record engineer here, and I'm just going to make sure he has everything he needs, and get the company to wait for Jennifer to get on as well, if that's okay. Yeah, okay. Yeah, really problem. Thank you. And this will be pretty quick. I see you have a two o'clock meetings. So probably before Jennifer gets here, can you just give me a little bit of an overview of what you're going to talk about in the two o'clock? So it's on the respiratory season. So the recommendations regarding flu and COVID and RSV, and we'll be joined by a colleague who can speak more about the disease circulation and what's going on in that space. Okay. So if I were to ask you about any of that, that Tom would be answering it to, are you able to refer to just a little bit about the the season coming up? Yeah, a little bit. Yeah, perfect. I've interviewed Tom before. But I don't think I've spoken with you directly. I've seen you, of course. But how long have you been in this position? Since 2015. Okay. So you've seen quite a dramatic shift. I'm trying to seem to know. Yeah. Oh, and I was going to clarify. So Jennifer referred to you as Dr. Shower. I have a PhD. Yes. HD. Okay. We always indicate if it's like MD, specifically. So just yeah, so no, it is not an MD. Okay, not a clinician. Okay. And it is pronounced shower in case. Shower. Okay. I was pretty sure on that one, but it's good to always make sure. And I'm fairly certain she's joining. She usually does or somebody is joining. So they were probably waiting till the very early birds. Is this the easiest time of season? It's been quite busy. Yeah, when it comes to there's there's lots going on is with the respiratory season and just vaccines in general. So is it better than four, three years ago? Yes. I mean, it is it's more manageable, but there's more topics that need more attention. So I think it's but in terms of work, life balance, it certainly is a different field these days. Sure. Yeah, we, you know, COVID is becoming more of a routine piece of what we do and not sort of the main standalone piece. Hmm. Do you deal with more misinformation now than you used to? Yeah, and I think it moves a little quicker too. Sure. Sure. misinformation and disinformation. I think both of those. Is it worse? Do you think during an election season? Oh, that's hard to say. It's not like, you know, on people's minds, the same way it was. Right. Two or four years ago. So yeah, that's true. What's some of the common misunderstandings that you hear? Um, I think whether people will get, you know, get sick from the shots, whether they're actually effective. Um, people are wondering about that. So, yeah. So understandable. Yeah. Yeah, for the most part, there's some that are a little bit more out there. But, you know, just good, good questions that people have about vaccines. Well, I don't care. Elizabeth. I thank you for letting us listen in. Yeah. Thank you. And Stephanie is here. So looks like all this right with the world. Or at least we're set for now. Um, so I'm just going to make sure I see my engineer typing here. So Zach, we're ready to go. Do you need any settings changes on my end? He says we are good. Okay. All right. So this will be fairly short and sweet. So, and I was telling Stephanie, I know you all have a two o'clock to get ready for as well. So thanks for taking some time. Um, so I'll just start with, um, what are you expecting for respiratory viruses this fall and winter? Yeah. So we're continuing to see this, you know, spread of COVID-19. We're expecting influenza and RSV to become, you know, significant players for causing illness in the next coming months. And so we do our encouraging folks to ensure that they're getting vaccinated now to provide that protection for when those diseases really start to circulate. That being said, we're already seeing COVID right now. That doesn't seem to have the same seasonality that we've experienced with influenza. And so as the COVID-19 vaccines are now available, we're encouraging folks to really make their plans to get their COVID-19 vaccines at this point. Do people still test for COVID? Is that worthwhile? If you're not sure if your symptoms are COVID or flu or another RSV? Yeah, testing for, you know, COVID-19 is always an important to know what you may have. You certainly want to include your healthcare provider in the decisions about medical management. But those over the home tests or at home tests are certainly an important point in knowing and helping you determine perhaps if you should be going out or going to a party. That being said, if you're sick with anything, whether it's COVID or anything else, you know, staying home when you're sick is always the best policy. What should people know about the new COVID vaccine? So we now have updated COVID-19 vaccines. And you know, these vaccines provide protection against the strains that are circulating. The COVID-19 virus continues to change. And so protection that you may have had from a previous infection or previous vaccinations, don't provide the level of protection against the current strains. And so it's important that everyone go ahead and get the updated version to get protection against what's currently circulating now and that we, you know, anticipate seeing in the near future. Do we know, are there any symptoms for the current strains of COVID that people should look out for? I think it's the usual, you know, COVID can cause a whole host of symptoms and it can vary from person to person. So I don't know that these strains are causing anything that's different than we haven't already seen, but it can be a wide, you know, range of symptoms. So I tacked those on because I saw that you guys were doing the two o'clock and wanted to get some of those questions. And so looking to the fall and school starting, what vaccinations are required for K-12 students and our flu and COVID part of that list. Yeah, so the vaccines that are typically required are the diphtheria, tetanus and pertussis, hepatitis B, polio, the measles, mumps and rubella vaccines, varicella. And then new this year for seventh graders and 12th graders is the meningococcal ACWY containing vaccine. And so those vaccines are required. We certainly know that not everything that is recommended for good health is required for school. So it's important to talk with doctors and make sure that, you know, kids are getting all of the vaccines, such as COVID-19 and influenza. You help us understand where the numbers are at for medical religious and personal conviction waivers. Yeah, so the waivers have been increasing for school in Wisconsin. And we're currently at about 6.1% of school age children reported having a waiver for one or more vaccines. The majority of that is from personal conviction waivers. The medical and religious waivers have stayed fairly constant over the years. But you know, those slight upticks are cause for concern, because it means that children in our communities and in our schools are not protected against the diseases that we could protect against. Are you able to tell us which vaccines have the higher rate of personal conviction waivers? I don't have that information. I will say when we look at the data for all of children in Wisconsin using Wisconsin immunization registry data, we are seeing the rates of the MMR vaccine go down in 2013. When we measured, you know, kids at 24 months of age, if they had one MMR, we were at 88%. When we measure that the same way in 2023, we're at 82%. So we are seeing reduction in some of the vaccines that are commonly or that are recommended. And MMR is measles, mumps and because mumps and rubella, correct. What percentage of a population can be unvaccinated and the whole group is still protected? So it really varies by disease. Unfortunately, for measles, it's quite high. It's somewhere in the range of 95 to 98% of individuals in a community need to be protected to prevent an outbreak from, you know, taking hold if measles is introduced into that community. And have we seen any of that in Wisconsin? Yeah, not yet. But I will say, you know, 2024 has shown a number of measles outbreaks in the US, most notably are our neighbors of Minnesota are currently experiencing a measles outbreak. I think they have about 49 cases with at least 11 of them having been hospitalized. And the majority of these cases are occurring in unvaccinated children. So we do know that we've got pockets in our communities and in our schools that have much lower rates and could be right for, you know, an outbreak occurring if measles were introduced. And so that is of concern. And we're continuing to work with local public health and health care providers and community groups to make sure that parents are aware of the importance of vaccination, particularly measles at this time. Well, parents in a community that is potentially going to experience an outbreak, are they going to get information quickly about how they should protect their child, even if their child is vaccinated, should they take their child out of school, things like that. Yeah, right now we're just continuing to work, as I said, with the schools and local health departments to offer MMR vaccine and make parents aware of the vaccines for children program is a program that provides vaccines to kids who are underinsured or uninsured or on Medicaid, Alaska Native American Indian, and really is an avenue to receive vaccines removing barriers. So if a family is concerned about cost, this is an avenue where their child can receive all of the needed vaccines. And so really trying to make sure that families are aware of this resource, and they don't need to be afraid of going to a provider and coming home with a big bill due to routine childhood immunizations. So trying to make sure that issues related to access and cost barriers, the families know about this program. Are there any points of misinformation about the MMR vaccine that you think is important to address? You know, the MMR vaccine has shown to be safe and effective. It's been in use for over 50 years with millions of doses safely administered. It has shown to be effective. And so those are such important points that this is not a new vaccine. It has a long history, and it really can do the job. And so trying to make sure that parents are aware that this is the best tool that we have to prevent measles. Do we know why that vaccine in particular is focused upon? I don't know. It's a good question. Okay. Anything else about flu or anything that you want to add that is important? I think it's just important for folks to remember that they need to make a plan for vaccination. You can receive your COVID-19 and your flu vaccine at the same appointment. That's okay. If you choose to separate them out, that's all right, too. And there's no waiting period between the two. The important thing is that you go ahead and you get them and protect yourself and your family and your community, particularly as we the weather gets colder and we start to go inside, the potential for disease spread is increases. And so go ahead and protect yourself now so that when those diseases start really circulating, that you're all set. All right. Anything else? I think that's it. Jennifer Elizabeth, and she can I add one more thing? Sorry. Absolutely. I'd like to, you know, I think the COVID-19, we've seen this disease now for a number of years, and it's important that folks remember that this can be a very serious disease with significant complications can result in hospitalization and death. And that when we look at the statistics regarding, you know, children who were hospitalized with COVID, about 50 percent of them didn't have any underlying illness. And so you don't know who or how the COVID-19 infection will affect individuals. And so it's so important to make sure that you're protected against that. Do we know any current numbers of hospitalization rates for COVID? So nationally, in August, there was an average of 900 deaths per week in the United States in the month of August. And that's the highest that we've seen since March. So we also know that in terms of hospitalizations, it's highest amongst those who are 75 and older, and less than six months of age. So we do know that it continues to cause significant illness and really have an impact on our communities. And we've seen that, you know, throughout the year, it's it's it's here, and it's causing illness right now, which really means why it's so important for folks to make that plan for vaccination right away. All right, great. Jennifer Elizabeth, anything from either of you? No, you've covered all the bases. Marissa, thank you so much. Yeah, thank you. Join us for the media availability coming up to for for more information. Yes, yep, we will, we will be there as well. Do you need an RSVP for that? Uh, yeah, or we can just send you the link. Okay, I'll I'll RSVP for that as well. Okay, thank you all. Thank you. We'll talk to you soon. Great. Bye bye. Bye. Bye.