What Vaccines Does My Teen Need?

By Nina Nosavan and Rosie Korman, pediatric residents at CHOC Children’s

Vaccines are not just important for little ones. Your preteens and teens need to be vaccinated too! It’s important for parents to be aware of vaccines updated that will benefit their adolescents.

Meningococcus (MCV)

Meningitis is a severe, life-threatening illness that begins with fever, headache, and stiff neck and can rapidly progress to coma, multi-organ failure, and death. Approximately 10-15 percent of cases are fatal, and of the survivors, 20 percent can have severe disabilities including hearing loss, brain damage, amputations, kidney damage and other complications. Almost all disease is caused by the five serotypes A, B, C, W, and Y of bacteria Neisseria meningitidis. Protection against four of the five of these serotypes is provided by the meningococcus conjugate vaccine (MCV). The meningococcus conjugate vaccine is recommended for all adolescents after age 11, with a booster given at age 16. This vaccine schedule provides critical protection against this devastating disease during the college years, when meningitis commonly occurs as outbreaks in young adults living in close quarters in dormitories.

The B serotype of meningococcus is not included in the MCV. Protection against this form of meningococcus requires a separate immunization. This vaccine can be given to any adolescent 16 to 23 years of age to provide protection from serotype B during this high-risk period. The serotype B vaccination is recommended to be given in multiple doses; there are two different brands of licensed vaccinations, each with a different dosing schedule. Ask your provider which serotype B vaccine they have available at their clinic, and which dosing schedule they recommend.

vaccinesPhoto courtesy of The National Meningitis Association.

Additionally, children 10 years or older who are at increased risk for serogroup B meningococcal infections should receive the vaccine. This group includes:

  • People exposed to a serogroup B meningococcal disease outbreak
  • People with no spleens or damaged spleens
  • People diagnosed with persistent complement component deficiency

HPV Vaccine

The HPV (human papillomavirus) vaccine protects against HPV infections and HPV-associated diseases such as cervical, vaginal, vulvar, penile, oropharyngeal, and anal cancers and genital warts.  HPV is very common; nearly all sexually active adults (both men and women) will become infected with at least one of the human papillomaviruses in their lifetime. The majority of HPV infections are asymptomatic, however, over time the human papillomavirus causes cervical and other cancers. The HPV vaccine has been shown to be incredibly effective in preventing both HPV infection and the subsequent cancers HPV causes. It is most effective if given prior to the onset of sexual activity (and thus prior to HPV infection), though is still highly effective in sexually active individuals. The vaccine is recommended for patients between 9 and 26 years of age.

  • Girls and boys who initiate the vaccine series before 15 years of age should receive 2 doses at least 6 months apart.
  • Teenagers and young adults who initiate the vaccine series after 15 years of age should receive 3 doses at 0, 1 or 2, and 6 months.

Learn more about the HPV vaccine from a pediatrician’s perspective, or ask your child’s healthcare provider for more information.

Tdap Vaccine

Infants and young children receive the DTap vaccine to protect against tetanus, diphtheria and pertussis. As they get older, the protection wears off. The Tdap vaccine is a booster that helps to protect your preteen or teen from these illnesses.

  • Tetanus (lockjaw) is caused by bacteria in the soil and enters the body through cuts in the skin. It can cause lockjaw, painful muscle cramps, breathing problems, and paralysis. Up to 1 out of 5 people who get tetanus die.
  •  Diptheria is spread through coughing and sneezing. It causes destruction of tissue in the upper respiratory system that impairs a person’s ability to breathe or swallow. It can also cause heart failure and paralysis. Up to 1 out of 10 people who get diphtheria die.
  • Pertussis (whooping cough) is spread through coughing and sneezing. It can cause infants to stop breathing or children to have uncontrollable coughing fits. It can make preteens and teens very sick.

The first Tdap vaccine should be given at age 11 or 12. If your teen is 13 to 18 years old and has not received the vaccine, talk to you doctor right away. This vaccine is also recommended for pregnant women during every pregnancy, and for everyone that lives in the same household as a newborn baby. A variant of this vaccine, Td, is recommended every 10 years for adults.

Catch-up Immunizations

Is your adolescent up-to-date on all their immunizations? Did you know that if your adolescent missed some of his immunizations as a child, it is not too late to immunize? Vaccinations for many common illnesses, including polio, hepatitis A, hepatitis B, varicella (chickenpox), measles, mumps and rubella, all can be caught-up during the adolescent years. Be sure to ask your physician if your child has received all the necessary immunizations, and whether any catch-up immunizations are necessary.

PPSV23 Vaccine

Pneumococcal disease causes infections of the blood, infections of the lining of the brain and spinal cord, ear infections, and pneumonia. Infants and young children should receive the pneumococcal conjugate vaccine (PCV13) to protect against these infections.

The pneumococcal polysaccharide vaccine (PPSV23) protects against 23 types of pneumococcal bacteria and is recommended for children older than 2 years of age with certain medical conditions such as sickle cell disease, HIV infection, chronic heart or lung conditions, or cochlear implants. Teenagers and young adults who have asthma or who smoke cigarettes should also receive this vaccine.

Download your immunization guide

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6 Things Your Pediatrician Wants You to Remember in 2017

The new year is a great time to kick start healthy habits with your children that can be practiced all year long. We spoke to Dr. Reshmi Basu, a CHOC Children’s pediatrician, who offered the following tips:

pediatrician
Dr. Reshmi Basu discusses 6 things your pediatrician wants you to know this year.
1. Get your flu shot

If you haven’t received your flu shot this season, it’s not too late. Remember, the nasal flu vaccine is not recommended this season. The flu can make you much more sick than a regular cold and can have more complications, like pneumonia, so it’s important that everyone in the household over 6 months old receives it. If there is a new baby in the family, you can protect the baby by making sure anyone in contact with the baby has received the flu vaccine.

2. Wash hands often to keep germs away

Proper handwashing is especially important during cold and flu season. And remember to wash for at least 15-20 seconds and make sure to scrub between fingers and under nails.

3. Protect your child’s skin

During the winter it’s important to moisturize frequently throughout the day, especially after baths or showers, to treat and prevent dry skin. And, if you’ll be out in the sun, don’t forget the sunscreen. It’s best to apply it 15-30 minutes before sun exposure and reapply often.

4. Make well-child appointments and stay up-to-date on vaccinations.

 When children are young, there are frequent well checks with the pediatrician and these appointments usually include vaccines. As children get older (after 5 years old) and vaccines are not a part of every visit, it is easy to forget the well checks. They are still important, however, to see how your child is growing, how she is doing in school, and discuss any concerns. It’s also a good opportunity to get the flu shot (depending on the time of year) and make sure all other vaccines are up to date. Download CHOC’s  guide to making shots less stressful for kids.

5. Stay active.

The American Academy of Pediatrics recently lifted their rule on no screen time for kids under 2, with some limitations. Find time to be active. Make it a family activity– go on a hike, ride bikes together, or play in the park.

6. Read aloud to young children, starting at birth.

Try to read together for at least 15 minutes every day. Reading to your kids from a young age can help them with their speech development, communication skills, and even academic performance. And it’s a fun way to spend time together!

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When to See the Pediatrician This Season

As soon as the school year begins, pediatricians start seeing more infectious diseases because these illnesses are more communicable in a classroom setting. Poor weather enhances that communicability, so these ailments become even more prevalent during winter months. It can often be difficult for parents to decide which infections can be treated at home and which require a trip to the pediatrician.

We spoke with Dr. Michael Cater, a CHOC Children’s pediatrician, about what ailments parents should keep a close watch for this season, and how to tell when it’s time to make an appointment with their child’s doctor.

when to see pediatrician
Dr. Michael Cater, a CHOC Children’s pediatrician, offers advice on when to see the pediatrician this season.

Influenza season tends to pick up in late December or early January, Dr. Cater says, but its prevalence in the community depends on how many people get immunized. The Centers for Disease Control recommends that everyone over the age of 6 months receive an influenza vaccine. However, for this season, the nasal flu vaccine is not available.

Sometimes it is difficult for parents to decide which illnesses can be treated at home and which ones require a trip to the pediatrician. Dr. Cater offers tips on when it’s time to make an appointment:

  • Many infectious diseases in children are associated with a fever. If a fever of 100.4 degrees or higher lasts longer than three days, then a visit to the pediatrician is needed for future evaluation.
  • Labored breathing that doesn’t respond to home remedies. This could be an indication of a more serious respiratory infection.
  • If a child is vomiting and does not respond to dietary restriction.
  • Cases of diarrhea when the child doesn’t respond to dietary restrictions.
  • Sore throat associated with a fever and tenderness in the neck. This could indicate Strep throat, requiring antibiotics for the most effective treatment.
  • Ear pain in conjunction with an upper respiratory infection such as a cold, especially if the ear pain begins four or five days after the onset of the cold. This is highly suggestive of an ear infection, requiring antibiotics for the most effective treatment.

To avoid common infections this season, remember to get your family vaccinated against influenza, and practice proper hand washing technique. Children should wash their hands:

  • Before eating
  • After going to the bathroom
  • After blowing their nose
  • After playtime

Use hand sanitizer when you’re on the go and think your child may have touched something contaminated with germs, but use actual soap and water when you see dirt. Spend at least fifteen seconds vigorously washing hands front and back, and between the fingers.

Download this guide to personal hygiene to help prevent the spread of germs this season.

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How to Make Shots Less Stressful

Vaccines represent significant breakthroughs in medical research and disease prevention. When the Centers for Disease Control’s recommended immunization schedule is followed according to plan, it is shown to be the most effective and safest way to protect your child from potentially fatal diseases, according to Dr. Jasjit Singh, medical director of infection prevention and control at CHOC Children’s. However, the process of going to the pediatrician and receiving shots can be stressful, or even anxiety-producing, for young children.

A patient’s relationship with their pediatrician is important, and once you have found the right primary care doctor for your family, it can set the stage for their feelings toward medical professionals or clinical settings later in life. Studies show that preparing your children for vaccinations should ideally include three components: explaining what will happen, how it will feel, and strategies for coping with any related stress or discomfort. Follow these simple steps on how to make shots less stressful.

  • Be honest. Tell children their vaccines may be uncomfortable or bothersome for a second or two, and have them practice slowly counting to two seconds so they get a sense of how long that really is. Tell them what to expect at their appointment, and explain why the procedure is necessary and how it will help them.
  • Use Neutral Language: Request that the health care providers let your child know what will happen and when, using neutral language such as “we’re ready to start,” advises Marni Nagel, a pediatric psychologist.
  • Encourage them to ask questions. Remind them that they can ask any questions they want to of their doctor or nurse.
  • Time the appointment well. For babies and toddlers, scheduling the appointment around their bottle/feeding time may help. Receiving a bottle or feeding right after the shot may help soothe your baby.
  • For infants, engaging in at least 4 of the 5 S’s has been shown to reduce distress after immunizations, says Nagel. These include swaddling, placing on the side/stomach while holding, making shushing sounds, rocking, and sucking. Sucking can be done through breastfeeding, a bottle, or pacifier. For infants, dipping their pacifier in sugar water has been shown to decrease stress associated with immunizations. You can also talk to your doctor about breastfeeding during and/or after the immunization.
  • Topical anesthetics. Ask your pediatrician if topical numbing agents may be appropriate for your child.
  • Control your reaction. Children are increasingly observant as they get older, and they will take careful note of your reaction. Remain calm and be mindful of your demeanor, and it may help send a message to your child that they need not be stressed either.
  • Distraction techniques. These will vary depending on your child’s age and interests, but could include telling stories and jokes, looking at a picture book or finding a hidden picture like “Where’s Waldo,” or blowing bubbles.
  • Positive Rewards/Treats. Consider going out for ice cream, going on a special outing such as to the park or playground, or another small treat after your appointment to encourage good behavior, or to soothe your child.

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Nasal Flu Vaccine Not Recommended This Season

An advisory committee of the Centers for Disease Control and Prevention recently recommended that the nasal spray influenza vaccine not be used this upcoming flu season. In this Q&A, Dr. Jasjit Singh, medical director of infection prevention and control at CHOC Children’s, offers an explanation.

Dr. Jasjit Singh
Dr. Jasjit Singh

Q: What does this mean for influenza vaccine recommendations for the upcoming flu season?

A: All individuals over the age of 6 months are recommended to get the influenza vaccine, and that will continue to be the case.  However, for this season at least, the nasal flu vaccine is not an option. Therefore, parents will need to plan for their children to get the flu shot this upcoming season.

Q: How does the standard flu shot differ from the nasal spray version in terms of composition and effectiveness?

A: Both the flu shot and the nasal spray contain the anticipated predominant circulating strains of influenza every year, but the nasal spray strains are made of weakened live virus while the flu shot is made of inactivated viral components. The CDC reviewed data from this past season that suggested that the nasal spray did not perform as well as it had in the past.

Q: Besides ensuring their children get a flu shot, what else can parents do to help prevent the flu?

A: In addition to ensuring their child is vaccinated against the flu every year, there are many things parents and other caregivers can do to help prevent the flu. Use proper hand-washing techniques, use respiratory etiquette, and stay home from work or school if you are sick with the flu, to prevent spreading it to others.

Q: What do you anticipate will be parents’ reactions to this recommendation? Is there anything else you’d like them to know? Is there anything else you’d like to share with parents about the importance of vaccinations?

A:  Vaccinations are one of the most effective public health measures that have been developed and they save thousands of lives each year. Influenza vaccinations are important because young children can get quite sick from the flu, and some even require hospitalization. Every year there are pediatric deaths in the U.S. due to influenza, about half of which occur in normal healthy children. Children can pass influenza on to the elderly or other fragile members of our community. It’s important for adults to get the flu shot too, particularly those who are caring for young children. Even though the nasal spray is not an option for vaccinating this particular season, it is still important to have your child vaccinated for this year.

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