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School’s starting and you’re so relieved your pre-teen or teenager is done with the annual fight over getting shots. But there are four vaccines that teenagers are advised to get that might not be on your radar.
And there are two new ones that even a fully vaccinated teen should be thinking about. You may need to ask outright — not all pediatricians will be as proactive about these later childhood shots as they are about the regular kids’ schedule. Kids and parents forget, too, says Dr. Paul Offit, director of the Vaccine Education Center at Children's Hospital of Philadelphia.
“They care about their health. And they trust their doctors and they believe that they should go to their doctors. And yet they don’t go. And many parents don’t think they need to,” Offit told NBC News.
But teens need annual checkups and they need vaccines.
Here’s a quick rundown of what older children and teenagers need:
All teens should get vaccinated against bacteria that can cause meningitis and if a child got one dose at 11 or 12, they should get a second dose at high school age.
Bacterial meningitis is a serious manifestation of infection with Neisseria meningitides bacteria. It’s an inflammation of the protective membranes that cover the brain and spinal cord. It kills one in 10 of those infected and in another 20 percent causes severe disabilities, including the amputation of limbs.
In October 2014, a new meningitis vaccine was approved. It protects against meningitis strain B, which is very rare but which caused some outbreaks at universities, including Princeton and the University of California Santa Barbara.
Though the new meningitis vaccine is not required yet, more states are adding the vaccine for bacterial meningitis to their requirements. All students entering 7th or 12th grade in New York state are required to have the meningitis vaccine. Ohio also requires students to receive the bacterial meningitis vaccine.
The Advisory Committee on Immunization Practices (ACIP), which makes vaccines recommendations, says the new meningitis vaccine should be an option for parents who want it. “It’s likely to be beneficial. It’s likely to not be risky,” said Dr. Anne Schuchat of the Centers for Disease Control and Prevention.
The human papillomavirus or HPV vaccine protects against viruses that cause a range of cancers and genital warts. Most adults eventually get infected and the viruses are by far the major cause of cervical cancer, which kills 4,000 U.S. women a year, as well as anal and penile cancers in men.
Kids can get two or three doses for full protection but federal health officials say most still don’t get them.
There’s a new HPV vaccine, too. The current vaccines most kids get protect against either two or four strains of HPV. The new vaccine protects against nine different strains, including types 31, 33, 45, 52 and 58, which cause about 15 percent of cervical cancers.
It’s OK to mix the vaccines, so if a child started on one of the older vaccines, pediatricians can finish up a three-shot series with the new one. There’s no recommendation for adding a dose of the new so-called nine-valent vaccine, but Offit said there’s no harm in giving it to a teenager to provide the added protection.
The combined tetanus, diphtheria and pertussis vaccine is the adult version of the shot all kids got in elementary school, called Dtap. It’s an important booster, according to Schuchat.
“We want everybody to get it at 11 or 12,” Schuchat said. “We know that teens who got five doses already in early childhood of the Dtap vaccine are still at risk for whooping cough as well as needing a booster for the tetanus and diphtheria.”
Even more important, says Schuchat, is for pregnant women to get a Tdap shot because it can protect their newborn until the baby is old enough to get vaccinated. Most cases of whooping cough are in infants too young to have been vaccinated.
Schuchat said no matter what a child’s age, it’s important to check the immunization record. "You can ask your doctor, ‘What’s my child need right now?’” Schuchat advised. “Even (for) the best informed parents, it’s really hard to keep up with the changing recommendations. The back-to-school visit can be important for a lot of health issues.”
An important note: the popular FluMist nasal spray wasn't available for the last two seasons and probably won't be this year. The CDC found that the spray, which uses live but weakened strains of flu virus to stimulate the immune system, hasn't protected kids or adults against the flu in recent years.
Another reminder — the vaccines should be free to everyone. The 2010 Affordable Care Act requires all insurers, public and private, to pay for ACIP-recommended vaccines without a co-pay. More than 40,000 clinics and pediatricians’ offices are enrolled in the Vaccines for Children program, which provides vaccines free of charge to kids without insurance.
“Between the VFC and the Affordable Care Act, public and private insurance covers all those ACIP recommended vaccines. We don’t want cost to be a barrier for parents,” Schuchat said.