A slight cough, a feverish nap, and a runny nose.
Nothing is more frustrating than a sick child, and dealing with the issue while school is in session is even worse. To best prepare, doctors are urging parents to make sure their kids’ vaccinations are up to date before they head to school for the first time.
According to the Centers for Disease Control and Prevention, children should begin vaccinating against 15 potentially serious diseases by the time they turn 2, including annual vaccinations against the flu and COVID-19.
Children receive most of these vaccinations during routine checkups, but some pediatric patients are still missing them because the pandemic has disrupted health checks, doctors say, and they urge parents to make sure their children are up to date on vaccinations before they start school.
“Although we don’t see these diseases as often, it’s important for parents to remember, they’re still out there,” said Dr. Kisha Davis, chief health officer for Montgomery County, Md. “Talk to your doctor about which vaccines are appropriate for you at what ages and stages.”
Childhood vaccines: Still catching up
The Vaccines for Children Program has led to record increases in vaccination since its establishment in 1994, but the pandemic has halted some of that progress.
In 2021, 92% of U.S. children under 2 were vaccinated against measles, mumps and rubella, below the federal target of 95% achieved in the 2019-20 season. According to the CDC:November 2023, The agency released a new report. Nationwide, vaccination rates for kindergarteners have been found to be below pre-pandemic levels.
School districts across the country require children to get certain vaccinations before attending class, but enforcement of those requirements has been lax during the pandemic, as students instead attended school and learned virtually from home, where opportunities for disease transmission are fewer.
Davis, who also serves as president of the American Academy of Family Pediatrics, said educators have become more focused on making sure students have meals and laptops at home, and “chasing up for vaccinations has become a lower priority.”
Dr. Glenn Fennelly, a professor of pediatrics at Texas Tech University Health in El Paso, said the pandemic has disrupted routine checkups where children would normally receive these vaccines, and some are still not caught up on their shots.
He also said people have become more hesitant to get vaccinated since the pandemic, and states are increasingly allowing exemptions to vaccines for non-medical reasons. Forty-one states saw an increase in the number of families seeking exemptions from vaccination in the 2022-23 school year, and 10 states saw an increase of more than 5%, according to the CDC.
Recent outbreaks of measles, a highly contagious vaccine-preventable disease, demonstrate the importance of high vaccination coverage.
At least 13 cases have been reported in 2024, According to the CDC:This includes an outbreak at a Florida elementary school earlier this year. Of the 219 cases reported this year, 40% have been in children under 5 years of age, and 87% have been in unvaccinated or unknown vaccination status adults and children.
“These are devastating diseases,” Fennelly said. “This is a worrying trend.”
What parents need to know about routine vaccinations
Most vaccines are given in multiple doses according to a schedule. Vaccines protect against diseases such as Hepatitis B, rotavirus, diphtheria, whooping cough, tetanus, Hib (Haemophilus influenzae type b), pneumococcal disease, polio, measles, mumps, rubella, chickenpox, and Hepatitis A.
Vaccines may be combined in one vial, giving protection against several viruses with one injection. For example, one injection is enough to protect against measles, mumps, and rubella in children. Diphtheria, tetanus, and whooping cough are also combined in one injection.
Davis said patients will be given different vaccines at specific times because studies have shown when the vaccines are most effective, but experts say there are ways to catch up if your child misses a vaccination window.
They recommend parents talk with their family doctor or pediatrician to create a schedule that works for them.
“Your doctor’s job is to manage your health in a way that’s tailored to your unique situation,” Davis says. “Lean on them. We’ll figure it out together.”
Influenza and COVID-19
Children only need to be vaccinated once in their lifetime, but doctors also want parents to continue to get their annual vaccinations regularly.
The CDC’s Advisory Committee on Immunization Practices recommends routine seasonal influenza vaccination targeting the three influenza A strains that circulated last winter for everyone 6 months of age or older.
“Our number one recommendation for protecting yourself and your loved ones from respiratory illness is vaccination,” said CDC Director Dr. Mandy Cohen. “Make plans for you and your family to get both up-to-date flu and COVID vaccines this fall, before we head into respiratory virus season.”
Similar to the flu shot, the COVID-19 vaccine is also recommended for children 6 months of age and older. In early June, a Food and Drug Administration advisory committee recommended that this season’s COVID vaccines target the JN.1 lineage of SARS-CoV-2.
Last winter, JN.1 was the predominant strain, but in the summer, its variant, FLiRT, was more prevalent. As of Friday, the variant KP.3.1.1 accounts for about 28% of COVID-19 cases in the U.S., while KP.3 accounts for more than 20%. According to CDC data:.
In its update, the FDA encouraged vaccine manufacturers to also target the JN.1 subvariant, KP.2.
The FDA is expected to approve a vaccine within weeks, and the nation’s two largest pharmacy chains, Walgreens and CVS, told USA Today they expect shipments of the vaccine to arrive within days of approval.
Older children can usually get these vaccinations at their local pharmacy, but most pharmacies don’t vaccinate children under 3. Davis suggests parents ask their health care provider if younger children can get vaccinated at their clinic.
Vaccine Mix-Up:According to the CDC, 128 pregnant women and 25 babies were mistakenly given the RSV vaccine.
Respiratory syncytial virus
The newest vaccine is an injection that prevents respiratory syncytial virus (RSV).
According to the CDC, RSV is a respiratory virus that infects the respiratory tract, including the lungs, nose, and throat. Each year in the United States, RSV causes hospitalization of about 58,000 children under the age of 5 and causes hundreds of deaths.
A monoclonal antibody made by Sanofi and AstraZeneca called Bayfortas had a shaky debut on the market last year.
The vaccine is recommended for infants 8 months of age or younger during their first RSV season, and can also be given to infants 8 to 19 months of age who are receiving their second vaccination if they are at high risk for severe disease.
In the United States, RSV season typically begins in September and continues through January, and Bayfortas has been shown to reduce the risk of hospitalization or medical visits due to RSV in infants by about 80%, according to the CDC.
Last year, a drug shortage coupled with a surge in RSV cases forced health officials to retract recommendations about who was eligible to get infant vaccinations.
At the time, Sanofi cited “unprecedented demand” for the vaccine, but told USA Today that an expanded manufacturing network would more than double the amount of vaccine it could supply this year, and it said it expected to have it ready by October.
However, it’s important to note that the RSV vaccine is not available over the counter, and medical experts say parents should work with their child’s doctor to make a schedule for getting their child vaccinated as soon as they become eligible.
Contributor: Eduardo Cuevas, USA TODAY
Adrianna Rodriguez can be reached at [email protected].
