July 18, 2017

When preparing your child’s back-to-school needs list, don’t forget to include vaccines

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The start of the upcoming school year is quickly approaching, which means school supplies, backpacks, new shoes and perhaps a new outfit or two will quickly become top of mind for parents.

University of Alabama at Birmingham physicians are asking parents to take inventory of another school-year need for many children — vaccines.

Each state and the District of Columbia have thier own vaccination requirements to attend public school, and if you are a parent who has not vaccinated your child according to the Centers for Disease Control’s recommended schedule but need to now that they are school age, you still can. UAB physician David Kimberlin, M.D., vice chair of Pediatrics, co-director of the Division of Pediatric Infectious Diseases, and also the American Academy of Pediatrics liaison to the CDC Advisory Committee on Immunization Practices, says it’s not too late to start getting your child caught up and back on the recommended schedule.

“The best way to treat diseases is to prevent them in the first place, and the diseases on the vaccine schedule are all preventable for the vast majority of our population,” said Kimberlin, who is also editor of the American Academy of Pediatrics’ Red Book, which establishes which vaccines should be given, when and to whom. “These diseases that are preventable through vaccination — polio, measles, rubella, diphtheria and others — can cause major harm unless your body has been taught through a vaccine to resist the disease. If you haven’t vaccinated your children previously and want to do so now, talk with your pediatrician about getting caught up, because it is possible and highly recommended.”

Stephen Russell, M.D., associate professor of internal medicine and pediatrics in UAB’s School of Medicine, says he has had parents who have previously rejected vaccinating their children change their mind. Whether it was because of their own further research, personally experiencing the devastation of one of these preventable diseases within their own family or through a friend’s family, or simply a change of heart, these parents have come to his UAB Medicine-Leeds clinic with one question: Now that we want to have our child vaccinated, what do we do?

vaccine graphics 2017“If parents who have previously not vaccinated their children decide they want to get the vaccines and get their children caught up, it can be done, and it can be done in one visit,” Russell said. “Many parents don’t know that, the sooner a child is vaccinated, the more effective those vaccines will be. Pediatricians can quickly help families get back on the vaccine schedule in a safe and effective manner.”

As of Aug. 22, 2014, all 50 states and D.C. require vaccinations for diphtheria, tetanus and pertussis, polio, measles, and rubella; 49 states and D.C. also require mumps vaccination; 48 states and D.C. require varicella (chickenpox) vaccination (Montana and Pennsylvania do not); and 45 states and D.C. require hepatitis B vaccination (Alabama, Maine, Montana, North Dakota and South Dakota do not) to enter kindergarten. Some states require Hib, PCV, flu and Hep A vaccines to enter kindergarten.

The HPV vaccine

Many states require more vaccines as children age, including Tdap and meningococcal conjugate vaccine. But another vaccine that UAB physicians say is crucial for both boys and girls beginning at age 11 is the human papillomavirus, or HPV, vaccine.

HPV infections in adults are so common that nearly all men and women will get at least one type of HPV at some point in their lives. Most people never know that they have been infected and may give HPV to a sex partner without knowing it. According to the CDC, about 79 million Americans are currently infected with some type of HPV. About 14 million people in the United States become newly infected each year.

Despite those numbers, a 2013 CDC survey showed that only 38 percent of U.S. girls and 14 percent of boys ages 13 to 17 had received the recommended doses of the HPV vaccine. And, currently, only Rhode Island, Virginia and D.C. require girls entering the sixth grade to get the vaccine. Rhode Island is the only state to require boys entering the sixth grade to get the vaccine.

Studies have shown the HPV vaccine to be close to 100 percent effective against the strains of HPV-linked cancers it is designed to fight. These cancers include those of the cervix and other cancers of the anus and genitals, as well as some head and neck cancers.

Four UAB physicians and researchers, including Kimberlin, recently published an editorial in the American Journal of Obstetrics and Gynecology suggesting that the way to fight the spread of HPV is for more physicians to counsel their patients of the dangers of HPV and the need to prevent the spread through vaccination.

“While much of the burden of HPV vaccine provision falls on pediatricians and primary care providers, they cannot do it alone,” Kimberlin said. “As clinicians who care for a large proportion of HPV-related conditions, obstetrician-gynecologists and other women’s health care providers must share the responsibility for vaccination of eligible patients. Obstetrician-gynecologists can support the efforts to eradicate HPV-related disease in their patients and their families via multiple avenues, including providing the HPV vaccine and being community leaders in support of vaccination.”

A recent change in the vaccine schedule enables children who receive the HPV vaccine starting at under 15 years of age to need just two doses to be fully immunized instead of three.

“It’s difficult for me to understand fully why someone would reject a medical miracle for their child, and that’s what vaccines are.”

While most states offer medical and religious exemptions to vaccinations, and some states allow philosophical exemptions, the American Academy of Pediatrics views nonmedical exemptions to school-required immunizations as inappropriate for individual, public health and ethical reasons and advocates for their elimination. Both Kimberlin and Russell strongly encourage parents who have either rejected vaccinating their children or neglected to get vaccinations according to the CDC schedule to talk to their pediatricians now, and make arrangements to get their children the necessary vaccinations they need before the school year begins.

“It’s difficult for me to understand fully why someone would reject a medical miracle for their child, and that’s what vaccines are,” Kimberlin said. “The very success of the vaccination program is probably a big part of why we as physicians face these obstacles today, because parents don’t see measles, polio and rubella the way they did 30, 40, 50 and 60 years ago. So they don’t have the perspective that their mothers, grandmothers and great-grandmothers had when it was common to lose a child to one of these now-preventable diseases.”

“One of the most amazing gifts we can give our children is the gift of health,” Russell said. “Routine vaccines given on time enable our kids to fulfill the dreams our grandparents had for us — a bright future not clouded by the storms of preventable diseases.”