president of the El Paso County Medical Society I want to thank you personally for that that makes me feel like a million dollars thank you so much I love doing the show I learned so much I learn when to panic and I learn when to calm down it's going to be fine so I appreciate you saying that that's great um give us give us a background on you I know we were talking about vaccines tonight but for those people I feel like everybody knows you but maybe there's someone tuned in that doesn't know you give us a small background on on who you are in the medical world well I was in uh private practice for over 26 years and uh certainly as an obstetrician gynecologist uh it was my pleasure to experience the miracle of of birth and being able the privilege of taking care of families and not just women but families because the the family unit was a part of that experience and then six years ago transitioned over to the chief medical officer role at University Medical Center it's been a fabulous experience and uh I've really enjoyed it and certainly I appreciate the association with the El Paso County Medical Society and being able to work with all the smart individuals not only in the El Paso County Medical Society but in our community and we have a great Community when it comes to metal and a lot of it uh I mentioned covet in the opening just just a little bit because there was really the coming together of all different medical sources in this community and I was so proud about El Paso when you hear about other communities not quite getting their act together we had our act together and UMC was a huge part of that on all the hospitals came together all the hospitals and those were vaccines we're talking about and I know we're talking about other vaccines right now because I feel like the coveted vaccine really has had its shiny day and it's still around which is great but I'd like to focus a little bit on the vaccines that you would like to talk about this evening and Gardasil is like the one that is screaming because there's been more recommendations and changes around Gardasil I feel like than a lot of other vaccines and if you can kind of head into that is why we have vaccines in the first place well I think I think to your point the vaccine why why do we have vaccines I mean vaccines have been with us for well over a hundred years and millions of people have gone through vaccines and so certainly there's a political aspect to the vaccine that we see today but the reality is that vaccines help prevent serious illness and that they have saved so many individuals not too long ago polio was a big problem now with the polio vaccine we have that ability to mitigate against serious effects from polio and this is transitioning into modern vaccines and that we have different methods of vaccines coming to the how they work within the body so the question is what do they do right what is it about a vaccine I mean it's and I think the part of that is the idea that it stimulates your body it helps you fight off disease it helps you not get so sick in many cases that's very important uh an ounce of prevention is worth a pound of cure right and so these these are very important from a population health from an individual health and each vaccine as we learn more about how we deliver the vaccine then we're able to get it with less side effects potentially and in medicine we as Physicians have to use a risk benefit so anything that we recommend we have to say is this here's the risks here's the benefits let's talk about it right let's see if this is what you you we agree to and with that in many cases we would only recommend what we think would be of a bigger benefit than the risk right nothing is perfect but having said that that we have been so successful in population health and keeping our our society healthy in many ways because of vaccines and I think tonight you're going to hear from the other Physicians about those successes and specific ones that as we move forward exactly and and we were talking about earlier just when you're talking about risk benefit and I know that you wanted to touch base on again as of OB GYN there are some vaccines that if you're pregnant you might want to either way to steer away from a while but I do want to touch base on that because there's always the questions and again not to get political people it's not not to have them maybe it's not the best time just right now and I'd love for you to touch base on that well I think you know as a Nobi gen over the course of my professional career I've we've seen a little bit of change in like for example in pregnancy so vaccines were not as important or emphasized early in my career but as we got further along we realized you know what they're not causing the issues that we want they are preventing preterm birth they are preventing some some problems that are a benefit so for example when you look at Tdap tetanus diphtheria uh that you you will have as a recommendation between 27 34 weeks to get it in every pregnancy even if you've had it before mm-hmm um you look at the flu vaccine so we think that the flu can affect pregnancy in a way because of the respiratory problems that can occur and it's recommended every pregnancy that you go ahead and get the flu vaccine so these are these are vaccines that we didn't necessarily recommend before and then now we have the covet and so covet vaccine is a new method of delivery and it's better and it has less side effects and it helps prevent early delivery it helps prevent ICU stays it helps prevent stillbirth and preterm delivery so these are things these are three vaccines that are we feel very strong would benefit it's a discussion right with your provider Bingo right you've got to talk to your provider you've got to ask them the questions that you have information that you may have received off of social media and understand what that is to see if that's something the right for you exactly like you said have that discussion with your doctor yes that's very important so I do want to Circle back around to the HPV vaccines um and Gardasil because I know that Gardasil 9 is relatively new and um if we can kind of quickly go through two doses three Doses and I know it's 15 and younger that we do want to ideally children before they start having sex to be very blunt about it that would be the ideal time to have both of these vaccinations done so it's a series of vaccinations so let's talk about prior to 15 over to 15 and just in general how you would tackle that when parents ask you these questions so I think that you know when you look at Gardasil garter still started only for for females right and it was to prevent some cervical change is is what they were looking at and it seemed to be effective and they found that the earlier the better to your point the before relations are started having said that as as they've done more studies and have they researched it they found that men benefit from it and that you you find that the Gardasil 9 versus the the early Gardasil was about Gardasil was four variants now the Gardasil 9 has nine variants so it covers a wider range of the human papillomavirus which is a benefit so when you talk about 15 year olds and younger so that's a two dose regimen normally and a six to a year apart so you spread it out you you don't overload that system you let it let it happen and then anything over 15 then it's a three dose system then it's usually uh four to six months and then you go wait again to have your third dose and you can wait if it's a year or so you don't have to start the the series over you go ahead and get it done so the nice thing is if you have two before the age of 15 it's not like you're going to need the third one after the age of 15. so two really does protect you under the age of 15 it helps out with that whole immune system understand yes that Gardasil does not prevent sexually transmitted diseases correct period right does not say you will not get the virus what it does do is it helps prevent changes leading to cancer cancer can be in the cervix cancer can be in the throat cancer can be uh in the rectum and so it is just again you said earlier and I just want to make this clear because a lot of people as was I when I I have a 26 year old and a 20 year old now and when they were uh pre-teens this came out and I thought okay well my son too and it was just at the point where well you have a son he needs to get this too and I remember thinking but he's a boy so I'm glad that you brought this up and again we're looking at the different strains of the virus it's not just cervical cancer correct so I wanted to to bring that back up too and I know that we're about to switch over to the other docs is there anything that we haven't talked about with you that you want to bring up before we switch over to the other doctors are going to be here they're going to kick you out isn't that sad thank you very much for the opportunity it's been a pleasure it always is as once again I think doctor-patient relationships are very important and being a little bit prepared when you go talk to your doctor with questions that you have and and trying to get the answers that that you feel comfortable with in your care whether it's vaccines or antibiotics or anything because everything has a risk and benefit if you understand that then that helps you your body heal better exactly and I do want to give it a nice another plug here for the El Paso County Medical Society and Dr Hendricks as the president this year we've kind of implemented this you can still ask questions I know that we're hearing this back and it's on a live program anymore however if you do have questions about any kind of vaccines feel free to email info epcms which is the El Paso County Medical Society so info at epcms.com and we will get those questions answered either to you directly with that email or we can answer the questions the next time we come on the air and say hey last month we had this topic and we're going to answer those questions so Dr Hendricks thank you so much for being here and you're watching the El Paso position stay tuned thanks again for joining us we are talking about vaccines defend what matters and we have three additional doctors here with us we have Dr Allison days who is the editor of the El Paso physician magazine which is hard work and the El Paso County Medical Society says thank you for that because there's a lot of stuff that you have to prove every single month and then it goes in every three months and you're also the medical director at healthy days Pediatrics with UMC so thank you very much we have Dr Roxanne tyrock who is with intellimedicine PA and she's also a Texas delegate to the American Medical Association so you guys have a lot of big things going on here and then we have uh the mucho muy importante dude with the city county health authority and you are the Public Authority on everything vaccines right and a lot of other things too but for today's purposes that that's who you are um so you're tuning back in we just had Dr Joel Hendricks on as well that kind of gave us a a background of why vaccines why why are there vaccines in this world and so there are so many questions we were talking about Gardasil for a little bit and the human papillonavirus vaccine and children and so there are two pediatricians on the board both you all are pediatricians so when you're looking at vaccines in children give us a little bit of background on why you do what you do Dr days oh I do what I do well I first of all I I didn't mention this in the intro but I actually also have a public health degree and so being both a public health person and a pediatrician as drones also is I think vaccines are sort of at the Forefront of that I think in definitely in United States history and maybe even world history I think the vaccine is literally probably the second most important Public Health success that we've had and it starts in infancy I mean the immune system is first developing in in infancy and shortly after and so they're also we're also kind of um encountering many new things every day as children many new viruses vaccines and and that's how our immune system develops and it makes sense to sort of help that immune system as it's growing to contact the things it's supposed to that will help us and avoid the things that might kill you you know so that's sort of how I see vaccines as part of the growing exposure you know every time you learn something what doesn't exactly what doesn't it was it was it something that doesn't kill you what is this if something doesn't kill yeah it makes you stronger for me whatever it is I absolutely believe that in terms of vaccines and I think and and you know when I approach it with with families with parents I also always let them know that I personally fully believe in vaccines and I vaccinated my children my family's vaccinated I'm vaccinated you know so it's just um you know to let them know that it's okay and it's actually a good part of medicine and development and being part of the world right exactly exposure to anything makes it a little bit stronger and Dr tyrock on that note we hear a lot lot of media attention around different vaccines one of them shingles vaccines there's a lot of media around that we don't have a lot of media on RSV but I'd like to talk about that especially in adults because we talk about that a lot currently in the last year or so with children but we haven't really transitioned a lot of media attention to that in adults and I'm throwing them all your way but I'm going to come back to a specific one but just kind of giving it to the audience there's pneumonia and flu and covid you know a lot of people see those kind of as the same type of ouchiness when you get sick is it pneumonia or is it something that's covid in the fluid that leads to pneumonia you know we'll talk a little bit about those vaccines tetanus that we'd ever talk about and you should have that every 10 years and then all vaccines that that adults need but let's talk about the shingles virus first because that I feel like media attention's been there for the last six seven years talk a little bit about the shingles vaccine virus and why people should get it well certainly and I do have some graphics you know they say that sometimes a picture speaks a thousand words and this graphic here this is one of the most dreaded complications of shingles shingles can affect the face it can affect the eye which can then affect your vision uh there are a lot of different uh side effects from or um symptoms from shingles the most common and well-known one is the rash that comes around on the thorax uh there's itching it's a blistering painful rash that's another dreaded complication is even after the rash goes away you may still have lingering pain in there that's called post herpetic neuralgia and many people will have to take medications for long periods of time after they've already recovered from their shingles because they still have that pain I've got headache sensitivity to light so we can prevent this at the age of 50 all adults are recommended to receive their first shingle shot and then there's a booster anywhere between two to six months after that first one that's very important to remember to get that booster nice and and sometimes there's these series and we're going to talk a little bit about that too and again with Kobe virus we knew that you had one and then you had to get another one another one too um and so let's talk a little bit about uh tetanus shots and uh we'll we'll show some some graphics uh in a moment when those are appropriate but tetan shots are usually given in my experience anyway that you had a bad accident and something was either Rusty or it's like you know what have you had a tetanus shot oh my gosh no I haven't so maybe talk about why that's important for people to just keep up on it maybe the general practitioners have that in their chart and maybe since we in this program we're trying to teach prevention we're trying to let people advocate for themselves to talk about their own tetanus shots well you're absolutely right that uh that is where most people think about getting a tetanus shot and and we should continue to think of that when you have a trauma a particularly a puncture wound that um you need to get a tetanus shot even if you had one two three years ago you still get another tetanus shot so all adults uh so your last childhood tetanus shot will be around what 12 13.

I'll I'll defer that to The Experts here and then 10 years after that you start getting the adult every 10 years you can get the TD which is uh one shot that contains tetanus and diphtheria or it's now considered acceptable to get a Tdap instead that adds pertussis um and so that's something that people tend to forget about and that's why we're talking about it here right beautifully said uh now to the muchimum importante dude um I'm saying that with a very terrible German accent and it's not coming out right it's even better when you say in German how do you feel more important now there you go um so we were talking right before we got on the air about the covid vaccine the flu vaccine pneumonia vaccine so we thought and I know when you and I did a show together I think last year that eventually the covet vaccine the flu vaccine may become one but right now we're still looking at covid vaccine and flu vaccine being two separate vaccines and I'd love for you to talk about the importance of maybe even getting both of those in tandem when it's that time and how often people should get those and I know it's loaded and it's been changing a lot over the last three years so again thank you for being the health authority we see you all the time thinking okay what's the latest today Dr okaranza tell us and thank you for giving me the space to talk to the people about that there's a lot of comments about vaccines get it not get it why we do recommend that we in El Paso suffered tremendously from the loss of the loved ones why because we didn't have any medication we didn't have the vaccine and people were dying or covet that is the main reason why we were still strongly recommend the covet vaccine and we're still going to continue recommending the covet vaccine every fall now it's not going to be the flu season now it's going to be the covet flu slash pneumonia season right and that's why we continue to tell the people exactly to get the covet vaccine every fall get the flu vaccine every fall and we know that these respiratory virus are going to be changing year after year and the vaccine as the virus changes he's going to continue changing trying to protect us from the variants or the strains that are going to be circulating in the fall winter and spring so that is the reason why we will continue sending that message out to the community please vaccinate please get your shots we don't want to see you in the hospital we love you but we we don't want to see in the hospital we love it but we don't want to see you here yes so that's a great question because I was thinking about the three are we at the point two now that RSV should be in every fall lineup so to speak so are we looking at and pneumonia vaccines that's another question do we recommend pneumonia vaccine for everybody tyrox got her papers out so anytime you want to jump in on a question feel free to do that so is that something you want to explain or talk about uh do you want to talk about kids or adults I'm adult let's first talk about adult okay because I think about RSV just myself right now in in Pediatrics but I'm talking about adults going forward is RSVP something that we are recommending on a yearly basis as well as the flu as well as covid results are we um am I addressing RSV now or am I addressing pneumonia now let's do RSV RSV yeah because like I figure that's the one people haven't really heard so much about right and the reason that we haven't heard about it is because it was just approved by the FDA in May and then the CDC advisor committee on immunization practices met in June for several days they deliberated on the recommendations on this vaccine for adults so the final verdict was that in individuals over the age of 60 that its shared decision making between the physician and the patient and there are several reasons for that um there are particular underlying disorders that render an individual at increased risk for hospitalization and death and those are coronary artery disease emphysema asthma congestive heart failure in particular those are the ones that were studied but there are many other disorders that fall into that category that we know you know from the past RSV Seasons that um such as lymphoma or transplant patients so data is not available on those patients yet um so there are two on the market the GlaxoSmithKline version is um uh it's an agent that causes the immunity and it's mixed with an adjuvant and it's about 50 percent of the volume of the at the same age event the GlaxoSmithKline put into the shingle shot it's to rsva the Pfizer version is a combination of the the agent for rsva and rsvb and there is no adjuvant so really we cannot perform head-to-head studies on these two because they're really not the same what we do know and you said this was first approved in May so we're still relatively new in this whole process okay fish not even really it's not even a study yet yeah yeah like we're seeing where this is going so that that's great so if we're going to recommend at this time the recommendation would be talk to your doctor to figure out if you're a person that that would be good is in the trial so to speak but not a trial so that's that's nicely put together Dr days um I kind of brought it up earlier regarding is it better to do vaccines separately or in a combination and maybe we can look at that also as a pediatric doctor and then also moving into adults so I know again 26 and 20 are the ages of my kids but I remember that one appointment where you go in and they had four that they were gonna get and it was like you're you know biting their nails the entire week before that explain why that's the case and again the combination of separate or together sure well one of the things that I think a lot of parents and and kids themselves or teenagers are very stressed about now when they go in the doctors is there are a lot of pediatric vaccines they're just sorry if we look at the scheduler a lot and that is a good thing because it means that we're finding more and more how to find some of these diseases how to protect against diseases and many of these these many of these vaccines before there were the vaccines people would say when they had people in the hospital dying they would say why don't we have a vaccine for this the same way they did for covid and then we did and but now parents are saying oh my god when I go in there's you know yeah as they look at 10 zillion different vaccines we need and won't it overwhelm the immune system and won't it really hurt my kid and won't it do this and do that so we spent a lot of time talking about that about this over time there are a lot so you don't want to have to give you know 10 different injections to a child at one visit especially small kids skinny kids right not a lot of fat to put it in or not a lot of muscle and so what they've done is they've created a lot of combination vaccines that combine some of the major ones you need and the ones you need multiple doses of you know so some of them would have like the Tdap which you've talked about um a Hib which is influenza bacteria not the flu but it's a bacteria okay it can also cause pneumonia and things like that um and hepatitis b is another one that they would put in a combination so there's a couple combination ones that combine different groupings of vaccines and for us as doctors I prefer the combo vaccines because it means that you're only giving let's say you're giving three injections to your child but you're really covering them for seven or eight so is that becoming more and more commonplace and and when did that really start I mean is that something um it seems relatively new It's relatively I want to say okay 10 years ago 15 10 around 10 years ago I would say that they started really pushing the combination vaccines and being able to figure out how to put them all together in one in One Direction so that's come about relatively recent now many parents are very excited about that the same as I am oh great we don't have to do that many injections right it's not going to be that my pain but there are other other parents who have now looked at it and said yeah but they're all at once that means that it's like they say that's going to overwhelm their immune system realistically most Studies have shown there's sort of no such thing as overwhelming the immune system is built if you look at other countries third world countries where they face these things every day without vaccines they're facing natural you know infection they should be overloaded but there's no other immune system is actually facing this stuff all the time and we're giving them a little little teeny bit in these vaccines of the actual virus or bacteria or not even sometimes just a a simulation of that that tricks our immune system into creating antibodies and so the antibodies getting it created to three the same way it would to one it's just exactly right at the same time so really that that I think that reasoning is somewhat of a fallacy that people think that combination is great I have to give a shout out to Dr Nikki your predecessor predecessor and I remember the media campaign two four and six months El Paso right Juarez and Las Cruces do you remember that so it was talking about when the parents like two four and six months you have to get a vaccine each one of those months yes is that something that's still the case is that still a a practice now is it still two months four months six months yeah still the case and we still see the children that they come for the wheelchair invasive and along with that they get their shot teenage just come and the dreaded question like why every time you come to the office I get a shot yeah yeah and I like to tell them sometimes you know the next time you come you don't need a shop for three years isn't that great except for maybe the flu maybe yes you tricked me you tricked me I used put some kind of a bribe in there when it's time to go to the doctor I remember that very much uh Dr okaranza let's talk about um again you're on the air a lot when anytime there is a a communal type of happening regarding vaccines so do you find that right now with the coveted vaccines it's it was The Shining Star for a long time everybody talked about it constantly and I feel like in the last year or so we were just talking before this program too the covid variant vaccine came out in October that was the last one is that correct that's correct so what was um and you don't have to give me numbers but just in general the response from the public of receiving the coveted vaccine after October was that lagged from the ones prior to because people weren't so worried anymore just give us what your background is in the team that you work with on people still being serious about it and initially because we had that experience that we were the hottest spot in the nation about covet the initial response to the vaccine when it was rolled out it was amazing we were the first city to reach very high levels of people vaccinated people wanted to get the vaccine and they saw that receiving the vaccine was going to be the life-saving event basically but then as the time goes by as people started getting secret covered and they saw well I didn't get sick that bad so I guess I don't need it that much so the response to the subsequent booster vac doses of the vaccine was not as great and unfortunately after October the uptake of the vaccine was not the greatest but definitely talk to your doctor talk to that trusted individual that you entrust the care to to tell you how effective it's going to be here and how you're going to be benefiting from receiving the vaccine because of your particular medical condition so at Public Health we can tell you as a blanket yes we recommend it for everybody but if you want to know something that is going to be specifically to you talk to your physician that's going to be the one key thing that you need to do and that is the reason why we need to continue having that trusted relationship with your physician so you can see why we continue to strongly recommend the vaccine we hope that everybody gets it everybody that is approved for it and we need to continue doing that because yes we want to see you well and alive and the vaccines are as we told you before a life-saving tool that we have in our big bag like the old days like you said Dr Nikki used to carry his ball Dr Nikki I know yeah I know um and Dr Hendricks earlier had had talked about risk and benefits I'm really looking at benefits benefits benefits you know so it really makes all the difference um Dr tyrock I we we talked about some very specific vaccines but there is a ton of other ones out there that we haven't touched base on so I'm asking you to pick either the ones that come to your mind as a person who's a specialist in this field like which other vaccines have we not talked about yet that you feel like need to be stressed to the General Public well thank you so much for asking that question the one that has changed recently is the pneumonia recommendations and for quite some time the recommendations have been that at the age of 65 a person of average risk that does not have high risk conditions would get the um the prevnar 13 and then about a year later they would get the pneumocouple pneumococcal 23 valence vaccine a year later did you say that okay so you're looking at Logan is that a series then well that was the recommendation so many people probably think that that's still the way it is but there have been two new players on the market okay and that is the 15 valence and the prevnar 20. so it it used to be simple decision making and now it's more complex for example if you got this then you would get that many people come into my office and they say I was told that I'm good for life because I got the pneumonia shot and really we need to be looking at this as pneumonia science pneumonia vaccine science changes over time and so you always want to check with your physician about what are the new recommendations have things changed so it's really kind of complex right now and also uh individuals that got the the seven valence way back when are now eligible to come back in to get vaccine way back when is that like five years ago ten years ago probably over 10 years ago with the seven okay so we're looking at that for pneumonia vaccine and say someone did get a vaccine and just like we were talking here tetanus I can't remember when the last time I had my tetanus shot and I had to check that out so just thinking of the the normal average person's like well was it 10 years ago 15 years ago my question there is when do you so whoever your doctor is should have your your shot chart you know which is something that all of our kids every time you go to school you got to have your chart so you can always check that chart um and I'm looking at Dr okaranza because I'm thinking too with the coven vaccine because we were getting vaccinated in a lot of great Community areas it really was up to the individual to bring our little card to our doctor and say please put this in my shot record so when we're looking at the normal population how do vaccinations get trapped are they are they now just part of every computer system and you know that's kind of like the uh oh my gosh the the system we have now where everybody's medical records are uploaded to fix the system is that kind of what's happening is that something that's becoming more and more normalized to where you really do know what vaccines you had if you go to Walmart for example and get your vaccines yeah because they're all over the place that's a good point yeah eventually we're going to be having some commonalities in the way that people need to sign so so people can share their medical records with other people in the same way the states are going to be sharing the vaccine records with other states as people move one thing that I want to make sure that we tell the parents especially those that are going to go to college they have kids that are going to go to college take your short record with you either because you're an adult now it doesn't mean that you're not going to be having shots and I would like Dr tyrex said yes you're not over so take your shot record with you see what you're going to be needing make sure that your other physician is going to be inputting all those shots that you already got into your new medical record and as you transfer medical records from provider to provider because they're going to be moving cities you're going to be moving jobs whatever it is the case take also the shot record with you so as the public health person how are we we El Paso but we in America as well of putting all these onto a Mainframe to where you can always access what you have had done to you medically throughout your lifetime and again I know we've been talking about this for several years now that we're trying to get to the point where it's easily if you're in a car accident for example and you can't take certain types of blood or you have certain issues how is that how is that working again just as a Mainframe for public health and I and I know we didn't practice this question before talk about this before I'm throwing it at you blind all right that's great so if you're not prepared for it let me know it's like Catherine can you please move on um but in general how are we doing with that yeah and these are the questions that we get especially as physiciansly yeah it's gonna it's gonna come because if you're gonna work in a specific place they're going to ask you for the shots how am I gonna pull them out if I have it in the box somewhere right but every state has its requirements there's some states like the state of Texas that you need to sign to keep your records for a long long time especially now that we don't have the cobit public health emergency if you don't sign that paper that says yes please keep my records they're going to be forgetting about it and the state is going to just toss them so it is uh up it's up to yourself it's a I'm Dan state so what that means is that you need to sign telling the state that you want to keep your records within the state so whenever you need them you can pull him out of there New Mexico for example it's a not that state so you're going to be in the registry as soon as you get a vaccine in that state so so here's a question that I'm thinking of of what other people might be hearing as we're talking about this and let's say it's someone who never paid attention to this but all of a sudden it's like you know what I don't know have I had three or four where could they go to right now to find out what vaccines they had is there a record right now that they can call and Doctor you're nodding your head Dr tyrock are you because if so I'm going to throw that question right your way this is a major problem in the adult population I I agree I mean even myself I'm not exactly sure so how do people access we we don't have Amtrak now there are some for adults or we don't have obligations to report to the state so this became very fractionated when people started going to pharmacies and very few pharmacies will send their vaccine the evidence of vaccine to the primary care physician and so pneumonia is one of those ones that when you're doing meeting a new patient and you're asking when did you get your pneumonia shot they won't know which one they got and they won't know when they got it right and so it behooves the adult to maintain your own records in a file or an Excel and keep that because physicians in the state of Texas don't have to keep your records forever if a practice closes and even if they stay open they don't have to keep them after a number of years so may I add to that also absolutely please from the Pediatric we didn't mention she mentioned that there is an Amtrak for adults although except for for covid where it was actually used for adults as well well but we do have that for Pediatrics in El Paso I mean in Texas and it's actually been very helpful oh great okay um so most kids if they have a Texas physician at the El Paso physician every time we see a patient and we give them vaccines we input it into the M-Track system which is the immunization tracking system for for Texas and so you can if you switch positions Physicians within El Paso or let's say you move to Houston they can access that we can access it here however it's just for Texas so if you got vaccines in New Mexico you moved to Texas we don't have those so that part's not complete yet so it's it's helpful it's not complete the other thing that Dr tyrock brought up which is really important now for children as well is that a downside to what happened during covet is that more parents started getting vaccinations at Walgreens and places like that because now they are allowing them to go down much farther in the child they won't do infants still but they'll do I think four and five-year-olds now and I've definitely teen 11 12 year olds um and so what happens is as she mentioned they don't necessarily enter it into Amtrak and so will have parents who recently will come to us and say they need so and so for school they need the reporting for school to to register and we don't know like you don't have it and we can't access because they got it at a pharmacy and we don't have that information and so I do think that's important for for parents to understand too it's not to say that they should never get anything at the pharmacy it can be useful sometimes to get it there but you definitely need to keep your own records if you do that and you need to bring those records to your doctor so then they can then enter it in because we can enter in vaccines that we don't personally give as long as we have the record of what we're done because that's that's also very important that leads me into the next question for you specifically um because we were talking about side effects and adverse effects and I'm thinking too with what you're saying if there was a vaccine that needed to be had to attend a certain School say this child already had that vaccine but doesn't remember the parent there's no record of it and they they got the vaccine again are there any vaccines that are uh that's not a good thing I mean or or and and I'm just trying to just educate here that it's it's you should have more protection than less protection that's correct maybe that's the way I'm trying to in general I mean parents ask us that all the time in general I can't think of a single vaccine that would harm you per se if you've got a double dose of it I mean generally especially if it wasn't you know the same day or something you know if it was a couple months later it's fine and as Dr arcaranza said at one point um you usually don't have to restart series of vaccines so like the Hep B you don't necessarily have to restart it unless you can show that you no longer have immunity to it then you would need to start it over um but you know many people get the first two let's say Hepatitis B and then they forget to get the third one you can still get that one later um same thing with the HPV same thing with HEPA because I only got one and then covet hit and then all the shingrix cut vaccines a lot of people too exactly but um but yeah so I think generally because we do have parents come do that I don't remember whether they got this or they got right that's fine you know it's probably better you're here in my office right now I'm going to give it to you let's do it anyway you know so you're sure that you have it we can show that registration to school you know and and you don't worry about it right because again if you already I mean if you think about it immunologically if you already have antibodies to that and you get another vaccine you might have a slightly increased risk of side effects as we say the same way we saw with covet if you had had the Cova disease and then you got the coveted shot those people tended to have more side effects right um and that happens with other vaccines as well but it's not going to hurt you per se it's not going to cause any long-term problems and I love that you brought up the side effects because that's actually a good thing um and I don't know if it was hourship that we talked about or Dr Roxanne tyrock if you want to talk about that but the idea that if you're getting a vaccine and your body's reacting to it and side effects Dr Akron said talk about why that's good if your body is reacting to a vaccine and you notice it why is that a good thing well that is a good thing because you know that your body is reacting the way that is supposed to be reacting a lot of the people don't want to get the vaccine because they said oh I feel so bad I feel terrible no more yeah no but it's good because it shows your body's working I know and I tell them it's like look it's better to have a night of chills than a whole two weeks of in the hospital so in Dr days brought a very important subject that we hear over and over why are we gonna overwhelm our body with something it's like no we don't we go to a child's party and there's a lot more bacteria and viruses there than what we give in the vaccine and we have a lot of comparisons and a lot of analogies that are going to help us understand a little bit better because the human body is so amazing in the way that it's going to react and what we're doing with the vaccines is that we're training that body to fight we're training the body to recognize what we don't need in our body and that's the way that is going to be reacting when he finds a fully strong virus and it's not going to cause a disease so a little bit of reaction is good we is something that we expect but don't be afraid of that so Dr tyrox you're like madly nodding her head up and down because I I know when I see that it's like there's reaction in there so talk a little bit more about that because I feel like you want to add a little bit more on that or are there some vaccines that you're gonna have more of a reaction than others maybe we can talk about that as well and what to expect and knowing that when you do have a side effect this is normal and if not just normal good what are some that you would be able to bring up well thank you for asking that um did you have that local reaction to the shingrix because that I did that is what I expect really common yeah I expected it so to me it was it was not a problem at all I thought okay this is into me again in my head it's working something's going on there my body's reacting to it it's working and that's the way I interpret that great and that that is a great way to look at it sometimes when I hear somebody say you know I didn't feel a thing at all I felt completely normal I'm almost a little worried like was there something wrong with that batch or uh was it uh out outside of the fridge too long or you know at Walgreens or so um anyway it is good to have a little bit of a reaction um sometimes people will uh go online and they'll read about all the potential side effects oh that's scary uh the one that people dread the most is Guillain-Barre syndrome if you look at the statistics they are very there is a very low low risk of this and for many vaccines it's the very first time you get it is when you have the highest risk for example with the shingrix and then subsequent doses the risk of that is lower so please don't be afraid to get your uh your adult vaccinations because of the fear of of side effects or potential bad outcome and I'd like to add to that also that um that we see that a lot in Pediatrics as well and parents will say we'll come in and say well I don't I'm not going to get my child this vaccine because they had a bad reaction last time they said well tell me exactly what the reaction was and sometimes they'll say oh they had a really high fever or they had a headache all the next day or whatever and I said well you know what that's not a bad reaction that shows that your immune system is reacting because if you think about the actual disease you would get a fever you would get this you would get that right so your body is reacting the same if it's reacting the same way as it would with the natural infection but you're only doing it for 24 hours so your body's not dying you're not ending up the hospital it's training right and so I spent a lot of time doing prevention with Pediatrics in terms of telling the parents that what to expect your child will get a fever today expect a fever you don't have to initially treat the fever if they're not uncomfortable and they're fine but expect the fever expect that tetanus they're going to have a sore arm expected HIV they're gonna feel a little dizzy you know there are various side effects we know that happen but that are part of your immune system reacting to that and and creating those immune that immunity creating those antibodies and things and I like to think I tell some of the little kids like think about you know the vaccine as um you know somebody in your house that's that's looking out the window and the disease or the you know is the burglar right and you know when you give a vaccine you're sending this burglar into the house and he's got a red shirt and so you're reacting the red shirt so the next time anytime you see a red shirt you're gonna be like okay fight against it right so that's the immune system and that's what we're doing I think pediatricians are so much fun to have on the program because it's like you know explain it to me like and then you always get it like like that's fantastic food likes to change his shirt every time but yeah probably for a while too was changing his shirt and shorts and pants and everything else for a while um I like to so there's a varicella vaccine I'm not familiar with that but I'd love for you to talk about what that is if you don't mind sure so the varicella vaccine is also one of the sort of overall relatively new ones I mean when I was younger it was didn't exist either and I think probably maybe sometime when I was in my residency it started so um I don't know late 1990s maybe early 2000s I don't remember when it first came into effect but not that long um and that's against chickenpox and most again parents will say well why do the kids need that well you got chickenpox and we were fine and for the most part that's true most people who got the chickenpox got it naturally it was a mild infection they're fine but certain amount of people know it was a really bad disease it can cause Encephalitis it can cause pneumonia it can cause a lot of other really really bad effects especially if you're have other diseases so if you're immunocompromised because of a cancer or you or some other autoimmune problem you're not going to react normally to chickenpox right and so after a while they decided that that would be a very good routine vaccine to give to kids to prevent them from getting that and it's done extremely well in terms of long-term protection so good it's it is a live virus we didn't talk about types of vaccine oh gosh that's a whole other show yeah and that's a live vaccine virus so it causes more and better lifelong immunity than other than so live viruses are in the end of the day are better to get correct because they mimic the natural immunity right yes they mimic the natural virus more right so um varicella it you know they initially had only one I think it initially came out with the just the one year old one I think that was the first one that came out okay and then they realized they didn't it did need a booster so now there's one at four years old as well so you can get one at one year and then you get one in on Entry to school but after that it's pretty much lifelong I mean most people that's impressive I don't you know it has some bearing on getting shingles as an adult um but whether you have the live infection or whether you have a vaccine you might still get [ -_-_ ] shingles that's why there's the shingles vaccine separately but um yeah I know it's been amazing I mean I haven't seen I did see a couple cases of chickenpox um live wild chicken pox about I want to say about 12 years ago but none of the kids were vaccinated here in town here in town none of the kids were vaccinated all of them went to the same birthday party um separate families and they all got chickenpox which is what we used to do oh my goodness 50 years ago everyone was going to chickenpox parties um and also super spreader yeah very super spreader and most of them are fine but they're really sick and the kids were and the parents had no idea what it was because they've never seen chickenpox before so that's what we see now that's what we want to see we want parents to come and say I've never seen this before right or how come my kid has never gotten chickenpox right you know why because they got the vaccine and that's that is such a beautiful thing this is the prevention show right we have about five minutes left and Dr okaranza I would love to we'll quickly go back we were talking earlier before the show of when was the first vaccine I think you looked it up right yeah and I think it said 1796 but I love the story around Dr Jenner and you know how it came to be it's like is there a way to defend herself so talk about the first vaccine and how it how it came to be yeah it was it was so interesting because when Dr Jenner was around 1700s and at that time smallpox was just killing whole towns and they didn't know how they're going to be able to protect but one observation that he did is was that Dairy Farmers were being spared from all these deadly disease from smallpox and you know why why why why why and she saw other cowpox was one of those that the Dairy Farmers were getting infected and they were therefore protected against the smallpox when all these epidemics would happen so he did an experiment and got the cat box from one of the dairy ladies cowpox I can't you know that's just so much right causing of the smallpox causing another monkey box that a lot of people heard right so and inoculated a major old nine-year-old kid and saw that the kid was protected against the smallpox and that's what they attributed the he is the father of the vaccination or the vaccine and after that he came Louis Pasteur with some of those and we remember the salt vaccine against polio and how many of the older people um older two I know but great grandparents used to remember that out of the whole block of kids some of them got infected with Napoleon never walked again we don't see that anymore and Dr day is touching that Dr Tyra that because we don't see it people tend to forget that we don't have that those diseases Global effort I mean no I mean rotary clubs all around the world that was the global effort and it's amazing what public health can do when you have like everyone's heads and hearts involved in all exactly any any moment ottoman hours a lot of us vaccinating people so we don't see those diseases anymore so that is the beauty of the vaccines that's what we're defending against and that's what we we can talk shows and shows and show us about what the benefits and and everybody needs to see their own risk and how we're battling that risk with something that is more of a protection a prevention that we're trying to do so like Dr Jenner started and made that observation now we're seeing that observation that we don't have polio we don't have measles we don't have hemophilus influenza tibia meningitis we used to have these children less than six months of age and as soon as they get fever we had to get the fluid out of their backs because we were so afraid that these kids were going to get meningitis and some of them die some of them came with disability so right we're trying to prevent that we're trying to cause a good and not a harm exactly and again the title of the program speaks exactly to that vaccines defend what matters um on that note though we have to wrap up it happens so quickly right the show but I do want to say to anyone who is listening and watching right now if you have a question specifically about vaccines we won't be able to tackle them in this program but we can open up the next program with the questions that you have or the County Medical Society can get back to you so if you do have a question email it to info epcms just think of the acronym of El Paso uh County Medical Society so epcms.com and also if there are our questions about shows that we've done in the past that for some reason weren't answers we have a army of doctors Dr Hendrix was talking about that that might be able to help out and answer those questions so that's always a good thing this program if you only got part of this program there's a couple places as we catch it again you can go to www.pbselpasso.org and just go to their programming or the local program on there just look for the El Paso position and then again you can go to the El Paso County medical society which is epcms.com and then also if you're a YouTuber this uh program in all and I say this program but really all the programs that we have that are able to be archived are on those platforms and that would be youtube.com and then type in the El Paso physician the word the has to be in front of it and then this show will pop up as well as other shows in the past that you all have been on so this is a special show on vaccines and I can't wait to see what's next and I thank all of you guys for being here again we've had Dr Joel Hendricks Dr Allison days Dr Ross and tyrock and Dr hecko on Hector octaranza can you tell I'm doing this really fast I'm Catherine Berg and we have to wrap up you've been 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