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Thanks to vaccines, most U.S. children are protected against serious diseases such as measles, mumps, diphtheria, polio, and chickenpox. But what happens to that protection in adolescence? A teen who missed a vaccination or booster as a child may need to be immunized. Sometimes a teen's living situation or medical condition makes it necessary to get a vaccination. Other vaccines lose their protective power over time, and teens and young adults need a booster to stay protected. Learn more about which immunizations teens need by taking this quiz, based on information from the CDC.
1. Who decides what immunizations children, teens, and adults need and when they should get them?
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The CDC, the American Academy of Family Physicians (AAFP), and the American Academy of Pediatrics (AAP) jointly issue a child and teen immunization schedule each year. Then the CDC's Advisory Committee on Immunization Practices (ACIP), with input from many liaison organizations, reviews the schedule to ensure consistency with new vaccine developments and policies, and publishes it each year. Before a vaccination can become part of routine medical practice, three steps must be taken: the FDA must license the vaccine; ACIP and the Committee on Infectious Diseases of the AAP and AAFP must recommend the vaccine for use; and the vaccine must be subsidized to cover children without private health insurance.
2. After the childhood series of diphtheria, tetanus, and pertussis vaccinations is completed—usually between ages 4 and 6 years—when should the next tetanus vaccine be given?
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A booster, known as Tdap, is given at ages 11 to 12. A teen who missed this booster should receive it. Immunity to diphtheria, pertussis, and tetanus starts to fade over time, so adults need a booster shot every 10 years throughout life for protection. One adult booster shot should be Tdap; the remainder can be Td. Vaccination is important for pregnant teens or teens who babysit young infants. Because of the risk of tetanus, this vaccine is also particularly important if the teen may be considering a body piercing or tattoo.
3. The childhood Hib meningitis vaccine protects against meningitis for life.
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The Hib vaccine routinely recommended to prevent serious illness in children provides protection against only the type of meningitis caused by Haemophilus influenzae type B (Hib). It doesn't protect against any other type of meningitis, such as meningococcal or pneumococcal meningitis or viral meningitis. The pneumococcal vaccine is now routinely given to children and may decrease infection by pneumococcal meningitis, although not enough time has elapsed since the beginning of routine pneumococcal immunization to verify that. Children ages 11 and 12 should receive the meningococcal conjugate vaccine to help prevent another type of meningitis. Meningitis is a general term for a viral or bacterial infection of the membrane lining a person's spinal cord and brain. Bacterial meningitis is usually more severe than viral meningitis and may lead to brain damage, hearing loss, or learning disability. Before the 1990s, Hib was the leading cause of bacterial meningitis, but the Hib vaccine has dramatically reduced the occurrence of this illness.
4. Meningitis strikes people of all ages, from infants to the elderly. One particularly virulent and almost always fatal type occasionally infects teens and young adults in colleges, boot camps, and other situations in which they are in close contact. What type of meningitis is it?
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This type of meningitis strikes quickly, causing severe headache, stiff neck, and fever, and is usually fatal. Often, by the time symptoms appear, treatment cannot save the victim. Meningococcal meningitis is spread by droplets in the air and by direct contact with an infected person, including coughing, kissing, and sharing cigarettes, utensils, cups, or lip balm—anything an infected person touches with his or her mouth. Those most at risk for this illness include high school and college students, particularly freshmen living in dormitories; U.S. military recruits; people traveling to countries that have an outbreak of meningococcal disease; and those who might have been exposed to meningitis during an outbreak. Although rare, the illness is significant enough that ACIP recommends all children ages 11 to 12 years get the meningococcal vaccine. The booster vaccine is also recommended at age 16. If a teen did not receive the vaccine at age 11 or 12, he or she can start at ages 13 to 15, with a booster at ages 16 to 18. The protection lasts about three years.
5. Under what conditions do teens need a vaccination for chickenpox?
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Teens should receive the "catch-up" chickenpox (varicella) vaccine series if they missed it as a child. In childhood, the vaccine is routinely given in two doses, the first at ages 12 to 15 months and the second at ages 4 to 6 years.
6. If a teen didn't receive the hepatitis A vaccine as a child, what conditions warrant getting the vaccine as an adolescent?
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The risk for hepatitis A increases with certain lifestyles (males who have sex with males, and users of illegal drugs) and occupations (health care or laboratory workers who come in contact with the hepatitis A virus), and for people who travel to countries where hepatitis A is common. Anyone at increased risk should be vaccinated. Teens with clotting-factor disorders or chronic liver disease should also receive the vaccine. (Any child age 1 or older who may be exposed to hepatitis A can receive the vaccine; it is often combined with the vaccine for hepatitis B.) Two doses of the vaccine are given six months apart.
7. Teens need the hepatitis B immunization if:
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Hepatitis B immunization is now recommended by ACIP for all adolescents. It is particularly important if the teen may be considering a body piercing or tattoo.
8. Because teens are young and healthy, they don't need an annual flu vaccination.
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Adolescents are just as likely to get the flu as children or adults. Teens are less at risk for complications of the flu because they are healthy with strong immune systems; those at highest risk for complications are very young children and elderly adults. But even healthy people can have severe complications from the flu. Although flu shots aren’t required for teens, the CDC strongly recommends annual flu shots for everyone older than 6 months through adulthood.
9. How are immunizations given?
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Although most people think of immunizations given as shots, some newer vaccines can be given by other means. The flu vaccine comes in a version that sprays in the nose. This version is available for children and adults ages 2 to 49. The typhoid vaccine is given by mouth. Other vaccines are given by injection: DTaP, MMR, and Hib, for example.
10. Teens entering high school are required to have had a second vaccination for measles, mumps, and rubella (MMR). Why?
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Most children get the second MMR around ages 4 to 6 years, when they start school. Some children, however, miss getting that second MMR and must make it up at the beginning of high school. This will help protect against getting all three of these diseases. In addition, rubella, the “R” in MMR, can cause severe development problems and intellectual disability in the developing fetus. Requiring teens to get a second MMR if they have not already had two doses ensures complete immunity to rubella, so that when a young woman later gets pregnant, rubella will not cause problems for her developing child.
11. Human papilloma virus (HPV) vaccine is required for both boys and girls before age 12.
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HPV vaccine is approved and recommended, but not required, for both girls and women and boys and men ages 9 to 26 to prevent genital warts and several types of cancer. These include cervical cancer, anal cancer, vaginal cancer, and vulvar cancer. The vaccine is given in a series of three shots over six months. Experts suggest that the vaccine be given at the adolescent health care visit at age 11 or 12. It is important that the series be given before first sexual contact, if possible, so that full protection from the vaccine can be developed.
