Vaccination is an important topic of individuals of all ages, as it is an important method of protection against various illnesses that may potentially be life-threatening. The goal of this article is to provide updated vaccination information regarding changes to scheduled vaccinations published May 14, 2014 by the North Carolina Commission for Public Health, and the type of diseases we are trying to protect ourselves against. Keep in mind that the new vaccine requirements will become effective July 15, 2015.
What is it about the meningococcal vaccine that sparked the new requirement?
There are two main types of meningococcal vaccines. A polysaccharide vaccine has been available since 1970s. However, similar to the polysaccharide vaccine against pneumococcal disease, it is most effective in adults and does not consistently generate immunity in young children.
The first conjugate meningococcal vaccine was licensed in the United States back in 2005, and a second in 2010. These are the preferred vaccines. Menactra is recommended for individuals aged 2 through 55 years of age. Menveo for those ages 11 to 55 years. The vaccine first was available and recommended for adults at risk populations, such as college age individuals to help protect against the most often fatal illness, Bacterial Meningitis. With growing numbers of cases in teens and young adults, now the vaccine has for the most part gone from being recommended to being required as of the 2014-15 vaccine schedule, and is available and recommended for those infants at risk.
Why is this information important?
Vaccines contain the same germs that cause disease. For example, measles vaccine contains measles virus, and Hib vaccine contains Hib bacteria. But the vaccine serum germs have been either killed or weakened to the point that they do not make you sick. Some vaccines contain only a part of the disease or germ. The goal of vaccination is to introduce the germ to the immune system to expose the body to the germ so that if it is exposed to the same germ in the future the body will be able to fight it off rather than getting sick with the illness. This is what makes vaccines such powerful medicine. Unlike most medicines, which treat or cure diseases, vaccines prevent them.
The State of North Carolina through the North Carolina Commission for Public Health (NCAC), implements recommendations to more closely align NC requirements regarding the number of doses of vaccine your child should receive with that of the nation. Your healthcare provider often provides a list of recommended vaccines at each well-child visit. It is important not only to bring your child in for the scheduled appointments for the general health assessment to ensure growth and development is tracked, but the other vital part of the appointment is vaccination. The goal: to provide each child the opportunity to keep every child on a regular schedule for vaccines for overall protection from the diseases shown to sometimes be fatal.
It is also fair to share that because vaccines contain germs that cause disease that the goal is to cause a response in the immune system. Everyone’s body will react differently. However, most often after vaccination, side effects can occur. Typically the healthcare provider will provide a handout that will summarize common reactions, and also a list of what is not common, and when to call with questions or seek help.
The reason childhood vaccines are so important is that children under 5 are especially susceptible to disease because their immune systems have not built up the necessary defenses to fight infection. By immunizing on time (by age 2), you can protect your child from disease and also protect others at school or daycare.
What can you do to help?
Ask for and keep a copy of the immunization record. Good record-keeping begins with good record-taking. When you need official copies of immunization records to enroll your child in child care, school, and summer camps or for international travel, they will be much easier to get if you have accurate, up-to-date personal records. You should be able to get an immunization card from your child’s doctor or from your state health department to keep record of vaccines for each child. I would also be recommended to keep the record in a safe place where you can easily locate it. Some store it with other important documents such as with birth certificates and social security cards.
New Vaccine Requirements
1. Pneumococcal conjugate vaccine (PCV) – 4 doses by 15 months of age
a. The number of vaccine doses required depends on the age of the child when the vaccine series began.
b. No individual 5 years of age or older is required to receive PCV.
2. Meningococcal conjugate vaccine (MCV) – 2 doses
a. One dose for individuals is required entering the 7th grade or by 12 years of age whichever comes first.
b. Booster dose for individuals is required entering the 12th grade or 17 years of age beginning August 1, 2020.
c. If the first dose is administered on or after the 16th birthday, the booster dose is not required.
Changes to Previous Vaccine Requirements
1. Polio vaccine – the booster (4th dose) is required on or after the 4th birthday and before entering school for the first time.
2. Varicella vaccine – 2 doses administered at least 28 days apart
a. One dose is required on or after 12 months of age and before 19 months.
b. A second dose is required before entering school for the first time.
c. Documentation of disease must be from a physician, nurse practitioner, or physician’s assistant verifying history of varicella disease.
Documentation must include the name of the individual with history of disease, approximate date or age of infection and healthcare
provider signature.
d. If there is question whether the child is immune, the provider can check a lab value to see if the individual is immune.
3. Tetanus, diphtheria, and pertussis (whooping cough) – Tdap
a. A booster dose of Tdap is required for individuals who have not previously received Tdap and who are entering 7th grade or by 12
years of age, whichever comes first.
4. School Entry from 6th to 7th Grade
a. Simultaneous administration of Tdap and MCV vaccines is allowed at the 11-12 year old recommendation.
NEW – 2 doses of Meningococcal vaccine. (First for individuals entering 7th grade or by 12 years, whichever comes first. A booster dose is required by 17 years of age or by entering 12th grade.
• The first dose does not apply to individuals who entered seventh grade before July 1, 2015.
• The booster does not apply to individuals who entered the 12th grade before August 1, 2020.
• If the first dose is administered on or after the 16th birthday, a booster dose is not required.
- An individual born before January 1, 2003 shall not be required to receive a meningococcal conjugate vaccine.
Changes for those 19 and older
For 2014, several new references were added, including the adult immunization schedule for vaccination recommendations for persons aged 19 years or older. Recommendations for person who have been vaccinated prior to the minimum age/interval between doses of vaccine in a series also were added.
Recommended adult immunizations
All adults need:
Influenza (flu) vaccine every year
Td or Tdap vaccine: Every adult should get the Tdap vaccine once if they did not receive it as an adolescent to protect against pertussis (whooping cough), and then a Td (tetanus, diphtheria) booster shot every 10 years. In addition, women should get the Tdap vaccine each time they are pregnant, preferably at 27 through 36 weeks.
Again, these are recommendations. It is always best to further discuss this information with your healthcare provider to determine which vaccines are priorities for you. We wish you well.
Jessica Sabrowsky MSN, RN, FNP-BC
