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The latest vaccines that keep kids healthy
By Mary Beth Koslap-Petraco, DNP, PNP-C, CPNP
* First published in Spring/Summer 2011
 Your children grow so quickly, and, as they grow, their needs change. One of the most important things you can do to keep your kids healthy is to immunize them.
Vaccines have saved countless lives. Children today are fortunate to live at a time when more vaccines have become available to prevent disease. No longer just for babies, vaccines are now important for all ages. Until just a few years ago, vaccines were no longer needed once a child received them at four and five years old. Now there are several vaccines for young adolescents and teenagers. And adults should be immunized against diseases that affect babies too young to be vaccinated. Here are the latest immunization recommendations.
Pertussis
Even though large numbers of children are vaccinated every day, there has been a tremendous increase in pertussis, otherwise known as whooping cough. According to the Centers for Disease Control and Prevention (CDC), 16,858 pertussis cases and 12 infant deaths were reported in 2009. The source of infection is frequently adult family members and older children who have not been vaccinated.
Tdap
Now the tetanus-diphtheria-acellular pertussis vaccine (Tdap) can be given regardless of the interval since the last tetanus or diphtheria-toxoid containing vaccine. The benefits of protecting infants far outweigh the risk of a possible reaction from the vaccine. Any adult or adolescent who has contact with young infants should receive one dose of Tdap vaccine. Tdap can now also be given to certain adults aged 65 and older. Those in this group who have close contact with infants one year old and younger should receive a dose if they have not received the vaccine previously. No pertussis vaccine was available for children seven through ten years of age before, but now one dose of Tdap is recommended for kids of that age-group who did not complete a primary series of diphtheriatetanus-pertussis vaccine.
 MVC
The Meningococcal Vaccines Work Group of Advisory Committee on Immunization Practices (ACIP) updated their recommendation to include routine meningococcal vaccination (MCV), which should be given to adolescents 11 to 12 years old, with a booster at 16. Those who received MCV at age 16 or older do not need a booster. For special situations where extra doses might be needed, speak with your health care provider. Routine immunization of those 21 or older is not recommended unless they are high risk.
Varicella
Even though most children have received chicken pox immunizations, outbreaks have continued. After reviewing the available data and considering the expert opinion of the members of ACIP, the recommendation was made for a second dose of chicken pox vaccine, also known as varicella vaccine, for kids under 13 years of age. The routine administration of the second dose of varicella vaccine is four to five years of age. Any child who did not receive a second dose at age four to five years should also receive a second dose. Children under 13 years of age need to wait three months before receiving a second dose of varicella vaccine. A second dose of varicella vaccine is already recommended for those 13 and older.
PCV13
Since pneumococcal conjugate 7-valent vaccine (PCV7) was licensed and recommended for infants, it has dramatically decreased meningitis and pneumonia as well as some ear infections. Now a 13-valent pneumococcal conjugate vaccine (PCV13) has been licensed, which provides expanded coverage and has replaced PCV7. PCV13 is approved for children 6 weeks through 71 months of age. Check with your health care provider for recommendations for your child.
HPV
There are vaccines available to prevent cervical cancers and pre-cancers in girls and young women. HPV4 prevents genital warts and some cancers of the penis in boys and young men. While ACIP does not explicitly recommend HPV4 for boys 9 to 26 years of age, it is a consideration in this age-group. HPV vaccine is administered in a three-dose series for both girls and boys. A second vaccine, HPV2, which prevents the two most common pre-cervical and cervical cancers in girls, is also available. ACIP has no preference for either of these vaccines in girls.
You might think vaccinating your young teen for a sexually transmitted disease is not necessary, but doing so can prevent cancers and cervical warts. The idea is to vaccinate before your teen is exposed to the viruses that cause these cancers, in order to offer them the greatest degree of protection.
 Flu Shots
Influenza is a very serious disease that can cause pneumonia and even death in some kids. The ACIP now recommends that everyone ages six months and older receive an annual influenza vaccine. Make sure you and your family receive the influenza vaccine every year. In some instances you can choose the type your child receives. The injectable form of influenza vaccine can be given to all kids and adults from six months of age on. The nasal mist influenza vaccine is for healthy folks 2 through 49 years of age. If you or your child has had an episode of wheezing in the year before the administration of the vaccine or has a chronic illness such as diabetes, kidney disease, cancer or any other autoimmune disorder, the nasal mist influenza vaccine should not be used. Discuss the type of vaccine best for your child with your health care provider.
Vaccines and Autism
You are most likely aware of the controversy surrounding vaccines and autism. Numerous studies have clearly shown no link between measles-mumps-rubella vaccine and autism. The most reliable source of vaccine-safety information is your child’s health care provider, so ask questions and get the answers you need to make good choices for your kids.
Because of safe, effective vaccines, we no longer face diseases such as polio, diphtheria, measles and mumps. Let’s keep it that way by fully immunizing our children.
RESOURCES
www.cdc.gov/vaccines
www.vaccine.chop.edu
www.immunize.org
www.ecbt.org
www.vaccinateyourbaby.org
www.immunizationinfo.org
www.pkids.org
Mary Beth Koslap-Petraco, DNP, PNP-C, CPNP, is the coordinator for child health at the Suff olk County Department of Health Service in New York and a clinical assistant professor at Stony Brook University School of Nursing. She is a past member of the advisory board of the Immunization Action Coalition and served on the National Vaccine Advisory Committee of the CDC.
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