Preventive care includes advice and information concerning physical growth and development as well as social and academic issues. Topics include a balanced diet as well as the importance of physical exercise and ongoing health maintenance activities including immunizations. School and after school activities are also important as are discussions about violence and injury prevention. Specific risk reduction topics include the use of tobacco, alcohol or other drugs as well as sexual practices.
One of the easiest ways to reduce risk in adolescents is through appropriate immunizations.
The HPV (Gardasil) vaccine prevents certain HPV types (HPV types 16 and 18) that have been associated with cervical/ vaginal cancer in women, penile cancer in men and anal and oropharyngeal cancer in men and women. It is a three dose series that is given at age 11 or 12 years and then a booster is given 2 and 6 months later. There must be at least 2 months between the first dose and the first booster and 4 months between the first booster and the second booster. A longer period can occur between doses but the adolescent is not adequately immunized until all three immunizations have been given. It is recommended for males and females.
The MCV4(Menactra) vaccine is a meningococcal conjugate vaccine that protects against 4 of the 5 serotypes that affect humans.
The Tdap (Boostrix) vaccine is a combined tetanus, diphtheria and pertussis vaccine that includes a pertussis component to prevent whooping cough.
The last vaccine is influenza vaccine and should be administered to everyone over 6 months every year.
If any immunizations have been missed they need to be administered to allow the adolescent to “catch-up”. This includes a three shot hepatitis B (HBV) series as well as inactivated polio series for those younger than age 18 years. Two doses of MMR and Varicella vaccine should also be verified. A two dose hepatitis A vaccine series (HAV) is also recommended for all adolescents.
If the adolescent is immunocompromised a pneumococcal vaccine is also recommended to prevent invasive pneumococcal disease. A booster dose of MCV4 (Menactra) is recommended 5 years after the initial dose at age 11 or 12 years.
In 2010 the HPV initial dose compliance for females was 40% and only 32% completed the three dose series. The compliance rate for Tdap and MCV4 were both under 70%. The rate for a second dose of varicella vaccine was only 58%. The best way to improve immunization compliance is through a top to bottom awareness of the benefits of immunizations and a review of immunization status every time an adolescent is seen in the office. All adolescents should have an annual healthcare visit and if a teen is seen who has a minor illness and they are behind in their immunizations catch-up immunizations should be given at the illness visit.
In terms of safety concerns the HPV vaccines are extremely safe. Almost 50 million doses have been given in the US and there have not been any serious safety concerns raised. The HPV vaccines are given at age 11 or 12 years so they are received and the child is immunized before there is a risk for exposure to the virus (HPV). Since teens are engaging in sexual activities at younger ages it is imperative they are protected early or the vaccine is not effective.
We believe every adolescent should receive these immunizations. We are confident they are safe and provide vital protection for your child from illness and cancer. We want to reassure you the risks for any of the immunizations are minimal when compared to the actual benefits. You are doing the right thing when you immunize your adolescent.