The importance of keeping your children’s immunizations up to date

by Sheryl Darling-Mooney, RN, Public Health Supervisor, VMH Community and Home Care

One of the tasks each year parents experience is getting their children’s immunizations up to date. Common questions include: What is my child’s immunization status? Are they caught up? What do they need?  What is that one for?

If you do not have a current immunization record for your child there are a few different ways you can get one. You can obtain a copy from the facility where your child received their immunizations, you can contact your local public health department, contact your school if your child is school age. Most states have a statewide immunization database that immunizations are entered into when they are given. Iowa has IRIS (Immunization Registry Information System) that is used by most healthcare providers, public health departments, pharmacies and schools. When an immunization is given it is entered into the IRIS database. The IRIS tool not only is a record for what was given but a guide for what and when future immunizations are due. This database covers people of all ages. It is possible not all of the immunizations given will be recorded in IRIS. If they were given before the facility administering the vaccine utilized IRIS or they were given in a different state they may not be available in IRIS. In these situations it is best to contact the facility where they were given.

There is a structured immunization schedule that is routinely followed from birth through seventh grade. After seventh grade the schedule generally includes “highly recommended” rather than required. It is best to know what vaccines are out there, why they are recommended as well as knowing something about the diseases they prevent when making sound decisions regarding your child’s immunizations. Reliable information can be found on the CDC website (Center for Disease Control), IDPH website (Iowa Department of Public Health) as well as your local healthcare provider and public health department. Much information can be found on social media sites and much of it can only be considered misinformation. Choose your information source wisely! Today there are many helpful Immunizations and boosters that should be given during the school years to keep your children healthy.

DTap/Tdap - Dtap (diphtheria, tetanus toxoids, and acellular pertussis) is a vaccine given to children between the ages of 6 weeks through 6 years of age). The usual schedule is a series of 4 doses at 2,4,6 and 15-18 months. A dose of Tdap (tetanus toxoid, diphtheria toxoid and acellular pertussis) is required before entry into 7th grade. A part of this vaccine combination is Pertussis (whooping cough) vaccine.  Pertussis, or “whooping cough” is a very contagious respiratory disease that can be fatal to persons not vaccinated or are immune compromised. The CDC also recommends all persons coming into contact with children, especially small babies who are not fully immunized, receive a Tdap to protect those most vulnerable to pertussis.

Hepatitis B - Hepatitis B is a long lasting infection that can lead to destruction of the liver, cancer of the liver and even death. The Hepatitis B virus can pass through microscopic breaks in the skin. A person can become infected in several ways such as during birth when the infected mother passes the virus to her baby, having unprotected sex with an infected person, being stuck with a used needle and by sharing personal items such as a razor or toothbrush. People often spread the Hepatitis B virus without even knowing they have it. Hepatitis B vaccination is a requirement for school age children and healthcare workers as well as many other types of employment. Hepatitis B vaccine is recommended for people of all ages. All newborn babies should get their first Hepatitis B vaccine within the first 12 hours of birth.

MMR - MMR is a vaccine that covers three diseases- Measles, Mumps, and Rubella (also known as German Measles). Measles and Rubella outbreaks are very rare among immunized people in the U.S.  but occasionally do occur and can have serious complications for those not immunized, including a pregnant woman’s unborn child. Children are required to have two Measles, Mumps, and Rubella (MMR) vaccines prior to entering school, if these get missed, they need to be given as soon as possible. We do see occasional outbreaks of Mumps, especially in the college age group. The individuals who have gotten Mumps have generally had a mild case of the illness which has been attributed to some immunity from the vaccine. In 2015 Iowa Department of Public Health worked with local public health agencies to give a third MMR to college students attending colleges in Iowa that were experiencing a Mumps outbreak. At this time a third MMR is not recommended for the general public.

Varicella - Varicella (chicken pox) is a common childhood disease that can be serious. It spreads when germs pass from an infected person to the nose or throat of others. Chickenpox causes a rash, itching, tiredness, and fever. It can lead to pneumonia, brain damage or even death. About 70-90% of people who get the vaccine are protected from chickenpox. All children who have not had chickenpox or gotten the chickenpox vaccine should be vaccinated. Currently children are required to receive two doses of Varicella vaccine before starting school. Getting the Varicella vaccine can also help prevent shingles later in life as they are caused by the same virus.

Inactivated Polio Vaccine - Polio is a paralytic illness that infects cells in the central nervous system that can lead to paralysis or even death. Before the introduction of this vaccine, thousands of people, mostly children, got polio every year.  IPV (inactivated polio vaccine) has proven to be a very effective vaccine and has lead to elimination of this disease in fully vaccinated individuals in the United States. The polio vaccine is a required vaccine that is a series of 4 vaccines given at 2, 4, and 6 months with a final one given between the ages of 4-6 years of age. This schedule can be modified if doses are not able to be given utilizing the usual timeline. Polio vaccine is not recommended for people over the age of 18.

Influenza - Influenza (flu) is a contagious viral disease that spreads from infected persons to the nose and throat of others.  For most people, it lasts only a few days causing fever, sore throat, cough, chills, muscle aches, headaches and fatigue.  Influenza can lead to pneumonia and is most dangerous to infants, the elderly and people with underlying health problems.  Anyone can get influenza, but rates of infection are highest among children.  By vaccinating children from 6 months to 18 years of age we can not only protect those young people, we can control the spread of the disease to all individuals.  The influenza viruses have the ability to change frequently, so the vaccine that fights them must be different every year.  That is why children should receive an influenza vaccination every fall when the flu season begins.

Meningococcal Vaccines - Meningococcal disease is a serious bacterial illness.  It is the leading cause of bacterial meningitis, an infection of the fluid surrounding the brain and spinal cord, in children 2 through 18 years in the United States.    There are two vaccines available to help prevent meningococcal disease. Each of these vaccines target different types of this deadly disease.

The principal mode of transmission is person to person through direct contact with oral or nasal secretions.  Students who spend time in crowded social settings are at higher risk due to the fact that many times they share drinks or utensils.  College students, especially those who live in dormitories, and their parents should discuss the risks and benefits of these vaccines with their health care providers.

HPV - HPV is a very common virus that can lead to many cancers including cancers of the mouth, throat, cervix, vagina, vulva, anus, and penis as well as genital warts.

HPV vaccine is a cancer preventing vaccine. This vaccine is recommended to males and females between the ages of 9-26. The younger the person is (in the recommended age group) receiving the vaccine the more antibodies they produce and the more immunity they get from this vaccine.  The HPV vaccine is given as a series of 3 shots.

HPV can be spread by intimate skin contact. Having sexual contact does increase this risk. People can get and spread HPV without knowing it.

Hepatitis A - Hepatitis A is a disease that mainly affects the liver and can lead to fatal liver diseases. The symptoms of Hepatitis A include malaise, fever, anorexia, nausea, vomiting, dark urine and jaundice. Vaccine is available to help prevent this disease. This vaccine can be given as early as one year of age. The vaccine is a two-dose series. If this is not given when child is first eligible it can be given to children over the age of one year.

The Veterans Memorial Hospital Community and Home Care staff keeps record of each child that has received a vaccination at their clinic as well as having access to any immunizations given at a facility that utilizes the IRIS (Immunization Registry Information System).  Veterans Memorial Hospital Community and Home Care offer immunizations for infants and children weekly. The office has Immunization Clinic hours from 1:00 -6:00 p.m. on the first and third Wednesday and from 1-4:00 p.m. all other Wednesdays of the month.

Call Veterans Memorial Hospital Community and Home Care at 563-568-5660 with any questions.

Source: Epidemiology and the Prevention of Vaccine-Preventable Diseases, 13th Edition, U.S. Department of Health and Human Services Center for Disease Control and Prevention.