While children are busy enjoying the summer, either at camp, at the local pool or spending time with friends at the community playground, parents should be thinking about ensuring that their children are fully up to date with their immunizations and physical exams.
Immunization against a range of potential diseases is a critical part of child health. According to Theresa Hetzler, MD, a member of the Valhalla, New York based General Pediatrics group at Children’s and Women’s Physicians of Westchester (CWPW) www.cwpw.org, keeping children’s vaccinations up to date is one of the single most important factors in childhood preventive medicine. Not only do school districts mandate that incoming and returning students are vaccinated against a range of diseases, but New York State and Connecticut mandate that children receive a range of shots to prevent everything from whooping cough and tetanus to chicken pox and measles.
“Vaccinations are mandatory to attend school and many pre-kindergarten and day care programs,” Dr. Hetzler explains. There are several immunizations that children need in infancy, with many boosters required prior to enrolling in pre-kindergarten, kindergarten or day care. These include the DTaP (diphtheria, tetanus and pertussis), polio, MMR (measles, mumps and rubella), varicella, and hepatitis B. Schools are mandating that all sixth graders have their tetanus booster in the form of Tdap before starting the school year. (This replaces the old tetanus booster with a formulation that has a pertussis component.) Dr. Hetzler points out that there has been an increase in pertussis, or whooping cough, in recent years. The rise in incidence may stem from the fact that adults’ immunity to pertussis wanes over time, as well as from new immigrants who may not be adequately vaccinated against the disease.
“The Tdap vaccine is promoted to adults, too, because pertussis can be very dangerous for babies who are too young to have been immunized,” Dr. Hetzler points out. “It can potentially be fatal.” As such, new mothers who are not protected should be immunized to protect their newborns from contracting the very contagious disease.
Young children also are required to be inoculated against polio, measles, mumps and rubella, and hepatitis B before entering school. Additionally, they should also be immunized against influenza, streptococcus pneumonia, and chickenpox.
The controversial HPV vaccine, marketed under the trade name Gardisil, prevents against the human papillovirus and is recommended for girls and boys 11 years of age and older. The virus can cause cervical cancer in girls, and anal and oral cancer in boys later in life. In addition, children at age 11 who attend sleep-away camp, and students heading to college, should be vaccinated against meningococcal meningitis.
General physical exams are also required in order to enter public school and day care. Additionally, complete physical exams should be conducted in kindergarten and in grades 2, 4, 7 and 10, as well as for every child new to a school district. Children who play sports are required to have a physical exam on an annual basis.
“Physical exams are important components of preventive health care,” Dr. Hetzler insists. “We routinely screen children by asking them screening questions, assessing height, weight and growth parameters,” and gleaning general and specific health information from the physical examination, she adds. “It’s so important for children to come in yearly; coming in just when a child is sick doesn’t address everything.”
Schools routinely do not provide comprehensive physical examinations, so parents should consult with their pediatrician as soon as possible to arrange for physicals and immunizations prior to the start of the school year. For parents who need financial assistance with immunizations, help is available through the New York State Vaccines for Children Program. “There is no reason not to get these immunizations,” Dr. Hetzler says.