Thursday, August 11, 2011

School Aged Vaccine Requirements Have Gone Overboard!

I have always had a problem with the amount of vaccines that are required of kids to attend school.  Now don’t get me wrong, I’m a firm believer in vaccines.  But I believe we need to focus our attention on what vaccines we are giving to our children as well as when we are giving them. 

First off, I don’t believe that State Board of Education committees should be REQUIRING school aged children to be receiving ALL of the vaccines the CDC only RECOMMENDS.  I don’t believe that the various deciding committees associated with the State Board of Educations truly understand what diseases are truly communicable within the school buildings and what ones are not. 

When was the last time you or I heard of a hepatitis A or B outbreak in a school (K-12) ?  Can you name one?  I can’t.  I can’t even name one prior to either of these vaccines becoming available.  When was the last time you heard of a meningitis case in an adolescent aged 11-17 that could have been prevented by the meningitis vaccine required of children age 11-12?  I bet you can’t name one of these episodes either, seeing that the CDC doesn’t have the data to show that this vaccine has made any difference so far in this age group. 

Yes, I agree once the child reaches the age of 18 and leaves for college that the incidence of meningitis goes up, especially if they live in the residence halls.  So, yes I believe they should be vaccinated then.  But not at age 11-12 for a almost non-existant chance of acquiring meningitis, and if they do acquire it, the vaccine does not cover the bacterial serotype they have come down with. 

And yet, the CDC does recommend children under the age of 5 receive a pneumococcal vaccine to prevent meningitis.  This has shown itself to be effective in preventing infections.  So why don’t the various State Board of Educations require this vaccine prior to children starting school? 

I believe that the School Boards have overstepped their boundaries.  Yes, I do believe there should be a certain amount of vaccines required for children to be in school.  Those that are communicable within the school boundaries, such as varicella, Tdap, MMR, and polio.  But those diseases which are not directly communicable between kids such as hepatitis A/B, HPV, and the almost non-existent meningitis in adolescents 11-17 should be left up to the parent and the pediatrician to decide on what is best for the child. 

Yes, I do believe kids should be receiving the hepatitis A vaccine from their pediatrician if they are in an area where hepatitis A is prevalent.  This typically means in South Texas, where there are a lot of Hispanics emigrants who bring the disease with them from Mexico.  Or in the case of hepatitis B, kids should receive this vaccine if they live in a household with a chronic hepatitis B carrier, an Asian household (due to the high prevalence of hepatitis B in this community) or if they decide to enter a healthcare career when they are going off to college. 

I’m tired of seeing kids come into my acute clinic with tears in their eyes, afraid of being seen by me because they believe I’m going to give them yet another vaccine.  We need to learn to balance what is best for each of our individual children with what is best for our community. 

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