Immunizations for the School-Age Child

The success of modern vaccines is one of the truly extraordinary accomplishments of medical science. In earlier generations many children contracted communicable diseases like polio and whooping cough, frequently with devastating consequences. Some children died; others were left with permanent impairments, perhaps dependent on a wheelchair. But the development of vaccines has made many of these childhood illnesses relatively rare and has thus improved the lifetime health and well-being of millions of people.

Unfortunately, some parents have become complacent about their children's immunizations. They have erroneously presumed that these serious diseases have disappeared or have been eradicated. Some parents have been frightened away by reports of possible side effects associated with certain vaccines.

However, the risks of not receiving immunizations are immense. (In some states, parents are legally accountable to obtain appropriate care for their children.) As a responsible parent, you need to ensure that your child receives all of the currently recommended vaccines. Today's vaccines are safe and generally produce only mild side effects (such as fever or localized redness). Severe adverse reactions are extremely rare.

For maximum effectiveness and protection, immunizations should be administered at particular ages. Your child should receive most of his childhood immunizations before his second birthday. These will protect him against 10 major diseases: polio, measles, mumps, chickenpox, rubella (German measles), pertussis (whooping cough), diphtheria, tetanus, Haemophilus (Hib) infections and hepatitis B. Immunizations also are available against rotavirus, influenza, rabies, pneumococcus and hepatitis A for special circumstances.

When your child is given a vaccine, he actually receives that part of the "weakened" or killed infectious organism that is able to stimulate his body to produce antibodies against it. These antibodies then protect him against the disease, should he ever come in contact with it.

Recent epidemics of preventable diseases have prompted the American Academy of Pediatrics to change its immunization recommendations so that additional shots are now advised between ages 4 and 12. In most parts of the country, states and/or school districts require children to have completed these inoculations before they can enter kindergarten.

Children ages four through six should receive booster doses of diphtheria, tetanus and pertussis (DTaP), polio, and measles, mumps and rubella (MMR) vaccines prior to entering school. If your school-age child has not received these booster immunizations, they should be given promptly. Sometimes the booster MMR is given between ages 11-12 years. An additional Td (tetanus and diphtheria) booster is recommended at age 11-12, and then every 10 years.

Because research is ongoing into developing new and improved ways to protect children from serious diseases, immunization guidelines change frequently. Talk with your pediatrician about his or her recommendations for your child.

Treatment for Side Effects

Before immunizing your child, your pediatrician should review with you what reactions you can expect and how to treat them. Generally, fever is managed with acetaminophen. For local reactions your pediatrician may recommend that you apply cool compresses for symptomatic relief.

If your child has any reaction that makes him uncomfortable for more than four hours, notify your pediatrician, who will want to note it in your child's records and prescribe appropriate treatment.

Live Virus Vaccines (polio, measles, mumps, rubella and varicella)

No live virus vaccine should be given to an immunodeficient or immunosuppressed child. Because measles disease is more dangerous to an HIV-infected child than is measles vaccine, such children may receive MMR (but not oral polio or varicella vaccines). Children who cannot receive oral polio vaccine can be safely vaccinated with inactivated polio vaccine (IPV).

Excerpted from "Caring for Your School-Age Child: Ages 5-12" Bantam 1999