Stehr-Green: Immunizations ‘through the ages’

Published 1:07 pm Wednesday, August 26, 2015

Immunizations protect young children against a variety of serious diseases. Recommended immunizations are started shortly after birth and continue at intervals through early childhood.

Immunizations, however, are a safe and effective way to prevent infectious diseases and deaths in all ages.

The following discussion highlights the vaccinations that might be needed in different age groups and is not meant to be a comprehensive listing of all of the vaccines needed by any one person.

School age

School presents an increased risk for the spread of infections due to close contact between children. Being vaccinated can prevent a child from getting infected from circulating diseases and prevent him or her, in turn, from spreading a disease. When enough children are immunized, those who are vaccinated can provide a shield of protection for those who cannot be vaccinated, including children with weakened immune systems and children who cannot get the shots because of certain medical conditions.

Children must be vaccinated against certain diseases to attend public or private schools in Washington.

School immunization requirements

Students attending public and private schools in Washington must be immunized against the following diseases:

• Chickenpox (Varicella)

• Diphtheria

• German measles (Rubella)

• Hepatitis B

• Measles (Rubeola)

• Mumps

• Polio (Poliomyelitis)

• Tetanus

• Whooping cough (Pertussis)

Note: If a parent wants to claim an exemption for their child, he or she must be counseled by a Washington licensed health care practitioner about the benefits and risks of immunizations unless the parent’s religious beliefs do not allow treatment by professionals.

Preteens and teens

Whooping cough — Whooping cough (or pertussis) immunizations are routinely given to children at 2 months, 4 months, 6 months, 15-18 months and 4-6 years. A number of years ago, it became clear that too many teens were getting whooping cough due to waning protection from childhood vaccinations. Now Washington requires that children going to public and private schools receive a whooping cough booster shot when they are 11 or 12 years of age.

Chickenpox — Two doses of chickenpox vaccine are currently necessary for a child to enter kindergarten in Washington, but the requirement has been phased in over time. New, this fall, all students in seventh and eighth grade will need to show proof of having received two doses of chickenpox vaccine or a health care provider’s previous diagnosis of chickenpox. In the fall of 2016, all students in ninth through 12th grade also will be required to have two doses of the vaccine.

Human papilloma virus (HPV) — HPV infection can cause genital cancer, other cancers and genital warts in both men and women. HPV is spread by sexual activity. Because the protection provided by the HPV vaccine is long-lasting, vaccination is recommended for boys and girls at age 11 or 12 so that they are immune to HPV before ever being exposed to the virus.

College age

Meningococcal disease — Meningococcal disease can cause serious infections of the bloodstream and linings of the brain and lead to brain damage, disability and death. Meningococcal disease is a concern on college campuses, especially for students living in dorms. Washington requires that every degree-granting institution in the state inform students of the risk of meningococcal disease and the benefits of immunization. Post-secondary education facilities (e.g., college) set their own policies regarding meningococcal vaccine requirements.

Pregnancy

Before becoming pregnant, a woman should be up-to-date on routine childhood vaccines. This will help protect her and her child from infections. In addition, women should be vaccinated against the following diseases during pregnancy.

Whooping cough (again) — Whooping cough is extremely dangerous in babies, especially for those less than 6 months of age. To protect infants, pregnant women should be vaccinated against whooping cough during their third trimester (27th to 36th week of pregnancy).

The vaccine allows the mother to pass protective antibodies to her baby before birth. The shot also decreases the likelihood that the mother will get whooping cough and spread it to her child. Because protection from the vaccine wanes over time, experts recommend that women get vaccinated during each pregnancy.

Influenza — Although flu vaccine is recommended for everyone 6 months of age and older, pregnant women are a high priority because influenza is more likely to cause severe illness and death in pregnant women and pregnant women with flu have an increased chance of premature labor and delivery.

The flu shot is safe in all stages of pregnancy; the nasal spray vaccine should not be given to women who are pregnant.

The vaccine should be administered every year because the viruses and the vaccine always are changing.

Older adults

Influenza — Adults 65 years of age and older account for 90 percent of the flu-related deaths in the United States and more than half of flu-related hospitalizations. Seniors, including those living in nursing homes and other long-term care facilities, should be vaccinated against influenza soon after vaccine becomes available, if possible, by October to allow development of immunity before influenza begins spreading in the community.

Pneumococcal disease — Pneumococcus is a bacterium that causes serious infections of the lungs, linings of the brain and bloodstream. Because the risk of serious disease and death increases with age, vaccination against pneumococcus is recommended for adults 65 years of age and older. Two different pneumococcal vaccines are available for adults; depending on a person’s previous vaccination history, only one or both vaccines might be needed.

Shingles — Shingles is a painful rash caused by the same virus that causes chickenpox. Shingles can lead to complications such as skin infections, vision loss, long-lasting nerve pain, hearing loss and balance problems. Anyone who has had chickenpox can get shingles; the older a person is, the more likely he or she is to get shingles and the complications. Adults 60 years of age and older should receive the shingles shot to prevent shingles episodes and reduce the course and severity of illness, if they get shingles.

Whooping cough (yet again) — In addition to mothers, grandparents can spread whooping cough to new babies. Grandparents should check their vaccination status and get their whooping cough shot at least two weeks before coming into close contact with a new grandchild.

Vaccinations are not just for babies. Protect yourself throughout life and consult your health care provider about the immunizations that are right for you.

Jeanette Stehr-Green, MD, is the Clallam County Interim Health Officer.