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Vital Signs


Vital Signs

Summer 2011

Parents Should Not Overlook Need for Vaccines in Older Children

VS-Summer11-VaccinesParents are well aware of vaccines needed for children during infancy, and around the time the second set of immunizations comes due at age 4 most are being prompted by their school district, which typically demands that children receive the required shots before entering kindergarten.

But more easily overlooked are key immunizations recommended at age 11 — a booster shot for pertussis (whooping cough), the meningitis vaccine and, more recently, a vaccine against key strains of the human papillomavirus (HPV), a common sexually transmitted infection that can increase the risk of cervical cancer in women and genital warts in both males and females.

“I see more and more patients who have missed the vaccines they should be getting at age 11,” says Eric Curcio, M.D., a general internist and pediatrician at Santa Monica- UCLA Medical Center and Orthopaedic Hospital. “For most parents, the last time their child had vaccines was at age 4, so they’ve gotten out of the practice of thinking about them — and if they aren’t bringing their child in for their recommended annual visit, their pediatrician isn’t able to remind them.”

But that will change with a new California law taking effect this year, Dr. Curcio notes. Beginning this fall, all students entering grades 7-12 will need to have obtained a pertussis booster shot, known as a Tdap, before starting school. The law is a response to the state’s worst outbreak of pertussis since the 1940s — approximately 8,600 cases were reported in 2010, including 10 infant deaths. In addition to pertussis, the vaccine protects against tetanus and diphtheria. The first pertussis booster shot is given at 4, one of several immunizations recommended for children at that age. Others include booster shots for polio, chickenpox, measles, mumps and rubella.

For school-age children, Dr. Curcio says, the annual visit is a time when the pediatrician can go through the child’s records and make sure none of the vaccines or vaccine boosters have been missed. “It’s also an opportunity to check hearing and vision, make sure they’re developing well and pick up any learning disabilities,” he notes.

VS-Summer11-VaccinesThe HPV vaccine, the first designed to prevent a type of cancer, was approved by the U.S. Food and Drug Administration in 2006 and was originally recommended for girls as they approach adolescence, before there is any likelihood of sexual activity. More recently it has been recommended for pre-adolescent boys as well.

All of the required school-age vaccines are highly safe and have minimal to no side effects, Dr. Curcio says, while the diseases they protect against are extremely serious and can be fatal.

“Many of these diseases drop off our radar when we stop seeing them,” Dr. Curcio says, “but as soon as the immunization rates start to fall, we are reminded that they are still out there and that if we let our guard down, we will see new outbreaks.”

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