As the dog days of summer wind down, many parents begin the necessary prep work to return their kids to school. Soon-to-be kindergarteners are fitted with backpacks larger than they are. Nervous incoming middle schoolers start getting pep talks from equally anxious parents. New high school freshmen have to explain to mom and dad that last year's clothes are now completely out of style.

What most of these kids have in common is that they will all need to get certain immunizations before they can begin going to classes. Parents go through their checklists: school supplies, new clothes, cases of their kids' favorite snacks and ... what else ... oh yeah, they finally open that large manila envelope that has been lying around untouched since June. The letter inside states that certain forms must be filled out and that required vaccines must be given. Then panic sets in - 10 days until school starts, and the next available check-up slot with the pediatrician is not for two months! After pleading with the pediatrician, the receptionist says she did some creative scheduling and can squeeze your child in tomorrow. Thank your lucky stars!

Now comes the hard part - getting your child to the office. She asks you, "Will I be getting any shots?" (Those may not be her exact words.) You think about it and say something vague, like, "I'm not sure. We'll see when we get there."

There are three main groups who will be getting their vaccinations: four-year-olds (usually the year before they start kindergarten), starting sixth graders and 16/17-year-olds. The kindergarteners will get the required booster shots (DPT-Diphtheria/Pertussis/Tetanus, Polio and MMR-V-Measles, Mumps, Rubella, and Chicken Pox). They will also be expected to have completed the entire series of Polio/DPT/MMR/Chicken Pox and Hepatitis B. Rising sixth graders need to get the Tdap (a new form of the tetanus shot) in order to be allowed into school. My office also strongly recommends that they get the Meningitis and HPV vaccines as well. The meningitis vaccine covers four of the five deadly strains. They get one at 11 years and a booster at 16/17 years. The HPV (Human Papillomavirus Vaccine) protects against a set of viruses that can cause cervical, penile, anal and oral cancer. If given at or before 14 years of age, it is a two-shot series; if given after 14 years of age, it is a three-shot series. The 16/17-year-olds will get their second meningitis vaccine and the Meningitis type B vaccine (also a two-part vaccine). College students who will be studying or working in hospital or clinical settings may also need to show proof of TB screening. Most colleges will require that your student have completed both of the meningitis vaccine series.

For a complete vaccine schedule and copies of the vaccine information forms, visit: www.cdc.gov/vaccines/schedules/easy-to-read/index.html.

Depending on where you live (DC, MD, VA), the HPV may be required for school entry. The typical side effects include muscle aches, injection site redness and mild fever. Rarely, more serious side effects may occur, such as allergic reactions or infections. Many websites have attributed other conditions like primary ovarian insufficiency, Guillain-Barre syndrome and Postural Orthostatic Tachycardia Syndrome (POTS) to the administration of HPV. However, the Centers for Disease Control and the Food & Drug Administration have extensively researched the data and have not found any relationship between these conditions and the HPV vaccine.

It's important for your child's vaccines to be up-to-date to not only to protect the child from deadly diseases, but also to prevent spreading those same diseases to others. These diseases have caused millions of childhood deaths in the past, and I doubt anyone wants them to return.

So enjoy those last days of summer, but remember to schedule your child's check-up and shots before school starts. Many schools will not allow the student to attend if their physical forms and vaccines are not completed properly. I encourage everyone to have a good talk with your pediatrician about the vaccines necessary for school. As they say, an ounce of prevention is worth a pound of cure.


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William "Dr. Bill" Incatasciato is a pediatrician at Capital Area Pediatrics. He practices in the Herndon office in the Woodland Park Crossing shopping center. For more information about Dr. Bill and/or his practice, visit capitalareapediatrics.com.