In most cases, teens or young adults will see an adult healthcare provider between 18 and 21 years of age. For those who previously saw a pediatric provider, this will mean choosing a new provider, transferring health records and taking charge of their own healthcare.
Although circumstances may vary, starting to plan for the transition to adult healthcare services should begin early in adolescence and should be discussed with teens preparing to graduate from high school. Talk with your teens about any health conditions they might have, and make sure they understand the symptoms and treatments involved. They should be familiar with any allergies they have, medications they take routinely and their immunization status.
Even young teens can be encouraged to take responsibility for simple aspects of their healthcare, such as completing health history forms at their provider’s office, scheduling follow-up appointments and reporting their symptoms. To promote these activities, talk with them about which health information to share with a provider, and encourage them to complete required university forms with the provider. Discuss the family insurance coverage, the copay (if any) and using the health insurance ID card. If your teens are going to college, update their health records and immunizations, and find out together which healthcare services are available on campus. Make a contingency plan that includes the clinics/hospitals that accept your insurance near their campus, and what your teens should do in an emergency. Many teens find it helpful to have a copy of their health information, including immunization records, in their email or saved on their phones to give new providers. If your provider does not help with the transition of your teen to adult care, use resources available at gottransition.org.
Most American college campuses require some immunizations and health services for their students, so review the available resources with your teens during college visits and orientation sessions. Visits to the campus health center will be confidential. Once you have prepared and planned for transition to adult healthcare services, you can be assured you have provided guidance and promoted responsible healthcare communication. Assist your teens in making an appointment to talk to your primary care provider about immunizations they will need.
The Value of Vaccines
Teenagers and young adults tend to think they are resilient and can’t get sick. Parents know better. You have been attentive in making sure your kids used seatbelts, were aware of the dangers of drugs and alcohol and knew the importance of a healthy diet and adequate sleep. You were responsible for making the appointments and getting all the information to make an informed decision regarding immunizations. They may not have liked getting the shots, but you knew you were doing this for all the right reasons. Now they are going out into the world and you want to be sure to continue the discussion about the importance of immunization.
The average college student has a high-stress lifestyle with inadequate sleep and a less-than-ideal diet. Combined with dormitory living, college campuses create an excellent environment for viruses and bacteria to spread rapidly. High vaccination rates are crucial for community immunity to protect and prevent outbreaks of diseases such as measles, mumps and influenza. You can help protect your children by asking your provider about vaccines your college-age children should receive and ensuring they are completed before leaving home.
According to the Centers for Disease Control and Prevention (CDC), mumps outbreaks, preventable by vaccine, have been on the rise over the past three years. As of March 2017, three college campuses across the nation reported mumps outbreaks. In addition to mumps, there has been a ride in meningococcal meningitis, also preventable by vaccines, involving several different strains of the bacteria. While professional guidelines recommend vaccinating teens for meningitis (types ACWY), a meningitis B vaccine is also available. This vaccine provides additional protection against meningitis, is safe and effective, and is now covered by many insurance companies. Ask your pediatric office about the meningitis B vaccine or visit your local health department for this vaccine.
The CDC reports that 5 to 20 percent of people in the United States get the flu each year. More than 200,000 people are hospitalized and tens of thousands die from flu-related complications. The influenza viruses are known to spread quickly on college campuses, and a report by the National Foundation for Infectious Diseases noted that college students who get the flu may have eight or more days of illness, missed school days and poor school performance. Encouraging your college-bound teen to get the flu shot annually, along with practicing hand-washing, has been proven to reduce the risk of illness. Teens are also encouraged to receive the HPV vaccine series to significantly reduce the risk of cancer in adulthood.
The Advisory Committee on Immunization Practices (ACIP) is a group of medical and public health experts that give the CDC recommendations for immunizations each year (visit https://www.cdc.gov/vaccines/schedules/easy-to-read/preteen-teen.html to see the 2018 immunization schedule for your teens).
Protect Your Teens
Going off to college is a huge milestone in the life of your kids. While there will be new challenges and risks to the health of your teens that you may not be able to control, ensuring immunizations and promoting transition of care will provide protection and offer reassurance for a healthy, successful future.
Cheryl Cairns, DNP, APRN, CPNP, is the quality officer for the primary pediatric department at Cleveland Clinic, with a focus on safety and immunizations, and Co-Chair of the NAPNAP Immunizations SIG.
Anne Derouin, DNP, APRN, CPNP, FAANP, is an Associate Professor and Lead Faculty of the PNP-Primary Care program at Duke University School of Nursing and serves as the Co-Chair of the NAPNAP Adolescent Healthcare SIG.
Lacey Eden, MS, FNP is an NP, the chair of the NAPNAP Immunization SIG, and an Associate Teaching Professor in the College of Nursing at Brigham Young University.
Dr. Meara Peterson, DNP, RN, CPNP-PC, is a PNP at a community clinic in San Diego, CA, and the chair of the NAPNAP Adolescent Healthcare SIG.