Summer’s in the air, and you are probably stocking your cupboards with sunscreen and bug repellent to protect your kids from painful sunburns and pesky bug bites. While these preventative measures are important, they are only a part of keeping your family healthy.
When thinking about summer vacation, think about immunizations. Summer is the ideal time for annual health care visits and immunization updates. If you find keeping track of your children’s immunization status overwhelming, you can talk to your health care provider about your family’s vaccines at these visits. Parents of school-age children are often surprised to find they are behind on their vaccinations. If your kids are 9 to 18 years or older, chances are you need to get their immunizations updated.
The need for extra vigilance with immunizations has never been greater. Immunization-preventable diseases such as pertussis (whooping cough), meningococcal meningitis and measles are rearing their ugly heads in our own communities. In the past decade, whooping cough cases have dramatically risen in the U.S. In fact, there were 48,277 cases of whooping cough in 2012, the highest number of cases since 1955. One in 20 Americans has been infected with the hepatitis B virus, and those who travel to other countries are at higher risk for hepatitis A infection. During 2013 the number of measles cases in the U.S. doubled. In 2014 there have already been documented measles cases in California, Pennsylvania, Hawaii, Texas, Washington, New York, Massachusetts and Oregon. In 2010 an outbreak of meningococcal meningitis in an elementary school infected and hospitalized five children, two of whom later died.
The rise in immunization-preventable diseases can be attributed to decreasing immunization rates. Even if your kids were fully immunized at some point, it’s important to ensure their protection with boosters at the appropriate times. A table showing the immunizations your school-age child may need can be found here: Vaccine Schedule (click here)
This summer is an excellent time to ask your health care provider about the following immunizations: Tdap, Hep B, Hep A, HPV, MMR, Varicella and Menactra.
Tdap, DTap and Td
With so many Ts and Ds these acronyms can be confusing, as they seem so similar. All three immunizations include a T for tetanus and a D for diphtheria. The P in DTaP and Tdap stands for pertussis (whooping cough). DTaP immunization is approved for children younger than seven years old. Tdap, on the other hand, is approved for children older than seven years old. Td is simply a booster given every ten years and covers tetanus and diphtheria. Each disease is potentially fatal.
Pertussis is a respiratory disease spread through coughing, sneezing and respiratory droplets. This disease causes violent, irrepressible coughing and extreme difficulty to take a breath in the midst of coughing intervals. This often leads to hospitalization and, in the worst cases, death. Unfortunately, infants are the most vulnerable to pertussis because their airways are so much smaller than older children, teens and adults. Sadly, pertussis is most commonly spread to infants from parents, grandparents or older siblings who are not adequately immunized. Even kids fully immunized before starting kindergarten are at risk for contracting and spreading pertussis. Regardless of previous vaccinations, children should receive a Tdap booster at age 11 to protect themselves and the infants with whom they come in contact. You can’t be too careful in getting your Tdap booster. This immunization is so important it is given to teens during adolescent pregnancy, to ensure protection of the newborn.
Most people are familiar with tetanus or lockjaw, although it is relatively rare. The disease is caused by bacteria found in soil, dust and water and causes severe muscle spasms. In some cases, the muscle spasms are so severe they prevent the person from breathing, leading to respiratory arrest and death.
Diphtheria, like tetanus, is rare in most developed countries. Diphtheria begins with cold-like symptoms, a runny nose and mild fever. The toxin released by diphtheria produces a thick lining that coats the back of the throat and nose, eventually blocking the airway. Additionally, it can cause heart arrhythmias, damage to nerves and organ failure. One in five children infected with diphtheria will not survive.
Hep A and Hep B
Hepatitis A, a virus that infects the liver, is spread through oral contact with infected feces. Because the virus is so contagious, even a microscopic amount of ingested hepatitis A can infect the liver. Luckily, rates of hepatitis A have dropped dramatically since the introduction of the immunization in 1995. Even if it’s not required prior to school entry, your child should receive the hepatitis A immunization if traveling anywhere outside the U.S. (with the exception of Canada, Western Europe, Australia, New Zealand and Japan). It’s also important to ensure protection against hepatitis A if your child has contact with an adoptee from a country with a high incidence of hepatitis A.
Hepatitis B also infects the liver, although it’s spread through body fluids, blood and open sores. The infection has the potential to cause chronic hepatitis, which leads to costly and ongoing medical treatment. This can easily be avoided, however, by immunizing your child. If your child was given an immunization at birth, most likely it was hepatitis B. To achieve adequate immunity, your child should have received two additional boosters. Check with your health care provider if you are unsure if your child is adequately immunized. The three-shot series can be given at any age and does not need to be restarted, regardless of the length of time since the previous dose.
MMR and Varicella
The MMR vaccine immunizes against measles, mumps and rubella, and the varicella vaccine protects against chickenpox. All four diseases can lead to long-term disabilities and expensive treatments. Measles and chickenpox have the potential to cause pneumonia, encephalitis and brain damage. Mumps was the leading cause of meningitis and hearing loss before the MMR vaccine. Rubella contracted during pregnancy causes birth defects such as deafness, blindness and heart defects.
All school-age kids who receive one dose of MMR before kindergarten need an additional booster by the time they are 11. School-age children that have not been vaccinated should receive two doses of MMR one month apart. MMRV is a vaccine that combines the MMR and varicella vaccines. If your child receives the MMRV, there should be a three-month interval between the two injections.
The human papillomavirus (HPV) is an infectious disease affecting the genitals, mouth and throat. Because high-risk strains of this virus can lead to precursor lesions and cervical cancer, the CDC states the HPV vaccine should be administered prior to infection with human papillomavirus. HPV is the most common sexually transmitted infection and the most common cause of cervical cancer. In 2010, nearly 12,000 women in the U.S. were diagnosed with cervical cancer, and 4,000 of those women died from the disease. HPV vaccination is a simple, effective way to prevent this type of cancer. The HPV vaccine is now recommended for boys and girls starting at ages 11 to 12 years, but can be administered at any age between 11 and 26 years.
Meningococcal meningitis is a potentially fatal disease affecting the entire spinal column and brain. Long-term effects of this disease include hearing loss and brain damage. The bacteria are spread through saliva and respiratory secretions. College dorms and other places with individuals living in close proximity to one another have a higher incidence of meningococcal outbreaks. Children 11 to 12 years old should receive Menactra, the meningococcal vaccine, and follow it with a booster when they are 16. College-age children 19 to 21 years old should receive Menactra if they are unvaccinated or their first dose was given before age 16.
Many countries are still affected by diseases that are uncommon in the U.S. If you are planning a trip outside the U.S. this summer, see your health care provider to discuss immunizations four to six weeks before your scheduled departure.
The CDC also has an interactive Web site for recommended vaccinations to receive before international travel: http:// wwwnc.cdc.gov/travel/destinations/list. Simply enter your destination and other details, and the site will provide you with information on the necessary vaccines.
Kick off the summer by getting ahead of the game, and schedule an appointment for your child with her health care provider now. Ensure your summer is both fun and safe by protecting your family’s health today.
Lacey M. Eden, MS, FNP-C, is an Assistant Professor and teaches in the graduate program in the College of Nursing at Brigham Young University. She is a primary care provider in a busy pediatric clinic in Draper, UT.
Karlen Luthy, DNP, FNP, is an Assistant Professor in the College of Nursing at Brigham Young University, and teaches in the graduate program. She is a primary care provider in a clinic in Salem, UT.