Contemporary Pediatrics Staff

	The American Academy of Pediatrics (AAP) has released its 

 for influenza vaccination during the 2013-2014 influenza season. As always, AAP recommends that all children and adolescents aged 6 months and older receive either the trivalent or quadrivalent influenza vaccine, and children should be immunized as soon as the vaccine becomes available. 

	The current vaccine will cover strains of influenza that are different from last season’s strains. Trivalent influenza vaccine contains the influenza A subtypes H1N1 and H3N2 and an influenza B virus that have been predicted as the likely influenza types for the upcoming season. The new quadrivalent vaccine will include an additional influenza B lineage. Two trivalent vaccines that do not use eggs also will be available for egg-allergic persons.

	AAP states that the dosing algorithm for influenza vaccines in children aged 6 months to 8 years remains unchanged from the 2012-2013 guidelines. There is no indicated preference between the trivalent and quadrivalent formulations. Healthy children aged 2 years and older can be given either inactivated influenza vaccine (IIV; trivalent or quadrivalent) through injection or live-attenuated influenza vaccine (LAIV; quadrivalent only) intranasally.

	Universal vaccination of children who attend day care or school has been shown to decrease the incidence of childhood influenza and also the transmission of influenza virus to household contacts and the community at large. As of August 24, 2013, the Centers for Disease Control and Prevention had 

 160 laboratory-confirmed, influenza-associated pediatric deaths during the 2012-2013 influenza season. The majority of deaths occurred among children who had not been immunized against influenza.

	The guidelines also stress the importance of immunizing all practice members. Ensuring that staff is immunized not only protects them from the flu but also provides a positive image of flu vaccination to patients and their parents. The AAP Section on Administration and Practice Management and the Childhood Immunization Support Program offer an “Earn Your Stripe” 

 that can be personalized to illustrate your practice’s influenza immunization support.

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Articles

The American Academy of Pediatrics (AAP) has released its guidance for influenza vaccination during the 2013-2014 influenza season. As always, AAP recommends that all children and adolescents aged 6 months and older receive either the trivalent or quadrivalent influenza vaccine, and children should be immunized as soon as the vaccine becomes available.

AAP guidelines for 2013-2014 influenza vaccination

	Do sick-visit immunizations dampen parental incentive to return for missed well-baby examinations? Apparently not, according to an examination of subsequent immunization levels and routine well-baby visits when sick visits for acute otitis media took the place of routine well-baby visits at 2, 4, or 6 months of age among a health plan population. No differences were detected in immunization rates or well-baby visits through 24 months of age between infants who received sick-visit immunizations and those who did not (Robison SG. 

 to get monthly clinical advice for today's pediatrician.

Do sick-visit immunizations dampen parental incentive to return for missed well-baby examinations?

Sick-visit immunizations

	About 17% of children and teenagers in the United States suffer from a mental disorder, according to a first-of-its-kind federal 

	The report, “Mental Health Surveillance Among Children-United States, 2005-2011,” is a compendium of government survey data assembled by the Centers for Disease Control and Prevention (CDC). It reveals a higher-than-expected and increasing prevalence of mental health issues among young people.

	Prevalences of attention-deficit/hyperactivity disorder (ADHD), behavioral and conduct disorders, autism spectrum disorders, depression, and anxiety in 3- to 17-year-olds totaled 16.5%. Some children with mental disorders-likely up to 40%-have more than 1 disorder, leading to overlap and potential inflation of prevalence rates.

	The most prevalent parent-reported current diagnoses among children aged 3 to 17 years were ADHD (6.8%), behavioral/conduct problems (3.5%), anxiety (3.0%), depression (2.1%), autism spectrum disorders (1.1%), and Tourette syndrome (0.2% among children aged 6 to 17 years). In the past year, 4.7% of 12- to 17-year-olds reported illicit drug use disorders and 4.2% reported alcohol abuse disorders. Almost 3% reported cigarette dependence in the past month. The overall suicide rate for 10- to 19- year-olds was 4.5 per 100,000 in 2010.

	The report notes that boys are more likely than girls to have ADHD, behavioral/conduct problems, autism spectrum disorders, anxiety, Tourette syndrome, and cigarette dependence. Girls are more likely than boys to suffer from depression or to abuse alcohol.

	In addition, children with mental disorders are more likely than children without to have other chronic health conditions, such as asthma, diabetes, and epilepsy. Also, mental disorders in children are associated with an increased risk for mental disorders in adulthood, which are associated with decreased productivity, increased substance use and injury, and substantial costs to the individual and society.

 for the public health issue totals $247 billion, according to the CDC.

About 17% of children and teenagers in the United States suffer from a mental disorder, according to a first-of-its-kind federal report.

Mental disorders affect 1 in 6 US kids

Lifetime earnings for primary care physicians (PCPs) fall  well below the career incomes of specialists, which makes attracting medical  students to primary care a difficult sell, according to a national 

Researchers from the University of California-Davis Center  for Healthcare Policy and Research found that PCPs, including practitioners in  geriatrics, family practice, general practice, internal medicine, and  pediatrics, earn approximately $3 million during their careers. 

In contrast, other medical specialties average $3.7 million  in lifetime earnings, with physicians in internal medicine and pediatric  subspecialties earning about $4.1 million. Lifetime earnings for surgeons  average $4.6 million, and for oncologists up to $7.1 million over a 35-year  career. Family practitioners, however, earn about $2.8 million in lifetime  wages.

Overall, average lifetime earnings in all other specialties  range from $761,402 to $1.58 million higher than primary care.

, a periodic evaluation of physician  demographic, geographic, and market trends, and adjusted to account for age,  sex, race, board certification, and other factors that could affect earnings.  Incomes for 6,000 physicians in 41 specialties were analyzed.

Investigators reason that specialist pay is high because  private insurance companies tend to duplicate Medicare pay rates, which are  based on recommendations from an American Medical Association committee on  physician pay that price specialist procedures higher than primary care office  visits. They say that such disparities in lifetime earnings might tend to  discourage medical students from considering primary care as a career.

Lifetime earnings for primary care physicians (PCPs) fall well below the career incomes of specialists, which makes attracting medical students to primary care a difficult sell, according to a national study. More >>

Contemporary Pediatrics Staff

Articles

AAP guidelines for 2013-2014 influenza vaccination

Sick-visit immunizations

Mental disorders affect 1 in 6 US kids

Wide gap between PCP, specialist career pay