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March 7, 2019

A bill to promote the benefits of immunization will be heard in the House Health and Human Services Policy Committee on Friday, March 8.

Please take 1 minute to contact your House member and urge them to support this effort to increase immunization rates. Our voice needs to be louder than those contacting legislators with anti-vaccine rhetoric.

In short, HF 1182 would provide funding to the Minnesota Department of Health and community-based organizations to promote the benefits of immunization for those communities most at risk. The education efforts would be focused upon geographic areas or populations experiencing or at risk of experiencing an outbreak of a vaccine-preventable disease.

Talking points:
  • Vaccines prevent serious illness and save lives. Yet misinformation about vaccines is all too common, leading many parents to opt out of vaccines and put children and others at risk.
  • States with more permissive vaccination laws, such as Minnesota, are at increased risk for outbreaks of vaccine-preventable disease.
  • Data from the Minnesota Department of Health shows that several communities and schools have high rates of non-medical exemptions. In Wadena County, for example, 13 percent of Kindergartners are entering school without required vaccinations.
  • Targeted education is needed to counter myths and falsehoods about vaccination, especially in communities with high rates of non-medical exemptions.

Please take 1 minute to contact your House member and urge him or her to support HF 1182. 

1. Enter your home address to find your MN House member:

2. Send him or her a brief email using the language above. Feel free to personalize or modify. Copy so we can track outreach.

Another option is a quick call saying, “I’m a constituent in your district and pediatrician calling to convey my support for HF 1182, a bill to help provide education to communities with low vaccination rates.”



September 15, 2020

Less than 30 days remain to complete the 2020 census. This is a once-in-a-decade opportunity to help make a difference in the lives of some of the most vulnerable children in the country.

In 2010, more than 2 million children went uncounted. With half of those under age 5, the consequences of underfunded health and social programs could impact nearly their entire childhood. In fact, census data are used to allocate more than $160 billion a year in federal funds for programs like the Supplemental Nutrition Assistance Program, Medicaid, the Children’s Health Insurance Program and Head Start.

Here’s how you can help:

  • Have conversations with families during office visits: Have you completed your census?
  • Share the  Rx to Vote and Fill Out the Census with patients’ families. Print out this “prescription” to share with families in your practice, encouraging them to register to vote and complete the census form.  Spanish version here
  • Reassure parents that private data is protected and cannot be shared with law enforcement or other government agencies.
  • database on the Count All Kids website helps identify neighborhoods and census tracts where the risk of undercounting young children is highest.
  • Encourage families to respond online ( or by phone (844-330-2020).

Visit this site to see what percentage of households in Minnesota have been counted by census takers, as well as total response rates from across the country.

Join the MNAAP Mental Health work group call scheduled for Sept. 22, 2020, from 12 – 1 p.m. for a webinar presentation on the “Minnesota Pediatric Mental Health Systems” with Denise Herrmann (MDH) and Angela Hirsch, LICSW American Indian Mental Health Clinical Coordinator (DHS). To receive login/call-in information for this training register here.

For questions about completing the Adolescent/Young Adult Depression Screening MOC4 please email Kathi Cairns at

September 11, 2020

According to the latest guidance from the Minnesota Department of Health (MDH), children should be sent home from school or daycare if they exhibit possible symptoms of COVID-19. The decision on when to return to school may often need to be done in collaboration with a clinician, and in some cases, may need an alternative diagnosis to COVID-19 to be made. Pediatric providers may have questions about what such evaluations should entail and factors to consider before making alternative diagnoses.

Join the Minnesota Chapter of the American Academy of Pediatrics (MNAAP), the Minnesota Medical Association (MMA) and MDH on Wednesday, September 16, from 12 -1 p.m. to review the challenges of assessing someone for a COVID-19 illness, keys to decision making, and an overview of the Minnesota Department of Health’s COVID- 19 Decision Tree for People in Schools, Youth and Child Care Programs, including guidance for siblings and other household contacts. The content will be followed by a 30-minute question and answer session.

This webinar is free and CME will be provided.

Special thanks to MNAAP Board Members Dr. Sheldon Berkowitz, Dr. Andrea Singh and Dr. Marcie Billings for being part of the team that consulted with MDH on the development of the COVID-19 Decision Tree.

Register now!

When parents report that their child does not sleep through the night or has other sleep disturbances, that can be a red flag in an appointment. There are four types of physical pediatric sleep disorders, often sorted into four “-somnias.” They include parasomnias, hypersomnias, dysomnias and insomnia.

Parasomnias include confused arousals, night terrors and sleepwalking. Pediatricians must distinguish these parasomnia episodes from seizures and nightmares. Then, reassurance is often sufficient.

Hypersomnias are disorders manifesting as excessive daytime sleepiness despite adequate sleep. Narcolepsy is the classic representative of this group, though other hypersomnia disorders exist. These children require a careful evaluation by a pediatric sleep specialist to ensure an accurate diagnosis.

Dyssomnias fragment sleep and include disorders such as obstructive sleep apnea (OSA) and restless legs syndrome (RLS). The pediatric sleep questionnaire (sleep-disordered breathing subscale) is a standardized tool to determine if a child with symptoms of OSA requires a sleep study. The four R’s define RLS: an URge to move the legs, occurring at Rest, Relieved by movement and often found in a Relative. If RLS symptoms require intervention, iron therapy helps in about half of patients who also have ferritin levels less than 50 ng/ml. 

Insomnia, difficulty falling or staying asleep, although easy to diagnose, often warrants a referral to a pediatric sleep specialist to determine cause and treatment. Causes of insomnia are often a developmental disability or a circadian rhythm disorder such as delayed sleep phase syndrome.

An overnight sleep study can confirm if your patient has obstructive sleep apnea. While your patient sleeps, pediatric sleep medicine specialists monitor blood pressure, electrocardiographic activity, blood oxygen level, brain wave pattern, eye movement, airflow through the nose and mouth and movement of respiratory muscles and limbs. 

Sleep medicine consults are available virtually and at several Gillette Children’s Specialty Healthcare locations. Sleep studies take place at the St. Paul campus. To make a sleep medicine referral, call the one-call referral line at 651-325-2200 or fax referral to 651-726-2622.


John Garcia, MD, is a sleep medicine physician at Gillette Specialty Healthcare for Children.

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