Shots help protect Idaho kids
After years of lagging behind other states, immunization rates get a boost
Are your teenagers and college students up-to-date on their shots? With the development of safe, effective vaccines for older kids, public health officials are placing a new emphasis on immunity for tweens, teens and college students.
"We're trying to reach those junior high and high school kids and get them ready for college entry," said Teresa Phillips, immunization program manager for the Central District Health Department in Boise.
"Most colleges now are requiring complete immunizations in order to attend school," she said.
In Ada County during 2006, almost 1,000 doses of a vaccine against meningitis were given, up from 385 during 2005. Meningitis is a potentially fatal bacterial infection that may be especially dangerous to high-schoolers and college freshmen.
Children ages 11 or older and young adults may need vaccinations for hepatitis A, hepatitis B, chicken pox and whooping cough, among others. A new shot against human papillomavirus, which can cause cervical cancer, is recommended for girls.
Shots may not just be for little kids anymore, but the emphasis of public immunization programs remains on the younger set. Many parents with kids starting school or day care in the fall will scour the house for immunization records or wipe away tears after shots at the doctor's office.
Treasure Valley public-health officials say it's for a good cause. Idaho's immunization rate for young children, once among the lowest in the nation, is at 78.1%, near the national average of 80.8 percent.
"We have made huge strides, but we still have work to do," Phillips said. "We still have a large number of kids out there who are not being immunized." Some of those kids have parents who believe shots can harm their kids. "There's a lot of people doing research on the Internet, and the information they get is not necessarily accurate," Phillips said.
An epidemic warning shot
A 1997 epidemic of pertussis, also known as whooping cough, prompted a statewide effort to track kids' immunizations, remind parents when shots were due and toughen the state's school and day-care immunization laws.
The epidemic has not reoccurred, but pertussis, which can be life-threatening to infants, continues to be a problem here: Idaho cases consistently exceed the national average. The state also continues to report sporadic cases of mumps, hepatitis A and other vaccine-preventable diseases.
Karleen Davis of Boise and her preteen daughter Sally Turley are doing their part to keep the state's immunization rates up. The pair visited the health department so Sally could get a booster shot for tetanus. It really doesn't hurt that much," Sally said afterward.
Davis said she keeps Sally up-to-date on her shots partly to protect people at higher risk of getting sick. "If we have a herd immunity, it won't get spread," Davis said.
Idaho parents are required to show proof that their kids starting school have had five shots against diphtheria, tetanus and pertussis, usually combined in one immunization; three doses of hepatitis B; two doses of MMR, the combined measles, mumps and rubella shot; and three polio shots. Parents who object to immunizations for personal or religious reasons can just say no, but the state makes it clear that parents can't say no just because they can't dig up kids' records when school starts.
The list of required vaccinations is shorter than in many other states, but a few booster shots, including one against pertussis, have been added here. A pertussis booster, part of a combination vaccine, now is recommended for schoolkids ages 11 or 12, but it isn't required. It is expected to keep immunity to the disease from wearing off as those kids grow up.
And in 2005, the state started requiring 4- to 6-year-olds to get two booster shots, one for measles, mumps and rubella, and another for diphtheria, tetanus and pertussis. Kids need those shots to go to school in Idaho, state law says. Six other CDC-recommended vaccinations, including the new vaccine to fight human papillomavirus, or HPV, don't make the list of must-have shots in Idaho.
Idaho lags behind much of the nation in vaccination requirements. Maybe that's because Idahoans are independent folks who by and large believe the government should stay out of personal decisions like whether their kids are up-to-date on their shots.
"I agree that parents should have the right to make that decision," said Phillips. "I also want parents to be educated with the correct information so they can make informed decisions."
The Central District Health Department has the HPV vaccine, approved in summer 2006 to ward off genital warts and cervical cancer caused by the human papillomavirus. Health-care providers support the vaccination, given in three doses to girls and young women, and it appears to be catching on slowly. It's expensive, about $140 a dose, but Blue Cross of Idaho and Regence BlueShield of Idaho, the state's largest insurers, pay for the vaccination. How much they pay depends on customers' policies. An estimated 80 percent of women nationwide will be infected with the sexually transmitted disease by the time they are 50 years old.
Vaccines to expect
Parents in the Treasure Valley can generally expect these vaccines, recommended by the CDC, to be offered at the ages indicated in the list at the right.
Shots required for day care or school entry or both are marked with a dash:
Birth
- Hepatitis B (first vaccination)
2 months old
- DTaP (first vaccination for diphtheria, tetanus, pertussis)
- Polio (first vaccination)
- Hib (Haemophilus influenza type b , first vaccination)
- Hepatitis B (second vaccination)
- Pneumococcal (first vaccination)
- Rotavirus (first vaccination, taken orally)
Just to make things more complicated, take note that Idaho's vaccine program supplies Pediarix, which is a single-shot combination vaccine for DTaP/polio/hepatitis B and can be given at 2, 4, 6 and 12-18 month visits.
4 months old
- DTaP (second vaccination for diphtheria, tetanus and pertussis)
- Polio (second vaccination)
- Hib (Haemophilus influenza type b, second vaccination)
- Pneumococcal (second vaccination)
- Rotavirus (second vaccination, taken orally, no shot)
6 months old
- DTaP (third vaccination for diphtheria, tetanus and pertussis)
- Pneumococcal should be throughout (third vaccination)
- Hepatitis B (third vaccination)
- Polio (third vaccination)
- Rotavirus (third vaccination taken orally)
12 months old
- Hib (Haemophilus influenza type b, third vaccination)
- MMR (first vaccination for measles, mumps and rubella)
- Hepatitis A (first vaccination, recommended but not required in Idaho)
- Varicella (first vaccination for chicken pox, recommended but not required in Idaho)
- Pneumococcal (fourth vaccination)
15 to 18 months old
- DTaP (diphtheria, tetanus and pertussis, fourth vaccination)
- Hepatitis A (second vaccination for hepatitis A, recommended but not required in Idaho)
4 to 6 years old
- DTaP (fifth vaccination for diphtheria, tetanus, pertussis)
- MMR (second vaccination for measles, mumps, rubella)
- Polio (fourth vaccination for polio recommended in Idaho, but not required by law)
- Varicella (second vaccination for chicken pox, recommended but not required in Idaho)
11 to 12 years old
- Human papillomavirus (girls) 3 doses
- Meningococcal (This shot to prevent bacterial meningitis is recommended at ages 11 or 12 or during adolescence. Infants get more cases of the illness, but adolescents are at higher risk of dying from it.)
- Tdap (This is a booster dose for tetanus, diphtheria and pertussis Follow-up booster shot should be given every five to 10 years, depending on federal recommendations.)
One more
If your kids have never had annual flu shots and they are age 8 or younger, they'll need two doses a month apart. After that, it's one dose every flu season, just like you. The CDC now recommends flu shots for healthy children as young as 6 months old.
Sources: Idaho Department of Health and Welfare, Vaccine Education Center, Children's Hospital of Philadelphia and Centers for Disease Control and Prevention
