Teen Vaccines

This 16 year-old boy was slipping away.  He had come to the Emergency Department sleepy and feverish.  Mom noticed that he was covered with red freckles, and new freckles were coming out while we spoke.  As the nurses and I worked, he became more lethargic, an ominous sign in a kid with obvious overwhelming infection: meningococcus.  The second-to-last procedure I did was the spinal tap.

This is a procedure where a needle is put into the back to obtain fluid from the spinal cord.  This fluid comes from the brain and is used to diagnose meningitis.  Instead of a trickle of clear fluid we see in well kids, yellow pus-laden spinal fluid shot out of the needle onto my gowned chest. This definitely was meningitis. The last procedure I did was to sedate him and put him on life-support, and then I did my best to comfort his parents as he went to the ICU.

The year was 1995.  The episode above happens less often now, thanks to the meningococcus vaccine introduced in 2005.  This is one of the vaccines kids get at age 11-12.  Yet a large amount of teens aren’t getting this and some other life-saving vaccines.  One-in-ten adolescents don’t get a tetanus booster, almost 1 in 4 don’t get the meningococcus vaccine, and less than half of teens get the cancer-preventing HPV vaccine!

Why are so many teens not getting these crucial shots?  The main reason is many no longer go to their regular doctor- parents fall out of the habit of taking them there. This because older kids don’t get the flurry of vaccines that the younger ones need, and don’t get sick as often.  On the occasion that an older child does get sick, walk-in clinics are more convenient- no waiting for an appointment!  With no regular doctor visits, there is no one to remind the parents that their kid needs this one more vital set of shots. Most “quick-care” does not care about illness prevention, scoliosis, acne, and keeping up vaccines.

What are teen vaccines, and why are they so important?  The most dramatic infection they prevent is the meningococcus/meningitis bacteria that our teen above had (cliff-hanger resolution: he survived and walked out of the hospital six days later). Meningoccus is highly contagious, particularly in crowded living conditions that teens often go live in: college dorms and military barracks.  Remember the UL-Lafayette meningitis scare from a few years back?  And once a teen gets meningococcus, he or she can get deathly ill very quickly.  Fortunately this is becoming less common as successive years of kids get vaccinated.

The least given vaccine for teens is the cancer-preventing HPV vaccine.  This is partly because HPV (Human Papilloma Virus) causes a less dramatic infection than meningococcus- teens get some warts in sensitive spots.  Also HPV is a three-vaccine series rather than just one shot for meningococcus- you’ve got to go back two more times to complete the series. However, HPV causes deadly cervical cancer and anal cancer (actress Farrah Fawcett died from anal cancer).  The vaccine prevents this.  But cancer is also less dramatic than meningoccus in this way: what teen and parent are looking ahead to the “later in life” of cancer?  Worrying about cancer down the road is just not on many teens’ and parents’ radar.  Surviving Driver’s Ed and teen parties are drama enough.

Finally, teens need to get two other vaccines: influenza vaccine and the good ol’ tetanus booster “Tdap.”  Influenza season approaches, and influenza is a nasty virus causing a whole week of cough, fever, body aches, headaches, nausea, and sometimes worse. Get the “flu” shot every year to avoid this highly contagious misery. And tetanus is a deadly illness that can infect any dirty wound- not just rusty nail pokes. What kid doesn’t get dirty wounds?

So don’t lose touch with your child’s “regular” doctor as your kid becomes a teen.  Your regular doctor knows your child best and treats the whole kid, unlike a “quick-care” clinic that only cares about your child’s latest illness.  Your kid’s doctor knows what your child truly needs for things like scoliosis, sports and school physicals, and acne.  And when to get the Teen Vaccines.