Parents used to think that once their kids were out of elementary school, they were done with vaccines. But the rules are changing.
In California, middle schoolers and high schoolers now have to prove that they're immunized against pertussis, or whooping cough, in order to attend school. It's one of dozens of states that have recently passed laws requiring vaccines for teens and tweens.
The California law was prompted by an outbreak of whooping cough that killed 10 babies last year, and sickened 9,000 people. "It had been 63 years since we'd seen those types of numbers," says Ron Chapman, director of the California Department of Public Health.
Pertussis causes a violent cough that can last for weeks, and can be deadly in babies too young to get vaccinated. Because it spreads easily in schools, and because the protection that children get from pertussis shots in early childhood wears off, health officials vaccinate older children to help halt spread of the disease.
But that means they have to vaccinate about 3 million children. "It is a huge, massive vaccination response," Chapman says. It also means rolling out every public health communication tool in the book, from multilingual public service announcements to Facebook posts.
Parents are targeted, too. Jeanette Restauro of Fairfield, Calif., got four different reminders to get her 11-year-old daughter vaccinated. "The first time I got the information was through my daughter's backpack," she says. "Then a few weeks later they did it again, then once on the email and once in a phone recording."
That worked: Restauro took Alyssa in to get the shot. It's something she never had to do when her four older children were that age.
But it's something that parents all over the country now have to start thinking about. In the past few years, dozens of states have passed laws requiring shots for teens and preteens. Pertussis (given in the Tdap shot) and meningococcus are the most common.
"It used to be that when you were in kindergarten you were done with immunization, but that's not how it is anymore," says Sharon Humiston, a professor of pediatrics at Children's Mercy Hospital in Kansas City, Mo. "You have immunizations throughout the lifespan now."
Sometimes that's because early-childhood vaccinations, like whooping cough, wear off and boosters are required. In other cases, it's because doctors have come up with new vaccines, like HPV. But it's not always easy to get teenagers in for these shots. One problem is that a lot of teens aren't covered by health insurance. And many parents and kids aren't familiar with the diseases.
Meningococcal disease is one of those. It's a rare but deadly form of meningitis. Humiston has seen teenagers grievously ill in the emergency room from meningococcus infections, and hopes she never sees it again. "I think that once parents see a photograph of one adolescent who has lost their limbs to meningococcal disease, they end up choosing the vaccine," she says.
That's why the federal Centers for Disease Control and Prevention and state health departments are trying to educate tweens, teens and their parents about both the diseases and the vaccines available. (The CDC's preteen and teen vaccines website includes a quiz, videos and a vaccine scheduler.)
In some cases, teenagers may need catch-up vaccines for diseases such as chicken pox or hepatitis B. And as teen vaccines become more common, parents and pediatricians are learning that while big kids may not cry, they don't always handle shots so well. Humiston says: "We even sometimes have adolescents who faint after getting their shots."
That's a reminder, if any is needed, that big strong 17-year-olds still need parents watching their backs when it comes to health.
DAVID GREENE, Host:
Now, the HPV vaccine is not the only new vaccine parents need to be thinking about. States are starting to pass laws requiring teens and preteens to get a host of other shots, as NPR's Nancy Shute reports.
NANCY SHUTE: Parents used to think that once their kids were out of elementary school, they were done with vaccines. But the rules are changing.
(SOUNDBITE OF AD)
UNIDENTIFIED WOMAN: Parents, there's a new rule for school. Students entering seventh through twelfth grade this fall need proof of a whooping cough booster shot before starting school. Don't wait.
SHUTE: That's an ad running in California. It's about a new law aimed at stopping a deadly outbreak of whooping cough that killed 10 children last year. Whooping cough is also known as pertussis. Ron Chapman is head of the California Department of Public Health.
RON CHAPMAN: We had over 9,000 cases of pertussis in California, which was the highest number of cases since 1947.
SHUTE: Whooping cough spreads easily in schools, and the protection that children get from pertussis shots when they're babies wears off. That's why health officials are trying to get all middle- and high-schoolers vaccinated.
CHAPMAN: There's a huge, massive vaccination response. We're talking about vaccinating upwards of 3 million children in California.
SHUTE: To do that, they're using every public health tool in the book. There are Facebook pages, Twitter feeds, rap songs.
(SOUNDBITE OF RAP SONG)
UNIDENTIFIED MAN: (Rapping) See your doc, get your shots. It's worth it now. My skills in soccer and my health are perfect. What? Preteens, get your shots.
SHUTE: Parents are targeted, too. Jeanette Restauro got four different reminders to get her 11-year-old daughter vaccinated.
JEANETTE RESTAURO: The first time I got the information was through my daughter's backpack. And then a few weeks later they did it again - and once on the email, and once on a phone recording.
SHUTE: Sharon Humiston is a pediatrician at Children's Mercy Hospital in Kansas City, Missouri. She studies teenage vaccinations.
GREENE: It used to be that once you were in kindergarten, you were done with immunizations. But that's not how it is anymore. We have immunizations throughout the lifespan now.
SHUTE: Meningococcal disease is one of those. It's a rare but deadly form of meningitis.
HUMISTON: I think that most parents, once they see a photograph of one adolescent who has lost their limbs to meningococcal disease, they end up choosing the vaccine.
SHUTE: That's why state and federal health agencies are making a big push to educate parents and teens about vaccines - like with this video, which urges students to get flu shots.
(SOUNDBITE OF VIDEO)
UNDENTIFIED MAN: It would be a lot easier to hang out with them if they took better care of themselves. I told Steve to get his flu shot. Oh, but no, he was too busy playing video games...
SHUTE: In some cases, teens may need also vaccines like chicken pox or hepatitis B. As teen vaccines become more common, parents and pediatricians are learning that big kids may not cry, but they don't always handle shots so well. Sharon Humiston sees that as a pediatrician.
HUMISTON: We even sometimes have adolescents who faint after getting their shots.
SHUTE: Which is a reminder that teenagers aren't quite grown up.
HUMISTON: We do think of them as being so big and robust, and that they can protect themselves somehow. But you know, no one can protect themselves against these microscopic viruses.
SHUTE: And when it comes to health, teens still need parents watching their backs. Nancy Shute, NPR News. Transcript provided by NPR, Copyright NPR.