Dr. Jacqueline Gerhart: Back to School Can Mean Immunizations

UW Health Family Medicine physician Dr. Jacqueline GerhartMadison, Wisconsin - UW Health Family Medicine physician Jacqueline Gerhart writes a column that appears weekly on madison.com and in the Wisconsin State Journal. Columns are re-published here with permission.


Dear Dr. Gerhart: I got a letter saying my son needs a Tdap booster. So, I went to the doctor and he said my child needs Tdap, varicella, hepatitis A, influenza, meningitis, and HPV. That’s a lot of shots. Should I get them all?


Dear Reader: I am guessing that your son is about 11 or 12 years old, or entering sixth grade. The Wisconsin Department of Health Services publishes yearly age and grade requirements for Wisconsin public schools. The 2013-2014 school vaccination guidelines state that students in 6th through 12th grades need to have the "adolescent" tetanus, diphtheria and pertussis (Tdap) vaccine. Prior to kindergarten, it’s likely that your child had the series of DTaP vaccinations, which contain the same types of vaccinations, but in different doses. But, the state created new rules from 2008-2010, and now, a "booster" of Tdap is required for grades 6 through 12.


It is good to get the Tdap booster for multiple reasons. First, updating your son's tetanus shot provides coverage if he were to get a dirty cut or step on a rusty nail. And, if he does get injured, then he won't need to get the vaccine at the time of injury. Children who get a Tdap booster are also covered for pertussis (whooping cough). Since kids can spread germs easily - it's good to protect your child through vaccination. Additionally, the more children vaccinated, the less likely that whooping cough will spread throughout the school - and that kids will bring whooping cough into their homes.


There are some exceptions to the school Tdap requirement. If your child had a tetanus shot (Td or Tdap) in the past five years (such as in the ER after having an injury), then this "counts." Once your child gets a tetanus booster, he doesn’t need further vaccination. One vaccination during pre-teen or teen years is enough.


Next, varicella. Varicella is now required by the state as well. If you can prove that your child had chicken pox, then this vaccine is not necessary. But if you are not sure then he needs the vaccination - which is a series of two shots. In the state of Wisconsin, to enter Pre-K, one dose of varicella is required. To enter kindergarten two doses are required. If your child is already past kindergarten and hasn’t gotten the vaccine, then the school will require it to be done now.


Of course, if you have a medical, religious or personal reason for not wanting your child to be vaccinated, there is an exemption form that can be filled out.


Now for the other vaccines your doctor recommended. Outside of the Wisconsin guidelines for entering school, there are recommended national guidelines from the Centers for Disease Control (CDC). Hepatitis A, influenza, meningitis, and HPV are not required by Wisconsin public schools. However, your doctor may recommend them based on CDC guidelines. As I have stated in my columns before, I do recommend that school-aged kids get a yearly flu shot. I also recommend that teens be vaccinated against human papilloma virus (HPV), to help prevent cervical cancer in women. And, I recommend the meningitis vaccine, for ages 11 and 12, with a booster around age 16-18, and advise that they should have at least have one meningitis vaccine prior to college.


Thanks for the question, and have a safe and healthy school year!


This column provides general health information and is not specific advice intended for any particular individual(s). It is not a professional medical opinion or a diagnosis. Always consult your personal health care provider about your concerns. No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Gerhart to people submitting questions.

Date Published: 08/27/2013

News tag(s):  jacqueline l gerhart

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