TEEN HEALTH:

The Alphabet Soup of New Vaccines: What You Need to Know

by Dr. Ann L. Engelland

(February 15, 2006) “The shots your doctor forgot to tell you about!”

I love being on line at the Stop and Shop. I almost always find a headline something like this one. It seems we doctors have always forgotten something or neglected to tell our patients about all there is to know. The checkout line is where I stay up to date on the latest medical advances, disappointments and scandals.

The fact is that new vaccines have been rolling out at a furious pace in the past several years. Although most of these changes affect younger children, there are three that are important for parents of teens and young adults to know about.

The Meningitis Shot

Meningococcal meningitis is a serious bacterial infection of the lining of the brain. About 2600 people a year used to contract the disease and it has a 15% death rate. For unclear reasons, college freshman are at particularly high risk for this form of bacterial meningitis. For many years, Menomune vaccine has been a rite of passage at the pre-college checkup.

Last year a new version of this vaccine, called Menactra, was licensed for use in younger adolescents. It is now recommended to be given at the 11 or 12 year old checkup.

The Whooping Cough Shot

Pertussis is short for Bordetella Pertussis, the bacteria that causes whooping cough, so named because of the characteristic “whoop” of inhaled air at the end of a long and exhausting spasm of cough typical of this respiratory infection. Pertussis vaccination has long been part of the arsenal of shots given to babies and children under age two. Although most severe and worrisome in young babies, pertussis can be quite debilitating, lasting up to two months with congestion and cough, and is frequently underdiagnosed in adolescents and adults. There may be as many as one million cases a year. Beyond the concern for the sick individual is the greater concern for unvaccinated infants and incompletely vaccinated babies in such a patient’s midst.

The Tetanus Shot

Until recently, the Tetanus booster was typically given around age 15. The recommendation has now changed to give Tetanus and Pertussis together at the 11-12 year old check up. This shot, called the Tdap and marketed under two names - Boostrix and Adacel - should be given to any child who has not had the Pertussis booster. This means that many older adolescents who may have had a tetanus shot already need to be re-vaccinated with the combined Tetanus/Pertussis vaccine.

The Cervical Cancer Shot

The what? A little background is in order. Although this vaccine is not yet available for common use, hopefully it will be soon, once clinical trials are completed. The Human Papillomavirus (HPV) is associated with 99% of cervical cancers. HPV is a sexually transmitted virus, usually causing little or no symptoms and first detected through abnormalities on a Pap smear. Over time, about one in a thousand of these infections will lead to cervical cancer. Considering that over 5 million new cases of HPV are diagnosed every year, there is a huge reservoir of people who can transmit or harbor the virus, and contribute to a large number of new cases of cancer.

In a large, well respected study published in the Journal of the American Medical Association, 55% of sexually active, uninfected adolescents acquired an HPV infection within three years of entering the study. Since adolescents are at particularly high risk for HPV infection, the focus of the vaccine development has been on teens.

So it ought to be good news that we have a safe and effective vaccine. The data on this vaccine show it to be unusually safe and effective. When educated about HPV vaccine, 75% of parents agree that vaccination for their children is a good idea. Nonetheless there is a vociferous campaign from "Abstinence Only" adherents to discredit the vaccine and to raise the fear that HPV vaccination will encourage early sexual activity in adolescents. Previous experience with Hepatitis B vaccine (also considered a sexually transmitted illness) and condom distribution campaigns has shown that none of these health initiatives have negatively impacted adolescent sexual practices.

So next time you see one of those enticing headlines at the supermarket about what your doctor hasn’t told you, remember that you heard it here. Teens need protection from meningitis, whooping cough and cervical cancer-causing viruses. Protection is at hand. Call your doctor.

Dr. Engelland has a practice in Mamaroneck devoted to Adolescent Primary Care. She can be reached at 698-5544. Have a teen health question? Use the form below to send it to Dr. Engelland. Please note: Dr Engelland cannot respond privately to individual queries online. Comments are welcome and anonymous questions may be answered in future columns. Serious medical problems should be referred to your own physician.

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