New Vaccines for the New Year

It used to be a right of passage – get the "preteen" tetanus booster and you’re golden until you are "old" – in your twenties! With the landscape of immunizations constantly changing, our teens will now have to wait much longer for those immunization bragging rights…teens are the latest target of new vaccine development, and redevelopment.

Vaccines target populations at risk and lessen the individual and population burden of otherwise horrible and difficult to treat illnesses. Between waning immunity from early childhood vaccinations and increased susceptibility to some young adult illnesses, teens are at the ideal ages to re-boost for certain vaccinations and administer the first dose for others.

The 2006 Childhood Immunization schedule is hot off the press: www.cispimmunize.org/IZSchedule_2006.pdf . You’ll notice that multiple vaccines are now commonplace at many well-child visits, including the teen visits. Keep in mind the reality is the pain of even multiple shots is far less than the impact of those illnesses on a growing body.

Here are the key changes to hone in on for 2006, as well as a glimpse of vaccines in development for the future:

Menactra: This is the vaccine for meningitis which tends to spread rapidly among older teens and college-aged students. It is a single-dose vaccine that can be given to 11-12 year olds, teens entering high school or at 15 years of age, and for college freshmen living in a dorm. It is a very effective vaccine which a long history of success in the UK. The CDC is currently investigating a few cases of a progressive neurologic condition called Guillain Barre Syndrome (GBS) that developed in 5 teens after receiving Menactra. However, there is still no reason to panic. According to the FDA, "the rate of GBS based on the number of cases reported following administration of Menactra is similar to what might have been expected to occur by coincidence, that is, even without vaccination."

Boostrix (TdaP) for teens: While this vaccine is new, the vaccine components are not. The DTaP vaccine has long been in the schedule for infants with a booster given at the kindergarten physical. But, immunity to Pertussis wanes by the teenage and young adult years and outbreaks have become more common in schools. So, the Td that teens used to receive has been replaced with a cousin, the TdaP and will be given at the 11-12 year old visit, or anytime between 13-18 years of age for teens not immunized earlier.

Hep A for 1-2 year olds: This vaccine has been around for a long while. Prior immunization schedules targeted high risk areas but the new schedule advocates universal immunization. One of the reasons vaccination is so important is that young kids who get Hepatitis A often have no symptoms but can pass the virus to other members of the family who can become very sick. Kids will now receive a first dose between 12-23 months of age with a booster 6 months later.

Vaccines to watch for in the future:

Proquad – measles, mumps, rubella and varicella. The advantage here is a reduced number of immunizations for the toddlers.

Rotavirus: This is a new version of a vaccine developed a few years ago and pulled off the market due to an increase in an intestinal condition called intussusception. Rotavirus causes a horrible stomach illness with vomiting, profuse diarrhea and dehydration prompting ER visits and hospitalization for many children. The studies done on this new vaccine are very promising and more information will be available as the vaccine becomes licensed and put into more use.

HPV for teens – human papalomma virus vaccine. This is the virus that causes genital warts and cervical cancer. HPV can be very hard to detect and many young women are unaware they have been exposed. This vaccine should alleviate a great concern for future generations of women.

It can be overwhelming to decide whether a "new" vaccine is right for your child. That is where your pediatrician comes in. You can also find updated school entry requirements at www.mass.gov/dph/cdc/epii/imm/imm.htm#school. General immunization information can be found at the American Academy of Pediatrics (www.aap.org), the Centers for Disease Control (www.cdc.gov), and Pediatrics Now, my new child health information web site (www.pediatricsnow.com).

So, with the immunization landscape constantly in flux, none of us will likely ever be vaccine free for very long. But if all goes well, our teens will have a healthier adult life than we have all had – and our grandchildren’s lives will be even healthier. A poke today really will keep the doctor away tomorrow. Worth the fleeting pain? I certainly think so.

What do you think? You can email questions or comments to me at drgwenn@pediatricsnow.com.

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