Category Archives: Vaccinations

‘Flu’ may not be flu


Children’s Hospitals and Clinics of Minnesota has seen a large number of influenza cases over the past several weeks, and many children have needed to stay overnight to help treat their symptoms. (iStock photo)

Joe Kurland

Influenza, or “the flu” as his friends call him, is a horrible bug. He wipes you out. He gives you a fever and makes your muscles and joints ache. Your head pounds and you just want to crawl into a warm cave and sleep.

There are many other bugs out there that want to be like the flu. Some of them are bad enough that people even use the term “flu” in their names like “the 24-hour flu” or “stomach flu.” Know this: Real flu does not last only 24 hours, and the real flu does not limit itself to your belly.

If you or a loved one is suffering from sudden vomiting, diarrhea and fever but get better within a day or two, that wasn’t influenza. Those symptoms usually are due to bugs that spread through food. And those bugs love this time of year. With family holiday gatherings, school or office parties, and shared meals, there are lots of chances for the bugs to spread and make people sick.

Some of the infections can come on quickly, such as Staphylococcus aureus infections, that can make you nauseated, vomit or suffer belly cramps and diarrhea in as little as an hour. Other infections can take days. Norovirus, which may show up two days after eating contaminated food, makes you feel miserable with abdominal cramps, vomiting and watery diarrhea. E. coli is another bug that can take as many as eight days or more before you are hit with gas, fever, stomach cramping and even bloody diarrhea.

Fortunately, most people recover quickly from these infections and many don’t need medical care. While you may not feel well enough to eat after infections like those above, it’s important to drink plenty of fluids (water, ginger ale, sports drinks) to prevent dehydration. When you feel well enough to eat, begin slowly and start with easy, bland foods such as toast, oatmeal or crackers. You don’t want to shock your belly with strong flavors, spice or heavy food.


ABC NEWS: Flu shots are dangerous… and 5 other flu myths busted


Things are different with the real flu, which is a respiratory illness. Influenza can come on suddenly, with symptoms often including fever, cough, sore throat, runny or stuffy nose, muscle or body aches and fatigue. Some people may experience vomiting and diarrhea, but they are not always present. Influenza infections can be life-threatening and require multiple days in the hospital. Children’s Hospitals and Clinics of Minnesota has seen a large number of influenza cases over the past several weeks, and many children have needed to stay overnight to help treat their symptoms.

And this is why we have an influenza vaccine: it helps prevent you from getting really sick. Sometimes (like this year) the flu changes (mutates) a bit. This can cause you to get real influenza symptoms even though you got your flu vaccine earlier in the season.

subscribe_blogNot fair, right?

Well, we may still have the advantage. The vaccine helps train your body to react to the influenza invader and keep the infection under control. You might feel sick for a week and spend some time doing puzzles in your bed (or warm cave), but the vaccine helps keep you out of the hospital. And good news: It’s still not too late to vaccinate against influenza.

Not every illness is the flu. But if you’re feeling sick and are concerned, it’s a good idea to contact us. Whether it’s a wicked seven-day coughing influenza or 24 hours of bathroom misery from a stomach virus, we’re here for you at Children’s.

Joe Kurland is a vaccine specialist and infection preventionist at Children’s Hospitals and Clinics of Minnesota.

The facts about this year’s flu vaccine


(iStock photo)

Despite what some vaccination opponents have written and some media have reported, the drifted flu strain doesn’t mean the vaccine doesn’t work. (iStock photo)

Patsy Stinchfield

Children’s Hospitals and Clinics of Minnesota this month is seeing record numbers of ill children — more than 450 cases, the most ever for this time of year — ranging from 4 weeks to 15 years old, with a fairly common 12 percent admission rate. Many of them have symptoms consistent with influenza, and of those admitted for a stay, 70 percent of the age-eligible kids have been unvaccinated against flu.

While the Internet, the once-nicknamed “information superhighway,” is full of helpful information, it also has its fair share of breakdowns and wrecks. Though it brings us a wealth of knowledge at our fingertips, misinformation also is abundant in today’s 24-hour news cycle. Depending on the topic, the practice can have serious consequences.

This year’s influenza vaccination was designed to protect against up to four strains of the flu (two A strains and two B strains). This month, the Centers for Disease Control and Prevention (CDC) announced that one of the strains of influenza, A H3N2, has drifted, changing itself from what was put in this year’s flu vaccine. It’s like the original plan for the vaccine and the circulating flu strain were to be like identical twins, but now the virus has changed its genetic makeup to present instead like brother and sister. This resulting strain in the vaccine is now about half as protective. However, there are two to three other strains in the vaccine that can help keep you and your family better protected from the flu.

Despite what some vaccination opponents have written and some media have reported, the drifted strain doesn’t mean the flu vaccine doesn’t work, even against A H3N2. It means that the vaccine may not be as effective against the mutated version of A H3N2, though it may lessen the severity of the symptoms from it. The vaccine still protects recipients against the two B strains and other A strain.

Q4_mighty_buttonEarly in each year, in order to manufacture flu vaccine for as many people as possible, the World Health Organization (WHO) makes its recommendations for which strains the flu vaccine should target. This year, according to IFL Science, WHO made its recommendations in February, and A H3N2 was included. The drifted strain was discovered in small numbers at the end of March.

Like with many diseases and illnesses, young children, expecting mothers and the elderly are most susceptible to influenza. Vaccination is important to protect yourself and others. Not everyone is healthy enough to receive the vaccine, which comes in the form of a shot or nasal mist, to protect themselves, so it’s up to everyone to work together to minimize the spread of the potentially fatal disease.

While the vaccine may not prevent someone from getting influenza A H3N2, it may keep a person from getting severe influenza requiring a critical-care stay. It’s not too late to vaccinate, and it’s vital to do so. Learn more about additional resources to protect you from the flu and how to get your vaccination.

Patsy Stinchfield, infectious disease nurse practitioner, is the Director of Infection Prevention & Control and  the Children’s Immunization Project at Children’s Hospitals and Clinics of Minnesota.

Beat the flu, get vaccinated


The flu vaccination is the best defense against what can be a serious infection at any age.

The flu vaccine is the best defense against what can be a serious infection at any age.

By Patsy Stinchfield, PNP

Influenza is a complex, tricky virus that is nearly impossible to predict. From 2013-2014, more than 1,300 Minnesotans were hospitalized with influenza.

And we know that of the 174 kids who died from influenza during the 2012-13 season, 90 percent of them had not been vaccinated. We know that pregnant women are more prone to influenza complications and are a high priority for getting vaccinated, but only half of pregnant women are actually protected.

Q4_mighty_buttonThe flu vaccine isn’t perfect, but it’s still our best defense against what can be a serious infection at any age. It reduces your chance of getting sick. But if you do become sick, it helps reduce the severity.

If not for yourself, vaccinate on behalf of babies who are too young to receive the vaccine (under 6 months of age), women and those with immunity problems or who are undergoing cancer treatment. When you get vaccinated, you protect yourselves and others.

A colleague told me that when her mom was undergoing cancer treatment, she got influenza and died from the infection. My colleague and her entire family were vaccinated that year before flu season and will never miss a chance to protect themselves against the disease that took their loved one.

Patsy Stinchfield, PNP, is the director of infectious disease and prevention at the Children’s Immunization Project at Children’s Hospitals and Clinics of Minnesota.

Children’s to host vaccination documentary screening

Subscribe to MightyChildren’s will host a screening of “Invisible Threat,” an award-winning documentary about understanding the science of vaccination and the misperceptions that lead parents to delay or decline life-saving immunizations, from 6-8:30 p.m. Thursday at its Minneapolis campus (2525 Chicago Ave. S.).

Parents, health care providers, staff and the public are invited. Flu vaccinations, courtesy of Kohl’s Cares, will be available for 150 people (between 6-7:30 p.m.) and administered by MVNA-qualified nurses. Healthy snacks will be served, and a panel discussion will take place after the film.

The 40-minute independent documentary, produced by high school student filmmakers, has earned praise from more than 50 organizations, including the Centers for Disease Control and Prevention, multiple children’s hospitals, and Every Child By Two, calling the documentary “powerful,” “fast-paced,” “well-balanced” and “impeccably produced.” The event is sponsored by the Minnesota Childhood Immunization Coalition.

Participate in #FighttheFluMN photo challenge

flu_prevention_kohls_600x600_4Flu season is just around the corner here in Minnesota and across the country. The Kohl’s Cares and Children’s Flu Prevention Project wants to know how you and your family plan to fight the flu this year. You’re invited to participate in the Flu Prevention Photo Challenge to show us how.

photoHere’s how to participate:

1. Snap a photo of you and/or your family fighting the flu.

Examples include:

  • Getting a flu vaccine
  • Washing your hands
  • Covering your cough
  • Showing off your “I got vaccinated” sticker

2. Post your photo on Twitter or Instagram using #FighttheFluMN (not case sensitive).

The contest runs until Wednesday (Sept. 17). Submit as many photos as you’d like. At the end of the day Wednesday, we’ll choose, at random, five people who each will receive a $50 Kohl’s gift card. Good luck and happy snapping!

Contest rules: Only photos posted by persons 18 years of age or older are eligible.

Social media disclaimer: We welcome and encourage open discussion on Children’s Hospitals and Clinics of Minnesota’s (Children’s) social media sites  including but not limited to our blogs, Facebook, Twitter, YouTube pages and online story-sharing forums  and look forward to any comments, stories and experiences you want to share. Other than the entries Children’s posts ourselves, the opinions and/or views expressed on these sites represent the thoughts of individual bloggers and online communities, and not those necessarily of Children’s or any of our directors, officers, employees, research staff, medical staff or members of our board of directors. All links to other websites found linked from Children’s social media sites are provided as a service to readers, but such linkage does not constitute endorsement of those sites by Children’s, and as such we are not responsible for the content of external websites.

While Children’s makes reasonable efforts to monitor and/or moderate content posted on our social media sites, we do not moderate all comments and cannot always respond in a timely manner to online requests for information. Children’s reserves the sole right to review, edit and/or delete any comments it deems are inappropriate. Comments including, but not limited to, the following may be deleted or edited by Children’s:

  • Abusive or hurtful comments about a blogger or another participant
  • Off-topic and redundant comments (this includes promotion of events, groups, pages, Web sites, organizations and programs not related to or affiliated with Children’s)
  • Comments that use foul language or “hate speech” (e.g., racial, ethnic or gender bashing language)
  • Personal attacks or defamatory statements or comments about a participant, instead of just criticizing his/her posting, opinion or comments
  • Comments that violate the privacy of our patients and their families

Please remember that information posted on any of our social media sites shouldn’t be considered medical advice and shouldn’t replace a consultation with a health care professional.

Please be aware that once you post something online, there’s the potential for thousands (or hundreds of thousands) of people to read your words, even years from now. We therefore suggest that you exercise caution when posting medical information on any of our social media sites and that you not disclose personal identifiable information like your location, medical record number, financial information, etc.

By submitting content to any of Children’s social media sites, you understand and acknowledge that this information is available to the public, and that Children’s may use this information for internal and external promotional purposes and fundraising purposes. Please note that other participants may use your posted information beyond the control of Children’s. If you do not wish to have the information you have made available via this site used, published, copied and/or reprinted, please do not post on this page.

The facts about enterovirus D68

Suspected cases of enterovirus D68 infections recently have popped up, with 12 states (Minnesota and Wisconsin are not included to date) contacting the Centers for Disease Control and Prevention for help confirming test samples.

Enteroviruses can be spread by close contact with an infected person who may cough or sneeze on you and by touching objects or surfaces that have the virus on them and then touching your eyes, nose or mouth.

Enteroviruses can be spread by close contact with an infected person who may cough or sneeze on you and by touching objects or surfaces that have the virus on them and then touching your eyes, nose or mouth. (iStock photo / Getty Images)

It is not a mystery virus – we see it every late summer/early fall. What is different is that this particular strain, EV-D68, seems to be causing more intense asthma symptoms, wheezing and respiratory difficulty for a large number of kids at the same time.

Now is as good a time as ever to learn about EV-D68 and enteroviruses in general.

CDC background on enteroviruses

  • Enteroviruses are common viruses – there are more than 100 types.
  • Most enterovirus infections in the U.S. occur seasonally during the summer and fall, peaking in September.
  • It’s estimated that 10 million to 15 million enterovirus infections occur in the U.S. each year.
  • Most people infected with enteroviruses have no symptoms or only mild symptoms, but some infections can be serious.
  • Infants, children and teenagers are most likely to get infected with enteroviruses and become sick. Infants and people with weakened immune systems are at risk of the virus worsening into heart or brain infections.

How is enterovirus spread?

“Enteroviruses can be spread by close contact with an infected person who may cough or sneeze on you and by touching objects or surfaces that have the virus on them and then touching your eyes, nose or mouth,” said Patsy Stinchfield, pediatric nurse practitioner and Children’s director of infectious disease and prevention.

Enterovirus D68

Enterovirus D68 is one of many enteroviruses. EV-D68 infections are thought to occur less commonly than infections with other enteroviruses. It first was identified in California in 1962. Compared with other enteroviruses, EV-D68 has been rarely reported in the U.S. in the past 40 years. There have been no known deaths due to the 2014 virus.

Subscribe to MightyWhat are EV-D68 symptoms?

EV-D68 usually can cause mild to severe respiratory illness; however, the full spectrum of EV-D68 illness is not well-defined. Most people who get infected are infants, children and teens. Most start with common cold symptoms of runny nose and cough. Some, but not all, may also have fever.  For more severe cases, difficulty breathing, wheezing or problems catching your breath may occur.

How should I care for my child if I suspect enterovirus D68?

There is no specific treatment for EV-D68 infections. Many infections will be mild and self-limited, requiring only treatment of the symptoms such as increasing fluids and rest or fever-reducing medicine.

Some people with severe respiratory illness caused by EV-D68 may need to be hospitalized and receive supportive therapy such as oxygen and nebulizations. There are no anti-viral medications or vaccines currently available for EV-D68 treatment or prevention.

What do I do if my child has these symptoms?

If your child has these symptoms, Stinchfield says: 

  1. If symptoms are mild, such as common cold, parents should do what they normally do with a sick child – increase his or her fluids, rest, keep home from school, give fever- and pain-reducing medicines.
  2. If symptoms are moderate, such as cold symptoms worsening or not getting better within a week, or new wheezing begins, take your child to your clinic.
  3. If at any time your child is having difficulty breathing or you are seeing blue lips or they are gasping for air, take him or her to the closest emergency room. 

How do I prevent enterovirus?

There are no vaccines for preventing EV-D68 infections.

Ways to help reduce the risk of getting infected with EV-D68:

  • Superb hand hygiene is important. Wash hands often with soap and water for 20 seconds, especially after changing diapers.
  • Avoid touching eyes, nose and mouth with unwashed hands.
  • Avoid kissing, hugging and sharing cups or eating utensils with people who are sick.
  • Disinfect frequently touched surfaces, such as toys and doorknobs, especially if someone is sick.
  • Cover coughs and sneezes.
  • Stay home if you’re ill.

How do I know if my child has enterovirus D68 or another respiratory illness?

Fall and winter seasons see many different viruses circulating in the community. Some of them that look similar with cough and runny nose include:

Respiratory syncytial virus (RSV) is a respiratory virus that infects the lungs and breathing passages. Most otherwise healthy people recover from RSV infection in one to two weeks. However, infection can be severe in some people, such as infants, young children and older adults. RSV is the most-common cause of bronchiolitis (inflammation of the small airways in the lung) and pneumonia in children younger than 1 year of age in the U.S. RSV is more often being recognized as an important cause of respiratory illness in older adults.

Influenza (flu) is a contagious respiratory illness caused by influenza viruses. It can cause mild to severe illness. Serious outcomes of flu infection can result in hospitalization or death. Some people, such as older people, young children, and people with certain health conditions, are at high risk for serious flu complications. The best way to prevent the flu is by getting vaccinated each year – Children’s is hosting vaccination clinics at Kohl’s stores around the Twin Cities metro area.

Participation strong for #MNvaxchat

By Jimmy Bellamy

Subscribe to Mighty

Thank you to everyone who joined us for #MNvaxchat on Monday night. More than 75 participants from across the U.S. engaged in a conversation about vaccinations with Patsy Stinchfield, PNP, Children’s director of infectious disease and prevention, and John W. Baker, MD, a pediatrician at Metropolitan Pediatric Specialists in Burnsville.

The informative hour-long chat, hosted by Children’s and Twin Cities Moms Blog, respectfully covered more than a dozen unique, well-researched topics with a highly engaged audience of parents and advocates.

The recipient of the $50 Target gift card is Linsey Rippy. Congratulations, Linsey!

We look forward to hosting more Twitter chats on a variety of health topics!

Jimmy Bellamy is the social media specialist at Children’s Hospitals and Clinics of Minnesota.

Children’s, Twin Cities Moms Blog host #MNvaxchat

Subscribe to MightyAugust is National Immunization Awareness Month, and Minnesota’s new immunization requirements take effect Sept. 1. With that and back-to-school mode under way, we’ll be co-hosting a Twitter chat with our friends at Twin Cities Moms Blog.

Join us for the live chat, using #MNvaxchat from 8-9 p.m. Monday, that will feature Patsy Stinchfield, PNP, director of Infection Prevention and Control and the Children’s Immunization Project at Children’s Hospitals and Clinics of Minnesota. Children’s and Twin Cities Moms Blog will be there, too. Participants who use #MNvaxchat in tweets during the live chat qualify for a chance to win a $50 Target gift card.

ALSO: Read the Children’s vaccinations blog archive on Mighty.

UPDATE: Participation strong, informative on #MNvaxchat

New Minnesota immunization requirements take effect in September

Minnesota’s new immunization requirements take effect Sept. 1, and with August serving as National Immunization Month, we urge parents to get their children’s vaccinations updated ahead of the upcoming school year.

The Minnesota Department of Health's statewide requirement changes were made to protect kids from measles, whooping cough and other preventable diseases. (iStock photo / Getty Images)

The Minnesota Department of Health’s statewide requirement changes were made to protect kids from measles, whooping cough and other preventable diseases. (iStock photo / Getty Images)

The Minnesota Department of Health’s statewide requirement changes were made to protect kids from measles, whooping cough and other preventable diseases.

Getting vaccinated before September is important.

“Vaccines take about a month or so, in general, to really be full force and working for your body effectively,” Pamela “Gigi” Chawla, MD, Children’s senior medical director for primary care, said in an interview with KARE-TV. “We want kids to be ready for their school year.”

The new requirements include:

  • Hepatitis A and B vaccinations for children enrolling in child care or school-based early childhood programs
  • Pertussis vaccine added to tetanus-diphtheria vaccine for seventh-graders
  • Meningococcal meningitis vaccine for seventh-graders

According to the Centers for Disease Control and Prevention, vaccinations given to children in the past 20 years will prevent an estimated 732,000 deaths and save $295 billion.

Looking to schedule an appointment? Contact one of our 12 clinic locations.

Changes to state’s immunization law (KARE-TV):

Trustworthy: Vaccines have earned that title

Two doses of measles-mumps-rubella vaccine will prevent measles in 99 percent of those vaccinated.

By Patsy Stinchfield, PNP

The confirmation of 83 cases of measles in Ohio this month and the recent quick diagnosis of a 19-month-old with measles in Minneapolis, Minnesota’s first case of measles this year, brought a timely reminder that the potentially deadly virus has not been eradicated and of the importance of vaccination. Having just wrapped World Immunization Week and National Infant Immunization Week, the importance of immunization is as great as ever.

In fact, the U.S. Centers for Disease Control and Prevention reported today that the 288 cases of measles in the country so far this year are the highest since 2000. The number of cases reported this year is the highest for the first five months of a year since 1994.

I worry that the numbers are a sign of growing credibility for a small band of celebrities and others who have thrown up an online smoke screen of fear of vaccines against measles, whooping cough and other common childhood diseases.

If even a relatively small percentage of Americans buy into this criticism, it would be disastrous. Measles, one of the most contagious airborne diseases, can be extremely serious, leading in rare cases to pneumonia and fatal brain infections. Infants too young to be vaccinated particularly are at risk.

We’re fortunate that the child in Minnesota, who actually had one of two measles shots and apparently contracted the disease during a visit to India, was diagnosed within minutes at Children’s – Minneapolis. Because the alert medical team picked up the symptoms so quickly, only 16 potentially exposed people had to be notified after the child was quarantined.

Three years ago, as many as 700 contacts had to be reached for some patients during an outbreak at Children’s.

What’s most frustrating is that it’s all so unnecessary.

The virus hasn’t changed all that much. It’s not like the HIV virus, constantly mutating. No; with measles the culprit purely is social – a breakdown in trust of medical experts whose longtime vaccine advocacy made measles and other common childhood infections a footnote.

Fear-mongering online vaccine critics are not winning, in a classical political sense. Thankfully, more than 90 percent of parents still trust their health care providers and nationally recommended vaccines. If they didn’t, we would see frequent headlines about deaths from measles, whooping cough and other diseases.

However, the remaining 10 percent of parents are hesitant, have vague fears and wonder who to trust. They routinely hear or read vehement vaccine bashing in social media circles, which feeds fear and denial – and new outbreaks. New York City and Orange County, Calif., currently are dealing with measles outbreaks.

Measles is so highly contagious that just passing through a clinic waiting room two hours after someone with measles has been there can expose an unvaccinated newborn, which may be devastating.

We all must protect the vulnerable in our community by forming a protective barrier of our own vaccination. That’s a simple point seemingly lost on the peddlers of myth and pseudoscience who have infected too many parents with baseless fear of vaccines that protect their own children and the community at large.

Parents should trust health care professionals who urge vaccination on schedule. At Children’s, we speak from experience. We have seen children die or become permanently impaired from vaccine-preventable disease. Ask our specialists how many unvaccinated, critically ill children they have cared for, and they would answer “too many to count.” And how many they’ve seen with severe vaccine side effect? You’ll get a blank stare, or “I don’t recall any; maybe one at most.”

We have seen children with measles on a ventilator, fighting for their lives. That’s a bitter sight when you recognize that two doses of measles-mumps-rubella vaccine will prevent measles in 99 percent of those vaccinated. There’s no contest between the benefits of vaccines and their extremely rare risks.

Before the measles vaccine was developed in the 1960s, there were 2.6 million measles-related deaths per year worldwide. In 2012, that number was down to 122,000, mostly in children younger than 5 in parts of the world where vaccines are scarce or their parents refuse to allow vaccination. The point is that we can’t afford to let our guard down in the U.S. or elsewhere. In a global society measles is a mere plane ride away for the unprotected.

The safe, effective and trustworthy action for infants, children, adolescents and adults is to get vaccinated on time for all recommended vaccine-preventable diseases.

Aside from sanitary drinking water, vaccines remain the safest, most-life-saving medical intervention we have to protect our children.

Patsy Stinchfield, PNP, is the director of infectious disease and prevention and the Children’s Immunization Project at Children’s Hospitals and Clinics of Minnesota.