At the beginning of each year, the American Academy of Pediatrics and the CDC release revisions in immunization recommendations for the year. As Raleigh pediatricians, we also keep an eye on changes in immunization requirements within the North Carolina school system. Some updates and reminders for 2020:

1.    Schools in Raleigh and throughout North Carolina will begin requiring proof of immunization for a second dose of meningococcal conjugate vaccine for rising 12th graders beginning in summer of 2020.  At Carolina Kids Pediatrics, all our pediatricians have been administering a second dose of this vaccine at 16-17 years of age at annual checkups for several years now. As with all North Carolina school immunization requirements, you will have until 30 days after the start of school to submit proof of immunization for this vaccine.
 
2.    We also offer a different type of meningitis vaccine (type B meningococcal vaccine) to older teenagers, especially if they are entering a higher-risk environment, like military barracks or college dormitories. This year, the AAP has added a recommendation that kids over the age of 10 with certain immune problems, including problems with normal spleen function or a condition called complement deficiency, receive this vaccine at a younger age - as early as 10 years old.
 
3.    The AAP now recommends that all children and adolescents up to age 18 receive the hepatitis A vaccine if they have not received this vaccine previously. At Carolina Kids Pediatrics, we have routinely administered 2 doses of hepatitis A vaccine between 1 and 2 years of age for over a decade. However, if you have an older teenager, your child may have been a toddler before this recommendation came into effect. Previously the AAP considered catching up older kids on this vaccine as optional – but the AAP is now recommending catch-up vaccination for all older kids who were not previously immunized. The vaccine is given as two doses 6-12 months apart.
 
4.    Tetanus boosters every 10 years have been recommended for a long time for all adults. According to current guidelines, the Tdap vaccine can now be used not just for preteens (we have done this for a long time), but also routinely every 10 years in adults instead of the old tetanus vaccine. This provides a boost to immunity against pertussis (whooping cough) in addition to protection against tetanus in adults. At Carolina Kids Pediatrics, kids get their first Tdap at their 11 year visit – but your 21 year old can now expect a Tdap booster instead of a standard tetanus shot if they still come to see us. 
 
5.    A word about measles: We are still experiencing a significant increase in measles cases throughout the United States as well as internationally (though thankfully not in the Raleigh, NC area). If you are traveling to an area with significant measles activity with a baby between 6 and 11 months, guidelines recommend an early dose of measles vaccination. Typically, measles-mumps-rubella vaccine is given to kids at Carolina Kids Pediatrics at 12 months and at 4-5 years. However, we recommend an early dose between 6-11 months for kids traveling to high-risk areas. You can find information on areas with a high risk for measles on the CDC website.
 
6.    Remember that the human papillomavirus vaccine is recommended as a 2-dose series for kids who start before their 15th birthday, but 3 doses are required to achieve a similar level of immunity for teens who start the vaccine after their 15th birthday. Because younger teens seem to have a better immune response to the vaccine, we support the AAP recommendation to immunize at 11-12 years of age at Carolina Kids Pediatrics.

Remember that all immunizations received by your child at Carolina Kids Pediatrics since December 2013 (when our current electronic medical record system became active) should be visible and printable from our patient portal. Of course, you can also contact us at (919) 881-9009 for a complete printed vaccine record which includes all vaccines given prior to this time also.

For more information about updates to immunization recommendations, check out: 

https://www.cdc.gov/vaccines/schedules/hcp/schedule-changes.html
 
Dr. Nechyba
Carolina Kids Pediatrics
Raleigh, NC