Monday, August 23, 2010


Parents should check to make sure students are up to date on required immunizations. There are other shots that may be helpful too.

By Deirdre Lockwood Chicago Tribune/from The L.A. Times

August 23, 2010 -- If your child is starting kindergarten, middle school or college this year, your back-to-school checklist not only includes pencils and notebooks but also those dreaded vaccinations.

"Immunization is one of the best things you can do to protect your child," said Dr. Mary Anne Jackson, chief of pediatric infectious diseases at Children's Mercy Hospitals and Clinics in Kansas City, Mo. "It's like putting your child in a car seat or a bike helmet."

First, check your state's vaccination requirements and the American Academy of Pediatrics' childhood and catch-up immunization schedules. If your child is behind on any shots, an online catch-up scheduler from the Centers for Disease Control and Prevention can help.

Schedule a back-to-school physical as soon as you can. It's safe for children to get all the vaccinations for their age group in one appointment.

Children on Medicaid or without insurance coverage for vaccines can get them free, except for an administrative fee of less than $20, through the Vaccines for Children Program. "Finance should never be a reason not to immunize your child," said Jackson.

Kindergarten, grade school

Most kids starting kindergarten need four shots if they have had all their early childhood immunizations. Children ages 4 to 6 should get the fifth shot of the DTaP vaccine against diphtheria, tetanus and pertussis, or whooping cough. They also need the second shot of the MMR vaccine against measles, mumps and rubella, and the final shots of the vaccines for polio and varicella, or chicken pox.

Make sure your child has had the three-shot series for hepatitis B, which is required in most states. The AAP also recommends the hepatitis A series if your child has not had it yet.

Middle school

Students starting middle school should get the Tdap vaccine against tetanus, diphtheria and pertussis, or whooping cough. This vaccine covers the same diseases as the DTaP but is a different vaccine for this age group. Current whooping cough outbreaks make this shot preferred over the Td booster, which covers only tetanus and diphtheria. Most states require either the Tdap or Td.

The AAP recommends that kids 11 to 12 receive the vaccine against bacterial meningitis, MCV4; it is required in a few states. Teens who haven't had this shot or the Tdap should also get them.

To prevent cervical cancer, middle school girls should receive three doses of the human papillomavirus, or HPV, vaccine, according to the AAP. Two versions of the vaccine are available: HPV2 protects only against cervical cancer, while HPV4 also prevents other genital cancers and genital warts. Either is recommended for girls, although Jackson said the second provides more benefits.

Girls can receive the first dose as early as age 9. The AAP also recently advised doctors to make the HPV4 vaccine available to boys 9 to 18 because it protects against genital warts. No state requires HPV vaccination.

Check that your child has been vaccinated for hepatitis A and B, as well as chicken pox (teens are at high risk to develop complications), Jackson said. Most states require the hepatitis B series, and kids 11 to 15 can get the two-dose formulation, Recombivax HB.

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