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New school year prompts vaccination reminders

Sunday, August 21, 2011

With all of the area schools now back in session for the 2011-2012 academic year, district health directors and local pediatricians are encouraging parents to make sure their children are vaccinated in cooperation with the Missouri School Immunization Requirements.

Additionally, health care professionals are encouraging parents to consider additional vaccinations that may not be required but are still beneficial to the health of children and young adults.

According to the Missouri Department of Health and Senior Services Bureau of Immunization Assessment and Assurance division, all students enrolled in public school systems must present documentation of month, day, and year for each immunization before they attend school and all immunizations must be up-to-date before students are permitted to attend classes.

Children beginning pre-school or kindergarten during or after the current school year are required to have their immunizations administered according to the Advisory Committee on Immunization Practices (ACIP) schedule, which can be found by visiting www.cdc.gov/vaccines/recs/ schedules/default.htm.

Parents should take note when checking up on immunizations that grades kindergarten through second, third through fourth, fifth through eighth, and ninth through twelve, each have separate immunization requirements, according to Kennett Public Schools Health Director Deb Cook.

Changes can occur year after year, due to the fact that the ACIP periodically reviews the recommended immunization schedule for children ages birth to 18 in an attempt to ensure that the schedule is current with changes in vaccine formulations and reflects revised recommendations for the use of licensed vaccines, including those newly licensed.

The influenza vaccine, for example, is now recommended for all children ages six months and older, which is a reflection of change in previous years' immunization requirements. Varicella vaccine recommendations have also been updated in recent years to reflect change in that the first dose should be administered between 12 and 15 months of age, in addition to the newly recommended second dose between four and six years of age.

Other changes in vaccination schedules over the last few years indicate that the relatively new, and sometimes controversial human papillomavirus vaccine (HPV) is recommended in a three-dose schedule with a second and third dose administered two to six months following the initial dose for older youth. Information provided through the ACIP schedule that routine HPV vaccinations are recommended for females aged 11-12 years; the vaccination series can be started in females as young as nine years old; and a catch-up vaccination is recommended for females 13-26 years of age who have not been vaccinated previously or have not received a full series of vaccinations. Cook explained that the controversy behind the recommendation for youth to be vaccinated with the HPV shot is mainly because some parents fear the moral ramifications often-associated with the vaccine. Many health practitioners in the area say that parents most often express an interest or concern in administering a relatively new vaccine that is designed to protect against a sexually transmitted disease (STD), especially since they don't believe that their child is going to be sexually active. For these parents, the CDC suggests that they rely on hard data that indicates there is good reason behind considering the vaccine among others administered to older youth. A 2005 Youth Risk Behavior Survey administered through the CDC reflected a percentage of 47 among high school students who reported they were having sexual intercourse. Of that percentage, 34 percent of the sexually active youth revealed through the study that they did not use a condom the last time they had sex. This obviously puts them in a position to have increased risk of contracting an STD, that could include HPV.

Even if a parent is not in denial, and their child is not one of the percentage of students engaging in sex, rather remaining abstinent until adulthood or marriage, the CDC and other health care professionals point out that there is still no guarantee that his or her chosen partner will have taken the same path of abstinence, which means they could have been exposed to HPV or other STD's. According to the CDC, more than 14 percent of women who were 18 to 25 with only one lifetime sex partner still had HPV infections.

Another vaccine for older youth and teens include the booster shot called Tdap, which is administered around the age of 11-12, and is a version of the DTaP vaccine given to infants and young children to address issues such as whooping cough. In addition to this immunization, Cook said the MCV4 vaccination, geared toward the prevention of Meningitis is another beneficial tool for parents and teens.

Meningitis is a serious and potentially fatal infection of the fluid surrounding the spinal cord and brain. The primary cause is meningococcal disease. Youth aged 16-21 are at the highest risk for the contagious disease, which spreads person-to-person through the air. This can occur through coughing, kissing, or sneezing. It can also be transmitted by touching something a person with meningitis has handled and then rubbing your own nose or mouth.

"Teens who get vaccinated with MCV4 are protecting themselves from an infection that can lead to lifelong disability or even death -- in 48 hours or less," says Dr. Amanda Cohn, an epidemiologist with the Centers for Disease Control and Prevention (CDC).

In Missouri, about 40 percent of teens, ages 13-17, have been vaccinated against meningococcal disease. This leaves more than half of adolescents unprotected against this life-threatening bacterial disease. In Dunklin County, there are more than 1400 teens in this age group.

Meningitis can have symptoms that are very similar to the flu, such as a high fever, nausea and vomiting and sleepiness. Other symptoms can include a stiff neck, consistent headaches and discomfort looking into bright lights. These mild symptoms, however, can rapidly progress into something disabling or even deadly. According to the CDC, about 10 to 15 percent of meningitis cases lead to death. Of those who survive, up to 20 percent suffer a serious life-changing outcome. Effects range from loss of limbs, deafness, loss of brain activity, nervous system problems, seizures and strokes.

The preferred vaccination for meningococcal disease, MCV4, protects against four kinds of this disease. This vaccination is effective for more than 90 percent of recipients and helps to prevent the disease from spreading from person-to-person contact.

Though very effective, this vaccination can have side effects such as redness and pain where the shot was given, and possibly fever. As with any vaccination, allergic reactions are possible. However, MCV4 vaccination allergic reactions are very rare.

When it comes to meningitis and vaccinations, Health Literacy Missouri (HLM) and the CDC recommend the following:

* Get vaccinated early. Vaccinations should be given to adolescents starting at age 11 to 12. Teens who did not receive the vaccination at their pre-teen check-up should get the vaccination as soon as possible, especially before starting college.

* Booster up. For those who received a first vaccination at age 11 or 12, a booster dose should be given at age 16, before the peak in increased risk. Adolescents who receive their first dose of MCV4 at or after age 16 years do not need a booster dose.

* Not just for kids. The meningococcal vaccine is required to attend any college in Missouri and for colleges in many other states. Additionally, adults should get the vaccine if they are military recruits, have a damaged or removed spleen, have terminal complement deficiency or are traveling or residing in countries where the disease is common.

According to the CDC, making sure that children of all ages receive their recommended vaccinations according to the suggested immunization schedule is one of the most important things parents can do to ensure their children's long-term health.

"It's true that some vaccine-preventable diseases have become very rare thanks to vaccines. However, outbreaks still happen," according to the CDC website. "Making sure children stay up-to-date with vaccinations is the best way to make sure our communities and schools do not see other outbreaks, with more unnecessary illnesses and deaths."

For local information on the various vaccinations available to school-aged children, including where you can get the meningococcal immunization, contact the Dunklin County Health Department at (573) 717-7317 or talk to your personal pediatrician. You can also learn more by logging on to the Centers for Disease Control and Prevention website at www.cdc.gov/vaccines, or contacting the agency by phone at 1-800-CDC-INFO.

* Information in this article was provided by the following healthcare resources: Kennett Pediatrics, Kennett Public Schools, The Centers for Disease Control and Prevention (www.cdc.gov), and Health Literacy Missouri, a non-profit affiliate of the Missouri Foundation for Health (HLM, www.healthliteracymissouri.org).

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