Suggested Criteria for Monoclonal Antibody Treatment of COVID-19 in Children
Children’s Minnesota, Mayo Clinic, and the University of Minnesota worked collaboratively to develop criteria for the use of anti-SARS-CoV-2 monoclonal antibodies in pediatric patients (12-17 years of age). These criteria were developed because the organizations felt the FDA EUA criteria were too broad for pediatric patients. See the criteria here. If you have questions about the criteria, contact Sarah Lim, MD, at the Minnesota Department of Health.
Childhood Immunization Rates
Garrett Jones, MD, FAAP, co-chair of the MNAAP Immunization Work Group, recently authored a Star Tribune Readers Write submission, writing,
“Although many Minnesotans are excited about the return to in-person learning for our children and the prospect of broad COVID-19 vaccine eligibility, many public health advocates remain concerned about the state’s childhood immunization rates. According to the most recent data from the Minnesota Department of Health, the state is behind by approximately 42,000 doses of the recommended early childhood vaccines and 21,000 doses of the recommended adolescent vaccines when comparing the calendar year 2019 with 2020 (January to December). Specifically, early adolescents ages 11-12 need vaccines to protect against meningitis, HPV-related cancers and pertussis (whooping cough).” Dr. Jones went on to write, “The Centers for Disease Control and Prevention currently recommends a minimum interval of 14 days before and after COVID-19 vaccines. This means that there could be as much as an eight-week period in which no other vaccines can be administered, depending on which COVID-19 vaccine your child receives.”
Consider communicating the importance of keeping on track with childhood immunizations with patients and families in light of this information from the CDC:
MDH Releases Guidance for Face Coverings During Organized Sports
The Minnesota Department of Health (MDH) recently released a report on Face Coverings in Organized Sports During COVID-19, which addresses some of the concerns raised by athletes and parents about masks during practices and games.
The report was developed in collaboration with an advisory group coordinated by MDH, including physicians in sports, pediatric, and pulmonary medicine. Other experts include epidemiologists and a former collegiate athlete.
MDH Recommendations for COVID-19 Testing for Minnesota Students
With the recent return of many middle and high schoolers to in-person learning, the Minnesota Department of Health (MDH) is recommending that all school-age youth returning to school, sports, or extracurricular activities, and their families, get tested for COVID-19 every two weeks through the end of the school year.
MDH suggests that regular testing of kids and families complements testing strategies already in place for educators and other staff. MDH is asking health care systems, especially pediatricians, for their support in sharing the message with parents and caregivers.
Information to share with patients and families can be found on this website, along with a sample newsletter, social media messages and a PDF of a flyer.
P-EBT Benefits for 2020-2021 School Year Available Starting in Late March
P-EBT, which is short for Pandemic Electronic Benefit Transfer, provides food benefits for hundreds of thousands of children who are not receiving the free or reduced-price school meals that they normally would because their school is using a distance- or hybrid-learning format.
To ensure children receive the food benefits known as P-EBT, families should make sure they are approved for free or reduced-price meals at their school through the National School Lunch Program as soon as possible.
Children will be eligible for P-EBT benefits for the 2020-2021 school year if they are approved to receive free or reduced-price meals at their school through the National School Lunch Program, and their school was in a distance- or hybrid-learning model for the majority of one or more months. There is no separate P-EBT application.
Find more information about P-EBT to share with families here.
Minnesota Department of Health Develops Registration Forms for COVID-19 Vaccine Phase 1a3
The Minnesota Department of Health (MDH) has developed online registration forms to help local public health departments identify health care workers who have not yet been vaccinated against COVID-19.
From the information in the message, health care workers are advised that if they are a health care worker in Phase 1a who has not been vaccinated, they should follow should fill out the Health Care Vaccination Connection Form. MDH will share the information you enter with your local health department. The health department will reach out to you when there are vaccines and appointments available.
Minnesota WIC Services during COVID-19
The Minnesota WIC Program continues to provide services to over 100,000 participants each month. These services include food benefits, nutrition education, breastfeeding support, and referrals. The vast majority of WIC clinics are providing these services remotely to protect the health of families and staff during the pandemic.
As you are aware, a WIC screening typically includes a health and nutrition assessment, height and weight measurements, and a hemoglobin test. Since WIC is not able to see families in person, the requirement to perform the anthropometric and hematological assessments is waived at this time. The Minnesota Department of Health (MDH) anticipates that the United States Department of Agriculture (USDA) will continue this waiver throughout the current and potentially future Public Health Emergency Declarations related to the pandemic.
MDH and WIC are asking health care providers to partner in order to meet the unique needs of WIC families during this unusual time. Please:
- Consider providing additional hemoglobin testing for children until the pandemic has subsided.
- Encourage WIC families to share height, weight, and hemoglobin results with the WIC clinic.
See the full memo to health care providers for more information.
Minnesota Launches Dashboard to Track Statewide COVID-19 Vaccine
A new public vaccine dashboard launched earlier this week details the progress of COVID-19 vaccine allocation, distribution and administration across Minnesota.
The dashboard, produced by Minnesota IT Services (MNIT) and the Minnesota Department of Health (MDH), provides a visual and user-friendly way to view key vaccination data in the state. The dashboard includes information on the number of doses promised (allocated) to the state by the federal government; shipped to Minnesota providers; and administered to Minnesotans. The dashboard will be updated daily.
More than 140,000 Minnesotans have received at least one dose of vaccine. Over 7,000 people have completed their vaccination series. For currently available vaccines, a complete series is two doses of the same vaccine product separated by three or four weeks depending on the vaccine. These numbers are reflected in the dashboard.
Chapter Stance on Masks as Youth Sports Resume
Starting January 14, youth sports games and scrimmages with other teams may resume, following a period of restrictions as part of several dial back measures in Executive Order 20-99.
The Minnesota Department of Health offers this COVID-19 Sports Practice Guidance for Youth and Adults, which includes recommendations for face coverings and clarification of those who are exempt from wearing face coverings. The guidance states, “It is important to communicate to parents and players that masks will be required for all practices and, when allowed, games.”
Pediatricians and other practitioners may be approached by parents seeking letters to exempt their child or teen from wearing a face covering during practice or play. We wanted to again emphasize the importance of wearing face masks, including in sports, except in situations where it would be contraindicated. MNAAP previously stated: “It is important to point out that for children with underlying asthma or other lung issues, there is no medical reason that they cannot wear a mask”. The AAP has also previously issued its own guidelines on return to sports, which also encourages the use of masks.
MDH Seeking to Distribute Ag Card Tests
The Minnesota Department of Health (MDH) is seeking to distribute Abbott BinaxNOW COVID-19 Ag Card tests, at no-cost, to qualifying health care facilities or pharmacies.
The BinaxNOW test is intended for the qualitative detection of antigen from COVID-19 in direct nasal swabs from individuals that present with symptoms of COVID-19 within the first seven (7) days of symptom onset. The test is a rapid antigen test, not a molecular (PCR) test. The device includes a custom nasal swab with the test card. The medical professional adds extraction reagent and inserts the swab after collection into the card.
To learn more and request tests, go to: https://www.health.state.mn.us/diseases/coronavirus/hcp/binaxnow.html
Consider Helping as a Distance Learning Tutor
Statewide, more children have moved to distance learning, threatening to widen the achievement gaps. One suggestion for pediatricians who would like to help is to sign up to be a virtual tutor. The Minnesota Department of Education recommends contacting your local school or school district, which may be keeping a list of virtual tutors available to help. Additionally, some local libraries offer free tutoring. Check in with your local school or library system to find out if they tutors available and/or if there is a need for volunteers.
Return to Sports Protocol for Student Athletes
The Minnesota State High School League (MSHSL) Sports Medicine Advisory Committee, in collaboration with MDH, has established a protocol for student athletes returning to sports after being diagnosed or testing positive for COVID-19. The protocol includes a recommended medical evaluation by a Qualified Medical Provider (MD/DO/PAC/ARNP) before returning to physical activity and team training. See more about this protocol.
Close Contact Reporting Guidance
The Minnesota Department of Health (MDH) sent a letter to MNAAP asking for chapter members help with an issue in close contact reporting. The letter, signed by Ruth Lynfield, MD, FAAP, state epidemiologist; and Sarah Lim, MD, explains that MDH “has received reports from healthcare providers of instances where they have been asked by patients to re-assess a close contact determination that has been made by public health, usually due to disagreement with recommendations for isolation or quarantine.”
If you receive such a request, MDH asks that you decline to provide a close contact determination and instead refer patients to MDH guidance and encourage compliance with public health recommendations.
You can read the entire letter here.
School Decision Guidance
The Minnesota Chapter of the American Academy of Pediatrics (MNAAP), at the request of the Governor’s Children Cabinet and pediatricians around the state, have put together a guide to help parents navigate what type of learning will be best for their children and adolescents as we start this school year. This document is intended to be used by pediatricians and other clinicians who provide care to children and adolescents as they talk with parents of their patients and also to be used by the parents as they decide what to do. Feel free to share it with whomever you believe may find it useful.
School Decision Guidance for Parents (PDF) School Decision Guidance for Parents
What to Do While You Wait for a COVID-19 Test Result from the Minnesota Department of Health (find versions translated into 11 languages on this page)
Mask Use for Children
MNAAP Stance on Masks at School (PDF) MNAAP Stance on Masks at School
MN Mask Guidance for School-Aged Children (PDF)MN Mask Guidance for School-Aged Children
A Toolkit for Helping Your Child Wear a Mask During COVID-19 from the University of Rochester Medical Center
Clinic Messages to Patients and Families
Communicating the importance of continuing well child visits and immunizations during the COVID-19 pandemic can clear up confusion for parents and patients, and provide reassurance. Consider using the templates below for written messages and phone messages to families about clinic practices to keep children safe and healthy during the pandemic. These messages can be revised to match your clinic’s specific protocol.
Message templates: Well child visit messages for families during COVID-19
Social media is a great tool to help remind parents and patients of the importance of continuing well child visits and immunizations, even during the COVID-19 pandemic. The AAP is reporting between 70 and 80 percent of children are delaying visits to the doctor out of fear over COVID-19.
Consider using one of the posts or images below, reposting a MNAAP post, or by creating your own and tagging MNAAP on Facebook or Twitter. You can also download this infographic to print or post: Well Child Visits Infographic
Sample social media posts:
- Well child care is important, even during a pandemic. Wash your hands often and call your pediatrician to discuss regular well child visit options.
- Stay on track with vaccinations! Washing your hands and social distancing help prevent COVID-19 and routine immunizations help prevent many other dangerous illnesses.
- Pediatricians are here for you by phone, through telehealth or in person! Call your doctor today to learn the options available for your child’s visits and vaccinations.
Social media images:
Important COVID-19 reminders:
Many Families Eligible for Lump Sum to Address Food Insecurity
Families still have time to apply for additional food assistance benefits to help feed their children this summer when they are not receiving school lunches. The extended deadline for Pandemic-Electronic Benefit Transfer (P-EBT) is now July 31. The benefits are issued by the Minnesota Department of Human Services in a lump sum of $325 per child to purchase food within a year of the date issued. Those who have applied will receive the benefit automatically; those who have not can apply for P-EBT online.
Families with school children who received the federal free and reduced-price meal program can apply for P-EBT online at
MDH recommends that all people who participated in recent protests and/or community clean-ups should be tested for COVID-19. This includes people who are asymptomatic. Free testing
is available at locations in communities impacted by recent large gatherings.
It is especially important to respect patient confidentiality in testing some patients following protests. Recognize that some patients may be afraid to seek care because they fear legal consequences from participating in protest activities. To ensure confidentiality, here are some recommendations:
- Do not ask patients about the details of their participation as this is not relevant to testing and may dissuade them from participation.
- If a patient mentions the details of their participation, do not document unless relevant to their immediate health needs.
- HIPPAA privacy rules supersede any concern you may have about your patient’s involvement in recent events.
- Results of these tests should be processed consistent with your institution’s policy
Minnesota Receives Waiver Approval for Telemedicine in Medicaid and MinnesotaCare
Minnesota recently received a Medicaid waiver approval regarding use of telemedicine for Medicaid and MinnesotaCare programs.
Resources by Topic
Children’s Emotional/Mental Health
Family Support Services
The Minnesota Department of Human Services (DHS) will begin issuing emergency supplements to qualifying households on April 28 and will continue throughout May on a staggered basis. People who qualify don’t have to take any action. Instead, the supplemental aid will be added to their Electronic Benefit Transfer (EBT) cards.
Guidance for Child & Teen Checkups (C&TC)
According to the Minnesota Department of Human Services, the benefit of attending a C&TC well visit and receiving necessary immunizations and screenings should be balanced with the risk of exposure to other children and adults with potential contagious diseases. Many providers are reviewing their daily workflows and practices in consideration of their patient population, safe practice capacity, clinic environment as well as guidance from the Minnesota Governor’s executive orders. The current American Academy of Pediatrics (AAP) recommendations for providing well visits and immunizations during the COVID-19 Pandemic as of Mar. 19, 2020 are:
- Newborn visits or infant weight checks
- Well child visits two years of age and younger, of special importance maintaining up to date immunization status
- Reschedule well visits for those in middle childhood and adolescence to a later date
COVID-19 Coding and Non-Direct Care
AAP Guidance: Telehealth Payer Policy in Response to COVID-19
The Great Plains Telehealth and Resource Assistance Center (gpTRAC) provides“Telehealth Office Hours”
With the significant uptick of interest in utilizing telehealth in the delivery of care (specifically at home), gpTRAC has initiated “telehealth office hours” via Zoom, specifically for Primary Care Clinics/Providers (Tuesdays at noon) and Mental Health Clinics/Providers (Thursdays at noon). These sessions will continue for several weeks in order to provide an opportunity for organizations and providers to get timely information and to ask specific questions as they initiate telehealth within their clinic structure. For the link to the on-going Tuesday (Primary Care) office hours, click here. The link for the Thursday (Mental Health) office hours can be found here.