The Importance of Immunizations in Adolescents

Misha Roitshteyn, M.D., Pediatrician

It is virtually impossible to overstate the importance of immunizations upon our health, and especially upon our children’s health. Yet, concerns seem to swirl around whether or not to immunize with more and more parents questioning the benefits of vaccinations and their potential side effects. There is much to consider in this debate. But, immunizations have been one of the most effective public health interventions of our time. Some of the most notable accomplishments of vaccinations include the eradication of smallpox, the elimination of polio from the western hemisphere, and the near elimination of measles in the United States.  Such vaccine-preventable diseases are no longer as prevalent and as life-threatening as they once were. However, risks and threats still exist and especially for those individuals who go unvaccinated.

Childhood immunization in the United States is at an all-time high for younger-aged children. For adolescents, there is not as much compliance with current vaccine recommendations. Several new immunizations have been introduced and guidelines, per the American Academy of Pediatrics, have changed. The following are recommended immunizations for older children:

One cannot address childhood and adolescent immunizations without referencing the recent pertussis outbreak, which occurred in many states in the United States and was declared an epidemic in California in July 2010. Pertussis, (pronounced per-TUS-iss), otherwise known as “whooping cough,” is a very contagious respiratory tract infection. Although it initially may resemble the common cold, whooping cough may become a more serious illness, particularly in infants and small children. Pertussis is most contagious during the incubation period, which is before coughing starts. The best and most effective way to prevent it is through vaccination. The childhood vaccine is called DTaP and the vaccine for adolescents and adults is called Tdap. Both vaccines protect against not only whooping cough but tetanus and diphtheria.

What challenges do doctors face when promoting immunization for children and adolescents?

It is difficult to keep parents informed of vaccine recommendations. There have been frequent changes in the adolescent immunization schedule. Physicians generally track research and advice of the American Committee on Immunization Practices (ACIP) and the American Academy of Pediatrics (AAP). Guidelines evolve over time with changes to age indications or dosing intervals. It is recommended that parents ask questions when they are confused and use annual exams as an opportunity to check-in with their child’s physician on the latest advice for immunizations.

Parental concerns about vaccine safety are understandable; but, sometimes concerns turn into undue alarm and may be fueled by media hype or inaccurate public information. In the last several years, to reduce real or perceived risks, the Center for Disease Control (CDC) and manufacturers of vaccines have recalled existing vaccines and recommended the use of thimerosol-free vaccines. These actions inadvertently increased public fear regarding vaccine safety. Then, with the increased use of social media, individuals opposed to immunizations can more easily express their views to a wider audience. Highly charged, conflicting opinions and the on-going debate can become overwhelming and confusing to those attempting to sort through the facts. It is important to carefully consider the source of one’s information about vaccines and formulate opinions and action plans in consult with accurate information, credible sources and your child’s physician.

An additional challenge for physicians attempting to insure adolescent immunizations is that older children and teenagers to not always see their physician for an annual physical. Or, when they do come for an appointment, they may do so without an adult. Doctors are required to provide the risks and benefits of immunizations to a parent or adult guardian. Some states are considering legislation to allow minors to consent for vaccines, but currently, this is not the case. So, doctors are prevented from advising on and administering vaccines if the older child comes alone to an appointment.

Lastly, cost and coverage may work against families in assuring that older teenagers are immunized. Some insurance carriers do not cover routine vaccinations after 19 years of age. Paying for these relatively expensive vaccines is difficult for many families, especially in today’s economic environment. If securing medical care presents a financial challenge, we encourage families to inquire about payment programs and/or community resources that may be available. Bay Valley Medical Group is willing to work with individuals and families to address such needs.

Due to the importance of keeping vaccinations up-to-date for all members of the family, make sure you schedule annual physicals and talk with your physician during your next office visit. Your physician is equipped to help you understand the latest in recommendations, outline the risks and benefits and work with you to help promote and maintain your child’s good health.

For additional information on childhood and adolescent immunizations, visit:

Center for Disease Control - www.cdc.gov
American Academy of Pediatrics - www.aap.org
Advisory Committee on Immunization Practices (ACIP) - www.cdc.gov/vaccines/recs/acip/default.htm

Dr. Roitshteyn is board-certified by the American Board of Pediatrics and practices at Bay Valley Medical Group’s Pleasonton office. He can be reached at 925-462-7060.