13. Overcoming COVID-19 Challenges in Different Practice Settings

With multiple types of practices in various locations that serve patients with a broad range of access to medical care facilities and health insurance, there is not a “one size fits all” answer for implementing  COVID-19 vaccines within a facility.  Join Corinne Kohler, MD, FAAFP, Marian Sassetti, MD, FAAFP, and Santina Wheat, MD, MPH, FAAFP as they discuss how they overcame challenges as they introduced COVID-19 vaccines into different practice settings.  They share their experiences with rural, city, and suburban locations in private practice and Federally Qualified Health centers (FQHCs) and discuss the ongoing changes and opportunities facing their practices. 

Objectives:

-   Recognize how various types of practices implemented COVID-19 vaccinations in their clinics when they first became available
-   Describe the evolution of various challenges & opportunities they have experienced since the introduction of COVID-19 vaccines & suggestions they share to make it easier for other practices

13. Overcoming COVID-19 Challenges in Different Practice Settings - I-VAC (illinoisvaccinates.com)
https://www.illinoisvaccinates.com/13-overcoming-covid-19-challenges-in-different-practice-settings/

Visit us at illinoisvaccinates.com/podcasts.

Chapters

• 0:00 Introduction
• 1:04 Start of Episode

Transcript

Corinne Kohler, MD, FAAFP:

Hello. Welcome to IVAC's podcast series. Today, we are going to be discussing overcoming challenges and opportunities in different practice settings. I am Corinne Kohler. I'm a family practice physician from East Central Illinois who has worked in a Federally Qualified Health Center. I am going to introduce Dr. Sassetti and Dr. Wheat. If you guys would introduce yourself. Dr. Sassetti?

Marian R. Sassetti, MD, FAAFP:

I'm Marian Sassetti. I'm a family physician in a private independently run practice we own just west of the city in Oak Park. I've been doing this for 30 years, and I'm delighted to be part of this.

Santina Wheat MD, MPH, FAAFP:

And I'm Dr. Tina Wheat. I am a Federally Qualified Health Center as well, Erie Family Health Centers in the City of Chicago. And I am also part of a training program. I am a program director for the Northwestern McGaw Family Medicine Residency Program at Humboldt Park.

Corinne Kohler, MD, FAAFP:

So as we've seen the COVID vaccine changing over the last 18 months, and certainly we just made new recommendations that have come out even this week from the CDC, let's talk a little bit about not only what has changed, about what maybe some of the challenges have looked like with some of the changes.

Santina Wheat MD, MPH, FAAFP:

So one of the things that we had when we started providing the COVID vaccine was that we only were offering it at certain sites. So we actually have 13 sites that are part of our organization, but only two of them were able to provide the vaccine because we were trying to follow the very strict guidelines about storage and making sure that we were getting it to the right number of people and following all of the criteria. And so for some of our patients, transportation was an issue to get to those specific places. If it wasn't in the location that was walking distance for them, around the bus line, that was for them.

I'm really happy to say that that's no longer a problem, that they can get it as just part of their visit. And along with that, it was just sort of that the information just kept changing so rapidly. Just as was mentioned how guidelines are changing this week as we're recording this, there was every single day information was changing. And so it was hard to know if you were always giving your patient the most up-to-date information. And maybe they were hearing things before we were hearing them and trying to make sure that we were just staying on top of the best information.

Marian R. Sassetti, MD, FAAFP:

This is Marian. For us, I'm delighted and honored to say that we are up and running, and it does feel very much like a well-oiled machine. My staff really understands how to take phone calls, how to answer. There is information from the CDC that our staff, especially the triage who are interfacing with calls, are up-to-date daily on the CDC, and that's remarkable. I would say that there's two challenges right now. I think the first one is keeping up on the information and making sure our patients are aware of it, especially the parents who are just desperate for that vaccine for kids five and under. "When is it coming? What should we do?" And we're just reminding them, "You'll know when we have it. It'll be up on our website. You can call."

What we didn't want is just phone call day after day after day. And it happened already when the booster was announced, the fourth dose was announced for 50 and over. We literally had patients that day jamming the phones. So I think that challenge of helping our patients understand it will work, it'll happen, everybody's going to get vaccinated, it's going to fit into our practice just like the previous vaccines did. I will tell you, I think a challenge is a philosophic one. I think we now all know that the patients who want to get vaccinated have gotten vaccinated. My staff is very aware of the threat of our patients who aren't vaccinated. They have young children, they have vulnerable people at home. So we have designated a get in the room as quickly as they can, and we've offered our staff PPE again if they want to wear it while if they're attending to our patients who choose not to get vaccinated.

But keeping the effort up, keeping ourselves buoyed, recognizing there's a challenge in that room, and it's a philosophic one. This person doesn't believe what we believe about this vaccine and this pandemic, and helping our staff and helping each other recognize that this is just part of it. This is just part of human nature. We can do this. But the exhaustion and weariness of that group of people in our practice that we want to be compassionate and careful with, I do think we have to be careful and very intentional about the way we are approaching them now with this next wave and coming into schools and kids going to school with other children who aren't vaccinated. So a philosophic challenge. I think we're up to it, but we're all pretty tired. So I think those are the two challenges in our practice.

Corinne Kohler, MD, FAAFP:

Yeah. I felt like at the beginning there were just lots of hoops that we had to jump through. We had to learn them, and then we jumped through them. Certainly, the initial messaging with the ultra cold storage and who could order the vaccine and the back quantity it could be ordered in and the limited sites was a challenge. Getting the information out to the general public and the clients was important. Our messaging was important. And I have certainly seen some of the messaging change. While I think the health industry has certainly said, "We want people to get vaccinated," and has done a lot of education, I think I'm seeing much more now that there's an awareness of the fact that the vaccine is really to prevent deaths and severe disease. That even if you are vaccinated, you still may get an infection. And I think getting that messaging out has been important.

As we go forward, I think there continue to be challenges. And one of them, as you both have mentioned, is the rapidly changing landscape, as we said, each day, each week, each month. And I think for us, one of the things that has been important is really having a designated person in the office who is the communicator of those changes, lets people know what's changed, what's different, not only from CDC recommendations, but maybe our internal structure, how we have handled the vaccine on moving it from an isolated location into the clinic and such like that. I know from talking to providers too, that there have certainly been some I-CARE challenges early on. And again, I think IDPH and ICAP especially has worked, and IAFP has worked really hard with providers to help improve that so that that's really not a block or a hurdle. What do you guys see that has improved or continues to be challenges for your practice?

Marian R. Sassetti, MD, FAAFP:

This is Marian again. We actually aren't experiencing any of the logistic challenges. From the beginning, we identified our office manager as a conduit to the IDPH Oak Park Department of Public Health and to our office to disseminate information for our staff. So our challenges really are because we have this system in place already when things are new or different, Nancy, who I'm delighted our audience is going to meet, our office manager and our senior PA, will be talking about how they got the clinic up and running. So, that's not a challenge. Logistics aren't a challenge. It's really the questions and the changes with upcoming boosters and kids going back to school. We are fielding a lot of questions about school. I am not experiencing logistic challenges at this point, I'm happy to say.

Santina Wheat MD, MPH, FAAFP:

I think the interesting challenge that we're unsure about or that's coming is the impact of funding for all things COVID related and will that change what's available? So we've recently changed what vaccines we're having in stock, for example. It isn't changing our ability to provide vaccines, but we're no longer stocking all of the vaccines because we want to make sure that we have the thing that is most useful for every patient that walks through the door. And so that communication piece has been a challenge, because I do think that sometimes some of our patients have something in their head of, "Oh, I only want this one," or, "I only want to get this specific thing." And so that can be hard.

I-CARE itself wasn't necessarily a challenge for us. And what we've actually seen is trying to get the information back in, of I-CARE being very specific on last names and how you pull information in. So if somebody had a vaccine in one place, it's not necessarily showing up with us that they'd had it done already. And so helping people get on that right schedule and make sure that they're having the vaccines that they need has just required a little bit more legwork for some of our team members and for our patients themselves. It's great when they have their vaccine card on their phone or they bring it in, and so we're able to help them know when they're due for their booster.

And I think as Dr. Sassetti mentioned, I think the biggest thing is the change of, when are the boosters actually recommended, not just for our patients but for our staff as well? And when they're able to get them, and trying to help guide people of, does this make sense? Does this not make sense? Absolutely anticipating some changes this week and how that will go for our pediatric patients. I think continuing to message that is always the challenge. And as Dr. Sassetti mentioned earlier, knowing that some people don't necessarily want the vaccine, trying to continue to message to them why we think it's important, how we're trying to help protect their family, even if it's not to protect actually getting the illness but just protect the severe disease, that that's still a risk, and to keep that message out there and not lose the energy ourselves to continue providing that message.

Corinne Kohler, MD, FAAFP:

Dr. Wheat, would you go ahead and continue with that for just a little more and talk about what some of your common questions and resistance points are, and then Dr. Sassetti?

Santina Wheat MD, MPH, FAAFP:

Yeah. I think that most recently, one of the questions or resistance points that we're getting is people have already gotten maybe the first round of the vaccine. So they got their first two doses or they got the first dose of the Johnson & Johnson vaccine. They want to know why we think they need a booster. Shouldn't that first one or that first series have been good enough? And so they're worried that the side effects of that booster dose might be worse than having the actual infection, especially since they've seen some people that have felt like they have had very mild symptoms.

And so talking through, though, we don't know necessarily about what long COVID is going to be for everyone, we don't know who's going to have, that we still don't know who's necessarily going to end up in the hospital. And that we do realize now that those initial doses are waning and we still want to prevent that serious illness and those hospitalizations and death. So there's some of that. And then there's also, we'll be talking in the future about pediatrics, but talking about whether everybody in the family needs the vaccine or not. Those are some of the questions that are coming up. And sometimes it's that, "Do I actually have to have this in order to go to school?" or, "Do I actually have to have this in order to go to work?" The differences and requirements are some of the questions that are coming up a lot for us.

Marian R. Sassetti, MD, FAAFP:

What I was going to say is as far as when our patients say things like, "I know so and so got it, got vaccinated, and they got the vaccine." And I say, "What happened?" And they say, "Well, they're fine." And I say, "Isn't that wonderful? The vaccine works." So it's kind of, I almost use that, "Yes, isn't it wonderful that you can get COVID now and not end up in the hospital and not end up dead and not end up suffering?" And they know where I'm going as soon as I say that. And I remind them, "Look, we haven't done..."

And I've talked about this before. It was like telling my patients, "Look, I do think there was a mistake. I think there was a mistake long ago when we didn't teach about vaccines. We don't give vaccines to prevent the illness. I gave your kid the chicken pox vaccine not because I didn't want them to get chicken pox. I didn't want them to die of meningitis, or heart disease, or pneumonia. That's why we give vaccines. And the reason I want you to get a vaccine is because I don't want you to get long COVID. Even if you don't get super sick, I don't want you to get long COVID. I don't want you to get neurocognitive issues. I don't want you to have fuzzy brain, I don't want your kid. I don't want to wonder if your child's developmental delay was something we could have prevented with a COVID vaccine."

That has become a new language. It just started recently. I didn't land on this way of talking to my patients except for in the last handful of weeks, I think, where I'm actually turning it around and, "Isn't it wonderful we have this vaccine? And aren't we lucky that we don't have to wonder if our child is going to be developmentally delayed from COVID?"

Corinne Kohler, MD, FAAFP:

And that was a message that I heard repeatedly at a vaccine webinar I just was sitting through yesterday and today was the messaging that it doesn't necessarily prevent the disease and it's not unique to COVID. That's true for influenza, as you said, vero cell and other things. So what we're preventing is severe disease and reducing death. We know that we have vaccine preventable death numbers, and CDC has good information on that. So I think just continuing to educate patients. I know that we still see some challenges with people sometimes getting in to the clinic or into pharmacies to actually get the vaccines, especially as some of our pharmacies are limiting hours. So as our farmers are in the field, or they have jobs, or rural areas, this is much more of a challenge to actually access physically the vaccines, but I think overall our counties have done an excellent job of handling that. I know locally our public health district and other public health districts have really worked through that, and I think their messaging has also been much more consistent and more positive from that.

So I think going forward again, as both of you have said, the messaging of how we present it, and the fact that COVID is here to stay, coronavirus is going to continue to mutate, I think the message that it's a three dose series and then maybe a yearly booster, as opposed to, why did we need a booster? Well, most of our other vaccines are three dose series. I mean, IPV's a three dose series. DTaP is a three dose series. We know it takes that long to build immunogenicity. So I think changing our messaging on that will definitely help going forward with that. What other advice would you give to people that are considering offering the vaccine or already offering the vaccine in their clinics?

Marian R. Sassetti, MD, FAAFP:

Well, at this point, my advice is I think to honor whatever fatigue or sadness, whatever grief that many of us have. And it's just another opportunity for me to say thank you to everybody who is doing such phenomenal work across Illinois. Some of my loved ones live in the Downstate and Central Illinois where you all are taking care of them. So the first thing is, to whatever extent we're burnt out, that expression, whatever we're feeling, I think whatever it takes to get over that. I used to take many vacations from COVID literature, where I would tell my colleagues, "I cannot read another thing about COVID for two days. You guys spot me. Send me information." And then we would do that for each other. And I think this is an opportunity if you're considering doing this to really understand this is historical. This will be something that you can talk about and should talk about.

I tell my staff, "You are participating in history. When you vaccinate somebody, especially our elderly in the beginning, you could go home and literally say to yourself and your loved ones, 'I helped prevent death in this person.'" So I would suggest that we rest up, and I talk a lot about that. If we're going to take on this challenge, make sure we've let go of the frustration of whatever these last two years have been and recognize we're participating in history. So I'd really encourage you to do whatever you need to do to take care of yourself to take on this challenge because I personally have found it extraordinarily rewarding. I'm still getting feedback from community members about how wonderful it was that our practice did this. And my staff also, we have a new staff who joined us and one of the reasons she thought she wanted to join us was how excited she was that we were giving COVID vaccines. So, that big picture kind of stuff.

My advice is pull back the lens, try and turn off the negativity that you may or may not be hearing and recognize that there is this invitation to participate in history. We have a historic vaccine. In the history of the human species, we've never come up with a vaccine this quickly after a disease was identified, and now we have Paxlovid and the monoclonal antibodies, so we really are quite empowered to fight this pandemic. And I'd really encourage all of you who are listening to get in there and get support and take advantage of IVAC and those of us who have done it, we're more than happy to support you.

Santina Wheat MD, MPH, FAAFP:

I really love that. I love you saying that we're all being part of history. I think that's absolutely right, and I think that's a wonderful message. I also would encourage people to look into the process if they're not doing it already. It's much easier than it was at the beginning. I think that there were a lot of reasons why people may have been hesitant at the beginning, and a lot of those reasons have gone away. The system of ordering has become much more streamlined and is easier. The refrigeration is a lot easier than it used to be. When we first started doing it, we had to be very sure that we used every single dose in a vile and to not waste, and those rules went away.

And also just, I think that one of the joys that I find of being a family doctor is being able to care for so many things in one visit. And being able to provide this vaccine is just one more way to do that, to be able to sit there and talk about the diabetes and the blood pressure and the amazing thing that's happening with their family right now. And, "Oh, by the way, are you ready for your booster today?" And to just have that be wrapped in. Or to talk about the kindergarten graduation that's coming up or the fun thing that's happened at school and, "Oh, do you mind getting your COVID vaccine at the same time today?" Those are some of the reasons that I went into family medicine, that I enjoy being a primary care physician. And being able to just wrap that into how you care for the patients in front of you, how you care for these families, this is just part of that.

Corinne Kohler, MD, FAAFP:

Dr. Wheat and I both work at Federally Qualified Health Centers, although our practice situation is different since I'm in a little bit more of a suburban rural type area. And one of the things that has certainly been encouraging is the messaging that this vaccine is available to everyone. It doesn't matter insurance, no insurance status. Yes. Initially, we looked at there's some age requirements. Obviously, when I say everyone, there were some things with that as we initially rolled it out. But typically, this is one vaccine that I feel has much better messaging as to it really is for everyone, and there's not a divergence there. As a more private practice, do you see that different at all, either in how you're messaging or your acceptance of your patients to the vaccine?

Marian R. Sassetti, MD, FAAFP:

Well, one of my great joys is that we are a very eclectic practice. We basically take whoever: uninsured, insured, Medicaid, private payers. I will say that the first blush of the vaccine, it was people who were just absolutely anxious, clamoring for it, and that as we were working out and getting the kinks out, that was a difficult time only because there was so much desire for the vaccine. Now we're at the point where there's so much vaccine and not as much as desire in the populations that we want to see. So I'm not sure that I'm seeing a private insurance, non-private insurance. I think that there are groups of people who are heavily entrenched, whether that's because of the politics that they're listening to or the social media that they're listening to.

Dr. Lambert did a beautiful job on a upcoming podcast where he was talking about his family's social media, where they accidentally included him on an anti-vaccine kind of tirade and he was able to weigh in on it. I do think that there's pockets in our practice area. We take care of a wide swath of many different zip codes. There are pockets that are heavily entrenched, and we are beginning to recognize that we haven't moved the needle a whole lot. The literature and discussion around long COVID and children's neurodevelopmental issues has begun to move the needle. I definitely see people doing a, "Wait a minute. Maybe I better think about this." So like I said, I think there's pockets. I'm not sure I'm ready to say that I see a difference across the board. I think that the populations that we already know are resistant are the same populations that are in my practice, even though I'm independent and private, as they show up at our door, it's the same demographics that we're seeing. There's no surprises, in other words.

Corinne Kohler, MD, FAAFP:

Dr. Wheat, any thought on different settings or different opportunities, different challenges?

Santina Wheat MD, MPH, FAAFP:

Yeah. I think that, similar to what Dr. Sassetti said, at the very beginning, it was the people that were really motivated to get the vaccine. And again, I'm seeing right now the people that are really motivated to get the fourth dose potentially as opposed to those patients who have not yet had their first dose, that are still very leery or not interested in vaccines in general if they're not required to have them. And so I haven't seen much difference based on patient type, per se. Since I'm at an FQHC, we don't have a wide diversity of payer mix, but I think that there are the people that are very committed to being as protected as they can. There are the people that are willing to get it only because we have it there. They wouldn't necessarily go out of their way to get it. So it's been a pleasure to see that group of people get vaccinated a little bit more as they're coming in for their visits and feeling safer coming out of their homes in different ways.

I will be very interested to see what happens with our under fives, whenever that gets approval. I will be interested to see how that happens. And then there are my patients that wanted to get through something specific and then get their vaccine. So we talked previously, they wanted to get through their pregnancy and then they were willing to get it afterwards, or they wanted to just get through some specific life event and then they're willing to get their vaccine. So I think there was different types of patients that are coming through, and I just continue to ask everybody, because every once in a while somebody surprises me that they've said, "No," up until now, and so I will just keep asking.

Marian R. Sassetti, MD, FAAFP:

Right. Yeah. But I think that's important for us to each recognize is for those of you who are listening, we are definitely having people come back and saying, "Okay, I'm ready." So, that is very real in my practice. And I always use the analogy, it's like anything that we try our very best with. I have my smokers, and I have a pat line I've just used for years, "Mr. Smith, smoking, I think, is your greatest health risk. So it doesn't sound like you want to talk about it today. It doesn't sound like you're ready to quit, but I want you to know when you come and see me again, because I really care about you, we're going to talk about your smoking." And I use the same line, "Look, I think the greatest threat out there right now is COVID and I really care about you. And when I see you again, I'm going to bring it up. And just so you know, I just don't want to see you suffer on my watch."

I think they like that. Secretly, I think they like that there's somebody literally saying, "I care about you, and it's the truth. I'm not making it up." And then they get some ability to have their own agency and say, "Okay, I'll think about it, and I'll come back." And especially since I'm beginning to talk about long COVID, I've seen the needle move a little bit, especially around children and especially around fears around Alzheimer's disease being provoked, unmasked by COVID. We don't know if that's true, of course, but that's certainly a concern for people and that kind of just fuzzy brain. Nobody wants it.

So the more I've been talking about long COVID, the more I've been talking about kids, everybody's terrified. Tina, I'm sure you know this, when you see your new babies, the parents don't take a breath until they make it to two and their babies aren't autistic. Everything worries them... Is this autism? ... until proven otherwise. So you say, "Look, we're very worried about this disease. I don't want to add COVID to it. I don't want to wonder if your child's neurodevelopmental issue is because of COVID I could have prevented." And they seem to be listening. So we'll see. I agree. We'll see what happens.

Corinne Kohler, MD, FAAFP:

And I think we see more of that too with our multi-generational families also. What you're saying is that, "I'm going to get the COVID vaccine so I don't have to worry about my three-year-old grandchild," or, "I'm a teacher. I don't want to spread it to my..." So I think we're seeing more of that. It's not just about you as an individual, me as an individual. I might be able to weather COVID, but who might I share it with that won't weather COVID as well?

Marian R. Sassetti, MD, FAAFP:

Exactly. Right.

Corinne Kohler, MD, FAAFP:

And so that's been part of the messaging that I've used with some of my patients, and that has helped. "You're not protecting just yourself. You're protecting those loved ones around you," and such like that. And I think going forward, like you've both said, as we expand the fourth dose, as we add in hopefully the younger population, it would be interesting to see how the public responds to that. I think as a clinic, we have to be very clear with, "All comers are welcome," with our messaging. And like you said, "I'm going to ask you every time because I care about you. And that's, you've worked with me long enough, you know I'm going to ask you every time," and that can go a long way too with that. And making sure that your staff is also on board.

So for me, I know some of the most rewarding things that I've seen is when I can get a whole family to buy in, especially if there's been an outlier, so some of the family's vaccinated and some of the family's not, and now they've decided that, yes, they will do it too because either they've been educated or someone has presented it in such a way that they're willing to do it. What other wins have you guys seen in your practices? I know, Marian, you have a pretty good story of some wins that you've had.

Marian R. Sassetti, MD, FAAFP:

Yeah. My favorites that I just love talking about is a woman in her late eighties who we've taken care of. My staff knows her as a beloved, just lovely woman, brings treats to the staff over the years, and was one of our first that we called on the phone and brought in. We literally were making phone calls to each octogenarian when it first came out. She came in and started weeping in gratitude, and my young staff just sat with her and shared that beautiful moment. Then on our group chat and through the computers, my young staff member was able to share that moment.

It's just so beautiful. And I think that it's going to stay with her. It stays with all of us. That was a moment in history where, the woman's name is Annette, Annette left, and my staff got to know that she saved Annette's life. I don't think that's an overstatement, I really do. In the middle of COVID, this was very early 2021, to be able to give somebody a COVID vaccine who's community dwelling with lots of comorbidities truly was a remarkable gift that this young woman got to participate in. And I love that. I love thinking about it.

The second one was the young moms coming in. When the vaccine for children was announced, one just started weeping and told me, "I can breathe again," meaning that's all she thought about was whether her kids were going to get sick with it. She just literally started to break down and say, "Finally, I can breathe. I feel some space again." So very gratifying to be able to do that. And that's one of the reasons I'm encouraging all of you who are listening is try not to be afraid of this. The kinks have been worked out of the system as far as we can tell. My experience with Oak Park Department and IDPH is that they are well-oiled at this point. They know how to anticipate your problems, your questions, and to make it so much easier for you this go round than it had been for those of us doing it up front. So try not to be afraid. This is a moment in history that I think that you'll be happy you embraced.

Santina Wheat MD, MPH, FAAFP:

I won't share a practice story, but I'll share a personal story because that's what I also do with my patients. I have two children that are in the five to 12 age range. And when I told my daughters that the vaccine had been approved for age five to 12 and that they had appointments scheduled to get them, my oldest daughter did a happy dance all through my room.

Marian R. Sassetti, MD, FAAFP:

Oh, that's right.

Santina Wheat MD, MPH, FAAFP:

She was so excited to know that she could have the vaccine. And we had lots of conversations. I mean, if you remember, Omicron came through not that long after the vaccine became available for ages five through 12. It was wonderful to be able to tell my children that, "Okay, so if you get it, you still might get it, but we've done everything that you can. We've done everything that you can, and you'll be able to have milder symptoms than you might have had if you didn't have the vaccine."

And that first time that somebody in my daughter's class tested positive for COVID and she was able to continue going to school, because she did not like remote schooling at all, she was so thankful that she kept being able to go to school and that she kept being able to go to her dance class because she didn't have to fully quarantine at that point. She just was able to wear her mask and continue doing the things that she wanted to do. That feeling that she had some control over her life again was wonderful, but that's been a really hard thing. And to see the joy that she could keep going. And she did get COVID, unfortunately. Not quite sure where, but despite being careful, she still got it. We talked about it afterwards and she said, "Wow, this could have been a lot worse, Mommy. This could have been a lot worse." She's only 10, but she got it.

Marian R. Sassetti, MD, FAAFP:

Beautiful.

Corinne Kohler, MD, FAAFP:

Yeah. I think that's well said. So I think as we go forward, again, getting that messaging out that unfortunately coronavirus is here to stay and the specific COVID-19 with all its variants is here to stay, and we all need to do our part. And hopefully, practitioners and clinicians will continue to offer a vaccine. And if they have questions, they will feel comfortable asking colleagues, going to the CDC website, whatever, for that. I want to remind everyone on the call that there are a number of resources available. We're trying to disseminate some information through our IVAC podcast, and there will be some future ones coming up, especially, as we mentioned, on pediatrics and some of the upcoming changes. But also, CDC website, immunized.org, which is a function of CDC. IVAC has a website. Illinois Vaccinates is the IVAC website. IAFP, Illinois Academy of Pediatrics, ACP, all of them have resources. I think the messaging is use a reliable, professional resource. Come to us if you have questions. Any final thoughts, Dr. Sassetti or Dr. Wheat?

Marian R. Sassetti, MD, FAAFP:

I've kind of, yeah, offered my philosophic ones. I think it's a time for me, especially, to be gratitude for you, my colleagues, and to, in my old age, just remind you, please rest up, whatever you have to do. I think this is a time in history, I think those of us who have chosen to participate, I think we're going to be unpacking it and processing it. And I always say, "Hold a vision, hold a vision of who you want to have been during this pandemic, and then follow that vision." And hopefully, it will be one of beauty and healing. And I think offering that this opportunity for us to say to each other, "Who do you want to have been during this pandemic?" and then go get that. And let IVAC help, let us help, let your community help you be whoever you could be as the best provider, the best healer during this pandemic.

Santina Wheat MD, MPH, FAAFP:

I love what Dr. Sassetti just said. And I will just add the reminder, please consider joining us in providing vaccines if you're not already. Please reach out if you need any help. And please remember to keep asking your patients about the vaccines. They might surprise you. It might be your win for the day, one day. That might be that moment that gets you through, that person that you didn't think was going to say, "Yes," and said, "Yes."

Corinne Kohler, MD, FAAFP:

Great words of wisdom from both of you. I appreciate that. So to the audience, thank you for joining us. Please be on the lookout for further announcements from IAFP and IVAC for future podcasts. Thank you, and have a good day.