Infectious Diseases | Mount Sinai Today

Mount Sinai Begins Offering COVID-19 Vaccines to Young Children

Nov 12, 2021 | COVID-19, Featured, Vaccines

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Soon after receiving the go-ahead from federal and state regulators, Mount Sinai moved quickly last week to begin offering vaccines to children age 5 to 11.

This was a moment that parents—including many in the Mount Sinai community—had been waiting for, a step toward ending the pandemic and moving back toward a more normal life. Vaccines for children age 12 to 15 were authorized in May. The Food and Drug Administration (FDA) first authorized COVID-19 vaccines for adults in December 2020.

Lower dose Pfizer-BioNTech COVID-19 vaccines were offered at special pods at The Mount Sinai Hospital and Mount Sinai Beth Israel, and Mount Sinai South Nassau used its popular Vaxmobile to deliver shots to children in the neighboring communities.

“COVID-19 has significantly affected our children in so many ways—even those who have not been sick have endured effects on their emotional and mental health, decreased physical activity, the loss of in-person learning and, for some, the loss of parents or other caregivers,” says Vicki R. LoPachin, MD, MBA, Senior Vice President, Chief Medical Officer, Mount Sinai Health System. “But the data show this vaccine to have very high efficacy at reducing infections and producing strong antibody responses, so we are confident it will be effective at preventing hospitalizations and deaths in our most vulnerable young ones. We encourage all of you who have children in your families to speak to your child’s health care provider, and schedule vaccination appointments as soon as you can.”

One focus at the outset was offering vaccinations to high-risk and the most vulnerable pediatric patients like Lexi Isler, who was born without a bladder and underwent a series of medical procedures before receiving a kidney transplant from her father, Luther, at Mount Sinai in early 2019.

“This is a great day. Having the vaccine relieves some of the mental stress,” her father said, standing beside his daughter after she received the vaccine. “We always wondered about her compromised immune system, and now we don’t have to worry quite as much with this extra layer of protection.” Lexi said she looks forward to going more places, including those that require vaccination. Immunocompromised people, such as transplant patients or those being treated for some cancers, have a reduced ability to fight infections and are more vulnerable to severe COVID-19.

To make an appointment at Mount Sinai for vaccination for anyone age 5 and older, click here. In addition, check the New York State, New York City, New Jersey, or Connecticut websites for other locations that offer appointments or walk-in vaccination. New York City is also offering in-home vaccinations for all residents 12 and over, as well as mobile vaccination vans

Mount Sinai is very pleased to now be able to offer the Pfizer-BioNTech COVID-19 vaccine for children age 5 to 11, says Lisa M. Satlin, MD, the Herbert H. Lehman Professor of Pediatrics and Chair of the Jack and Lucy Clark Department of Pediatrics at the Icahn School of Medicine at Mount Sinai and Pediatrician-in-Chief of the Mount Sinai Kravis Children’s Hospital.

“Clinical studies in more than 2,000 children in this specific age group showed that the vaccine was extremely effective in preventing symptomatic COVID-19 and generated a robust antibody response,” Dr. Satlin says. “It is critical that all children—and especially those disproportionately affected by COVID-19—be vaccinated to not only protect them from the short and long-term effects of infection, but to eliminate the secondary impact of disease on in-person education and other interactions that are critical to growing children’s mental and physical well-being.”

When the Pediatric Vaccine Pod opened on Thursday, November 4, at The Mount Sinai Hospital, staff from the hospital’s Child Life and Creative Arts Therapy Department were on hand to support the children arriving for this historic opportunity, and they will continue to staff the pods as long as needed.

While the development of a COVID-19 vaccine for children age 5 to 11 brings great excitement and optimism in the fight against COVID-19, for many children getting an injection can be a scary experience. Child Life Specialists work with children and their caregivers to identify coping strategies to mitigate fears and anxieties related to medical experiences such as vaccines.

Relaxation techniques such as deep breathing, the provision of popular items such as an iPad or bubbles to help alternate focus, and comfort positioning where a child is securely held in a caregiver’s lap, are some of the ways the child life specialists work alongside the medical team to enhance the patient experience.

Child life specialists and music therapists helped to create a supportive patient and family centered environment. Music therapists used music as a technique for coping during the injection, and also provided live music throughout the space to set a calming tone.

“This is a great opportunity to translate supportive interventions that have been impactful to our patient and families in our inpatient and outpatient environments into a new area of care,” says Licensed Music Therapist Todd O’Connor.

The Child Life and Creative Arts Therapy team makes sure that children leave their visit feeling proud of their accomplishment. The children received a vaccine sticker along with activity books and other fun give-away items that were available for them to use during the vaccine observation period and to take home from their visit.

“We are delighted to partner in this important initiative,” says Child Life Specialist Cheryl Strauss. “We realize that the vaccine is a two-part series, and we aim to help children recognize their strengths and coping abilities for successful return visits.”

Make an appointment at Mount Sinai for vaccination for anyone age 5 and older

Get more information from Mount Sinai about COVID-19 vaccines

Is Your Child Afraid of Getting a Shot From the Doctor? Here’s How to Help Them

Nov 9, 2021 | Children's Health, COVID-19, Featured, Vaccines, Your Health

A trip to the doctor is a common childhood fear. But when kids are afraid of needles, even a simple checkup can cause problems for children and their parents or guardians alike. With the proper preparation and planning, you can help make your next doctor’s visit as smooth as possible, and that’s more important than ever for those getting a COVID-19 vaccine.

In this Q&A, C. Anthoney Lim, MD, the Director of Pediatric Emergency Medicine for the Mount Sinai Health System and the Medical Director of the Pediatric Emergency Department and Pediatric Short Stay Unit at Mount Sinai Beth Israel, explains how you can help calm your child’s fears and ease their anxiety about the doctor’s office and needles. And if needed, how you can talk with your doctor in advance about key issues, including medications that can help reduce the pain. Certified child life specialists and music therapists will also be present at the Mount Sinai vaccination pods to help support children of all ages using play, preparation, distraction and relaxation strategies.

“We have plenty of experience with children who are afraid of injections, so we can work with you and your child to ensure they get immunized in a safe and comfortable manner,” says Dr. Lim, who recently gave his own seven-year-old son the vaccine. “We are creating a very family-friendly space for the COVID-19 vaccine because you will need to bring them back in three weeks for their second shot, so it’s especially important that your child has a positive experience.”

How common is it for kids to be afraid of needles?

It is a very common fear. We see it among children who may have been hospitalized or have chronic illnesses and are in the doctor’s office a lot. But a healthy child without any medical problems is equally prone to needle-phobia.

How can I talk to my child who is afraid of needles?

There are many things you can do to help normalize the process, and it’s important to prepare. A lot of it is knowing your child and if they are at an age that we can talk about their fears. Then, prepare them by having a conversation in advance, letting them know what is going to happen at the doctor’s office and explaining what the process may look like. It can help quite a bit. Not all kids want to talk about it. But they are generally pretty smart, and they will know they are going to the doctor and what they are going for. It’s also worth remembering: Kids will often follow your lead. So if you are prepared and calm, your children will more likely be prepared and calm

Anything more specific?

For younger kids, play can be a really helpful way to prepare for a doctor visit. It provides children the opportunity to approach the event with a sense of control while creating a safe environment to express feelings and to practice coping strategies. One option for younger kids is showing them with their stuffed animal or having them play doctor to get used to what happens when you get your vaccine. For instance, when we were teaching kids how to use masks, we had them make a mask or put a mask on their teddy bear so they can see what it looks like. This is a similar process.

What about bringing something to distract my child?

You can bring a toy to distract them or a doll or plaything they can squeeze really hard. Tablets or smart phones are fine, so make sure your devices are charged. You can bring a cold pack because sometimes that will numb the area a little bit and that is often helpful. There are special cold packs for kids that also include a vibrating tiny bee that can help soothe and distract young children.

Any other techniques?

There are many relaxation strategies that children of all ages can use when feeling anxious and worried. One example is deep breathing—taking deep breaths right before the shot, and then breathing out as the shot is being delivered, can help minimize the discomfort. For younger kids, there are specific positioning techniques you can use, basically a big hug that exposes their arm for the nurse to administer the shot.

What about medications?

Most of the time, approaches that do not involve medications work really well in kids. Prescription medications require a visit or a discussion with your doctor beforehand. There are prescription products, like EMLA or ELA-Max, which are creams that contain a local anesthetic we sometimes use for children for some injections and vaccines. You put the cream on your child’s arm before you go to the doctor’s office because it takes about an hour to kick in. Over-the-counter topical creams are also available.

Is it okay to take over-the-counter pain relievers?

We recommend pain relievers like Motrin or Tylenol but only if your child experiences muscle pain or fevers after they receive the shot, and not beforehand.

How is Mount Sinai helping to make the vaccination process easier for young kids?

At our hospitals, we are setting up special areas for vaccinations for young children. We want to make it a child-friendly, family-friendly environment. We want to make sure that they have a great experience

What should I do if I have more questions?

There are some great resources online, such as from the American Academy of Pediatrics and from the Meg Foundation, an organization that helps families with pain management. A conversation with your pediatrician is very valuable.

Get more information about COVID-19 Vaccination, Appointments and Resources

What You Need to Know About COVID-19 Vaccines for Children Ages 5 to 11

Oct 28, 2021 | Children's Health, COVID-19, Vaccines, Your Health

The moment many parents have been waiting for is approaching: Federal regulators are expected to decide soon whether to authorize COVID-19 vaccines for children ages 5 to 11. Vaccines for kids ages 12 to 15 were authorized in May.

The Food and Drug Administration (FDA) first authorized COVID-19 vaccines for adults in December 2020, and the safety and efficacy of vaccines has been widely discussed ever since. But those with young children still have many questions.

In this Q&A, Roberto Posada, MD, a pediatric infectious disease specialist in the Jack and Lucy Clark Department of Pediatrics at Mount Sinai Kravis Children’s Hospital and Professor of Medicine (Infectious Diseases), and Medical Education, at the Icahn School of Medicine at Mount Sinai, answers some of the questions most commonly asked of pediatricians and explains why the vaccines are extremely safe and highly effective.

How effective is the new Pfizer vaccine for children ages 5 to 11?

The new vaccine is highly effective at protecting children from severe COVID-19 disease. The studies, which included more than 4,000 children, showed children developed essentially the same level of antibodies that result in 90 percent or higher protection in adults.

How safe are they?

The vaccines are extremely safe, the same as with adults. There were minor side effects, such as pain at the site of the injection, fatigue, and headache. Importantly, there were no serious adverse events at all related to the vaccine among the more than 4,000 children that were part of the studies.

What about concerns about rare cases of heart inflammation in young men and boys?

Myocarditis is an inflammation of the heart, and a side effect that has been seen very, very rarely, mostly in young adult males. It was not seen in the recent studies of young children; there were no cases, and although the studies were too small to estimate what the rate might be in the general population of children, we expect it to be lower than in adolescents.

Will children experience any side effects from the vaccine? What can I do about that?

It is very likely that children who receive the vaccine, just like adults and older children, will experience pain at the site of the injection or headache. Those are expected to go away within a day or so. Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can be very helpful in managing the symptoms. Parents should follow the guidance of their pediatrician as to how to administer those medications to their children.

If my child had COVID-19, do they still need to get a vaccine?

Anyone who already had COVID-19 should still get the vaccine. That’s because cases of a second COVID-19 infection can happen in people who already had a first infection. The vaccine provides more protection against subsequent infections for people who already had COVID-19.

What are the benefits of vaccinating children ages 5 to 11 against COVID-19?

First of all, vaccinating young children protects them from getting seriously ill from COVID-19. We know that children have a lower risk for developing severe COVID-19 infection compared to adults, but that doesn’t mean they cannot develop severe COVID-19 infection. In fact, as an infectious disease specialist, I have seen children in the intensive care unit with complications of COVID-19. In addition, we know that even if children don’t get very sick themselves from COVID-19, children who have COVID-19 can pass it on to other people—to their parents, their siblings, their grandparents, and to kids and other people at school. So vaccinating children can also protect our community at large, including people that are at higher risk from COVID-related complications.

What if my child is afraid of injections?

It is not uncommon for children to be afraid of injections. Pediatricians have been giving vaccines for decades. Our staff are experienced in working with children who are afraid of injections. They will work with you and your child to make sure your child can get immunized in a safe manner.

Can the vaccine affect the fertility of my child?

It’s a very common misconception that the COVID-19 vaccine can affect fertility. There’s no evidence at all that the COVID-19 vaccine has that effect.

My child is 11 and about to turn 12. Should I wait and get them the adult vaccine?

We recommend that children get vaccinated at the first opportunity. Studies show that children age 11 responded very well to the pediatric formulation of the vaccine.

How do I get more information?

Parents who want to get more information about the COVID-19 vaccine for their children should contact their pediatrician for specific advice.

During the COVID-19 Pandemic, You Should Still Get the Seasonal Flu Shot

Sep 30, 2021 | COVID-19, Your Health

Every fall, doctors, health care providers, and public health experts begin reminding everyone that it’s critical to get the flu shot. This year, as we continue to cope with COVID-19, it’s even more important.

There are a number of reasons why the ongoing pandemic means you should make sure to get your flu shot as soon as possible, according to Waleed Javaid, MD, Professor of Medicine at the Icahn School of Medicine at Mount Sinai and an expert on infectious diseases.

For starters, if you become infected with COVID-19, getting the influenza virus as well can make a difficult situation even worse. Doctors saw patients in this situation at the beginning of the pandemic, and they know the combination of these two infections can make it more difficult to recover and can exacerbate some of the most serious symptoms, including difficulty breathing.

“COVID-19 and the flu are not a good combination,” Dr. Javaid says.

Fortunately, we have vaccinations for both the flu and COVID-19 that will help prevent you from experiencing the worse of either virus. In fact, the U.S. Centers for Disease Control and Prevention (CDC) strongly recommends that you receive the flu shot if you are eligible—even if you are fully vaccinated against COVID-19. And if you have not yet received the COVID-19 vaccine, or are eligible for a booster dose, you do not need to space out dosing, the CDC says you can receive both shots on the same day. The COVID-19 vaccine and the flu shot do have similar, mild side effects, which include fever, body aches, headache, and nausea. So, if you are concerned about side effects, the vaccines can also be taken on different days.

Face masks—which have become a wardrobe staple since the start of the pandemic—may do double duty by helping to reduce the risk of contracting both COVID-19 and the flu. But Dr. Javaid notes that additional measures are still warranted. This includes proper hand hygiene, avoiding those who have a respiratory illness, and getting your flu shot.

The CDC recommends getting a flu shot as early as September or October. But if you miss this window, it is not too late. You can get the shot as long as the flu is circulating, which is normally through early spring.

Another reason reducing the incidence of seasonal flu this year will be especially important is that it can be difficult to distinguish between the flu and COVID-19, according to Dr. Javaid. The symptoms are almost exactly the same: fever and chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, sore throat, and congestion or runny nose. You can read more about these similarities from the CDC. One potential difference is that if you are infected with COVID-19, you may experience a new loss of taste or smell. The similarities could result in confusion as doctors try to diagnose patients.

Of course the flu shot doesn’t guarantee you won’t get the flu. But the CDC estimates the vaccine each year typically reduces serious cases of the flu by 50 to 60 percent. For those who get the flu even though they have gotten the vaccine, the shot helps reduce the severity of the illness and avoid hospitalizations.

For those who may be wondering, there is no evidence that the flu shot can make you more susceptible to getting COVID-19. That being said, if you are infected with COVID-19 or the flu, the timing of your vaccination may need to be adjusted. If you are in this situation, Dr. Javaid says, you should contact your health care provider, who can advise you on the latest recommendations.

Vaccine Facts: COVID-19 Vaccines Are Safe—and Essential—for Pregnant Women

Sep 23, 2021 | COVID-19, Featured, OB/GYN, Vaccines, Women's Health, Your Health

For those who are pregnant or considering getting pregnant, there are so many health questions, from “Is caffeine okay?” to “Can I still exercise?” But during the COVID-19 pandemic, some are also wondering if the COVID-19 vaccines are safe to take.

In this Q&A, Joanne Stone, MD, MS, Director of Maternal Fetal Medicine at the Mount Sinai Health System, explains the dangerous risks of COVID-19 during pregnancy, shares the facts on why you should get the vaccine, and offers reassurance for those who may be worried.

New Guidance on COVID-19 Vaccines: In April 2023, the Food and Drug Administration and the Centers for Disease Control and Prevention announced some major changes for COVID-19 vaccines. Click here to read more about what you need to know.

Update: The Centers for Disease Control and Prevention on September 29, 2021, strongly recommended COVID-19 vaccination either before or during pregnancy because the benefits of vaccination outweigh known or potential risks. Read more from the CDC

If someone is pregnant, or trying to get pregnant, should they get vaccinated?

Yes, if you’re pregnant, or thinking of getting pregnant, or even if you’re breastfeeding, this is absolutely the time to get the vaccine. I would not wait one extra day. I would get it today because there’s a lot of data that shows the vaccine is very safe and it’s not associated with miscarriage or infertility. Also, it’s the most important way to prevent COVID-19 infection.

Joanne Stone, MD, MS

Are pregnant people especially at risk for COVID-19?

Pregnant women who get COVID-19 infection are at a much higher risk for adverse outcomes, such as severe disease and even maternal death. There’s also higher risk for complications, including preeclampsia, which is high blood pressure in pregnancy, as well as increased risk for the baby, including preterm delivery. For all these reasons, the risks of COVID-19 infection are much higher for both mom and baby. So it’s extremely important to prevent this disease during pregnancy through vaccination plus other measures like mask wearing and social distancing.

What else should patients know about the vaccines and pregnancy?

Patients should understand there are a lot of myths out there that have not proven to be true. For example, there’s no increased risk of infertility if you get the vaccine prior to getting pregnant. Pregnant people should also know that there are complications associated with COVID-19 in pregnancy, and these complications that can be prevented by getting the vaccine. Also, the vaccine has been studied extensively. All the major organizations involved with women’s health care—including the Society for Maternal-Fetal Medicine and the Centers for Disease Control and Prevention—are strongly advocating that people who are pregnant get the vaccine.

Face Masks Are Still a Fact of Life, Here’s What You Need to Know About Safe Use

Sep 20, 2021 | COVID-19, Your Health

Woman who is alone on street, takes mask off while outside

Now, almost two years into the fight against COVID-19, face coverings have become a necessary addition to our everyday wardrobe. Along with proper hand washing and social distancing, their use has helped to prevent the spread of COVID-19. As the pandemic goes on and the effort to get people vaccinated continues, the U.S. Centers for Disease Control and Prevention (CDC) has issued additional guidance about face coverings. Importantly, the CDC now clarifies that while some outdoor, unmasked activity is relatively safe, both unvaccinated and vaccinated individuals should continue masking when indoors to protect themselves and others from the highly contagious Delta variant.

Krystina Woods, MD, Hospital Epidemiologist, Medical Director of Infection Prevention, and Deputy Chief Medical Officer at Mount Sinai West, explains the care and use of masks over the long haul and why those vaccinated against COVID-19 still need to mask up.

Why is it important that vaccinated people continue to wear face coverings?

We now know that vaccinated people can both become infected with COVID-19 and pass it on to others. And because of that, in certain settings, it is extremely important for even vaccinated people to wear masks.

Is it still less risky to be unmasked while outdoors? If so, why?

When you’re outdoors, there’s better ventilation. So, for example, if there is someone nearby who has been infected with COVID-19, the amount of virus can be diluted by all the freely moving air, making it less likely that others will be infected.

It is also important to remember that part of the thinking about being unmasked outdoors is that you’re unmasked while still being socially distant. If you are in a really, really large crowd; the protection is not going to be as good. You are much safer choosing to take your mask off outdoors if you have the ability to have a little bit of distancing.

So, being unmasked when on an early morning walk through a sparsely populated Prospect Park is okay, but if you’re window shopping on the weekend on a packed street in SoHo, throw on a face covering.

If my risk of severe illness is low, why should I continue to take precautions once I am fully vaccinated?

We need to continue to be careful. You don’t always know what the health problems are of those around you and, there’s a certain amount of civic responsibility that we have to each other.

None of us live completely isolated and, over the last 18 months, we’ve all felt what it is like to have to isolate ourselves from those we care about. So, we need to be careful about the fact that there are still people who have not gotten vaccinated, those who are not eligible for vaccination—like children—, and those who are otherwise vulnerable—like the elderly and immunocompromised. We have a duty to protect those amongst us who do not have the protection of vaccination.

Should I upgrade to a better face mask?

I wouldn’t see this as a necessity. The most important thing is that the face mask is multi-layered and fits well. If you are using a cloth mask, it is a good idea to double mask by using a surgical mask underneath the cloth mask. In place of that, a regular surgical mask is sufficient. However, if someone feels more comfortable wearing an N95 or its international equivalent (the KN95 or KF94), they certainly can—just make sure the masks are legitimate. The CDC has advice on how to identify counterfeit masks.

How do I know if my face mask has a proper fit?

Your mask should not fall off of your nose as you’re talking and it should fully cover your nose and the mouth. Additionally, it should not have large gaps around the perimeter of the mask—around the sides or the top and bottom. And, you should be able to tolerate wearing the mask for an extended period of time without feeling uncomfortable.

How should I take care of my cloth face masks?

Reusable masks should be washed at least daily, by hand or in your regular washing machine. And you can put them in the dryer, or hang them up to dry. If you have a disposable face mask, throw it away after wearing it once. And always wash your hands after handling or touching a used mask. The CDC has a lot more information about masking here.

Get more COVID-19 information from Mount Sinai

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