Immunizations

Adolescent Immunizations

Recommended immunizations

The importance of continued immunizations at ages 11 through about 21 years (adolescence) is not always recognized. Adolescents need to continue their immunization series and receive booster shots for ongoing protection (immunity) against diseases. Many adolescents were born after the current recommendations for certain immunizations, such as for hepatitis B, were established. So they did not receive all their needed shots (injections) in early childhood.

The U.S. Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatrics, and the American Academy of Family Physicians recommend a specific immunization schedule for children and adolescents each year.⁴ This schedule outlines the immunizations and booster shots needed during adolescence as well as when catch-up immunizations should be given.

To print a list of what shots are needed, go to the U.S. Centers for Disease Control and Prevention (CDC) interactive Web site at www2.cdc.gov/nip/adultImmSched.

Immunizations given during adolescence usually include:

Human papillomavirus (HPV), for girls(What is a PDF document?)

This shot, called Gardasil, protects against four types of HPV that together cause most cases of cervical cancer and genital warts.⁸

Who should get it?

• Girls 11 to 12 years old need three doses, given over 6 months. (The shot can be given to girls as young as 9.)
• The CDC also recommends this shot for females 13 to 26 years old who did not get it when they were younger. But the American Cancer Society states that there is not enough evidence to recommend for or against the shot for women 19 to 26 years old.⁹

If your daughter already has HPV infection, talk with her doctor about whether to get immunized. The shot has not been shown to help existing HPV infection, but it may protect her from other HPV infections.⁸

For help deciding if the HPV vaccine is right for your daughter, see:

Should my daughter get the HPV vaccine?

Meningococcal (MCV4, or Menactra)(What is a PDF document?)

This shot protects against bacterial meningitis and blood infections (sepsis).

Who should get it?

• All adolescents should get this shot at age 11 or 12. Teens ages 13 to 18 who haven't had the shot should get it as soon as possible.
• All college freshmen who live in dormitories and have not had this shot should get it.

If MCV4 (Menactra) is not available, the other form of the vaccine (meningococcal polysaccharide vaccine, or MPSV4) can be given.

Tetanus, diphtheria, and pertussis (Tdap)(What is a PDF document?)

This booster shot protects against tetanus, diphtheria, and whooping cough (pertussis).

Who should get it?

• All adolescents age 11 or 12 need this shot.

Other immunizations

Some adolescents may need or want additional immunizations for situations that increase a person's risk for exposure to disease, such as being in group-living situations (when attending college or summer camp) or traveling to foreign countries. These immunizations may include:

Hepatitis A (Hep A)(What is a PDF document?)

This shot protects against hepatitis A.

Who should get it?

• Adolescents may need this shot if they did not get it as a child. Talk to your child's doctor if your child never got this shot.
• Some states and communities have set up routine immunization because hepatitis A occurs there more often than in other areas. Adolescents living in these areas need this shot.
• Adolescents in communities where outbreaks of hepatitis A are happening may need this shot.
• Anyone 1 year of age and older who is traveling to certain foreign countries, such as those in Central or South America, also needs this shot.

Hepatitis B (Hep B)(What is a PDF document?)

This is important if your child never got this shot.

This shot protects against hepatitis B.

Who should get it?

• Anyone 18 years of age or younger who has not had this shot should get 3 doses over a period of about 6 months.
• If your child hasn't had this shot before starting college, it should be given.

Chickenpox (varicella)(What is a PDF document?)

This is important if your child never had chickenpox or never got this shot.

This shot, called Varivax, protects against chickenpox.

Who should get it?

• Adolescents and adults who are not already immune to the chickenpox virus need this shot. Anyone who gets this shot at age 13 or older should get two doses at least 4 weeks apart.

Chickenpox infection can be very serious when it occurs after childhood.

Measles, mumps, and rubella (MMR)(What is a PDF document?)

This is important if your child never got this shot.

This shot protects against measles, mumps, and rubella.

Who should get it?

• If your child did not get either or both doses, he or she should try to get immunized at age 11 or 12.

College students usually need to have a written record showing proof of immunity, such as having received two doses of MMR.

Pneumococcal polysaccharide (PPV)(What is a PDF document?)

This shot does not necessarily reduce the risk of getting pneumonia, but it can prevent some of the serious complications of pneumonia, such as infection in the bloodstream (bacteremia) or throughout the body (septicemia).

Who should get it?

• Adolescents with certain chronic diseases, such as diabetes or heart disease, need this shot.

Inactivated influenza (flu) shot(What is a PDF document?) or nasal spray flu vaccine (FluMist)(What is a PDF document?)

This immunization helps protect against the flu. Flu viruses are always changing, so the flu vaccines are updated every year. Protection lasts up to a year for both vaccine types.

Who should get it?

• Adolescents with certain health conditions, such as asthma, chronic heart or lung disorders, or an impaired immune system, need this immunization one time each year.
• Siblings or close contacts of all children younger than 5 years old and of anyone who is at high risk for complications of the flu should be immunized each year.
• Anyone who wants to reduce the chance of becoming ill with the flu or spreading it to others should get immunized.⁶

Healthy people ages 2 years through 49 years can usually get the nasal spray form of the vaccine, called FluMist. Pregnant women can get the flu shot but not FluMist.

Immunization safety

Many parents worry that immunizations are dangerous if given when their child has a cold or other minor illness. Talk to your child's doctor if you have concerns about the timing of shots. But keep in mind that shots can usually still be given during a mild illness, while medicines are being taken, and in other situations where a child may not be in perfect health. There are very few reasons that doctors suggest a person postpone or not get an immunization.

Consult your doctor or public health department if your child missed an immunization or to find out whether your child needs a specific immunization. For more information about each vaccine, see the topic Vaccine Information Statements.

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Author:	Debby Golonka, MPH	Last Updated: February 29, 2008
Medical Review:	Adam Husney, MD - Family Medicine Michael J. Sexton, MD - Pediatrics William Atkinson, MD, MPH - Public Health and Preventive Medicine
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