Latest Messages to AAP Members

Past Letters

September 7, 2023 – NASEM Report
Dear colleagues,  
Today, the National Academies of Sciences, Engineering and Medicine (NASEM) released a report that calls for a series of bold strategies to strengthen the pediatric workforce and children’s access to pediatric subspecialty care. 
The report, The Future Pediatric Subspecialty Physician Workforce: Meeting the Needs of Infants, Children, and Adolescents, sponsored by the AAP and other medical organizations, outlines four goals and more than a dozen recommendations for financial and payment incentives, enhanced education and recruitment, support of physician scientists, and enhanced collaboration between primary care pediatricians and pediatric subspecialists.  
These are goals shared by the AAP. A robust pediatric workforce is essential to providing appropriate care and that includes access to primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists. Many of our pediatric specialists are in short supply in some regions of the country, and unless we make a change, this will only get worse. 
We must continue to advocate for loan repayment, alternative training pathways and physician payment.  
The report also calls for a comprehensive approach to increase the availability of pediatric subspecialists in clinical and research settings, and more federal funding for the Pediatric Subspecialty Loan Repayment Program.  
And we urgently need higher Medicaid payment rates for pediatric services.  
When I travel the country talking to pediatricians, the topic of payment inevitably is brought up. Low payments relative to adult medicine leads to inadequate resources, strained systems, and increased pressure to see more and do more. As pediatricians, we enter the profession with the mission of taking care of infants, children, and adolescents. The mission has not changed. But if we don’t improve the payment formula, we will not be able to ensure every family’s access to high-quality care regardless of their socioeconomic status, address, or demographics.  
Supporting the resources needed to sustain pediatrics as a profession is critical. The pandemic experience and its aftermath exposed the fragility of our health care system, especially for children and adolescents. While there is no magic wand, we know how to make changes to systems of care. 
The Academy will continue our important advocacy work to ensure that children have access to the subspecialty care they need by reversing the historical undervaluing of pediatric care. 
For detailed coverage of the report, please read the article in AAP News.   
 Warmest regards,   
Sandy Chung, MD, FAAP   
President  
July 5, 2023 – Latest developments in immunizations
Dear colleagues,
I hope you all enjoyed the 4th of July holiday! We are closely watching several developments with immunizations and other products to protect against infectious diseases, including COVID-19, pneumococcal and RSV. While there have been some steps toward approval, there remain a lot of questions about how pediatricians ultimately will be able to administer them. Here’s an update on what we are currently aware of regarding the status of these products, and what AAP is doing.
1. Covid-19 Vaccines
Updated strain: As you may have read in AAP News, the Food and Drug Administration’s (FDA) Vaccines and Related Biological Products Advisory Committee (VRBPAC) recently voted to switch to a monovalent vaccine containing an omicron XBB strain, and FDA advised manufacturers to begin updating their COVID-19 vaccines with the monovalent XBB.1.5 composition, the most common circulating strain in the United States. We do not have a specific date when these updated monovalent vaccines will be available, but it is likely to be this fall. Some practices may determine that they will delay ordering vaccine until more information about this new product is available.
Dosing schedule: The Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) COVID-19 Workgroup has indicated it would support moving to a simplified schedule -- such as a single annual dose for children over age 2 -- but there remain several regulatory and manufacturing steps before that could be adopted. AAP continues to advocate for single-dose vials for all doses. As more information is released, AAP will continue to cover these developments in AAP News and to update the COVID-19 dosing guide.
Commercialization plans: Preparations are being made to end the purchase and distribution of COVID-19 vaccines by the federal government and transfer this process to the commercial marketplace. This process, also referred to as “COVID-19 commercialization,” is expected to take place in early fall. The specific date has not been announced.
Part of the process will include coverage of COVID-19 vaccines through the Vaccines for Children (VFC) program. Read our recent letter sent jointly with the Association of Immunization Managers (AIM) urging the CDC to allow additional flexibility.
As we move closer to COVID-19 commercialization, the Academy will continue to advocate for policies and pricing that will make it easier for pediatricians to administer COVID-19 vaccines to their patients and to improve the vaccination rate for children.
2. PCV20
The ACIP recently recommended the use of 20-valent pneumococcal conjugate vaccine (PCV20) in several scenarios for children (see more details in AAP News.) Given the complexity of this schedule, the AAP will work to ensure members have access to clear implementation resources. We will share that with you as soon as more information is available.
3. RSV
On June 8, the FDA’s Antimicrobial Drugs Advisory Committee (AMDAC) voted to recommend using nirsevimab for infants during or entering their first RSV season and for children up to 24 months who remain at risk for severe disease in their second RSV season. Of note, this product does not yet have FDA approval, though approval may occur in late fall. While the safety and efficacy data of the product show great promise, questions remain about how to administer it in relation to a maternal RSV vaccine that may receive FDA approval in a similar timeframe. Read more about the decision in AAP News.
As nirsevimab is a monoclonal antibody, additional details including use of immunization information systems, and administrative codes to account for counseling, have yet to be determined. If nirsevimab is licensed by the FDA and recommended by the CDC, the Academy will work to support equitable access for all children.
Back-to-school season is nearly upon us, and these evolving recommendations create additional challenges for pediatric practices. The AAP is committed to keeping you apprised of new developments as we learn about them. Meanwhile, thank you for all you are doing to make sure children and adolescents in your communities are healthy and strong.
Warmly,
Sandy Chung, MD, FAAP
President
May 11, 2023 – The end of the COVID Public Health Emergency
Dear AAP member:

Today, the U.S. ended the Public Health Emergency (PHE) for the COVID-19 pandemic. We have all experienced the myriad and lasting impacts on the mental and physical health of the children and families we care for as well as on our profession. The end of the PHE doesn’t end these impacts, but it does mark a transition in how we will manage this crisis moving forward.
I want to communicate with you what AAP is doing now. A few items on our short list:
Disease surveillance: With the end of the PHE, we will no longer have access to as much data on the number of child COVID-19 infections. The AAP will be sunsetting our weekly tracking of state COVID reports, but we will continue disease surveillance as we do for other infectious diseases. We’re committed to sharing real-time updates as needed. We must also continue to prepare for future surges of COVID-19, which may occur as the virus continues to mutate.
Mental health: Given the magnitude of loss in the pandemic, I wanted to share a resource to help you care for children and families experiencing trauma. See the webpage on Trauma-Informed Care, which includes a PediaLink course and other resources. We continue to advocate for changes to improve the payment and availability of resources for pediatricians who are taking care of children and adolescents with mental health conditions.
COVID-19 vaccine recommendations: The CDC has updated its mRNA COVID-19 vaccine recommendations to recommend only bivalent vaccine and simplify the dosing for younger children. We know, however, this remains complex for pediatric practices. AAP offers a quick reference dosing guide, which we will continue to update as recommendations change. CDC is hosting a webinar at 2 p.m. ET today on the updated recommendations. Learn more here.
Getting paid for giving bivalent COVID vaccines: Based on the updated CDC guidelines, six new immunization administration CPT codes have been created for the reporting of immunizations for COVID-19. More information is here.
COVID-19 vaccine ordering: Based on our conversation with the Association of Immunization Managers, states remain able to place orders for both Pfizer and Moderna bivalent vaccines from the existing U.S. stockpile, which is anticipated to last through summer. If pediatricians in your state are experiencing supply issues, work with your chapter to contact your state Immunization Program Manager. The CDC’s Advisory Committee on Immunization Practices meets June 21-22 to discuss fall strain selection and fall vaccine recommendations. We will bring you updates as they unfold.
AAP continues to advocate for ways to make it possible for pediatricians to offer the COVID-19 vaccine, including:
• Vaccine payment from payers on day one of commercialization
• Flexible ordering policies for COVID-19 vaccines, including the number of vials required per order
• Single-dose preparations of COVID-19 vaccine with improved labeling to minimize administration errors
• Liberal return policies for expired doses
• Longer invoice and payment schedules so pediatricians can be paid first before having to pay for new vaccine orders
• Greater flexibility in the Vaccines for Children program
Telehealth: The Drug Enforcement Administration listened to comments from AAP and extended telehealth flexibilities for prescribing controlled substances at least through November rather than ending with the PHE. Meanwhile AAP offers an online course to help pediatricians meet the requirement for eight hours of training.
Immigrant health: We are closely monitoring the situation for children and families at the U.S. southern border once the public health law used to expel immigrant children and families during the PHE, known as Title 42, expires. Stay tuned for more information soon.
We continue to work together to ensure that infants, children, adolescents, and young adults can achieve optimal health and wellbeing. Thank you for all that you do, every day, to take the best care of families in your communities.
Warmest regards,

Sandy Chung, MD, FAAP
President
March 31, 2023 – Why Advocacy Matters
Dear AAP member:

I was just in Washington, DC at the AAP’s annual Advocacy Conference, the first time the meeting has convened in person since 2019. I am still buzzing with the energy from connecting with so many of you – more than 320 pediatricians from 46 states – and hearing from the first two pediatricians elected to Congress, Reps. Kim Schrier, MD (D-Wash.) and Yadira Caraveo, MD (D-Colo.), among other distinguished speakers. Our advocates asked Congress to pass bipartisan proposals to make social media platforms safer for children and youth.

Against the backdrop of our conference, several national events made news:
• Social media and youth mental health: The CEO of TikTok recently testified on Capitol Hill and generated momentum around the topic we were there to raise with lawmakers. We could not have been in Washington at a more relevant time to urge bipartisan legislation to address this important need. I hope we will soon see progress. If you are passionate about this topic, add your voice to our effort by reaching out to your members of Congress.
• Nashville shooting: Sadly, another school shooting took place this week, this time in Nashville, Tennessee, claiming the lives of three nine-year-old children and three adults. Acts of gun violence have tragically become so commonplace. Our hearts go out to the families and our support to the survivors. As firearms are now the leading cause of death for youth, please know that we have not stopped advocating for gun violence prevention policies to keep children safe. AAP Tennessee Chapter President Jason Yaun, MD, FAAP, was at our Advocacy Conference, and was able to meet with elected officials from his state with other colleagues from Tennessee on Tuesday.
  
  I have seen such eloquent words shared this week from pediatricians across the country, enumerating in ways that only pediatricians can just how devastating the impact of an assault weapon is on a tiny body, the ways in which the surviving members of a community are forever traumatized, the impossible conversations parents are having with their children around dinner tables across the country, “What if it happens here? Am I safe?” It does not have to be this way. We will continue to fight for policies to protect children from gun violence.
• ACA lawsuit: Yesterday, a court ruling struck down a large category of the preventive services currently required to be covered by insurance plans as part of the Affordable Care Act. The AAP weighed in through an amicus brief in this case, supporting the law’s preventive care coverage. As the government determines when and how to appeal this ruling, we remain concerned that essential services like breastfeeding and lactation support for new parents and anxiety screenings for adolescents are at risk of being dropped from insurance plans if this ruling ultimately stands. Stay tuned for more updates as the decision makes its way through the courts.
And of course, I write this note just before the official end of the Medicaid continuous enrollment requirement today, March 31. As I wrote last week, AAP has new resources at www.aap.org/MedicaidUnwinding for you to share right away to help make sure your Medicaid patients remain covered during this transition.

We will continue to speak up on these topics and stay in touch as we see progress. Thank you for all you do.
Warmest regards,

Sandy Chung, MD, FAAP
President
L to R: Dr. Chung, Rep. Schrier, MD and Rep. Caraveo, MD
February 21, 2023 – COVID-19 vaccine commercialization
I write with a message of reassurance and resolve on COVID-19 vaccine commercialization, as we continue to learn more from our conversations with federal officials.
Here is what we know so far:
• Commercialization is unlikely to take place before this fall, when the federal government runs out of funding to buy more vaccine. Ashish Jha, MD, MPH, White House COVID-19 Response Coordinator, outlined this timeline in a tweet earlier this month. This is good news for pediatricians, who will have more time to prepare for the transition. The end of the public health emergency this spring is separate from the timeline for commercialization.
• The stated goal from the administration is for a bivalent vaccine for all ages to be available when commercialization begins. A bivalent product will be much simpler for pediatricians to stock and administer than the current monovalent vaccine.
• The administration and manufacturers are also striving to have single-dose vials available when commercialization happens, which should bring relief to many practices that otherwise would not have been able to afford to place new orders.
Here’s what we don’t yet know but are advocating for with vaccine manufacturers, with payers and with the federal government:
• Vaccine payment from payers on day one of commercialization
• Flexible ordering policies for COVID-19 vaccines, including the number of vials required per order
• Improved labeling of COVID-19 vials to minimize errors in administering the vaccines
• Liberal return policies for expired doses
• Longer invoice and payment schedules so pediatricians can be paid first before having to pay for new vaccine orders
• Greater flexibility in the Vaccines for Children program
• Opportunities for administration officials to talk directly to AAP members about pediatricians’ needs ahead of commercialization
I will update you often as these conversations continue over the next few months and share any news we learn about timing and scope of commercialization in the meantime. We will not stop advocating for the changes we know you need to make sure that all eligible children are able to be vaccinated against COVID-19 by their pediatrician. Thank you for all you do.
Warmest regards,
Sandy Chung, MD, FAAP
President
February 10, 2023 – What the End of the Public Health Emergency Means for Children’s Coverage
Dear AAP Members:
Changes are coming to several public health protections that have been in place throughout the pandemic – including last week’s announcement that the COVID-19 public health emergency will end on May 11. You likely have questions about what these changes mean for your patients and your practice, especially as you continue to confront a reality on the ground that underscores just how far the pandemic is from being over.
The Academy is in close communication with Administration officials, and doing everything in our power to ensure pediatricians are seen, heard and supported. We’ve been closely tracking these developments and long anticipating the changes: what they will mean for children, families and pediatricians, and what action needs to be taken as the dates approach.
Here’s what you need to know:
Efforts to preserve Medicaid and CHIP coverage
A requirement that kept individuals enrolled in Medicaid during the public health emergency will end on March 31. This policy – called the Medicaid continuous eligibility requirement – was passed as part of pandemic relief legislation in 2020.
Why it matters: Medicaid and the Children’s Health Insurance Program (CHIP) became the primary sources of children’s health care coverage during the pandemic, so these changes could put their coverage at risk.
What happens next: Starting on April 1, states will begin what is known as the 14-month “unwinding process” to redetermine Medicaid eligibility for all enrollees. The Centers for Medicare and Medicaid Services has provided extensive guidance on how states should navigate this process. Also, new guardrails put in place by federal law will aim to hold states accountable.
What we can do: AAP.org/MedicaidUnwinding has information and resources for pediatricians and AAP chapters, and we will continue to add more in the coming weeks. Pediatricians will play an important role in spreading the word to families about these changes, and we will be providing you with tools to help you do that.
Ending the public health emergency
The end of the public health emergency will have implications for COVID vaccine payment and distribution, testing and treatment, as well as programs families rely on, like WIC.
The timeline for each of these changes will vary and we’re continuing to learn more details as they become available. We know these policy changes must consider the needs of children and pediatricians – especially ensuring pediatricians are paid for vaccine counseling and that COVID vaccine commercialization does not create barriers for pediatric offices to affordably purchase and administer the vaccine. The AAP is in regular communication with Administration officials on these issues and will provide more information about what the end of the public health emergency means for your practice.
In the meantime, please stay tuned for updates from the Academy along with resources to help you and your patients to navigate these changes. We’re in this together. Thank you for all you do every day for children, families and your communities, and I will continue to be in touch.
Warmest regards,
Sandy Chung, MD, FAAP
President
January 26, 2023 – Reframing the Conversation About Child and Adolescent Vaccinations
Dear AAP Members:
As the CDC reported this month, we’ve seen a decrease in immunization rates among young children in the past three years. This likely has several causes, including barriers to access that were exacerbated during the pandemic, the spread of mis- and disinformation, and our collective, ongoing challenge to build confidence in immunizations.
We know you face this challenge every day in your practices. I have certainly seen this at my own practice. At the AAP, we have been working on multiple projects to improve immunization rates at a national level. This includes new communications research the AAP commissioned with the FrameWorks Institute, a think tank that uses rigorous social science methods to unveil the foundational mindsets and assumptions people hold on numerous issues, and empirically based guidance on how to talk about them outside the exam room setting. I am delighted to announce that this work is now available.
This new research has yielded evidence-based strategies we can use to build public understanding of and support for vaccine access for everyone. Whether we are sharing information about vaccines in social media or in a news interview, talking with policymakers or addressing a group of parents, these framing strategies can help improve how we talk about vaccines. These conversations in the “public square” - whether that’s in virtual or in-person spaces – ultimately will help us shape public attitudes about vaccines and their benefits.
Some of you heard a preview of this research at the AAP National Conference & Exhibition in October during a plenary address by Julie Sweetland, PhD, a sociolinguist and Senior Advisor at FrameWorks. The full report is now available here, and I encourage you to explore it in detail. I also hope you will join me at 11 a.m. CT on Feb. 2, when AAP is hosting a webinar so you can hear firsthand from Dr. Sweetland about the research. To register for the webinar, go here.
Meanwhile, here are a few strategies FrameWorks and AAP recommend when talking about vaccines in these public conversations:
• Talk about the benefits of vaccination for the common good.
• Talk about improving vaccination access as a preventative public health measure.
• Focus on how vaccines are beneficial to children’s long-term health and wellbeing.
• Use a computer updates metaphor to explain how the immune system improves its performance through vaccination.
• Use a literacy metaphor to explain how the immune system learns how to respond to viruses through vaccination.
For more on these recommendations, and examples of messages, check out the report. FrameWorks and AAP will be releasing more tools and communications assets in the coming months.
I’ll also note that a large body of research exists to inform the communications strategies you use when talking about vaccines with parents one-on-one in your practice, including making a strong recommendation and using motivational interviewing techniques. Those are effective and important in the clinical setting. This additional research shows that slightly different framing strategies will be effective when we are addressing large audiences, and will help us shift public thinking more broadly and build support for policies that will increase access to vaccination for all children and adolescents.
Thank you for all that you do for infants, children, adolescents, and young adults in your communities.
Warm regards,
Sandy Chung, MD, FAAP
President
November 2, 2022 – Recent Surge in Viral Illnesses and Its Impact on Our System of Care
Dear colleagues:
Pediatricians across the country are seeing high numbers of patients with illnesses like RSV, influenza and COVID. Parents are worried. And many hospitals and emergency departments are full or nearing capacity -- due to the ongoing mental health crisis among young people, this surge in viral illnesses, and systemic reductions in pediatric units and workforce. The AAP’s members will always step up to care for children, but our system of care is stretched and stressed, and it is taking a toll.

We know pediatricians are under high levels of stress, and we are advocating right now for short- and long-term changes that can help ensure all children have access to the health care they need, and that can support pediatricians in their work to care for them.

As I outlined in this op-ed published today in CNN Opinion, the AAP calls for these measures:

• More funding and resources to address mental health care, as described in our call to the White House to issue a National Emergency Declaration.
• Investment in pediatric health care capacity, including increasing Medicaid payment rates to at least parity with Medicare.
• Expansion and support of the pediatric workforce, including pediatric subspecialists as well as respiratory therapists and nurses.
We also call for immediate funding to enable pediatric care teams to rapidly ramp up services to care for the children in crisis now. The AAP will continue to advocate for these and other improvements at all levels of government.
This viral surge comes at the same time as some impending changes in how COVID vaccines are financed and distributed, which will also present challenges to pediatric practices as they administer the vaccines to children.

Late last month, AAP president-elect Sandy Chung, MD, FAAP and our CEO Mark Del Monte met at the White House with Ashish Jha, MD, the COVID-19 Response Coordinator. Dr. Chung and Dr. Jha had a productive discussion about how to make sure pediatricians can continue to lead the way in vaccinating children against COVID as the government prepares to shift the vaccine to the commercial marketplace. The meeting was an opportunity to raise important issues related to vaccine payment and financing that AAP outlined in an earlier letter.

Meanwhile, some of the families coming to the emergency department now may not need urgent medical care, but rather reassurance. The headlines are alarming for families. To help educate parents about RSV, influenza and other illnesses that could be cared for at home, AAP is sharing videos, GIFs, HealthyChildren.org content, and other materials on all social media channels. We welcome your help sharing these materials in your networks:
• A video showing distressed RSV breathing in a baby
• A video from pediatrician Joanna Parga-Belinkie, MD, FAAP, discussing the RSV surge
• An RSV vs COVID symptoms chart, FAQs about RSV and an article on RSV, flu and COVID, all on HealthyChildren.org
• A newly updated campaign toolkit on influenza, with shareable videos, graphics, articles and messages
Though the circumstances right now are challenging, pediatricians know what to do to care for our patients in this moment -- how to work with fewer resources, with surges in illness, with parents who are increasingly worried about the health of their children. But we cannot keep doing this work without some real change. Please know that as you confront these difficult days, you are not alone. We will continue to work to improve our health care system to better meet the needs of children, and we will always continue to be here for you.
Thank you for all you do.

Sincerely,
Moira Szilagyi, MD, PhD, FAAP
President
June 21, 2022 – COVID Vaccines for Children 4 and Under Have Arrived
Dear AAP members:
This is an exciting week – vaccines for children ages 4 and younger are finally arriving! We should celebrate this moment, which fills me with optimism. For all of us, it has been a long, frustrating wait for vaccines to protect our youngest children – 18 months, to be exact, after the first vaccines were authorized for adults. I know many pediatricians are planning to offer the vaccines immediately to families who are eager to protect their young children.
Today, AAP is launching new campaign materials, including charming new PSAs in English and Spanish, that encourage families to talk with their child’s pediatrician about their questions on COVID-19 vaccines. Survey after survey shows that one of the most effective drivers of vaccine confidence is a one-on-one conversation with a trusted health care provider.
Our work is cut out for us. As of mid-June, 23 million children ages 5 to 17 have received two doses of COVID vaccine. But 26 million in this age group have yet to receive any doses. Summertime and back-to-school checkups offer an opportunity to have these important conversations and get everyone in the family caught up on their vaccines.
AAP offers members resources such as a COVID-19 Vaccine FAQ, Practice Implementation FAQs, and Preparing for COVID-19 Vaccines to facilitate the vaccine ordering and administration process. These and other critical updates for members on COVID-19 vaccines can be found here on the AAP.org website. In addition to the PSAs, you can find graphics and videos perfect for sharing with families in the COVID-19 Vaccine Confidence Campaign Toolkit, and several new and updated HealthyChildren.org articles:
• COVID Vaccines for Kids 6 Months and Older: FAQs for Families
• What Should Parents Know About the COVID Vaccine For Kids Under 5?
• When Can Kids Get the COVID Vaccine or Booster?
• COVID Vaccine Checklist for Kids
Thank you, as always, for everything you do for children. And, finally, click on the image below to find a dancing Band-Aids GIF, in case you ever need one.


Sincerely,
Moira Szilagyi, MD, PhD, FAAP
President
June 15, 2022 – Lending Your Voice to Ending Gun Violence
Dear Colleagues:
Today, I will testify before a key Senate committee about the need to protect children from gun violence. You can tune into the hearing here, which will begin at 10 am ET.
But, what I am reaching out to say to you this morning is thank you.
In a span of just over two days, hundreds of you helped us to do something remarkable: In advance of today’s hearing, we submitted more than 300 testimonies to the committee from pediatricians across the country who shared, in their own powerful words, the impact of gun violence on children, families and communities. Read some testimonies in this press release and the full list here. We've also amplified several stories on social media.
Your words were heart-wrenching, raw and moving. I am truly humbled and in awe of the work you do every single day. I hope the senators will hear your words loud and clear and enact meaningful change, and we will continue to be in touch with advocacy opportunities as negotiations continue.
In the meantime, from the bottom of my heart, thank you.
Moira Szilagyi, MD, PhD, FAAP
President
June 8, 2022 – Lending Your Voice to Ending Gun Violence
Dear colleagues:
Two weeks ago, 19 children and 2 teachers were killed in a mass shooting at Robb Elementary School in Uvalde, Texas. Today, Uvalde pediatrician Dr. Ray Guerrero testified alongside one of his patients, Miah, who survived the shooting by covering herself in her best friend’s blood in order to appear dead. For them, for their classmates, for their community, we must continue to speak up.
The path forward may not be clear, but our role as pediatricians could not be more certain. Today, I am sharing three specific ways you can lend your voice to our efforts to end gun violence in children’s lives.

1. Share our new video. AAP put out this video today to show how gun violence robs children of the moments that make up a life. Please share this video in email or on social media (here are links for YouTube, Facebook and Twitter).
2. Share your story with the Senate. Next week, a key hearing on gun violence prevention is taking place in the Senate Judiciary Committee. We have the opportunity to share pediatricians’ perspectives from across the country with these senators. This is a rare and meaningful moment. Please consider submitting your own testimony, which will be officially filed into the congressional record, in this simple form. Due to the rapidly approaching hearing date, our timeline is tight. We must collect all stories by the end of the day on Friday, June 10. I hope I can count on you to lend your voice.
3. March with us. This Saturday, June 11, marches against gun violence will be taking place in Washington, D.C. and nationwide. Find a march near you, and if you attend, please email your photos to kids1st@aap.org. Here’s a collection from 2018 when pediatricians marched following the school shooting in Parkland, Florida. Also, take a look at our advocacy toolkit for more ways to speak out, and our federal advocacy website, federaladvocacy.aap.org, to urge your senators to take action.
So much hangs in the balance of this moment. Thank you for showing up, even in our anguish, our outrage, our fear. You are making a difference.
In gratitude,
Moira Szilagyi, MD, PhD, FAAP
President
May 26, 2022 – Taking Action to Keep Children Safe
Dear colleagues:
This has been a hard week for all of us who care for children. We find ourselves once again gripped with grief, shock and outrage as we mourn the loss of an entire fourth grade classroom and their teachers in Uvalde, Texas.
Like so many of you, in this moment, I want to channel these feelings into something that will make a difference. As I said in the press statement AAP issued earlier this week after the shooting, “Despite past inaction, we must not assume there is no hope for change. We should not grow accustomed to these acts of gun violence.”
Next week, Congress is on recess. The Academy is advocating for three policies that have the potential to garner bipartisan support in the Senate. I urge each of you to take a moment next week and reach out to your senators, urging them to:
• Enact universal background check legislation to ensure that those who are most likely to perpetrate gun violence cannot purchase guns.
• Enact comprehensive extreme risk protection orders legislation, which allows family members or law enforcement to petition a judge to temporarily remove firearms from a person deemed at risk of harming themselves or others.
• Fund gun violence prevention research at $35 million for the U.S. Centers for Disease Control and Prevention and $25 million for the National Institutes of Health.
For more details and to email Senate offices directly, visit federaladvocacy.aap.org. You can also call your Senate offices by contacting the U.S. Capitol switchboard at 202-224-3121.
I just finished testifying earlier today before the House Appropriations Labor, Health and Human Services Subcommittee on the Academy’s top priorities for Congress to fund. Given the events of the week, I adjusted my remarks to lift up the urgent need to fund gun violence prevention research and to focus on a public health approach to reduce gun violence, which I hope resonated with Subcommittee members.
Next weekend, the Academy will be participating in Wear Orange Weekend and National
Gun Violence Prevention Awareness Day, June 3-5. We will have more resources to share next week about these opportunities and other ways you can speak up to prevent gun violence.
Until then, know that I share in your anguish and anger and renewed resolve to continue to advocate for our children to be safe wherever they live, learn and play. I am grateful to work alongside 67,000 fellow advocates for children, who can come together and continue to speak up for them, even in our lowest moments.
Thank you for all you do,
Moira Szilagyi, MD, PhD, FAAP
President
March 10, 2022 – The War in Ukraine
Members of the Academy:
Over the last two weeks, we have seen heartbreaking images and read stories of children and families hurt and killed in the devastating attacks on Ukraine and forced to flee their homes to neighboring countries. As physicians, it is in our nature to want to do something to ease the distress and remediate the trauma.
The war in Ukraine also serves as a reminder that children, from infancy through young adulthood, are always disproportionately impacted by morbidity and mortality associated with armed conflict. The children of Ukraine join the many others around the world exposed to the brutal realities of war and subjected to extreme trauma and suffering.
The AAP policy statement, “The Effects of Armed Conflict on Children,” details the direct and indirect effects of armed conflict and makes recommendations for clinical practice, systems strengthening and advocacy. Many of us care for families who are refugees or have family in areas of conflict. You may find this toolkit useful in supporting these patients and families.
The AAP is coordinating with the International Pediatric Association and is ready to support our colleagues in Ukraine and in those countries caring for the refugees. We know our members are ready to assist. The humanitarian crisis is ongoing, and there will be a long recovery period whenever the fighting ends. The most immediate action our members can take is to donate to organizations that can help. Below are three options you may wish to consider.
American Academy of Pediatrics Disaster Recovery Fund: This fund creates resources that address an array of recovery situations. The Disaster Recovery Fund supports children in harm after any kind of disaster, anywhere in the world and allows the Board of Directors to grant funds to AAP chapters and international pediatric societies whenever and wherever the need is greatest. Go to donate.aap.org and select “Disaster Recovery” when making your gift.
UNICEF: A gift to UNICEF can support initiatives that provide emergency relief in Ukraine and elsewhere. UNICEF’s humanitarian work in Ukraine is focused on safeguarding children's rights to safety, health, education, psychosocial support, protection and water and sanitation services. The AAP has created a dedicated fundraising campaign, and you may participate by donating here.
MedGlobal: This physician-founded relief organization (MedGlobal.org) is a humanitarian nongovernmental organization with experience providing medical care to refugees, internally displaced persons (IDPs), and other vulnerable communities around the world. The AAP has ongoing work with them to improve care for refugees in Bangladesh. This week they have sent a physician-led team to Poland and Moldova to assess needs on the ground among Ukrainian refugees. In addition to monetary donations, there may be a future opportunity to volunteer your time and expertise with this organization. You may make a donation here.
Thank you for considering a donation.
As media coverage in the U.S. of the war continues, children may see upsetting footage and have questions. For guidance on how to talk to children about traumatic events in the news, see this HealthyChildren.org article. Please also see these two AAP Voices blog posts by Sherri L. Alderman, MD, MPH, IMHM-E, FAAP, and Dipesh Navsaria, MPH, MSLIS, MD, FAAP, who write about the terrible toll that armed conflicts and separation from parents take on infants and young children.
Finally, if you are a Ukrainian speaker, your skills may be in special demand. Please let us know if you would be willing to consider volunteer opportunities that require these language skills by emailing President@aap.org.
Sincerely,
Moira Szilagyi, MD, PhD, FAAP
President
January 10, 2022 – Signs of Hope
Dear colleagues:
This month, as I begin my new year as AAP president, I’m unfortunately sharing a staggering statistic we have now reached in the pandemic: More than 580,000 new cases of COVID-19 were diagnosed in children and teens in the week ending Jan. 6. This is the highest one-week tally at any time during the pandemic. It brings the total number of children who have tested positive for COVID-19 to nearly 8.5 million. More than a third of these cases have occurred in just the past four months.
For those of you working in pediatric practices, in clinics or in hospitals over the past few weeks, these numbers do not come as a surprise. You have seen it first-hand in your own communities as the Omicron variant has infected both vaccinated and unvaccinated alike. And because many children remain unvaccinated – or are too young to be vaccinated – children are bearing a disproportionate burden of this illness. So are pediatricians, as many of you also struggle with staffing shortages due to COVID infections among your team, just as the demand for pediatric health care is increasing. These are challenging times.
The good news is that we know much more about this virus than we did two years ago, and we have more tools at our disposal. We understand the disease and how best to isolate and care for infected patients. We have access to masks and other personal protective equipment. And we have a vaccine that offers strong protection against severe illness, even with Omicron.
As of Jan. 5, among 5- to 11-year-olds, about 7 million children – or 25% of this population – have received an initial dose of vaccine. Among 12- to 17-year-olds, 15.7 million teens, or 63%, have received at least one dose. Vaccination rates vary significantly state-to-state, and we have work to do among our more hesitant families who still have questions about the vaccine.
For families in your community who have been in the “wait and see” group on the question of the vaccine, this may be the data they need to move forward with the decision to vaccinate their children. Millions of children and teens have now been vaccinated, and the safety data are very reassuring. We know the vaccine works well to protect children from the worst effects of the disease, including MIS-C. And the rapid spread of this very contagious new variant means higher numbers of unvaccinated children (and adults) are more likely to become infected and require hospitalization. The AAP strongly recommends vaccination for everyone who is eligible, including boosters for those age 12 and older.
I know you are already doing so much, and I want to extend my appreciation for all the innovation you have brought into your work since the beginning of the pandemic. We have seen how you have incorporated the COVID vaccine into your already busy practices, managed new testing and PPE protocols, responded to shifting evidence and new guidance, and communicated with families in your practice who needed to hear from a trusted voice. We have also seen the personal toll that this pandemic has taken on you and your families as you rise to meet the challenge of this moment, as the virus has once again upended routines and threatened the safety and stability so many of you work so hard to maintain.  
Please know the AAP is here for you. I am here for you. And while there are many things that continue to surprise me about this virus, the strength, the resolve, the unity of the pediatric workforce is not one of them. We will get through this together. And by speaking with one voice, offering reassurance in this moment of uncertainty, we will help our patients get through this as well.
The AAP will continue to evaluate and update recommendations for how to care for children and bring you this guidance as quickly as it is developed. You’ll find interim guidance, links to AAP Town Hall sessions, and other critical updates here. We want to hear from you, too. Please share questions, comments and challenges with our COVID-19 email box at COVID-19@aap.org.
Thank you for all you are doing, every day, in your communities to care for children.
Warm regards,
Moira Szilagyi, MD, PhD, FAAP
President