Not that long ago, an adolescent could walk into my office for a physical exam and walk out with a smile on his or her face after receiving no vaccines. That's no longer the case. In the past decade, several new vaccines have emerged for this group of patients, causing confusion about what is recommended.
These vaccines are often recommended for teens:
-- HPV vaccine.
-- Meningitis vaccine.
-- Tdap vaccine.
-- MMR vaccine.
-- Hepatitis A vaccine.
1. HPV vaccine. This vaccine has been targeted toward the preteen population, as human papilloma virus is typically acquired in older teens and young adults. HPV is the virus that causes cervical cancer and genital warts. The advantage to starting this series early, before age 15, reduces the number of immunizations needed from three to two. If this vaccine series is initiated after the age of 15, a three-dose series is recommended.
2. Meningitis vaccine. Meningitis is a serious illness that causes layers of the brain to become swollen. Several different viruses and bacteria can cause this. While no vaccine can prevent viral meningitis, there are now two types of meningitis vaccines. The first is the more common meningitis ACWY vaccine, which typically requires two shots -- the first around 11 years of age, plus a booster at age 16. Sometimes, this vaccine series should begin earlier, depending on whether your child has a medical condition that could benefit from receiving it at an earlier age. The other meningitis vaccine, meningitis B, is indicated for 16 years and up. Some people choose to receive their second dose of meningitis ACWY and their first dose of meningitis B simultaneously, in order to reduce the number of doctor visits for immunizations.
3. Tdap vaccine. The next vaccine consists of three immunizations combined into one, and it protects against three different bacterial illnesses. In addition to the most commonly known, tetanus, this vaccine includes diphtheria and pertussis. It's indicated between the ages of 11 to 12. Tetanus has historically been thought to be contracted by stepping on a rusty nail but is often actually transmitted through contact with contaminated soil, which can occur when walking outdoors in bare feet. Another component of this vaccine is pertussis, which is commonly known as whooping cough. This bacterium is transmitted through respiratory droplets and therefore can be highly contagious. The third component is diphtheria, another disease that affects the respiratory system and is transmitted via airborne contact as well.
4. MMR vaccine. Another vaccine with three components is the measles, mumps and rubella vaccine. The re-emergence of measles in communities across America has been receiving widespread attention. Measles is known for its very contagious nature. It can be spread as easily as by being in the same room with someone who is infected. Measles includes a group of symptoms known as the three Cs: cough, congestion (mostly nasal, which is also termed coryza) and conjunctivitis followed by a distinct rash. Mumps commonly affects the lymph nodes and glands on one side of the face, resulting in swelling on that side of the face and a rash. Rubella, while generally thought to be a milder illness, can be deadly in unborn children, so during pregnancy, a woman's immunity to rubella is routinely checked.
5. Hepatitis A vaccine. This vaccine was created to protect against one of the many strains of viral hepatitis that can affect the liver, causing cirrhosis, or scarring, of the liver. In general, symptoms are related to the gut and can include nausea, vomiting or stomach pain. In rare cases, the skin may turn yellow, which is called jaundice. This strain of hepatitis can be transmitted to humans from contaminated foods. Two vaccines over a period of six months are necessary, but often, adolescents received these earlier in their childhood. A quick review of an adolescent's immunization record will help determine whether a booster is necessary.
And let's not forget the influenza vaccine, which is traditionally given in the fall. This very contagious virus occurs with some regularity during the adolescent years, so it needs to be updated yearly given its short window of effectiveness.
In addition to these important vaccines, the adolescent visit is a prime time to discuss concerns such as growth, sexual health and maturity. Some other newer health topics to discuss include peer pressure, substances such as marijuana use and vaping, gun safety and the use of digital media.
Although the adolescent visit may now include more than a few minutes of questions and counseling, it's a critical step in bridging the gap between childhood and emerging adulthood.
Dr. Neha Vyas has been contributing to U.S. News since 2017, writing about health education and general medicine. She has been featured in several media outlets, including Reader's Digest, cnn.com, Good Housekeeping, Men's Health, CBSnews.com, MedPage Today, Real Simple and Health magazine. Dr. Vyas has been practicing family medicine since 2001 and currently resides in Cleveland.
Dr. Vyas is an assistant clinical professor at Case Western Reserve University School of medicine and Cleveland Clinic Lerner College of Medicine, and she is a fellow of the American Academy of Family Medicine. She earned her undergraduate degree in Anthropology from Rice University and her medical degree from Baylor College of Medicine, both in Houston.
Dr. Vyas uses her knowledge in evidence-based medicine to provide high quality health education to empower her patients as well as the community at large, all with the goal of developing healthy families and communities.