Vaccines for preteens and teens must to make up for the immunity loss gained through vaccination in infancy and early childhood
By Syed Akbar Hyderabad: Vaccines for adolescents and teenagers? This may surprise many parents. But the Indian Academy of Paediatrics in its latest vaccination guide recommends that preteens and teens should be given booster doses of certain vaccines to keep them in good health and free from dangerous diseases. Vaccination of preteens and teens will also make up for the loss of immunity in case they are not given vaccines in their infancy or early childhood. Vaccination can be carried out till the boy or the girl is 18 years old. While the American Academy of Paediatrics recommends four vaccines for preteens and teens, the Indian Academy of Paediatrics in its vaccination guide for 2011 recommends just two vaccines. According to AAP, vaccines for tetanus, diphtheria and pertussis (Tdap), human papillomavirus (HPV), human influenza and meningococcal conjugate vaccine (MCV4) should be given to adolescents. However, IAP feels that Tdap and HPV are sufficient. HPV is given only to girls in their preteens or teens. “Vaccines aren't just for babies. As kids get older, the protection provided by some of the vaccines given during childhood can begin to wear off. Older kids can also develop risks for certain infections as they enter the preteen and teen years. The preteen and teen vaccines not only help protect them, but also their friends, community and family members. Teens may need to catch-up on vaccines they missed when they were a preteen. Teens may also need a booster of a vaccine that requires more than one dose to be fully protected,” says the latest recommendation by the AAP and the Centers for Disease Control and Prevention (CDC) of the USA. The Indian Academy of Paediatrics is of the view that adolescence should be considered an appropriate age for catch up immunisation as well as for administration of certain vaccines which may not have been available earlier. Preferred age for administration is at 10-12 years, but catch up may be done till 18 years. “The vaccination guide book of the Indian Academy of Paediatrics recommends only two vaccines for routine use in adolescents - Tdap and HPV (in case of girls),” points out Dr Sharmila Asthana, consultant paediatrician, Apollo Hospitals. She, however, adds that meningococcal vaccine is suggested in case of an outbreak. “MCV is not given routinely to all children or adolescents. Influenza vaccine is also given only in special circumstances (if a child has compromised lung function as in asthma) and is not recommended for routine use in all adolescents.” According to Dr Sharmila, vaccines can be given as catch up for those adolescents, who missed some of the childhood vaccines. Doctors however, warn that adolescents may experience mild side effects, which include redness and soreness in the region of vaccination. A few of them might faint after getting a shot. Sitting or lying down for about 15 minutes after a vaccination can help prevent fainting. Most side effects are very minor, especially compared with the serious diseases that these vaccines prevent, argues the CDC. Senior physician Dr B Hari Kishan clears the myth that vaccines are only for children. “Many people, particularly adolescents, become ill or disabled or die from diseases that could easily have been prevented by vaccines. Some childhood vaccinations may not protect them for the whole of their lives so they need a booster,” he adds. He also recommends vaccination for adults, as since newer vaccines are developed regularly, some adults might not have been vaccinated as children. Dr Hari Kishan points out that older people are more likely to have a serious disease from common infections like pneumococcal pneumonia. “Some vaccines are vital for most adults, especially older people. Others may depend on a person’s health status, lifestyle and occupation. Vaccines such as pertussis contain inactivated bacteria or viruses. Others contain only the antigens that are important for protection. For example, tetanus and diphtheria vaccines contain inactivated toxins (toxoids), and pneumococcal vaccine contains the capsular polysaccharide”. Diphtheria and tetanus vaccine is recommended for all those who have not received it in childhood. If vaccinated previously, needs a booster dose one in 10 years. Pneumococcal vaccine is recommended for all above 55 years age, people with diabetes, asthma, COPD and kidney and liver diseases. In case of hepatitis A doctors recommend that people living in hostels and who eat outside frequently should take the vaccine. But hepatitis B vaccine is recommended for all (if not vaccinated previously). Vermicelli (chicken pox) should be given for people living in crowded places and healthcare personnel. Typhoid vaccine should be administered for all, especially schoolchildren, hostel dwellers and people, who eat out frequently. ------------------- Some facts =========== * It is wrong to believe that vaccines are meant for children and infants only. Preteens and teens should be given booster or doses of vaccines. Both Indian Academy of Paediatrics and American Academy of Paediatrics recommend that vaccines can be given to boys and girls up to the age of 18. This will boost their immunity if they were given vaccine in their childhood. If not given in their childhood, the vaccines will provide new immunity against diseases. * Tdap vaccine that gives protection against tetanus, diphtheria and pertussis or whooping cough should be given to adolescent even if they were vaccinated in early childhood. Teens, who have missed the booster dose in preteens and vaccination in early childhood, should also be vaccinated. Human Papillomavirus vaccine (HPV) is given to adolescent girls. * While American Academy of Paediatrics recommend Tdap, meningococcal conjugate vaccine, HPV and swine flu vaccine for adolescents, Indian Academy of Paediatrics says Tdap and HPV are sufficient. * According to the Centers for Disease Control and Prevention (CDC) of the USA, whooping cough can make preteens and teens sick enough to miss several weeks of school and other activities. It can also be passed on to others, including babies, who can die from it. * Meningococcal meningitis can become deadly in 48 hours or less. Even with treatment, people die in about 10 per cent of cases. About 20 per cent of survivors of meningococcal disease have a long-term disability such as deafness, brain damage, or an amputated arm or leg. AAP says preteens should receive this vaccine at age 11 or 12 and then get a booster at age 16. Teens who received MCV4 for the first time when they are 13 through 15 years old will need a one-time booster dose when they are 16 through 18 years old. * The human papillomavirus (HPV) vaccines protect girls and young women against the types of HPV that cause most cervical cancer. One HPV vaccine also prevents anal cancer and genital warts in both females and males, says CDC.