The past five years have witnessed important new developments and recommendations for protecting adolescents and young adults from serious illnesses through the use of vaccines. The most current recommendations from the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP) are summarized below; also on websites: CDC.gov or AAP.org.
Pneumococcal Vaccine: Streptococcus pneumoniae (pneumococcus) causes pneumonia, meningitis, middle ear and blood infections. In November 2009 the CDC expanded its recommendation for use of the pneumococcal polysaccharide vaccine (PPSV) to include individuals 19 years and older with asthma or who smoke. In addition, all children, adolescents and young adults with chronic illnesses including diabetes, liver disease, immuno-compromising conditions or on immunosuppressive medications, or lacking a functional spleen should receive this vaccine every five years.
Gardasil-HPV Vaccine: Human papilloma virus (HPV) is by far the most common sexually transmitted infection in the United States. The inactivated 3-dose vaccine, most optimally administered at 0, 2, and 6 months, protects against two types of HPV (16 and 18) which cause 70% of cervical cancers and two types (6 and 11) which cause 90% of genital warts. We generally recommend this vaccine for all of our patients at age 11–12 years, to achieve an optimal immune response and to administer this vaccine well before sexual activity begins; also for older adolescents and young adults if not already immunized. The December 2009 CDC recommendations extended use of this vaccine to include males ages 9–26 years to reduce their likelihood of acquiring genital warts.
Hepatitis A Vaccine: Hepatitis A virus is transmitted via contaminated food or water or among close contacts, causing an illness with an abrupt onset of fever, nausea, abdominal pain and jaundice. The inactivated vaccine, in use since 1995, is now recommended to include all children in the United States between 1–2 years of age. The vaccine is administered as a two-dose series 6–12 months apart. We recommend this vaccine for our patients who have not already received it.
Menactra: Initial vaccination is recommended at age 11–12 years with a booster vaccination at age 16 to protect against the devastating infection of meningococcal meningitis. One MCV4 dose should be administered to previously unvaccinated college freshmen living in dormitories.
Tdap: This vaccine protects against Tetanus, Diphtheria, and Pertussis (whooping cough) and is recommended as a one-time booster at age 11–12 years or 5 years (sooner in certain situations) after the last Td.
Varicella (Chickenpox) Vaccine: A second dose is now recommended for individuals who previously received only one dose. Anyone who had chickenpox disease does not need to be immunized.
Influenza Vaccine: The injectable inactivated vaccine is recommended for all Americans and in particular for all children up to age 18. Egg allergy is a contra-indication. The attenuated live virus nasal Flu-Mist vaccine is an option for those who do not have asthma, an immune deficiency, or marked nasal congestion.
