I hope to meet many more of you at this year’s coming events, including our planned gatherings in San Bernardino, Riverside, and Santa Barbara counties. I am thankful to be surrounded by such an inspiring community of pediatricians across southern California who are providing compassionate and comprehensive care to the children of our region despite heavy workloads and a challenging practice climate.

We are also heading into another season familiar to pediatricians: the RSV season. Last week, an AP article highlighted the recent surge in RSV infections impacting emergency departments and pediatricians’ offices across the country. There has been high demand and inadequate supply of the new RSV immunization, nirsevimab (Beyfortus). Reuters reported that the CDC is expediting the release of more than 77,000 additional doses of nirsevimab, so there is hope that the more of our higher risk patients will be able to receive the vaccine. AAP News has additional information and links on their website about nirsevimab availability and guidelines.

I have been hearing from some chapter members about challenges in obtaining nirsevimab and receiving payment for vaccinating their patients. As I mentioned in last month’s newsletter, the chapter is forming a pediatric council to help pediatricians and health insurance providers communicate around opportunities to improve the delivery of pediatric health care. Nirsevimab access is an example of an important and urgent issue that will be addressed by our pediatric council. If you are interested in joining the council or have feedback about other issues the council could address, please contact our executive director, Tomas Torices.

This month’s Member Spotlight features Dr. Andy Chang, a pediatric urologist practicing at Children’s Hospital Los Angeles and at satellite locations in San Gabriel Valley and Orange County.

In the Trainees Corner we have an article on epilepsy, submitted by Dr. Maya C. Ayoub, a PGY5 Child Neurology Fellow at Mattel Children’s Hospital, UCLA.

In this month's issue of The Quorum, AAP-CA2's Legislative Intern Anil Chaganti provides insight on the role played by legislation in nutritional health. If you are interested in legislative advocacy, please consider joining the chapter’s Advocacy Committee, which meets monthly to discuss bills and other advocacy issues.

Finally, I would like to welcome our new chapter members and encourage them to get involved by joining a chapter committee. Information about our committees and other resources are available on our website, aapca2.org. Your support makes the work of this chapter possible! 

Upcoming events in this month’s newsletter include:

• Nov 29 | Moving Away From the Precipice (Wellness webinar)

... and more. Please see the Upcoming Events section below.

Best wishes,

Grant Christman, MD, MACM, FAAP

How many times have you seen a patient in your clinic with mental health concerns and discovered at the end of the visit that they were already seeing a therapist? Or had a family come into the ER who can’t remember what medications the child has been taking for asthma? In response to the crisis of inadequate access to crucial medical information, California has created a ground-breaking new framework requiring all medical providers and hospitals to share confidential health information through a Data Exchange Framework. The Data Exchange Framework (DxF) is an opportunity to create equitable and affordable health information exchange, so that patients, providers, and other healthcare entities can access the health information they need, wherever they are and whenever they need it.

AAP-CA2 recently received a grant from California Human and Health Services to inform and support pediatric health care providers and systems in this transformative set of policies and procedures that will allow us to share health records electronically in a private and secure manner.

Learn about how you can support the Data Exchange Framework initiative by accessing the documents below:

• Data Exchange Framework Initiative Updates
• State and Federal Efforts Promote Greater Health Information Sharing
• What is the Data Exchange Framework
• DxF Social Media Posts Examples

The Quorum

November 2023: Nutritional Health  

Guest Writer: Anil Chaganti

AAP-CA2 Legislative Intern

Child nutritional health involves ensuring that children are receiving the correct balance of nutritional intake to meet the necessary biological requirements. This is often influenced by social determinants, including the access families have to healthy and nourishing food, their neighborhood and ... Read more

November Social Pedia Newsletter

November is Diabetes Awareness Month, Epilepsy Awareness Month and Prematurity Awareness Month. Check out and share helpful resources through your social media accounts. View all the details, Here

Epilepsy Considerations for the General Pediatrician

Epilepsy Awareness Month

Maya C. Ayoub, MD, EdM I PGY5 Child Neurology Fellow I Mattel Children’s Hospital, UCLA

With a prevalence of nearly half a million children in the US, epilepsy is one of the most common neurologic conditions in childhood (CDC, 2019). Aside from the often-difficult management of seizures and the medication side-effects, epilepsy carries with it the increased complexities of higher rates of psychiatric comorbidities. Read more ...

We'll Come To Your School or Hospital

Dear Medical Schools and Pediatric Residency Programs in AAP California Chapter 2, 

Are you interested in learning more about local advocacy efforts? Do you want to hear more about getting involved in AAP California Chapter 2? If yes, then please consider inviting our chapter leadership to your local pediatric interest group meeting, pediatric residency noon conference, or any other gathering. Our chapter leadership wants to connect with the trainees in the area so reach out to chapter2@aapca2.org to schedule an event at your medical school / residency program!

Local pediatricians and pediatric subspecialists gathered on October 25th at Maggiano's in Woodland Hills for another fabulous Town Hall hosted by AAP-CA2 Ventura County Representativen Ken Saul, MD, FAAP. Thank you to all that attended!

Featured speaker, Jerome Sigua, MD, a Senior Medical Science Liaison with US Medical Affairs, presented A New Era in RSV Prevention. Takeaways from the presentation are shared below.

• In the U.S., nirsevimab is a monoclonal antibody indicated for the prevention of RSV lower respiratory tract disease in neonates and infants born during or entering their first RSV season¹. 
• Nirsevimab is also indicated for children up to 24 months of age who remain vulnerable to severe RSV disease through their second RSV season¹.
• The U.S. Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) voted unanimously 10 to 0 to recommend routine use of Sanofi and AstraZeneca’s nirsevimab for the prevention of respiratory syncytial virus (RSV) lower respiratory tract disease for newborns and infants below 8 months of age born during or entering their first RSV season. The Committee also voted unanimously 10 to 0 to recommend routine use of nirsevimab for children aged 8 to 19 months who are at increased risk of severe RSV disease and entering their second RSV season².

References:

1. Beyfortus (nirsevimab) package insert. Swiftwater, PA: Sanofi Pasteur Inc.; 2023.
2. Meeting of the Advisory Committee on Immunization Practices , August 3, 2023.

Reach Out and Read’s Focus on Early Relational Health

By Delesa Barnes

Reach Out and Read Inland Empire Program Coordinator

At the heart of Reach Out and Read (ROR) lies the understanding that reading aloud, storytelling, and sharing books are pivotal in establishing a lasting and meaningful connection between caregivers and children. Read more...

November Update  

This month’s immunization update includes the updated adolescent immunization schedule (HPV vaccine now recommended at age 9), important information about increasing RSV activity and updated CDC recommendations for Nirsevimab due to limited supply, and more guides and resources for immunization recommendations this fall.

Click Here for the November Update

LACDPH | Acute Communicable Disease Control Program, Community Outbreak Team

LA County Symptom Guidance for Schools

November 2023 Update

The Los Angeles County Department of Public Health would like to inform you about a new resource: LA County Symptom Guidance for Schools (available in English and Spanish).

This 2-page PDF provides general recommendations and symptom-based considerations for both parents and school/childcare administrators on when children can safely return to school. It is adapted from CDPH guidance developed in conjunction with Pediatric Infectious Disease specialists.

We hope this new resource serves as a practical tool for use in your clinical work with patients and their parents. Please feel free to download and distribute the document as needed.

These recommendations do not replace or revise existing laws or requirements applicable to schools and child care facilities. Instead, they are aligned with the principle that safe, in-person learning and child care are fundamental to a child’s wellbeing. 

For additional health resources relevant to parents, visit the LA County COVID-19 Education Toolkit.

Supriya Bavisetty, MD, FAAP - Santa Clarita

Robert Clark, MD, FAAP - Long Beach

Carlos Jimenez, MD, FAAP - Porter Ranch

Susan Kressly, MD, FAAP - Sanibel, FL

Ray Lengvilas, MD, FAAP - Upland

Alina Lubag, MD, FAAP - Tracy, CA

Brenda Pelayo, MD - Long Beach

Rebecca Rodriguez, MD, FAAP - Culver City

Pictured below are some of our chapter members who attended the AAP National Conference and Exhibition in Washington DC this past October.

(Top) Tanya Altmann, MD during a book-signing event. AAP-CA2 VP Melissa Ruiz, MD with District IX Vice Chair Eric Ball, MD, AAP President Sandy Chung, MD, and District IX Chair Yasuko Fukuda, MD. AAP-CA2 Member at Large Cori Cross, MD presented a lecture on Screen Time and Beyond. Adrian Castro, MD with AAP-CA2 executive director Tomas Torices, MD.

(Bottom row) AAP-CA2 Policy and Legislative Affairs Analyst Kamaal Jones, MD presented a lecture on Advocacy Insights from Gun Violence Survivors.

Christine Thang, MD, Moira Szilagyi, MD, Elizabeth Volpicelli, MD and Ashley Shim, MD at the opening night reception. Dr. Chang presenting Anthony Fauci, MD with the AAP Honorary Fellow Award. Dr. Fukuda with Harvey Kart, MD and Dr. America Hailey Nelson, MD.

Gasol Foundation (founded by NBA Champions Pau and Marc Gasol) is a nonprofit that works through evidence-based programming, evaluation and research, and advocacy to promote children’s wellness, with a focus on eliminating childhood obesity.

Every Gasol Foundation program incorporates physical activity, healthy eating, sleep, and emotional well-being to improve the health of our children and their overall development.



Learn more…

View our fall programming map

Gasol Foundation USA Named National Youth Sports Strategy Champion

The Office of Disease Prevention and Health Promotion (ODPHP) has named Gasol Foundation USA a National Youth Sports Strategy Champion! 

The National Youth Sports Strategy (NYSS) is an essential resource for policymakers and key decision-makers in youth sports. It aims to unite U.S. youth sports culture around a shared vision: that one day, all youth will have the opportunity, motivation, and access to play sports. NYSS Champions represent organizations that are working towards achieving this vision. Gasol Foundation USA is thrilled to further the mission of the NYSS and help foster a lifelong love of sports and physical activity for our youth. 

Research indicates children who obtain regular physical activity gain important physical and mental health benefits. It is crucial, now more than ever, to promote the benefits of and access to physical activity and sports opportunities to youth and their families- regardless of race, ethnicity, sex, ability, or zip code. 

Gasol Foundation, along with other NYSS Champions, are currently featured on the health.gov/ NYSS website as part of a growing network of organizations working to improve the youth sports landscape in the US.

New Registry Requirement to Submit Immunization and TB Data 

AB 1797, a new California bill effective January 1, 2023, requires providers to enter immunizations and TB tests they administer, as well as a patient’s race and ethnicity, into a California immunization registry (CAIR OR RIDE/Healthy Futures).

This reporting requirement includes newly recommended immunizations, such as

• Nirsevimab to prevent severe RSV disease for infants and toddlers  

Many of your questions can be answered by visiting the AB 1797 Immunization Registry FAQs page.

Not Yet Enrolled? Enroll Now!

Join us for an upcoming webinar with Dr. Thomas Demaria, a clinical psychologist who has worked in hospital, corporate and academic settings during his thirty-five-year career. Dr. Demaria will be presenting on "Moving Away from the Precipice through Enhanced Professional and Personal Wellness."

Learning Objectives:

1. Evaluate factors associated with professional burnout and fatigue

2. Identify the direct and indirect impacts of stress on patient care and practice management

3. Develop new professional and personal wellness strategies which enhance growth and satisfaction.

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In the first week of December, Climate for Health is offering a live virtual Ambassador Training aimed at public health professionals. Co-hosting the training will be the American Public Health Association, the Association of State and Territorial Health Officials, Healthy Babies Bright Futures, the National Association of County and City Health Officials, the National Environmental Health Association, and the National Network of Public Health Institutes. These 6 incredible organizations will offer case studies and discussion of public health climate solutions in action.

RSVP HERE

Please join us for a town hall to discuss the creation of a shared national curriculum on climate change for pediatric residencies! We present case examples of how to integrate climate and health topics into residency didactic sessions and institutional structures, as well as how to advocate for climate both in the patient room and in broader settings.



RSVP HERE

Join us for a groundbreaking educational experience that bridges medical excellence between continents. The inaugural collaboration between faculty from Children’s Hospital Los Angeles and King’s College Hospital, London, invites general pediatricians and advanced practitioners caring for children to explore the latest advancements in Pediatric Liver Disease Care.

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