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Derick Boerner
President Ninth District PTA
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John Bradley, M.D.
Medical Director, Infectious Diseases Rady Childrenโs Hospital
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Pauline Lucatero, M.S.N
Director of Nursing Family Health Centers of San Diego
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Christian Ramers, M.D., MPH, AAHIVS
Chief of Population Health & Infection Control Specialist Family Health Centers of San Diego
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Mary McKenzie
Reporter ABC 10News
Mary McKenzie joined the 10News team in March of 2017. Mary is a Southern California native and is thrilled after years of circumnavigating the country to finally be back in the land of perfect weather and year-round outdoor activities.
Mary started her news career in Sioux Falls, South Dakota as a morning anchor and reporter for KSFY, the local ABC affiliate. She covered blizzards, floods and tornadoes, getting a crash course in storm coverage of nearly all kinds.
She also covered health and education stories for the station. News 12 Long Island was Mary’s next stop, where she added wildfire, hurricane, and believe it or not, earthquake coverage to her resume. Mary began freelancing in New York before signing on to inaugurate News 12’s weekend morning show for two years. Baltimore was the next stop, at WBFF-TV, where Mary worked as the weekend morning anchor and reporter. There she covered the Freddie Gray riots and tackled the city’s heroin epidemic as the station’s health reporter.
Mary and her husband chase two young kids and two rambunctious dogs, and try to spend as much time outdoors as possible, hiking and exploring San Diego. While indoors, she cheers on her USC Trojans and her husband’s Green Bay Packers.
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Dr. David Miyashiro
Superintendent, Cajon Valley Union School District
Dr. David Miyashiro is a forward-thinking, award-winning education leader with a 17-year career spent revolutionizing learning approaches, education models, and school district capabilities in Southern California. As a digital pioneer, he has navigated districts into the hi-tech era, delivering numerous innovation “firsts,” for which he has garnered professional honors. Those include Superintendent of the Year and recognition from the White House and U.S. Department of Education as one of the “Top 35 District Leaders in Personalized Learning.” Districts under his leadership have also won awards, such as the California School Boards Association’s Golden Bell Award, the National School Boards Association’s Magna Award for Digital Learning, and the California Distinguished Schools Award.
As the superintendent of the Cajon Valley Union School District since 2013, Dr. Miyashiro has headed multiple transformational initiatives, programs, and partnerships that have produced a robust digital ecosystem of learning opportunities for teachers and the district’s 17,000 students. He established the first Computer Science Magnet School in the U.S., pioneered a digital teacher academy, and forged collaborative partnerships with technology vendors for unique 21st-century education opportunities. His efforts earned the district acceptance into the League Of Innovative School Districts, selected by Digital Promise and the U.S. Department of Education as a National Model of Excellence and Innovation. He also designed and rolled out personalized technology learning programs for students and assisted the White House and the U.S. Department of Education in forming a National Personalized Learning Plan.
In tandem with championing a digital focus, Dr. Miyashiro has also driven the district’s performance in other areas: He advanced the agenda for health and wellness through a national health and wellness curriculum model and secured a $280K grant to implement it. He also tripled the time principals and district administrators spend on campus and in classrooms, shaped a scalable model for response to intervention (RTI) and language enrichment, and led the district through six successful union agreement negotiations.
From 2009 to 2013, Dr. Miyashiro served as the assistant superintendent for the Encinitas Union School District. He wielded his passion for technology and educational improvement expertise to open doors for enhanced digital learning, as well as strengthening health and wellness programs and increasing engagement among principals and district administrators. In 2010 Dr. Miyashiro pioneered one of the first 1:1 ipad digital initiatives making Encinitas Union an Apple Distinguished District in 2012.
In 2007, Dr. Miyashiro moved to Laurel Elementary School, a Title 1, 30 % English language learner (ELL) school in the East Whittier City School District, and enacted sweeping reforms that exited the school from program improvement status by 2009. He implemented school-wide targeted professional development, infused structured teacher collaboration, revamped curriculum, and initiated new global student learning opportunities. He further improved tutoring for at-risk students, reduced discipline referrals 90%, and quadrupled parent engagement in the PTA.
In 2003, he became the principal at Richman Elementary School in the Fullerton School District. Within three years, removed the school from program improvement status. During his tenure, he also lifted the academic performance index (API) from 591 to 800+, expanded tutoring through collaborative partnerships, cut discipline referrals by 90%, and propelled PTA membership 500%. He also secured $700K in grants to enhance learning and paved the way for digital learning.
Dr. Miyashiro has a Doctorate in Education, specializing in Educational Leadership and Policy, from the University of California and a Master’s in Education Technology and Curriculum from Grand Canyon University. Credentials include Administrative Services, California Teaching Professional, and the Cross-Cultural, Language, and Academic Development Credential (CLAD).
Dr. Miyashiro is the CA State Board of Education’s appointed Co-Chair of K-12 Computer Science. A progressive thought leader, he frequently presents as a keynote speaker on various hot topics at industry conferences and summits.
Write in Questions with Answers</br>from Dr. Bradley and Dr. Ramers
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I am a parent of two children at Rancho San Diego Elementary. What would you say to people who are skeptical of either the vaccination(s) or mask wearing to stop the spread? - Mable
Dr. Ramers: It’s OK to be skeptical, and it has been very confusing as small bits of information come out at different times, but the way science works is that individual studies come out one by one and eventually yield an evidence base and a consensus that we take to be truth and fact until disproven. The science behind vaccines of course will continue to evolve, but to date these COVID vaccines have been the most intensely studies in history and we have a very good understanding of the rare safety events (most are on the order of a few per million which is about the chance of being hit by lightning). All the epidemiologic data as well as our collective experience as healthcare workers has shown us that the overwhelming majority of severe cases of COVID-19 requiring hospitalization and death have occurred in unvaccinated people, demonstrating that the vaccines are the best tool we have at protecting people and decreasing the chances of suffering these consequences.
Regarding masks, I have largely the same answer. Studies done in labs that simulate droplet transmission are absolutely clear that they can prevent droplet spread from one person to another. The epidemiology strongly supports this as well with many studies showing that universal masking in schools reduces spread by around 30-40%. Not perfect, but a very good tool. Finally, it’s important to realize that correct mask-wearing technique (cover that nose!!) and the quality of the mask explains a lot of the variation and why masks don’t work even better. N95 masks are better than KN90 masks which are better than surgical masks, which are better than cloth masks, which are better than bandanas and gaters. I take care of around 50 highly infectious COVID patients per week in our monoclonal antibody clinic and have not yet contracted COVID (I have the blood tests and weekly negative PCRs to prove it!). Being fully vaccinated and wearing an N95 properly and consistently has protected me and potentially saved my life.
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According to the Washington Post they stated approximately 1 in 5,000 boys vaccinated between the ages of 12-17 are getting myocarditis or pericarditis. One of my sonโs experienced a side effect from the MMR vaccine that at the time, approximately 10 years ago, they said only occurs in 1 in 20,000 children. So 1 in 5,000 doesnโt sound very rare to me. - Joleen
Dr. Bradley: As we shared, reported cases are actually not all confirmed. When the information on the CDC’s investigation into whether the reported cases were actually supported by reviewing the children’s medical documents and speaking to their doctors, only half the reported cases appeared to be truly related. While any rate in these children is certainly of concern, the true rate is probably closer to 1 in 15,000. Most important is that all the children with myocarditis recovered and there has not been a single case of long term injury, and no deaths. The CDC and FDA are continuing to track side effects, and when the number of kids who have received vaccine is in the millions, most all of the side effects will be known and will be shared with us all.
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A concern I have is in regards to the required weekly testing for the unvaccinated staff and volunteers but not for the vaccinated. It is a fact that at a school within this district that vaccinated staff contracted and then spread Covid on a school site... - Joleen
...Students and staff were sick with Covid. Students spread this to their vaccinated parents that then also became very sick. This vaccine does not stop someone from contracting Covid or stop them from spreading it. The CDC also stated that the viral load of an unvaccinated case and a vaccinated “breakthrough” case are the same. I personally know of 14 people in my life that were fully vaccinated but still contracted Covid and some also spread it to others within the past few months. So to force children to take this brand new vaccine does not make any scientific sense.
Dr. Bradley: Breakthrough infections in vaccinated people were discussed, and no amount of immunity from either vaccine or from natural infection will reliably protect someone from a close exposure to an infected person. Adults are better able to keep apart from other adults with ‘colds’ or ‘coughs’ but it is difficult for a parent or grandparent to not hug a symptomatic child with COVID. Kids are not reliably able to keep apart from their friends when not under adult supervision, which is probably why it is currently spreading in schools. The contagiousness of vaccinated people with COVID is less than the contagiousness of those with COVID who have not received the vaccine. With fewer symptoms, it is likely that vaccinatated people have less cough than unvaccinated, and the amount of virus in your mucus drops much more quickly if you were previously immunized, than if you were unvaccinated.
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This does not imply that I am anti vax. All of my children have all of the required vaccines. Doctors are not allowed to discuss any of the possible severe side effects with patients and they can not guarantee my childrenโs safety from getting this vaccine. - Joleen
Dr Bradley: Doctors not only allowed, but are supposed to discuss vaccine safety with all parents. That is their job.
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Is it to be expected that we will continuously vaccinate our children without any guarantee of safety or knowing any of the long term effects of this vaccine? In my childrenโs situation this vaccine is more dangerous to them than Covid is? - Joleen
Dr. Bradley: Antibody levels decrease over time, but that happens with all vaccines. The body switches to a “memory” mode of immunity, where the cells that produce antibody go into hibernation until the body is exposed to COVID again. Dropping antibody in the vaccinated does not mean that you will get the same severity of disease as the unvaccinated. The less we can vaccinate, and the more people get COVID disease, the more likely that a new mutant will develop, one that is more deadly than the current strain, so decreasing the number of infections everywhere in the world is a high priority. This virus does not mutate nearly as fast as influenza, and actually has an internal mechanism to stop mutations within its RNA, that works reasonably well. We discussed the benefits of vaccine, even one with Emergency Authorization, against the risks of the infection. So far, there are no significant long term side effects that occur with any substantial frequency in the vaccine, which now has been tracked for safety for over a year, and is continuing to be tracked by FDA and CDC. The virus is far more dangerous to children than a spike protein vaccine.
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Will it be discussed and emphasized that the โapprovalโ is for EUA (emergency use authorization)? And, how is it an emergency when Covid numbers have been decreasing, medical staff laid off/suspended/etc. if we are in such a โpandemicโ and the numbers for children with covid have been incredibly low?
Dr. Bradley: Covered in discussion. We also now know, as of November 2, from data collected and reported by the CDC that in certain regions of the United States, up to 35% of children have evidence of infection by blood test, without our even knowing and far fewer cases actually having been reported, so the ‘pandemic’ is still ongoing in the unvaccinated (both children and adults).
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For those children who have tested positive for COVID, please explain why the vaccine is recommended vs allowing natural virus antibodies to protect.
Dr. Ramers: There seems to be a ‘false confidence’ in natural immunity. As I mentioned, I see patients every day who have infections precisely because their natural immunity has failed. It is true that some people do gain good protection after an infection, but there are reasons to be skeptical that natural immunity will protect everyone. Some viruses do mutate rapidly enough to be able to evade even a very good immune response. Some infections are able to evade the immune response from the beginning (examples include HIV, Hepatitis B, herpesviruses HSV-1/HSV-2, varicella/chickepox, HPV). In other examples, even a good ‘natural immunity’ response isn’t enough to prevent from reinfection. If we take other coronaviruses as an example (such as one of the less lethal ‘common cold’ ones like Coronavirus HKU1 or OC43), people can get reinfected by the same virus every single year because immunity tends to fade away. While it is true that surviving an infection should give some protection, the data suggests that this protection is highly variable from person to person. And finally, we really don’t have very good tests to differentiate who is truly protected and who isn’t. While we can easily send a spike Antibody test, these tests don’t give an adequate picture of the full immune response, and don’t even tell us how good that person’s spike protein antibody actually is. There are much more sophisticated tests (neutralizing antibodies, tests for memory B-cells, memory T-cells, etc) that are only available in research studies. So not only can we not guarantee that natural immunity will be strong enough or last long enough to protect someone, we don’t even have a reliable way to test for it. Natural immunity PLUS vaccination actually gives the best responses we have seen, and result in something called ‘hybrid immunity’. The uncertainty and variability that has been observed with natural immunity, combined with the very high levels of protection seen in COVID survivors after vaccination are what’s behind the recommendation that all should receive vaccination, including those who have survived COVID.
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My understanding is with any viral illness, generally once you've had it - you shouldn't get that specific illness again. While it can/does mutate so too does the efficacy of a vaccine as it morphs into a new strain.
Dr. Ramers: This is not necessarily true and gets to a ‘false confidence’ in natural immunity. As I mentioned, I see patients every day who have infections precisely because their natural immunity has failed. Some viruses do mutate rapidly enough to be able to evade even a very good immune response. Some infections are able to evade the immune response from the beginning (examples include HIV, Hepatitis B, herpesviruses HSV-1/HSV-2, varicella/chickepox, HPV). In other examples, even a good ‘natural immunity’ response isn’t enough to prevent from reinfection. If we take other coronaviruses as en example (such as one of the less lethal ‘common cold’ ones like Coronavirus HKU1 or OC43), people can get reinfected by the same virus every single year because immunity tends to fade away. While it is true that surviving an infection should give some protection, the data suggests that this protection is highly variable from person to person. Natural immunity PLUS vaccination actually gives the best responses we have seen, and result in something called ‘hybrid immunity’. The uncertainty and variability that has been observed with natural immunity, combined with the very high levels of protection seen in COVID survivors after vaccination are what’s behind the recommendation that all should receive vaccination, including those who have survived COVID.
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a) Duration of vaccine "protection"?
Dr. Ramers: This is an area of active research right now. The fact is that we can’t guess how long immunity will last until we’ve had enough time to follow up large groups of people to see how likely they are to be reinfected. There is pretty good evidence that vaccinated people will maintain really good ‘immune memory’ in their long-lasting memory B-cells and memory T-cells, even if their antibody levels wane over time. This means that even if full protection from infection fades away over time, the body will still be likely to maintain a really good and rapid response if/when exposed again. This is why even though breakthrough cases are happening, we’re seeing that the vast majority of them are mild and don’t make people very sick. It’s still the unvaccinated that are making up the overwhelming majority of serious cases that are landing people in the hospital.
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b) Will a booster be recommended?
Dr. Ramers: Complicated question, and it depends on what we’re trying to prevent. Are we trying to stop all infections, or is the goal to prevent serious infections, hospitalizations or deaths. The primary series (2 shots Moderna or Pfizer) are still doing quite well at preventing most people from having severe cases and winding up in the hospital. However, it has become clear that more vulnerable people with weaker immune systems are having their protection wane a bit faster. That’s why the current recommendation for boosters is strongest for those who are severely immunosuppressed, those over age 65, and those over age 50 with underlying medical conditions. The company of course wants to sell more of its vaccine, so they are asking FDA to approve boosters for everyone. FDA and CDC will not allow this unless the evidence is starting to show that everyone would benefit from a booster and that the safety is acceptable.
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I would like to know that stats on serious illness / death for children currently from covid. I would also like to know more information on the relationship between antibodies after a child has had Covid, and the likelihood that he/she could contract illness again, specifically serious illness / death.
Dr. Bradley: The best, most comprehensive and current information on COVID disease was presented at the CDC meeting to academic advisors (people like Drs. Ramers and Bradley), available at the CDC website: https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2021-11-2-3/03-COVID-Jefferson-508.pdf
In general the lower the antibody level, the more a person is likely to have symptomatic disease on re-infection, and immunization is known to greatly reduce serious disease, hospitalization, and death in adults. However, antibody is only part of the body’s defense, as specific lymphocytes (specialized white blood cells) can also recognize COVID virus and protect from infection.
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Is this safer than just wearing a mask?
Dr. Bradley: More effective at preventing spread of COVID than masks, but since masks are not injections, masks would be considered safer.
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How many children was it tested on?
Dr. Bradley: Covered in discussion: 3000 children with vaccine, and 1500 got saltwater injections for comparison (placebo). It was very important to compare side effects in those with vaccine to those with placebo, as it was demonstrated that 25% of kids who just got saltwater (which should have no side effects, other than some pain at the site of the shot), reported fatigue from the shot.
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Does it cause infertility?
Dr: Bradley: No
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Why force something on children when there are such low rates of them getting this virus?
Dr. Ramers: As I showed in the initial slides, the numbers so far would refute your statement of ‘low rates of getting this’. It is true that children have *lower* rates of having severe cases or dying of COVID, there have been >6.5 million cases of COVID in kids, >65,000 have been serious enough to wind up being hospitalized, and even though the death rate is very low, >800 children have died from COVID-19. This is way higher than death rates for many other infectious diseases for which standard prevention by vaccination have been accepted and integrated into our society. You are required in California to have proof of vaccination against 9 infectious disease in order to start Kindergarten unless you have a legitimate medical exemption. Why should our standard for this disease be different? How many dead or hospitalized children would be an acceptable number? If the data showed that the vaccines were dangerous I would agree that we should be more cautious, but the safety data, when interpreted carefully and correctly, is strongly in support of these being incredibly safe vaccines, particularly at the lower dose being used in the 5-11 year age group. I would recommend you review the publicly available slides that were discussed at the CDC ACIP meeting from 11/2 and 11/3. In particular Dr. Oliver’s slides go through the risks and benefits of vaccination, relative to other infectious diseases that your child is likely already vaccinated against. https://www.cdc.gov/vaccines/acip/meetings/slides-2021-11-2-3.html
Resource Links
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- SAN DIEGO COUNTY COVID-19 INFO:
coronavirus-sd.com - CDC INFO ON VACCINE FOR KIDS:
cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/children-teens.html - LIST OF VACCINE INGREDIENTS:
cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines.html - WHERE TO MAKE A VACCINE APPOINTMENT:
coronavirus-sd.com/vaccine - FHCSD VACCINE SITE:
fhcsd.org/covid-19-vaccines/ - MONOCLONAL THERAPY OPTIONS:
fhcsd.org/covid-19-treatment/ - FACTS & MYTHS ABOUT VACCINES:
cdc.gov/coronavirus/2019-ncov/vaccines/facts.html - SD COUNTY EVALUATING INFORMATION:
sandiegocounty.gov/content/sdc/hhsa/programs/phs/community_epidemiology/dc/2019-nCoV/EvaluatingInformation.html - MASKS PREVENTING SPREAD, SCHOOL CLOSURES:
cdph.ca.gov/Programs/OPA/Pages/NR21-307.aspx - CDC DATA ON VACCINE FOR KIDS:
cdc.gov/vaccines/acip/meetings/slides-2021-11-2-3.html
- SAN DIEGO COUNTY COVID-19 INFO: