Immunizations

Adolescent Immunizations

Recommended immunizations

The importance of continued immunizations in adolescence (ages 11 through about 21 years) 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 and also 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:

Flu shot (What is a PDF document?)

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

Who should get it?

Flu immunization is recommended once a year for:⁵

• All children 6 months through 18 years of age.
• Household contacts and caregivers of anyone who is at high risk for complications of the flu.
• Anyone who wants to reduce the chance of becoming ill with the flu or spreading it to others.

Healthy people ages 2 years through 49 years can usually get the nasal spray flu vaccine (FluMist) (What is a PDF document?) instead of the flu shot. Pregnant women can get the flu shot but not FluMist.

For the most current CDC guidelines about seasonal flu, go to www.cdc.gov/flu.

H1N1 influenza (swine flu) (What is a PDF document?)

This shot helps protect against infection caused by the H1N1 flu virus. H1N1 flu may cause symptoms such as fever, cough, body aches, sore throat, and extreme tiredness. Most of the time, the illness is not serious. But severe cases can lead to pneumonia, serious lung problems, and death.

Who should get it?

• All children and young adults from age 6 months to 24 years need this shot.
• Pregnant females and people who live with or care for children younger than 6 months of age also need this shot.

Most people need one dose. Only children ages 6 months through 9 years need two doses. The H1N1 shot can be given along with the seasonal flu shot. Healthy children ages 2 and older can usually get the nasal spray form (What is a PDF document?) of the vaccine instead of the shot (What is a PDF document?) .

For more information, see the topic H1N1 Influenza (Swine Flu). For the most current CDC guidelines, go to www.cdc.gov/h1n1flu.

Human papillomavirus (HPV) (What is a PDF document?)

The vaccines Cervarix and Gardasil protect against two types of human papillomavirus (HPV) that cause cervical cancer. Gardasil also protects against two types of HPV that cause genital warts. And it protects against some uncommon cancers, such as vaginal cancer.

Who should get it?

• Girls 11 or 12 years old need three doses of either Cervarix or Gardasil, given over 6 months. (The series of shots can be given to girls as young as 9 or 10 years old.)
• Females 13 to 26 years old who did not get it when they were younger should get this series of shots.
• Males ages 9 to 26 can get three Gardasil shots to reduce the chance of getting genital warts.

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

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

HPV: Should my daughter get the 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.

Some people need booster shots.⁷ Check with your doctor.

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 ages 11 or 12 need one Tdap shot. Teens ages 13 to 18 who haven't had the shot should get it as soon as possible.

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:

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.

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.
• Anyone who will be in close contact with an adopted child from a country that has high rates of hepatitis A needs this shot. This includes household contacts and babysitters. This recommendation only applies for the first 60 days the child is in the United States.⁶

Two doses are needed over at least 6 months.

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 three doses over a period of about 6 months.

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 (PPSV, or Pneumovax 23) (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.

Immunization safety

Most side effects from vaccines are minor, if they occur at all. The doctor may have your child stay in the office for up to 15 minutes after the shots are given, to watch for any reactions.

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 for which doctors suggest that 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 26, 2010
Medical Review:	John Pope, MD - Pediatrics William Atkinson, MD, MPH - Public Health and Preventive Medicine
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