April 3, 2018

Vaccinations for your teenager

Overheard in clinic last week (and a variation of this statement is heard at least once every single week): Parent says to the teen, "If you keep mouthing off, I'll tell the doctor to give you shots." No. Not appropriate to use the threats of vaccines as punishment.

We get it — nobody likes shots, not kids, not parents, and certainly not teenagers.  When we see teenagers in clinic for their sports physicals or annual physicals, it is not uncommon for one or multiple vaccinations to be recommended.

"BUT I thought I was done with vaccination," they protest — their eyes get wide, then they narrow — "I have an important basketball game tomorrow" or "I'm feeling kind of sick."

You will get no argument from your health care team that vaccines aren't very fun, but let's talk about the vaccinations recommended in the teenage years and why they are so important for your child's health!

Flu vaccine

Every year the flu vaccine sees some bad press, and this year is no exception. Recent reports from the CDC estimate that the flu vaccine is only 36% effective at preventing the flu. This has been a particularly nasty flu season, and even people who were vaccinated are getting the flu. However, it is important to remember that preventing 36% of flu cases is actually a substantial amount of cases and will prevent hospitalizations and deaths. This flu season alone the flu has been considered a causative factor in the deaths of 84 children since October.

The flu vaccine is not perfect and this year it is even less perfect than usual, but the flu can be a serious disease and increasing your protection against the virus is certainly beneficial. Think about all the important basketball games you might miss if you come down with the flu, an illness that can last up to 14 days! It's also important to remember that even if you do get the flu after having received the flu vaccine, the illness can be less severe than if you hadn't been vaccinated.

Additionally, getting the flu vaccine every year builds your body's ability to fight off many different flu strains. Even if next year's vaccination fails to cover one of the worst strains of flu that year you may have been vaccinated against that strain or a similar strain two years ago offering you lasting protection against that virus. The CDC recommends that all children under 6 months of age and adults receive a yearly flu vaccination. This includes teenagers, too.

HPV vaccination

This nifty vaccination actually prevents cervical cancer! Even though we hear about medical advances for treating cancer all the time in the news the ability to prevent cancer is unique and incredible. Cervical cancer is a cancer of young women, and even though it may be hard to imagine cancer in your teenage years this is when it is most important to reduce your risk of getting this disease.

  • If you receive the HPV vaccine before age 15: you only need two shots, six months apart

  • The HPV vaccination is recommended for girls up to age 26 and boys up to age 21 (and up to 26 in some circumstances). Even if you are older than 15 it is not too late to protect yourself.

  • If you are older than 15, three shots are required — the second shot must be at least four weeks after the first and the third shot at least 12 weeks after the second shot.

  • If the time between vaccines is longer than the times mentioned above, that is OKAY, it is still important to get all three vaccines for the best protection. If you wait longer than 6 months you will not have to re-start the vaccination series- so if you have unfinished series don't be afraid to come in and complete those at any time

Meningitis vaccine

Meningitis is a serious infection of the brain. About one in 10 people affected with this condition will die from it, and survivors may have serious brain injury as a result of the infection. Meningitis is spread through the exchange of droplets from the nose or mouth such as when coughing, sneezing or kissing. It can spread very quickly in areas where many people are living in close quarters such as in college dormitories. This vaccination is important for all teens because of the seriousness of this infection, but is especially important for teens heading off to college or to the military.

  • There are now two vaccinations that protect you against meningitis: The Meningococcal conjugate vaccine (Menactra or Menveo) and the Serogroup B meningococcal vaccines (Bexsero or Trumenba).

  • Previously there was no vaccine against the Serogroup B of Meningococci (one type of the bacteria that causes meningitis) it has been given since 2014 so you may not remember your older children receiving this vaccine. This advance allows us to protect more kids against more types of meningitis and is important for your teen or preteen. More information about this vaccine can be found in this previous post about the MenB vaccine.

  • The first does of the meningococcal conjugate vaccine is given at age 11-12 and a booster dose is give at age 16.

  • The group B meningococcal vaccine is given between age 16-18.

Tetanus vaccine (Tdap)

The tetanus vaccine is combined with the vaccine for diphtheria and pertussis (whooping cough). This vaccine is part of the normal vaccination schedule for kids, and most kids will have received tetanus vaccination at 2, 4, 6 and 15 months and again in kindergarten. The CDC recommends that teens and pre-teens age 11-12 get a booster of this vaccine called a Tdap vaccine which offers more protection against tetanus and less protection against pertussis and diphtheria, which are more commonly illnesses of childhood. Adults are then vaccinated against tetanus again every 10 years for the rest of their lives

  • Your child may be due for a Tdap booster in their teenage years if they did not receive it at 11 or 12.

  • If your child received Tdap at age 11 or 12 they will be due for a tetanus booster at age 21 or 22.

Additional information about these vaccines can be found on the CDC website. Of course, your health care provider can always provide additional information about these vaccinations and answer any questions that you might have.

Fast forward to my fantasy conversation in clinic: Parent says to the teen, "What a great day! Today you get the tools to prevent some serious infections and cancer. Sure, it may be uncomfortable for a few minutes, but it's so much better than getting those diseases."