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Military Health System

Don't Hesitate: Vaccinate Today for School

Image of A boy gets the COVID-19 vaccine. Naval Hospital Corpsman 2nd Class Vernon Thomas, a preventive medicine technician, gives a vaccine to a military family member at Naval Hospital Jacksonville’s Immunizations Clinic, Aug. 8, 2019. (U.S. Navy photo by Petty Officer 1st Class Jacob Sippel)

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Back-to-school time is here already, and many parents are required to show proof of vaccinations before their children can return to in-person classes.

TRICARE covers the cost of physicals for school enrollment, which include vaccinations.

Parents should know that these vaccines have been proven safe and effective many times over in large clinical trials in this specific population to fight or eradicate childhood diseases. The same goes for teenagers.

So, protect your children. Protect yourself. Stay up to date and talk to your pediatrician or health care provider today about vaccinations for children and teens.

Think of childhood vaccines in five primary groups, said Army Capt. (Dr.) Nicholas DeStefano, officer in charge for primary care and a family physician at Weed Army Community Hospital, in Fort Irwin, California:

  1. Very early childhood vaccines generally given at 2, 4, and 6 months: hepatitis B (Hep B), diphtheria-tetanus and pertussis (DTaP), Haemophilus influenza B (Hib), pneumococcal conjugate vaccine (PCV), polio vaccine (IPV), and rotavirus vaccine.
  2. Early childhood vaccines generally given at 12 or 15 and 18 months include the very early vaccines again, except for rotavirus and Hep B, measles-mumps-rubella (MMR), varicella (chicken pox), and hepatitis A (Hep A).
  3. Childhood vaccines given at age 4: DTaP, IPV, MMR, and Varicella.
  4. Preteen vaccines given at age 11: DTaP, human papillomavirus (HPV), and meningococcal (meningitis).
  5. Teen vaccine given at age 16: meningitis.

Flu Vaccine

The influenza vaccine should be given every year to children 6 months and older. “Influenza has a history of causing significant illness especially in children under 5 and adults over 65,” DeStefano said. “If or when the restrictions lift for COVID-19, people are going to return to family gatherings, and we are likely to see a significant increase in influenza cases,” he warned.

Also, he said he “tries to help parents make the connection between mask wearing and social distancing and the number of influenza infections last year,” which were far lower than usual, adding: “It also helps to remind families that once we are able to have children safely in schools across the country, we don’t want them to get sick and have to be out of school again for flu.”

The flu vaccine usually becomes available in late August or early September. Check with your health care provider.

DeStefano said he strongly recommends the COVID-19 vaccine for “anyone who is eligible.”

He said he generally spends more time discussing getting the flu vaccine because of the age of the patients he sees, who are too young for the COVID-19 vaccines under the Food and Drug Administration’s emergency use authorization.

The Pfizer COVID-19 vaccine can be given to youths 12 years and older. It is recommended that anyone 16 and older be immunized against COVID-19. Large studies are ongoing in children younger than 12.

A teen boy gets the COVID-19 vaccine.
Army Staff Sgt. Michael Witham, from the DENTAC at Fort Campbell, Kentucky, administers a COVID-19 vaccine to military family member Alan Saucer at Blanchfield Army Community Hospital, April 15, 2021. The 17-year-old chose to get vaccinated to reduce his chances of contracting the disease and possibly spreading it to others. (U.S. Army photo by Maria Christina Yager)

Vaccine Hesitancy

Like other doctors, DeStefano sees parents who are hesitant to vaccinate their children.

“The most effective methods to address vaccine hesitancy are specific to addressing each individual parent’s concerns,” he said.

“My grandparents lived in a world with few vaccines and cars with no safety features,” he tells parents with vaccine concerns. “Our desire to protect ourselves and our children has led to an increase in the number of vaccines against deadly diseases in the same way it has led our cars to have seatbelts, airbags, side airbags, and backup cameras,” he tells them.

PCSing

As for children who are making permanent changes of station (PCSing) with their families, DeStefano recommends the standard battery of age-appropriate vaccines.

Additionally, he recommends an early MMR vaccine in children 6-11 months old who are PCSing to Europe and the Japanese encephalitis and typhoid vaccines for those PCSing to Asia.

DeStefano suggests parents check the CDC’s travel site for the specific country to which they are being stationed to get the exact vaccination requirements.

College-age Vaccinations

Dr. Prabha Gupta, an internist at Kenner Army Health Clinic in Fort Lee, Virginia, recommends that college-age patients get a tetanus/acellular pertussis (whooping cough) combination because, “for some, it’s been more than 10 years since their last tetanus shot, and they may not have had the whooping cough vaccine before,” she said.

“I definitely recommend an influenza shot and a COVID-19 vaccination,” she added.

“We know the patterns of influenza” every year, but it would be a “double whammy if a patient got flu and COVID-19 together,” she said.

Her approach to the COVID-19 vaccination question is to “tell you the facts, the evidence, and why it’s important, and my advice, but say, ‘It’s up to you, the patient, to decide whether to get the COVID-19 vaccine.” She said “nine out of 10 walk out of the room with the shot.”

Other immunizations for college-age patients are the meningitis vaccine, which is not mandatory, but a student who doesn’t take it has to sign a waiver, she said.

Additionally, Gupta double-checks that her patients have received the MMR vaccine and have proof of that vaccination. If not, they must have a blood test to check for MMR antibody levels in their blood.

HPV is the most “under-discussed” vaccine, Gupta said. “I discuss it” because the vaccine is recommended for those up to 26 years of age.

“I don’t know if pediatric health care promoted the vaccine or not,” Gupta said, “so I give them the option of a three-dose regimen.”

DeStefano is an enthusiastic proponent of the HPV vaccine because it prevents cervical cancer in women and throat and anogenital cancers in both sexes. The HPV vaccine “targets the highest risk strains of HPV, which account for over 90% of cervical cancer,” he said.

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