Are your children prepared to return to school?

By Peter S. Waldstein, M.D., F.A.A.P and Julia A. White, M.D., F.A.A.P
Peter WaldsteinBack to school time is upon us, which is a great opportunity to make sure your child is ready from a health perspective. There are new requirements this year for adolescents for vaccines. It is also a great time to refresh on illness prevention while being at school.

Staying Healthy
Maintaining proper health begins at home. Back to school time is a good excuse to refamiliarize your children on the importance of hand washing at home and school. Most illness is spread through contact, and hand washing has been proven to be one of the most effective ways to prevent your child from becoming ill while at school. Washing before eating, after playtime, and anytime before touching the face, mouth, or eyes is key. If you are not able to wash, you may use hand sanitizer instead. You can consider packing a small travel-sized Purell bottle in your child’s bag to encourage proper hygeine. Also remind your child to cover coughs with the arm. Should your child become ill, he or she should stay home to prevent others from becoming ill. Check with your pediatrician if you are unsure if they should stay home.

Another component to staying healthy is maintaining regular well physical exam
visits with your pediatrician. As your child gets older, this often becomes less frequent. Regular visits for screening, physical exam, and updates on vaccinations are important to maintain health and for early detection of disease. Remember to check with your pediatrician’s office before school starts to see if your child is due for a routine well exam.

Peter WaldsteinVaccinations
According to the California School Immunization Law, certain vaccinations are deemed required before entering school. In the last year, the number of pertussis (whooping cough) cases was the most in greater than 50 years sparking a new addition to the law via AB 354 for the Tdap vaccination (Tetanus/Pertussis). While the Tdap vaccine has been recommended in place of the regular tetanus booster for ages 11-18 since 2005 by the CDC’s Advisory Committee for Immunization Practices (ACIP), it was common that adolescents were not vaccinated since they often do not see their pediatricians on a regular basis at this age.

Although children are vaccinated earlier, their immunity begins to lessen in the teen years making them particularly susceptible at this age for the disease. In addition, with increased numbers of adolescents having the disease, it is putting the community at
increased risk.

While not required for school, there are 2 other vaccinations recommended for
adolescents. Since 2005, the meningococcal vaccine has been recommended with a booster dose to be given at 5 years after the first dose. Meningococcal meningitis is a bacterial infection of the membranes surrounding the brain and spinal cord. It can be rapidly progressive starting initially with headache, fever, and a very stiff neck.
Progression can lead to more serious complications including seizures, disabilities, and even death. Adolescents are in the highest risk age group, which is why it is important for your child to have the vaccine.

The Human Papillomavirus (HPV) vaccine is the newest recommendation. HPV is transmitted through sexual contact causing not only genital warts but cervical cancer. Most cases of HPV, however, are asymptomatic making it common to spread the virus without knowledge. It is estimated that about 80% who are sexually active are infected with HPV at some point by the age of 50. It is a 3 shot series given to girls at ages 11-12 over the course of 6 months. The reason for early vaccination is to ensure the best possible immunity by the time adolescents and young adults are at risk. In 2009, one of the HPV vaccines was approved for use in males, as it prevents 2 of the strains that cause genital warts. Although the ACIP does not yet recommend routine vaccination in males, it does endorse its use to prevent genital warts in males.

For resources regarding vaccinations, go to the Centers for Disease Control ( or the California Department of Public Health

Prevention is key when maintaining health in your family. By teaming with your pediatrician and having good health prevention practices, your child can be ready for a great school year.

Dr. Peter S. Waldstein is a Clinical Assistant Professor of Pediatrics at UCLA. Dr. White and Dr. Waldstein are both Attending Physicians at Cedars Sinai Medical Center with a private practice in Beverly Hills.