As children grow into adolescents, many parents don't think much about having them vaccinated. After all, the bulk of physicians recommend immunizations during infancy and early childhood; once adolescence hits, vaccination rates typically taper off, leaving a large number of older children and teens vulnerable to vaccine-preventable diseases. Vaccines for adolescents include the following:
Annual influenza vaccine is recommended for everyone ages 6 months and older. Unless the adolescent has asthma or is immune compromised, either the “flu shot” (TIV) or the nasal vaccine (LAIV) can be give.
HPV (human papillomavirus) vaccine, which prevents cervical cancer, is the second vaccine that prevents cancer. The hepatitis B vaccine, which prevents liver cancer, was the first.
HPV is a virus that can affect the genital area of the body. “Low-risk” types, including types 6 and 11, account for approximately 90 percent of genital warts, and “high-risk” oncogenic types can cause cervical, vulvar, vaginal, anal and penile cancer. Types 16 and 18 HPV account for approximately 70 percent of all cervical cancer cases.
There are currently 2 HPV vaccines. The quadrivalent vaccine protects against 4 types of the virus: HPV types 16 and 18 that are known to cause cervical cancer in women as well as other types of cancer in both men and women, and HPV types 6 and 11 which cause external genital lesions in both men and women. The bivalent vaccine protects against 2 types of the virus: HPV 16 and 18.
The vaccines are preventive and not therapeutic, thus they are most effective when administered before exposure to HPV via sexual contact. However, the vaccines are also recommended for females 11 to 26 years old who have had sexual contact, have had positive PAP tests or who have evidence of prior HPV infection. Both HPV vaccines are recommended for adolescent females age 11 to 12 years of age (with administration at 9 to 10 years of age if preferred) and for those age 13 to 26 years who have not previously received vaccination. The quadrivalent vaccine can be given to males ages 11-26 who are interested in preventing HPV. Research regarding efficacy among males and women older than age 26 years is ongoing.
Meningococcal (MCV4) vaccine addresses N. meningitidis serogroups A, C, Y and W-135, which account for nearly 80 percent of adolescent cases of meningococcal meningitis or bloodstream infections. This vaccine has several advantages over previous versions of the meningococcal vaccine including booster responses (memory), herd immunity if enough adolescents are immunized and possibly elimination of the carrier state.
The Center for Disease Control (CDC) currently recommends immunizing all 11 to 18 year olds, entering college freshmen planning to live in dormitories and specific groups at increased risk of acquiring this disease. High-risk adolescents, including those with functional asplenia and persistent complement deficiency, who have received the vaccine in the past should have a second MCV4 vaccine 5 years after the first.
The MCV4 vaccine, unlike the earlier polysaccharide version of the vaccine, requires an intramuscular injection.
The MMRV vaccine (combination of measles, mumps, rubella and varicella) is not licensed for use in those 13 years of age or older, so if both MMR and varicella are required above the age of 13 years, separate vaccines (given on the same day at different anatomic sites) are recommended.
Tetanus, diphtheria and acellular pertussis (Tdap) vaccine vaccine was licensed by the United States Federal Drug Administration (FDA) in 2005. Since 2000, the number of cases of pertussis (whooping cough) has increased to epidemic proportions in people 10 to 19 years old. This is due to waning immunity that occurs 5 to 8 years after childhood immunization and also after natural infection. Experts estimate there are nearly 1 million cases of pertussis each year in the United States. Not only does this disease pose a threat to the health of adolescents and older adults, but it also puts the lives of partially immunized or unimmunized infants at risk.
The CDC has recommended that all adolescents 11 to 12 years old routinely receive the Tdap vaccine. Further, adolescents 13-18 years old who have not previously had the vaccine should receive it as soon as possible . A 5-year interval between other diphtheria and tetanus containing products and Tdap is encouraged for adolescents unless the benefit of vaccination (ex. high pertussis rates in an area) exceeds the risk of local reaction.
Varicella (chickenpox) vaccine is recommended for several populations. At the end of June 2006, a second dose of varicella was recommended for all children, adolescents and young adults who have previously received only one dose and have no evidence of having had the disease. A second dose will decrease the risk of break-through disease and associated school absence, missed work and potential medical complications associated with the chickenpox.
