Four Seasons Pediatrics suspended the use of the Rotateq until we were able to see and review the FDA opinion. We also sought to review the basis for the opinion and any further scientific information that was used in the FDA opinion. Our independent review of the available information concurs that use should be continued. Over 100 million doses have been distributed worldwide. The benefit of saved lives exceeds the risk of DNA fragments found that have not been shown to cause any disease in humans. If you missed this vaccine last week, when we suspended the use, please call us to schedule a nurse visit to get the vaccine. Thank you for your understanding – Dr. Miller and Dr. Elmer on behalf of Four Seasons Pediatrics.

For more information, please see this link:

FDA Link for information

It has been determined that the Merck vaccine contains two strains of a porcine (pig) virus DNA.  Neither of these strains causes disease in humans and one of the strains is found in meat that is consumed by humans and felt to be safe.   The product used by Four Seasons Pediatrics (Rotateq) was one of the most extensively tested vaccines before it came to the market.  Four Seasons Pediatrics waited one year after FDA approval before we used this vaccine.    Approximately 6 million doses of Rotateq have been distributed in the United States and have dramatically reduced this diarrheal illness in the United States.

A rotavirus vaccine protects children from rotaviruses, which are the leading cause of severe diarrhea among infants and young children.   Each year more than 500,000 children die from diarrheal disease caused by rotavirus, and another two million are hospitalized.  Nearly every child in the world will suffer an episode of diarrhea caused by rotavirus before age five.  Although the severity of rotavirus infections differs between children living in developed and developing countries, the rates of infection is similar in both settings.   Clean water supplies and good hygiene have little effect on the transmisssion of infection, and further improvements are unlikely to prevent disease.

Based upon the effectiveness of the vaccine, a 2009 review estimated that vaccination against rotavirus would prevent about 45% of deaths due to rotavirus gastroenteritis, or about 228,000 deaths annually worldwide.  Since there are about 20-60 deaths in the United States from rotavirus infection, this translates to saving about 9 to 27 deaths per year in the United States.

Practice Comment From Dr. Miller and Dr. Elmer:

 A scientific review at this time shows that the risk of the virus itself (a known risk), exceeds the risks of the DNA of the porcine virus in the vaccine (no evidence of any disease in humans).  More than 6 million doses of vaccine have been distributed in the United States, and 106 million doses have been distributed worldwide. This gives us great comfort, as we have not seen any significant problems with the vaccine and the vaccine is highly effective.

• Request something you left in the office (e.g. Daycare Form)
• Request a copy of forms
• Request a copy of medical records
• Request a routine prescription refill
• Ask a billing question
• Request test results
• Request a well visit appointment
• Request a referral or a list of specialists (e.g. list of Dermatologists)

For most parents, a phone call may still be your best option.  Using e-mail adds an element of convenience (e-mailing forms will reduce vists to pick up forms in the office).  To provide this service in a HIPPA compliant form (to protect your privacy), we are using a commercial service known as HouseDoc.  Almost all communications are free of charge.  There are some communications that involve a transaction fee of $2 along with other applicable charges.  For example a form request has a $5 fee + $2 transaction fee totaling $7.  Here’s how it works:

Go to Housedoc.us.   Register under patient registration (we recommend 1 parent register per family).  You may enter your preferred pharmacy.  Once you have registered, look for the link to “My Providers”.   Then click the link to “Search Providers Database”.   Under the first name field type “FSP”.  Under the last name field type “Office”.  Once you find our office, click “Request Access”.   Once we have confirmed your information, we will grant access and you may then proceed with any requests.  

Please note the following:

• At this time the only charges incurred are related to Form Fees and copies of medical records.  There are no other charges for use of the service
• We cannot send an email to you, we can ONLY respond to your email.  Please do not call the office to ask us to email something to you.  Use Housedoc to send the request.   We then send a response back to you with the appropriate file, form etc attached. 

• Use a repellant when going outside
• Perform a Tick check at the end of each day – if you find a tick, sit down, relax and pull the tick gently to tent the skin.  Just wait until the Tick releases.  Do not pull too hard, or the Tick may break.  If it does, this is ok, as it will work itself out
• Tick’s do not need to be saved or tested, it is not part of current recommendations
• You should be aware of the signs of Lyme Disease

The first sign is a red rash at the site of the Tick bite.  It generally occurs within 1-2 weeks and is a red spot with concentric red rings surrounding it (the Bull’s Eye Rash).  Along with the rash, a person may experience flu-like symptoms such as swollen lymph nodes, fatigue, headache, and muscle aches.

See the following link for more details:

http://kidshealth.org/parent/infections/bacterial_viral/lyme.html