Study: More Pre-Teens Get Vaccines When Middle Schools Require Them

MONDAY, May 7 (HealthDay News) — Pre-teens living in states that
require vaccinations for incoming middle school students are more likely
to be immunized than those in states without such requirements, a new
study finds.

Current vaccine guidelines from the U.S. Centers for Disease Control
and Prevention recommend that boys and girls aged 11 to 12 receive three
immunizations or boosters: tetanus/diphtheria/pertussis (TdaP);
meningococcal conjugate; and three doses of the human papillomavirus (HPV)
vaccine.

In 2008-2009, 32 states required TdaP and three required meningococcal
conjugate. One state, Virginia, required HPV vaccination for girls during
those years.

About 80 percent of kids aged 13 to 17 received the recommended TdaP
vaccine in states that required vaccination for middle school entry
compared to 70 percent of kids in states that didn’t require it. For
meningococcal vaccine, those rates were 71 percent versus 53 percent.
Researchers did not report HPV vaccination rates in Virginia versus
elsewhere.

“State requirement for vaccines for middle school entry does have a
positive influence on vaccination coverage. Adolescents in their states
are more likely to have received these vaccines,” said study co-author
Shannon Stokley, a CDC epidemiologist.

The study was released online May 7 and is to be published in the June
print issue of Pediatrics.

School vaccination requirements stretch all the way back to 1855, when
Massachusetts became the first state to require smallpox vaccine for
school entry, according to background information in the article. Over the
decades the number of vaccines required expanded, the majority of which
need to be received before entering kindergarten.

More recently, many states have mandated that pre-teens have certain
vaccines for entering middle school.

“Vaccines are vital to the health of the adolescent. They are very,
very important, and we’ve seen from the state-by-state variations that
when you place requirements for vaccinations on school entry you increase
the rate that parents will seek vaccinations,” said Dr. Carrie Byington, a
member of the American Academy of Pediatrics’ Committee on Infectious
Diseases and a professor of pediatrics at the University of Utah School of
Medicine.

Yet, even state mandates don’t mean every child will be vaccinated.
Every state allows a medical exemption for children, and 48 states plus
the District of Columbia also allow either religious or philosophical
exemptions, while some allow exemptions for both reasons, Stokley
said.

Only West Virginia and Mississippi do not allow non-medical exemptions,
she added.

Instead of mandates, many states require that schools or public health
departments inform parents about the diseases the vaccines protect against
and the current vaccine recommendations. However, the study found states
that offered education had no better vaccine rates than those that
didn’t.

That doesn’t mean education doesn’t matter, Stokley said.

And though vaccine mandates appear to work, “state requirements are
just one strategy to increase immunization,” Byington noted.

Other strategies that can boost vaccination rates include ensuring that
kids have access to vaccines and making sure that pediatricians advise
parents about the shots, she said. Research has shown that parents trust
pediatricians regarding vaccines and are more likely to get their kids
vaccinated if the pediatrician recommends it.

For middle schoolers, the vaccines protect against several serious, and
even deadly, diseases, including diphtheria, a highly contagious bacterial
disease that effects the respiratory system and can lead to swelling of
the heart muscle tissue, heart failure and death; tetanus, a bacteria
found in the soil that can enter the body through a deep cut and lead to
months of serious, painful muscle spasms and lockjaw; and pertussis, or
whooping cough.

In 2010, California saw the worst outbreak of whooping cough in 50
years, leading to more than 27,000 people sickened and the deaths of 10
infants. The outbreak led to urgent calls for parents to keep their
children’s pertussis vaccines up to date.

Meningococcal disease is a leading cause of bacterial meningitis, an
infection around the brain and the spinal cord that kills about one in 10
people who contract it, according to the CDC. “Meningitis is a very
serious disease. A person can seem fine, and within hours all of a sudden
they can be very ill and potentially die,” Stokley said.

Human papillomavirus is a common virus among people in their teens and
early 20s and is spread during sex, potentially causing genital warts in
men and women. Certain strains cause cervical cancer in women and also
anal cancer, Stokley said.

More information

Check out the recommended vaccine schedule for kids and adults at the
U.S. Centers for Disease Control and
Prevention
.

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