Backpacks, pencils, paper, and notebooks are necessary items for most children as they head back to school in the fall. Parents anticipate and expect this supply list every year because for the most part it varies very little. In comparison, the need for children to have annual well child visits does not change from year to year as well. However, I am often amazed at the number of parents who wait until the last minute to schedule their child’s yearly physical and immunizations.
Each year about this time, doctor’s offices are flooded with those frantic parents who just now realized (so they say) that their precious darling needs a school or sports examination. Even though they went through the same scenario the previous year, it apparently caught them by surprise this year, right? Well, that is the explanation they try to sell to our staff as they beg, borrow and sometimes steal for an appointment slot that was booked weeks in advance by those highly-organized parents who wanted to beat the rush. “If you don’t get him in today, they will not let him in school! I work full time and this is my only day off! (Did you not know about this scheduled vacation day in advance?) If you can’t get me in, I will have to find a new doctor!” If you can think of it, we have heard it: every excuse known to man.
Therefore, in the spirit of helpfulness, I dedicate this column to our parental procrastinators. Let’s start with the basic facts: children need to be seen at least on a yearly basis. I always encourage parents to consider making the appointment around the time of the child’s birthday. This would also be a great time to schedule dental visits as well.
Preschool children (ages 3-5)
By age 2, most children should have received the bulk of their immunizations including protection against diphtheria, tetanus, polio, measles, mumps, rubella, varicella, hepatitis A, pneumococcal, and h. flu. Many of those vaccines can now be given as combinations, so it is not as traumatic as it used to be.
Preschools are required to document that children are properly immunized or that they have a letter, usually from a physician, stating the reason that they are not vaccinated. Some schools or daycares will not even accept the child otherwise. Immunization records are very important and should be kept in a safe place. These documents may be needed for future travel plans, employment or educational endeavors. If I had a dollar for every time we have had to re-fax vaccine records to the same individuals, I would be a rich woman.
Not only do I spend a lot of time explaining the importance of immunization, I also expend a lot of energy trying to convince people that immunizations do not cause autism. There is a large segment of our communities who choose not immunize their children. Some refuse them in their entirety while others delay the initiation of vaccines.
Although the estimates of Autism Spectrum Disorder in 2002 was higher as compared to the 1990’s with 1 in 68 children meeting criteria for ASD, there has been no causal relationship between immunizations and autism per a scientific study by the Institute of Medicine. Furthermore, the controversial preservative, Thimerosal, was removed from all childhood vaccines in 2001.
Elementary through High School (6-18)
The age range should have completed the bulk of the required vaccines and should be receiving boosters at this point. For instance, between the ages of 11-13, children need a tetanus booster, Tdap. This vaccine helps protect them from tetanus or lockjaw, diphtheria, or whooping cough. Each of these diseases is caused by bacteria. Diphtheria is spread via droplets from sneezing or coughing and tetanus is spread through open skin wounds from cuts or scratches particularly obtained from dirty rusty objects.
These annual exams are not solely for the administration of vaccines, but are also intended to ensure that children are developmentally appropriate for their ages. Are they walking before 15 months? Are they speaking 2 word sentences by the age of 2? Are they socially interactive? All of those skills plus a host of others are assessed at well child exams.
It is also important for athletes to be examined for congenital heart problems or joint issues. Eating disorders or exogenous testosterone use can sometimes be discovered during these exams as well. Discussion around head injuries and repetitive concussions should also be included.
Back to school time is more than just making sure our kids have adequate paper and new school clothes and uniforms. To learn effectively, our children need to be healthy and armored with the right immunizations to help prevent disease.
Yours in Service,
Denise Hooks-Anderson, M.D.
Assistant Professor
SLUCare Family Medicine
yourhealthmatters@stlamerican.com
