The many new vaccine requirements the last few years can make it difficult to keep your child's shots up to date.
Among the vaccines that were introduced and regularly used over the last five to six years are the Hepatitis B series and the chickenpox shot. While most younger children are getting these shots with their regular immunizations, older children, especially if they are 10 to 12 years old, may not have received them when they were younger.
Another shot that your older child may not have received yet is Hepatitis A, but since it is only required for older children in certain areas of the United States that are considered to be high risk, your child may not actually need it.
There are other new vaccines and vaccine recommendations that may mean your child needs shots this year before going back to school, including:
- a chickenpox booster shot
- Menactra, a shot that provides protection against meningitis
- Gardasil, the HPV vaccine for older school age girls, although it is not yet required for attending school
DTaP (Diphtheria, Tetanus, Pertussis)
- most children have five dosages by the time they start school, including one after their fourth birthday
- remember that children also need a tetanus booster when they are around 12 years old
- a new booster dose providing protection against tetanus, diphtheria and pertussis (Boostrix) is also now available for adolescents between the ages of 10 to 18 years old
MMR (Measles, Mumps, Rubella)
- two doses of MMR are usually required by school entry. In the past, the second dose was given when a child was either 4 to 6 years old or 12 years old. Now, it is usually given earlier, but some older children may not have gotten two doses yet.
IPV (Polio)
- most children have four or five dosages by the time they start school, including one after their fourth birthday
Varivax (Varicella, or the Chickenpox vaccine)
- Your older child will need the chickenpox shot if he has not already had chickenpox in the past. Most younger children receive it when they are 12 to 18 months old. Although younger children used to be given just one dose, it is now required that kids get a chickenpox booster shot when they are 4 to 6 years old. Older kids should get their booster at their next well child visit or as soon as they can so that they don't get chickenpox.
Hepatitis B
- a series of three shots that is now started in infancy. Older children are usually caught up by 12 years of age if they haven't received this vaccine yet.
Hepatitis A
- a set of two shots for children over 12 months years of age. All infants and toddlers are now getting this shot as a part of the routine childhood immunization schedule, but there is currently no plan for routine catch-up immunization of all unimmunized 2- to 18-year-old children, unless they live in a high-risk area with an existing Hepatitis A immunization program or if the kids are themselves high risk. Kids are high risk for example, if they travel to developing countries, abuse drugs, have clotting-factor disorders, or chronic liver disease, etc.
- Hepatitis A is required to attend preschool in many parts of the United States
Hib
- while required for school entry, children do not usually receive this shot after they are five years of age, so children who have missed this shot don't usually need to get caught up before school starts if they are older than 5 years old.
Prevnar
- a vaccine that can help to prevent infections by the pneumococcal bacteria, which is a common cause of blood infections, meningitis and ear infections in children.
- Prevnar is typically given between the ages of two months and five years, and isn't approved for older kids, so your older child wouldn't need this shot if he didn't get it when he was younger. It is often required to attend preschool though.
- Another version of this vaccine is available for certain older high-risk children though, including kids with immune system problems, although that wouldn't be required for school.
Meningococcal vaccine
- College-bound children, in addition to the routine immunization requirements, also need a meningitis shot. Current recommendations are for college freshmen, especially if they will be living in a dormitory, to receive one dose of the Meningococcal vaccine.
- Menactra, the newest version of the Meningococcal vaccine, is now recommended for children who are 11 to 12 years old or before entering high school or college.
Sources:
American Academy of Pediatrics Policy Statement. Hepatitis A Vaccine Recommendations. Early Release: 4/9/07.
Prevention of Hepatitis A Through Active or Passive Immunization. Recommendations of the Advisory Committee on Immunization Practices (ACIP). CDC Morbidity and Mortality Weekly Report. May 19, 2006 / 55(RR07);1-23.
Recommended Immunization Schedules for Persons Aged 0--18 Years --- United States, 2007. CDC Morbidity and Mortality Weekly Report. January 5, 2007 / 55(51);Q1-Q4.
