Common Vaccine Requirements for School

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School vaccine policies can change from time to time, especially when a new vaccine makes a debut. This happened when the chickenpox booster shot was introduced in 2006 and when new vaccines for DTaP and meningococcal meningitis were approved by the U.S. Food and Drug Administration (FDA) in 2020.

The approval of a vaccine by the FDA doesn’t mean that it will automatically be added to the list of vaccines required for school (or covered by insurance, for that matter). In many cases, it will, but it doesn’t hurt to check just to be sure.

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If a vaccine is recommended by the Advisory Committee on Immunization Practices (ACIP)—a group of experts within the Centers for Disease Control and Prevention (CDC)—it is automatically included as an Essential Health Benefit (EHB) under the Affordable Care Act and covered by most insurance.

DTaP Vaccine

DTaP is a combination vaccine that protects against diphtheria, tetanus, and pertussis (whooping cough). Most children will have gotten five doses by the time they start school, including one after their fourth birthday.

DTaP vaccines are delivered by intramuscular injection (into a large muscle). There are six licensed for use by the FDA:

  • Daptacel
  • Infanrix
  • Kinrix
  • Pediarix
  • Pentacel
  • Quadracel
  • Vaxelis

A tetanus booster is required for children between the ages of 11 and 12. In addition, the Tdap vaccine—known by the brand names Adacel and Boostrix—is recommended for teens and adults to protect against pertussis.

MMR Vaccine

The MMR vaccine covers three diseases: measles, mumps, and rubella (German measles). Two doses are usually required by the time a child is starting school. The typical schedule is one shot at age 1 and the second dose between ages 4 and 6.

There is one MMR vaccine approved by the FDA called M-M-R II. It is a live attenuated vaccine delivered by subcutaneous injection (beneath the skin).

Measles was declared eliminated in the United States in 2000 but has since begun to reemerge in local and regional outbreaks due to the avoidance of vaccination in people swayed by the anti-vaccine movement.

Inactivated Polio Vaccine

The inactivated polio vaccine (IPV) is a killed (inactivated) vaccine use to prevent polio. Most children will have had four or five doses by the time they start school, including one after their fourth birthday—just in time for kindergarten.

In the United States, the vaccine is known by the brand name Ipol. It is delivered either by intramuscular or subcutaneous injection.

Varicella Vaccine

The varicella vaccine provides protection from chickenpox. If your child hasn’t had chickenpox, they will need the vaccine to attend school. They will also be required to get a booster shot between the ages of 4 and 6.

There is one varicella vaccine approved by the FDA called Varivax. It is a live attenuated vaccine delivered by subcutaneous injection.

Hepatitis B Vaccine

The hepatitis B vaccine provides protection against the hepatitis B virus (HBV), likely for a lifetime. It is given in a series of three shots beginning at infancy. Older children have usually had all three by age 12.

There are three hepatitis vaccines licensed by the FDA that are used in specific age groups:

  • Engerix (birth to 19 years)
  • Heplisav-B (18 years and over)
  • Recombivax (birth to 19 years)

Each vaccine, delivered by intramuscular injection, is classified as a recombinant adjuvanted vaccine (meaning it involves DNA coding and the use of a substance, called an adjuvant, that provokes an immune response).

According to the National Center for Health Statistics, 5.3% of men and 3.4% of women in the United States are living with chronic hepatitis B. This infection can cause long-term liver injury, cirrhosis, and liver cancer.

Hepatitis A Vaccine

All infants and toddlers routinely get a hepatitis A vaccine to protect against the hepatitis A virus (HAV). In many parts of the United States, hepatitis A vaccination is required for young children to attend preschool. The vaccine is given in two doses at least six months apart.

There are two inactivated vaccines, delivered by intramuscular injection, that are approved to prevent hepatitis A in the United States:

  • Havrix
  • Vaqta

Meningococcal Vaccine

All 11- to 12 year-olds should be vaccinated with a single dose of a quadrivalent meningococcal conjugate vaccine, which is used to protect against a potentially deadly form of bacterial meningitis. Children need a second shot at age 16 so they remain protected when they are at the highest risk of infection (during their college years).

There are four FDA-licensed meningococcal vaccines, delivered by intramuscular injection, that are approved for use in different age groups:

  • Bexsero (10 to 25 years)
  • Menactra (ages 9 months to 55 years)
  • Menveo (ages 2 months to 55 years)
  • Trumenba (10 to 25 years)

Bexsero and Trumemba are both recombinant adjuvanted vaccines. Menactra and Menveo are inactivated vaccines.

A Word From Get Meds Info

It is important to check with your pediatrician to ensure that your child is up-to-date with their vaccines, including those that may not be on the school’s required list.

An example includes the Gardasil-9 vaccine used to prevent human papillomavirus (HPV)—a virus linked to cervical cancer and anal cancer in adults. Though Gardasil-9 is on the ACIP recommended list, some schools have been known to exclude it because HPV is sexually transmitted.

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