CS HCVG15-PTT-114 02/33/2017 DISTRIBUTED BY: health conditionssuchasasthma,diabetes, disease andheart flu vaccine,it’s forthosewithchronic especiallyimportant spread Whileallpreteens ittoothers. andteensshouldgeta healthy preteens andteenscangetvery sickfrom thefluand others.of gettingseasonalfluandspreading Even itto The annualfluvaccineisthebestway to reduce thechances Flu Vaccine doctor ornurseaboutgettingthemnow. orfinishedtheHPVvaccineseriesshouldask started Preteens andteenswhohaven’tvaccine 6-12monthsapart. All 11-and12-year-olds shouldreceive twoofHPV shots girls andboysfrom HPVinfectionandcancer HPV. causedby both vaccineshelpprotect (HPV) Human papillomavirus HPV Vaccine age16. at meningococcal shot when theyare 11or12yearsshot old.Theyneedasecond infection intheblood).Preteens needthefirstmeningococcal lining around thebrainandspinalcord) andsepticemia (an cancausemeningitis(swellingof thebacteriathat ofthe some against vaccineprotects Meningococcal conjugate Meningococcal Vaccine now.getting theshot asapreteen, ask theirdoctorornurseabout get aTdapshot Preteens age11or12.Ifyour shouldgetTdapat teendidn’t tetanus, (whoopingcough). diphtheria,andpertussis three seriousdiseases: against This vaccinehelpsprotect Tdap Vaccine What vaccines need? doesmy child your preteen illnesses. orteenfrom theseother they were babies. There are canhelpprotect vaccinesthat they may comeincontact withdifferent diseasesthan when babies getcanwear offaskidsgetolder. Andaskidsgrow up Vaccines aren’t justforbabies. Someofthevaccinesthat Why needvaccines doesmy now? child Last updatedJANUARY 2017 Vaccines forPreteens: What Parents ShouldKnow What elseshouldIknowaboutthesevaccines? yourvaccines that childmay need. good ideatoaskthedoctorornurseevery year ifthere are any a physical examrequired forsports, school,orcamp. It’s a checkup. Your preteen orteencanalsogetthesevaccinesat A goodtimetogetthesevaccinesisduringayearly health bevaccinated? When shouldmy child even in are orlater. circulating, long asfluviruses January illness inyour community, canbebeneficialas fluvaccination While it’s before besttobevaccinated flubeginscausing soon asit’s available inyour community, October. ideallyby Thebesttimetogetthefluvaccineisas to getvaccinated. www.cdc.gov/vaccines/teens vaccines onCDC’s Vaccines forPreteens andTeens website at may need.You canalsofindmore aboutthese information Talk toyour child’s vaccinesthey doctorornurseaboutwhat Where canIlearnmore? cdc.gov find outmore abouttheVFCprogramby goingonlineto Native.Medicaid-eligible, AmericanIndianorAlaska You can for children ages18years and younger, whoare uninsured, The Vaccines forChildrenprogram (VFC) provides vaccines helppayingHow canIget thesevaccines? for beforeyeast, theyreceive orchickeneggs, latex, any shots. if your childhasany seriousallergies, includingallergies to effects are rare. totellthedoctorornurse Itis important very canhelpprevent Seriousside minutes aftertheshot, fainting. andthenforabout15 or lyingdownwhengettingashot Sitting preteens andteensmightfaintaftergettingashot. wasgiven. ofthearmwherein thepart theshot Some safe. Theycancausemildsideeffects, likesoreness or redness These vaccineshave allbeenstudiedvery carefully andare |DI SEASES andthe VACCINES THAT PREVENT THEM | andtypingVFCinthesearchbox. INFORMATION FORPARENTS Control andPrevention Centers for Disease Health andHuman Services U.S. of Department .

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If You Choose Not to Vaccinate Your Child, | information for parents | Understand the Risks and Responsibilities.

Reviewed March 2012

If you choose to delay some vaccines or reject some vaccines entirely, there can be risks. Please follow these steps to protect your child, your family, and others.

With the decision to delay or reject Before an outbreak of a vaccine- vaccines comes an important preventable disease occurs in your responsibility that could save your community: child’s life, or the life of someone else. • Talk to your child’s doctor or nurse to be sure your child’s Any time that your child is ill and you: medical record is up to date regarding vaccination status. • call 911; Ask for a copy of the updated record.

• ride in an ambulance; • Inform your child’s school, childcare facility, and other caregivers about your child’s vaccination status. ­ • visit a hospital emergency room; or • Be aware that your child can catch diseases from people who • visit your child’s doctor or any clinic don’t have any symptoms. For example, Hib you must tell the medical staff that your child has not meningitis can be spread from people who have the received all the vaccines recommended for his or her age. bacteria in their body but are not ill. You can’t tell who Keep a vaccination record easily accessible so that you can is contagious. report exactly which vaccines your child has received, even when you are under stress.

Telling health care professionals your child's vaccination status is essential for two reasons: • When your child is being evaluated, the doctor will need to consider the possibility that your child has a vaccine- preventable disease. Many of these diseases are now uncommon, but they still occur. • The people who help your child can take precautions, such as isolating your child, so that the disease does not spread to others. One group at high risk for contracting disease is infants who are too young to be fully vaccinated. For example, the measles vaccine is not usually recommended for babies younger than 12 months. Very young babies who get measles are likely to be seriously ill, often requiring hospitalization. Other people at high risk for contracting disease are those with weaker immune systems, such as some people with cancer and transplant recipients. CS233434S When there is vaccine-preventable If you know your child is exposed to a disease in your community: vaccine-preventable disease for which he • It may not be too late to get protection by getting vaccinated. or she has not been vaccinated: Ask your child’s doctor. • Learn the early signs and symptoms of the disease. • If there are cases (or, in some circumstances, a single case) • Seek immediate medical help if your child or any family of a vaccine-preventable disease in your community, you members develop early signs or symptoms of the disease. ­ may be asked to take your child out of school, childcare, or organized activities (for example, playgroups or sports). IMPORTANT: Notify the doctor’s office, urgent care facility, ambulance personnel, or • Your school, childcare facility, or other institution will tell emergency room staff that your child has not been you when it is safe for an unvaccinated child to return. fully vaccinated before medical staff have contact Be prepared to keep your child home for several days up to with your child or your family members. They several weeks. need to know that your child may have a vaccine- • Learn about the disease and how it is spread. It may not preventable disease so that they can treat your child be possible to avoid exposure. For example, measles is so correctly as quickly as possible. Medical staff also contagious that hours after an infected person has left can take simple precautions to prevent diseases from the room, an unvaccinated person can get measles just by spreading to others if they know ahead of entering that room. ­ time that their patient may have a contagious disease. • Each disease is different, and the time between when your • Follow recommendations to isolate your child from others, child might have been exposed to a disease and when he or including family members, and especially infants and people she may get sick will vary. Talk with your child’s doctor or with weakened immune systems. Most vaccine-preventable the health department to get their guidelines for determining diseases can be very dangerous to infants who are too young when your child is no longer at risk of coming down with to be fully vaccinated, or children who are not vaccinated due the disease. to certain medical conditions. • Be aware that for some vaccine-preventable diseases, there are medicines to treat infected people and medicines to keep Be aware. people they come in contact with from getting the disease. 4 Any vaccine-preventable disease can strike at any • Ask your health care professional about other ways to protect time in the U.S. because all of these diseases still your family members and anyone else who may come into circulate either in the U.S. or elsewhere in the world. contact with your child. 4 Sometimes vaccine-preventable diseases cause • Your family may be contacted by the state or local health outbreaks, that is, clusters of cases in a given area. department who track infectious disease outbreaks in the 4 Some of the vaccine-preventable diseases that community. ­ still circulate in the U.S. include whooping cough, chickenpox, Hib (a cause of meningitis), and If you travel with your child: influenza. These diseases, as well as the other vaccine-preventable diseases, can range from mild • Review the CDC travelers’ information website to severe and life-threatening. In most cases, there (http://www.cdc.gov/travel) before traveling to learn about is no way to know beforehand if a child will get a possible disease risks and vaccines that will protect mild or serious case. your family. Diseases that vaccines prevent remain 4 For some diseases, one case is enough to cause common throughout the world, including Europe. ­ concern in a community. An example is measles, • Don't spread disease to others. If an unimmunized person which is one of the most contagious diseases known. develops a vaccine-preventable disease while traveling, This disease spreads quickly among people who are to prevent transmission to others, he or she should not not immune. travel by a plane, train, or bus until a doctor determines the person is no longer contagious.

For more information on vaccines, ask your child's health care professional, visit www.cdc.gov/vaccines or call 800-CDC-INFO (800-232-4636) INFORMATION FOR PARENTS 2018 Recommended Immunizations for Children 7-18 Years Old

Talk to your child’s doctor or nurse about the vaccines recommended for their age. Tdap Meningococcal MMR HPV Flu Tetanus, Inactivated Measles, Chickenpox Human Pneumococcal Hepatitis B Hepatitis A Influenza diphtheria, Polio mumps, Varicella papillomavirus MenACWY MenB pertussis rubella

7-8 Years

9-10 Years

11-12 Years

13-15 Years

16-18 Years

More Preteens and teens Preteens and teens All 11-12 year olds All 11-12 year Teens, 16-18 information: should get a flu should get one should get a 2-shot olds should get years old, may be vaccine every year. shot of Tdap at age series of HPV a single shot of a vaccinated with 11 or 12 years. vaccine at least meningococcal a serogroup B 6 months apart. conjugate meningococcal A 3-shot series is (MenACWY) (MenB) vaccine. needed for those vaccine. A with weakened booster shot is immune systems recommended at and those age 15 age 16. or older.

These shaded boxes indicate when the vaccine is These shaded boxes indicate the vaccine should be recommended for all children unless your doctor tells given if a child is catching-up on missed vaccines. you that your child cannot safely receive the vaccine.

These shaded boxes indicate the vaccine is This shaded box indicates children not at increased risk recommended for children with certain health or may get the vaccine if they wish after speaking to a lifestyle conditions that put them at an increased risk for provider. serious diseases. See vaccine-specific recommendations at www.cdc.gov/vaccines/pubs/ACIP-list.htm. Vaccine-Preventable Diseases and the Vaccines that Prevent Them

Diphtheria (Can be prevented by Tdap vaccination) Measles (Can be prevented by MMR vaccination) Pneumococcal Disease (Can be prevented by pneumococcal vaccination) Diphtheria is a very contagious bacterial disease that affects Measles is one of the most contagious viral diseases. Measles Pneumonia is an infection of the lungs that can be caused by the the respiratory system, including the lungs. Diphtheria bacteria virus is spread by direct contact with the airborne respiratory bacteria called pneumococcus. These bacteria can cause other types can be spread from person to person by direct contact with droplets of an infected person. Measles is so contagious that of infections too, such as ear infections, sinus infections, meningitis droplets from an infected person’s cough or sneeze. When just being in the same room after a person who has measles has (infection of the lining of the brain and spinal cord), and bloodstream people are infected, the bacteria can produce a toxin (poison) already left can result in infection. Symptoms usually include a infections. Sinus and ear infections are usually mild and are much in the body that can cause a thick coating in the back of the rash, fever, cough, and red, watery eyes. Fever can persist, rash more common than the more serious forms of pneumococcal nose or throat that makes it hard to breathe or swallow. Effects can last for up to a week, and coughing can last about 10 days. disease. However, in some cases pneumococcal disease can be fatal from this toxin can also lead to swelling of the heart muscle Measles can also cause pneumonia, seizures, brain damage, or or result in long-term problems, like brain damage and hearing loss. and, in some cases, heart failure. In serious cases, the illness can death. The bacteria that cause pneumococcal disease spread when people cause coma, paralysis, or even death. cough or sneeze. Many people have the bacteria in their nose or Meningococcal Disease (Can be prevented by meningococcal vaccination) throat at one time or another without being ill—this is known as Hepatitis A (Can be prevented by HepA vaccination) Meningococcal disease has two common outcomes: meningitis being a carrier. Hepatitis A is an infection in the liver caused by hepatitis A virus. (infection of the lining of the brain and spinal cord) and The virus is spread primarily person-to-person through the bloodstream infections. The bacteria that cause meningococcal Polio (Can be prevented by IPV vaccination) fecal-oral route. In other words, the virus is taken in by mouth disease spread through the exchange of nose and throat Polio is caused by a virus that lives in an infected person’s throat and from contact with objects, food, or drinks contaminated by the droplets, such as when coughing, sneezing, or kissing. Symptoms intestines. It spreads through contact with the stool of an infected feces (stool) of an infected person. Symptoms can include fever, include sudden onset of fever, headache, and stiff neck. With person and through droplets from a sneeze or cough. Symptoms tiredness, poor appetite, vomiting, stomach pain, and sometimes bloodstream infection, symptoms also include a dark purple typically include sore throat, fever, tiredness, nausea, headache, jaundice (when skin and eyes turn yellow). An infected person rash. About one of every ten people who gets the disease dies or stomach pain. In about 1% of cases, polio can cause paralysis. may have no symptoms, may have mild illness for a week or from it. Survivors of meningococcal disease may lose their arms Among those who are paralyzed, About 2 to 10 children out of 100 two, may have severe illness for several months, or may rarely or legs, become deaf, have problems with their nervous systems, die because the virus affects the muscles that help them breathe. develop liver failure and die from the infection. In the U.S., about become developmentally disabled, or suffer seizures or strokes. 100 people a year die from hepatitis A. Rubella (German Measles) (Can be prevented by MMR vaccination) Mumps (Can be prevented by MMR vaccination) Rubella is caused by a virus that is spread through coughing and Hepatitis B (Can be prevented by HepB vaccination) Mumps is an infectious disease caused by the mumps virus, sneezing. In children rubella usually causes a mild illness with fever, Hepatitis B causes a flu-like illness with loss of appetite, nausea, which is spread in the air by a cough or sneeze from an infected swollen glands, and a rash that lasts about 3 days. Rubella rarely vomiting, rashes, joint pain, and jaundice. Symptoms of acute person. A child can also get infected with mumps by coming in causes serious illness or complications in children, but can be very hepatitis B include fever, fatigue, loss of appetite, nausea, contact with a contaminated object, like a toy. The mumps virus serious to a baby in the womb. If a pregnant woman is infected, the vomiting, pain in joints and stomach, dark urine, grey-colored causes swollen salivary glands under the ears or jaw, fever, muscle result to the baby can be devastating, including miscarriage, serious stools, and jaundice (when skin and eyes turn yellow). aches, tiredness, abdominal pain, and loss of appetite. Severe heart defects, mental retardation and loss of hearing and eye sight. complications for children who get mumps are uncommon, but Human Papillomavirus (Can be prevented by HPV vaccination) can include meningitis (infection of the covering of the brain and Tetanus (Lockjaw) (Can be prevented by Tdap vaccination) Human papillomavirus is a common virus. HPV is most common spinal cord), encephalitis (inflammation of the brain), permanent Tetanus mainly affects the neck and belly. When people are infected, in people in their teens and early 20s. About 14 million people, hearing loss, or swelling of the testes, which rarely results in the bacteria produce a toxin (poison) that causes muscles to become including teens, become infected with HPV each year. HPV decreased fertility. tight, which is very painful. This can lead to “locking” of the jaw so infection can cause cervical, vaginal, and vulvar cancers in a person cannot open his or her mouth, swallow, or breathe. The women and penile cancer in men. HPV can also cause anal Pertussis (Whooping Cough) (Can be prevented by Tdap vaccination) bacteria that cause tetanus are found in soil, dust, and manure. The cancer, oropharyngeal cancer (back of the throat), and genital Pertussis spreads very easily through coughing and sneezing. bacteria enter the body through a puncture, cut, or sore on the skin. warts in both men and women. It can cause a bad cough that makes someone gasp for air Complete recovery from tetanus can take months. One to two out of after coughing fits. This cough can last for many weeks, which 10 people who get tetanus die from the disease. Influenza (Can be prevented by annual flu vaccination) can make preteens and teens miss school and other activities. Influenza is a highly contagious viral infection of the nose, throat, Pertussis can be deadly for babies who are too young to receive Varicella (Chickenpox) (Can be prevented by varicella vaccination) and lungs. The virus spreads easily through droplets when an the vaccine. Often babies get whooping cough from their older Chickenpox is caused by the varicella zoster virus. Chickenpox is infected person coughs or sneezes and can cause mild to severe brothers or sisters, like preteens or teens, or other people in the very contagious and spreads very easily from infected people. The illness. Typical symptoms include a sudden high fever, chills, a family. Babies with pertussis can get pneumonia, have seizures, virus can spread from either a cough, sneeze. It can also spread from dry cough, headache, runny nose, sore throat, and muscle and become brain damaged, or even die. About half of children the blisters on the skin, either by touching them or by breathing joint pain. Extreme fatigue can last from several days to weeks. under 1 year of age who get pertussis must be hospitalized. in these viral particles. Typical symptoms of chickenpox include an Influenza may lead to hospitalization or even death, even among itchy rash with blisters, tiredness, headache and fever. Chickenpox previously healthy children. is usually mild, but it can lead to severe skin infections, pneumonia, encephalitis (brain swelling), or even death.

If you have any questions about your child’s vaccines, talk to your healthcare provider. Last updated on January 17, 2018 • CS289048-A Information for Health Care Professionals about Adolescent Vaccines

The Centers for Disease Control and Prevention (CDC) recommends four vaccines for adolescents to prevent: • Tetanus, Diphtheria, Pertussis Note: Recommendations for catch-up dose and minimum interval • Meningococcal disease Note: A booster shot for teens • Human papillomavirus Note: Added indications for Gardasil; recommendation for boys • Influenza Note: Universal recommendation for everyone 6 months and older These recommendations are supported by the American Academy of Pediatrics, the American Academy of Family Physicians, and the Society for Adolescent Health and Medicine.

What can YOU do to ensure your patients get fully vaccinated? • Strongly recommend adolescent vaccines to parents of your 11 through 18 year old patients. Parents trust your opinion more than anyone else’s when it comes to immunizations. Studies consistently show that provider recommendation is the strongest predictor of vaccination. • Use every opportunity to vaccinate your adolescent patients. Ask about vaccination status when they come in for sick visits and sports physicals. • Patient reminder and recall systems such as automated postcards, phone calls and text messages are effective tools for increasing office visits. • Educate parents about the diseases that can be prevented by adolescent vaccines. Parents may know very little about pertussis, meningococcal disease, or HPV. • Implement standing orders policies so that patients can receive vaccines without a physician examination or individual physician order. Direct parents who want more information on vaccines and vaccine-preventable diseases to visit the CDC website at http://www.cdc.gov/vaccines/teens or to call 800-CDC-INFO.

Note about syncope: For all vaccines given during adolescence, syncope has been reported in both boys and girls. To avoid serious injury related to a syncopal episode, adolescents should always be sitting or lying down ► to receive vaccines, remain so for 15 minutes, AND be observed during this time. Overview of Adolescent Vaccination Recommendations • All 11 or 12 year olds should receive a single dose of Tdap vaccine if they have completed the recommended childhood DTP/DTaP vaccination series and have not Age ► 7–10 YEARS 11-12 YEARS 13-18 YEARS received Tdap ▼ Vaccine • All 11 or 12 year olds should receive a single dose of meningococcal vaccine, with a booster dose at Tdap Childhood Recommended Catch-Up age 16 years Catch-up • All girls 11 or 12 years old should get 3 doses of either HPV Recommended Catch-Up HPV vaccine to protect against cervical cancer; All boys 11 or 12 years old should get 3 doses of quadrivalent MCV4 High-Risk Recommended Recommended HPV vaccine to protect against genital warts and anal cancer Flu Recommended • All adolescents should receive a single dose of influenza vaccine every year

National Center forU.S. Immunization Department andof Health Respitatory and Human Diseases Services Office of the DirectorCenters for Disease Control and Prevention Tdap (tetanus toxoid - reduced diphtheria toxoid - Meningococcal Conjugate Vaccine (MCV4) acellular pertussis) Vaccine Although rates of meningococcal disease are the lowest they Because immunity from childhood DTaP vaccines wanes by have ever been in the United States, about 1000 cases are adolescence, a booster dose is recommended. Of the nearly reported each year in this country. Each case is alarming and 17,000 cases of pertussis reported in the United States in 2009, potentially deadly. The incidence of meningococcal disease 4265 occurred among 10- through 19-year-olds. Increasing increases in adolescence and early adulthood. About 10-15% immunization rates among adolescents is an important strategy of adolescents who contract the disease will die, and about 20% for reducing disease among both adolescents and infants too will suffer from a long-term disability. According to the 2010 young to be fully immunized. According to the 2010 National National Immunization Survey-Teen (NIS-Teen), about 63% of Immunization Survey-Teen (NIS-Teen), about 69% of 13- through 13- through 17-year-olds received MCV4. 17-year-olds received Tdap. Recommendations: Recommendations: • All 11- or 12-year-olds should receive a single dose of me- ningococcal vaccine, with a booster dose at age 16 years. • All 11- through 18-year-olds should receive a single dose of Tdap vaccine (preferably at age 11 or 12 years) if they have • For adolescents who receive the first dose at age 13 through completed the recommended childhood DTP/DTaP vaccina- 15 years, a one-time booster dose should be administered, tion series and have not received Tdap. preferably at age 16 through 18 years. Persons who receive their f0irst dose of meningococcal conjugate vaccine at or • Children aged 7 through 10 years and adolescents aged 11 through 18 years who did not complete the childhood DTaP after age 16 years do not need a booster dose. series or with unknown vaccine history should be given one • Adolescents with persistent complement component defi- dose of Tdap as part of the catch-up regimen. Td should be ciencies (e.g., C5-C9, properidin, factor H, or factor D) and used for any other doses needed. asplenia should receive a 2-dose primary series administered 2 months apart and then receive a booster dose every • Tdap should be administered regardless of interval since the 5 years. last tetanus or diphtheria toxoid-containing vaccine. While longer intervals between Td and Tdap vaccination could • Adolescents aged 11–18 years with HIV infection should be decrease the occurrence of local reactions, the benefits of routinely vaccinated with a 2-dose primary series. protection against pertussis outweigh the potential risk for • Vaccination is also recommended for unvaccinated college adverse events. freshmen who live in dormitories, and also for unvaccinated • Tdap vaccine can be administered at the same time as other military recruits. Older adolescents, including college adolescent vaccines. students, who wish to decrease their risk for meningococcal disease, may elect to receive meningococcal vaccine. Vaccines licensed in the United States: • Boostrix® (GlaxoSmithKline) is indicated for active booster • Meningococcal vaccine can be administered at the same immunization for the prevention of tetanus, diphtheria and time as other adolescent vaccines. pertussis as a single dose in persons 10 through 64 years Vaccines licensed in the United States: of age. • Menactra® (sanofi pasteur) is indicated for active immuniza- • Adacel® (sanofi pasteur) is indicated for active booster tion of persons 9 months through 55 years of age for the immunization for the prevention of tetanus, diphtheria and prevention of invasive meningococcal disease caused by pertussis as a single dose in persons 11 through 64 years N. meningitidis serogroups A, C, Y and W-135. of age. • Menveo® (Novartis) is indicated for active immunization of persons 2 through 55 years of age to prevent invasive Possible side effects: meningococcal disease caused by N. meningitidis serogroups Pain, redness, swelling at the injection site; mild fever; head- A, C, Y, and W-135. ache; fatigue; nausea, vomiting, diarrhea, or stomach ache. Possible side effects: Contraindications and precautions: The most commonly reported side effects are redness or • Tdap is contraindicated for persons with a history of serious pain at the injection site. A small percentage of recipients allergic reaction (e.g., anaphylaxis) to any component of reported fever. the vaccine. • Tdap is contraindicated for adolescents with a history of en- Contraindications and precautions: cephalopathy (e.g., coma or prolonged seizures) not attribut- • Meningococcal vaccine is contraindicated among persons able to an identifiable cause within 7 days of administration known to have a severe allergic reaction to any component of a vaccine with pertussis components. This contraindica- of the vaccine, including diphtheria toxoid, or to dry natural tion is for the pertussis components and these adolescents rubber latex. should receive Td instead of Tdap. Human Papillomavirus (HPV) Vaccine • Individuals will get the greatest benefit from the vaccine if it is administered before they have initiated any type of sexual Cervical cancer, caused by HPV, is one of the most common can- activity with another person. cers in women—every year in the United States, about 12,000 women are diagnosed with cervical cancer, and about 4,000 • Studies demonstrate that the risk for HPV infection is high women die from this disease. HPV types 16 and 18 are the most immediately following sexual debut. It is also important to common high-risk types associated with cervical cancer, while note that 1 in 5 women who have only had one lifetime sex HPV 6 and 11 are the most common low-risk types associated partner have been infected with a high-risk HPV type. with genital and respiratory tract warts (recurrent respiratory • Vaccination is recommended for patients with HPV-related papillomatosis or RRP). High-risk HPV types have also been disease and/or apparent HPV infection because the vaccine associated with other, less common cancers and precancers in can offer protection against infection with HPV vaccine types women, such as vulvar, vaginal, anal, opharyngeal carcinomas not already acquired. However, vaccination will not have a and dysplasia. HPV-associated cancers in males include certain therapeutic effect on existing HPV infection or HPV-related anal, penile, and oropharyngeal carcinomas and dysplasia. disease.

According to the 2010 NIS-Teen, about 49% of 13- through • HPV vaccine can be administered at the same time as other 17-year-old girls have started an HPV vaccine series. However, adolescent vaccines. only about 32% received all 3 doses. Completing the 3-dose HPV vaccine series is very important to ensure protection Possible side effects: against cervical cancer and other HPV-related disease. Pain, headache, redness or swelling at the injection site are the most commonly reported side effects. Vaccines licensed in the United States: • Cervarix® is indicated for the prevention of cervical cancer Contraindications and precautions: and precancers caused by HPV types 16 and 18. • HPV vaccines are not recommended for use in pregnancy. If a patient is found to be pregnant after initiating the vaccina- • Gardasil® is indicated for the prevention of cervical, vulvar, tion series, the remainder of the 3-dose series should be vaginal and anal cancers and precancers, as well as genital delayed until completion of pregnancy. However, if a vaccine warts, caused by HPV types 6, 11, 16 and 18. dose has been administered during pregnancy, no interven- Recommendations: tion is needed. Clinicians should report exposure to Gardasil • All 11 or 12 year olds should receive 3 doses of HPV vaccine during pregnancy to Merck at 800-986-8999, and exposure to protect against HPV-related disease. to Cervarix during pregnancy to GlaxoSmithKline at 888-452- 9622. • All girls 11 or 12 years old should get 3 doses of HPV vac- cine to protect against cervical cancer. Girls and young • HPV vaccines are contraindicated for persons with a history women ages 13 through 26 should get all 3 doses of an HPV of immediate hypersensitivity to any vaccine component. vaccine if they have not yet received all doses. Both brands Gardasil is contraindicated for persons with a history of of vaccine are highly effective for preventing cervical cancer immediate hypersensitivity to yeast. Prefilled syringes of and precancer caused by HPV types 16 and 18. Gardasil also Cervarix have latex in the rubber stopper and should not protects against anal cancer and genital warts. be used in persons with anaphylactic latex allergy. Cervarix single-dose vials contain no latex. • All boys 11 or 12 years old should get 3 doses of quadriva- lent HPV vaccine (Gardasil) to protect against genital warts Influenza Vaccine and anal cancer. Boys and young men 13 through 21 years, CDC recommends universal annual flu vaccination for every- who did not get any or all of the three recommended doses one aged 6 months and older. Flu can be serious, and even when they were younger, should also get the HPV vaccine fatal, for healthy adolescents, but pre-teens and teens with cer- series. MSM and immunocompromised males should receive tain medical conditions are more likely to suffer from serious flu the vaccine through age 26 years, if they did not start or complications. Conditions that place people at high risk include complete the vaccine series when they were younger. chronic lung disease (such as asthma); heart disease; endocrine • HPV vaccines are administered in a 3-dose schedule. The disorders (such as diabetes); blood disorders; neurological and second dose should be administered 1 to 2 months after neurodevelopmental conditions; kidney, liver, and metabolic the first dose, and the third dose should be administered 6 disorders; and weakened immune systems due to disease or months after the first dose. There is no maximum interval medication. Flu seasons are unpredictable and can be severe. between doses. If the HPV vaccine schedule is interrupted, Each year in the United States, more than 200,000 people are the vaccine series does not need to be restarted. hospitalized from flu-related complications. • Whenever feasible, the same brand of HPV vaccine should Annual influenza vaccination is the most effective method for be used for the entire vaccination series. However, if the preventing influenza virus infection and its complications since vaccine provider does not know which brand of vaccine was flu viruses are constantly changing. Protective immunity gener- previously administered or have it available, either brand of ally develops in 2 weeks after being vaccinated. HPV vaccine can be used to complete the series. Vaccines Licensed in the United States: • Varicella vaccine: Complete the 2-dose series if not previ- • Trivalent Inactivated Influenza Vaccine (TIV) is given as an ously completed, with at least 3 months between doses for injection. It can be used for people 6 months of age or older, persons aged 12 months through 12 years. (If the second including healthy people, those with chronic medical condi- dose was administered at least 28 days after the first dose, tions, and pregnant women. Brands licensed in the United it can be accepted as valid.) For persons aged 13 years and States include Fluarix®, Fluvirin®, Fluzone®, FluLaval®, and older, the minimum interval between doses is 28 days. Afluria®. • Inactivated poliovirus vaccine (IPV): The childhood series • Live, Intranasal Influenza Vaccine (LAIV) is given as a nasal is 4 doses. However, only 3 doses are needed for pre-teens spray. It can be used for healthy people 2 through 49 years and teens who received their third dose after 4 years of of age who are not pregnant. FluMist® is the only brand age, as well as pre-teens and teens in your care who have licensed in the United States. not received any doses. In all cases, a minimum interval of 6 months is needed between the last two doses. Recommendations: • Adolescents should receive a single dose of influenza vac- • Measles-mumps-rubella vaccine (MMR): Complete the cine every year. 2-dose series if not previously completed, with at least 28 days between doses. • Influenza vaccine can be administered at the same time as other adolescent vaccines. A vaccine series does not need to be restarted, regardless of the Possible side effects: time that has elapsed between doses. Refer to the CDC Catch- Up Immunization Schedule for more information. TIV (injection): Soreness, redness, or swelling at the injection site; hoarseness; sore, red or itchy eyes, cough; fever, aches. If these problems occur, they begin soon after the shot and usu- Vaccine Information Statements ally last 1 to 2 days. TIV contains noninfectious killed viruses and Vaccine Information Statements (VIS) are an excellent source cannot cause influenza. of information for patients about the risks, benefits, and side effects of vaccines. Federal law requires that VIS be given out LAIV (nasal spray): Runny nose, nasal congestion, or cough; before vaccines are administered. To download any VIS, visit fever; headache and muscle aches; wheezing; abdominal pain http://www.cdc.gov/vaccines/pubs/vis/default.htm or occasional vomiting or diarrhea. LAIV contains weakened in- fluenza viruses that cannot replicate outside the nasal passages and cannot cause influenza. Vaccine Adverse Events Reporting System Doctors and other health care professionals are encouraged to Contraindications and precautions: report any adverse events following administration of vaccines • Influenza vaccines should not be administered to people to the Vaccine Adverse Event Reporting System (VAERS), which who have anaphylactic hypersensitivity to eggs, unless the is jointly administered by CDC and the U.S. Food and Drug Ad- recipient has been desensitized. ministration. Visit http://vaers.hhs.gov for more information or • Moderate or severe acute illness with or without fever is a to file a report. precaution for vaccination. People who are moderately or severely ill should not be vaccinated until they recover. Vaccines for Children • GBS within 6 weeks following a previous dose of influenza The Vaccines for Children (VFC) program provides vaccines at vaccine is a precaution for use of influenza vaccines. no cost to professionals who serve eligible children. Children • LAIV (nasal spray) should not be administered to pregnant younger than 19 years of age are eligible for VFC vaccines if they adolescents, adolescents with chronic medical conditions are Medicaid-eligible, American Indian or Alaska Native or have (including asthma, metabolic disease, or hemoglobinopathy) no health insurance. Children who have health insurance that as well as adolescents receiving aspirin or other salicylates. does not cover vaccination can receive VFC vaccines through Federally Qualified Health Centers or Rural Health Centers. VFC vaccines cannot be denied to an eligible child if a family can’t Catch-Up Vaccines for Adolescents afford the administration fee. For more information about -par ticipating in VFC, visit Pre-teens and teens should receive doses of these vaccines as indicated to complete each series: http://www.cdc.gov/vaccines/programs/vfc/ • Hepatitis B vaccine (HepB): Complete the 3-dose series if not previously completed. Note: A 2-dose series (separated by at least 4 months) of Recombivax HB® is licensed for children aged 11 through 15 years.

Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.S. Department of Health and Human Services. References to non-CDC sites on the Internet do not constitute or imply endorsement of these organizations or their programs by CDC or the U.S. Department of Health and Human Services. CDC is not responsible for the content of pages found at these sites. URL addresses listed were current as of the date of publication. ÿ  ÿ ÿÿÿ ÿÿ !!ÿ "ÿ#$ÿ%!ÿÿ% "&ÿ'()012ÿ4050146ÿ789@ 0PEÿIpGiEÿGEiCwÿgPCwgÿDpuutfEÿpuBCfHrg6ÿpfFÿGBpfFÿfprEgÿsCBÿDpuutfEgÿBChItfEiHÿBEuCrrEfF EFÿsCBÿuPtiFBEfÿpfFÿpFCiEguEfIgxÿ0PEÿhgEÿCsÿIBpFEÿfprEgÿtfÿIPtgÿtrrhftpItCfÿguPEFhiEÿtgÿsCBÿ dÿeCfghiIÿBEiEDpfIÿ5e)qÿgIpIErEfIgÿsCBÿFEIptiEFÿBEuCrrEfFpItCfgÿ tFEfIt—upItCfÿAhBACgEgÿCfiHÿpfFÿFCEgÿfCIÿtrAiHÿEfFCBgErEfIÿGHÿIPEÿ5e)qÿCBÿe2ex vwwwxuFuxyCD€DpuutfEg€PuA€putABEug€tfFE‚xPIriƒx vÿRXÿ bbQ wT!Y dÿ„PEfÿpÿDpuutfEÿtgÿfCIÿpFrtftgIEBEFÿpIÿIPEÿBEuCrrEfFEFÿpyE6ÿ 2tAPIPEBtp6ÿIEIpfhg6ÿpfFÿpuEiihipBÿAEBIhggtgÿDpuutfE20pq 2pAIpuEi pFrtftgIEBÿpIÿpÿghGgE hEfIÿDtgtIx )fspfBt‚ 2tAPIPEBtp6ÿIEIpfhgÿDpuutfE20 (Cÿ0BpFEÿ(prE dÿ'gEÿuCrGtfpItCfÿDpuutfEgÿtfgIEpFÿCsÿgEApBpIEÿtf†EuItCfgÿwPEfÿ xyz{|}~€‚ÿ„ z„†yzÿIHAEÿ‡ÿDpuutfEˆtGÿvq‡q0ƒ 5uIˆ)‡ pAABCABtpIEx ˆtGEBt‚ ˆtGÿvq‡q‰Šqƒ qEFDp‚ˆ)‡ dÿ‡EACBIÿuitftupiiHÿgtyftstupfIÿpFDEBgEÿEDEfIgÿICÿIPEÿˆpuutfEÿ5FDEBgEÿ ˆEApItItgÿ5ÿDpuutfEˆEA5 ˆpDBt‚ 1DEfIÿ‡EACBItfyÿ4HgIErÿvˆ51‡4ƒÿCfitfEÿvwwwxDpEBgxPPgxyCDƒÿCBÿGHÿ ˆp Ip ˆEApItItgÿ‡ÿDpuutfEˆEA‡ 1fyEBt‚‡ IEiEAPCfEÿv@88@77‰‘‰ƒxÿ ‡EuCrGtDp‚ÿˆ‡ dÿ‡EACBIÿghgAEuIEFÿupgEgÿCsÿBEACBIpGiEÿDpuutfEABEDEfIpGiEÿFtgEpgEgÿ ˆhrpfÿApAtiiCrpDtBhgÿDpuutfEˆqˆ ‹pBFpgtiÿ ICÿHChBÿgIpIEÿCBÿiCupiÿPEpiIPÿFEApBIrEfIx )fŒhEfpÿDpuutfEÿvtfpuItDpIEFƒ))ˆ ŠhiItAiE dÿ’CBÿtfsCBrpItCfÿpGChIÿABEuphItCfgÿpfFÿuCfIBptfFtupItCfg6ÿgEEÿwwwx ŠEpgiEg6ÿrhrAg6ÿpfFÿBhGEiipÿDpuutfE ŠŠ‡ ŠŠ‡ÿ)) uFuxyCD€DpuutfEg€PuA€putABEug€yEfEBpiBEug€uCfIBptfFtupItCfgxPIrixÿ ŠEftfyCuCuupiÿgEBCyBChAgÿ56ÿe6ÿ„6ÿŽÿDpuutfEŠEf5e„Ž2 ŠEfpuIBp ŠEf5e„Že‡Š ŠEfDEC ŠEftfyCuCuupiÿgEBCyBChAÿ‡ÿDpuutfEŠEf‡e ‡E‚gEBC ŠEf‡’ˆGA 0BhrEfGp 5AABCDEFÿGHÿIPEÿ qfEhrCuCuupiÿ9DpiEfIÿuCf†hypIEÿDpuutfEqeˆ9 qBEDfpBÿ9 qfEhrCuCuupiÿ7DpiEfIÿACiHgpuuPpBtFEÿDpuutfEqq4ˆ7 qfEhrCDp‚ Q!Rÿÿÿ  ÿS!ÿ qCitCDtBhgÿDpuutfEÿvtfpuItDpIEFƒ)qˆ )q‰‘ TUUUVV"QWQ!WXY ‡CIpDtBhgÿDpuutfEg‡ˆ9 ‡CIpBt‚ ‡ˆ’ ‡CIp0E ÿ RÿÿS!ÿ 0EIpfhg6ÿFtAPIPEBtp6ÿpfFÿpuEiihipBÿAEBIhggtgÿDpuutfE0FpA 5FpuEi TUUUVXV"Y ‡CCgIBt‚ 0EIpfhgÿpfFÿFtAPIPEBtpÿDpuutfE0F 0EftDpu ÿ Rÿÿ`RÿSR!!ÿ (Cÿ0BpFEÿ(prE TUUUVXV"Y ˆpBtuEiipÿDpuutfEˆ5‡ ˆpBtDp‚ bÿv! ÿ"ÿÿab!!ÿÿcR"!! 20pq6ÿPEApItItgÿ‡ÿpfFÿtfpuItDpIEFÿACitCDtBhgÿDpuutfE20pqˆEA‡)qˆ qEFtpBt‚ 20pq6ÿtfpuItDpIEFÿACitCDtBhgÿpfFÿÿxyz{|}~€‚ÿ„ z„†yzÿ 20pq)qˆ€ˆtG qEfIpuEi TUUUV"V"Y IHAEÿ‡ÿDpuutfE 0PtgÿguPEFhiEÿtfuihFEgÿBEuCrrEfFpItCfgÿtfÿE•EuIÿpgÿCsÿ–pfhpBHÿ96ÿ789@x 20pqÿpfFÿtfpuItDpIEFÿACitCDtBhgÿDpuutfE20pq)qˆ “tfBt‚ ”hpFBpuEi ŠEpgiEg6ÿrhrAg6ÿBhGEiip6ÿpfFÿDpBtuEiipÿDpuutfEg ŠŠ‡ˆqBC”hpF

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ˆAF9‰•E7ÿiA99@GAF@DGP }ÿ  ÿÿ  ÿÿ  ÿ ÿ ˜DF8Pÿh8GA9FSAÿÿ ÿ  ÿ  ÿ  ÿÿÿ gÿQIDB8H98GFHÿl–vlxÿ‰Dÿ‰Ai8ÿGDFÿS898@i8IÿqIA7"ÿ   xÿ   ÿÿ ÿÿ €‡ÿ ÿ  ÿ ÿ ÿÿ™d€#ÿÿ5 „(efÿ ÿ ÿ qÿ !ÿ ÿxÿÿdÿ ÿ  xÿq2ÿx #  ÿ% #ÿ™ xÿ  ÿ ÿÿ ÿ   ÿÿ %ÿ ÿ ÿg)% ÿ gÿw8SHDGHÿAc8Iÿtvlxÿa8ASHÿGDFÿTEBBaÿ@RREG@d8Iÿ % x#ÿ€ xÿ  ÿÿ  ÿ  ÿ # %%ÿÿhÿ !ÿÿÿ @F‰ÿyqAw"ÿÿqÿ ÿÿd%ÿÿ%ÿÿ ÿ&%ÿ   ÿÿ!ÿ ÿ ) ÿ55ez!ÿ™   ÿqt!ÿ02qtt4w3ƒy"q324uq32r!ÿ   ÿw%  xÿ ÿÿ y#ÿ†ÿÿ ÿ   ÿiijkÿ%ÿ"ÿ ## $ ÿ ## $ $ $t4$ $%$  ÿ  !ÿ ÿd#  $%$%& $&% $  ## t43ƒ4#%# ()012341&5 Talking to Parents about HPV Vaccine Recommend HPV vaccination in the same way and on the same day as all adolescent vaccines. You can say, Now that your son is 11, he is due for vaccinations today to help protect him from meningitis, HPV“ cancers, and pertussis. Remind parents of the follow-up shots their child will need and ask them to ”make appointments before they leave.

Why does my HPV vaccine is important because Some HPV infections can What diseases are child need it prevents infections that can cause cancer—like cancer caused by HPV? HPV vaccine? cause cancer. That’s why we need of the cervix or in the back to start the shot series today. of the throat—but we can protect your child from these cancers in the future by getting Is my child really HPV is a very common infection the first HPV shot today. at risk for HPV? in women and men that can cause cancer. Starting the vaccine series today will help protect your child Studies continue to prove How do you know from the cancers and diseases HPV vaccination works the vaccine works? caused by HPV. extremely well, decreasing the number of infections and HPV precancers in young people Why do they need Like all vaccines, we want to give since it has been available. HPV vaccine at HPV vaccine earlier rather than such a young age? later. If you wait, your child may I’m worried my child need three shots instead of two. Studies tell us that getting HPV vaccine doesn’t make will think that getting kids more likely to start this vaccine makes it I’m worried about Yes, HPV vaccination is very safe. having sex. I recommend OK to have sex. the safety of Like any medication, vaccines can we give your child her first HPV vaccine. Do cause side effects, including pain, HPV shot today. swelling, or redness where the shot you think it’s safe? was given. That’s normal for HPV vaccine too and should go away in a There is no known link Can HPV vaccine day or two. between HPV vaccination cause infertility Sometimes kids faint after they get and the inability to have in my child? shots and they could be injured if children in the future. they fall from fainting. We’ll protect However, women who develop an your child by having them stay HPV precancer or cancer could seated after the shot. require treatment that would limit their ability to have children.

Would you get Yes, I gave HPV vaccine to HPV vaccine for my child (or grandchild, etc.) I strongly recommend each What vaccines are your kids? when he was 11, because it’s of these vaccines and so actually required? important for preventing cancer. do experts at the CDC and major medical organizations. School entry requirements are developed Why do boys need for public health and safety, but HPV vaccination can help prevent HPV vaccine? don’t always reflect the most future infection that can lead to current medical recommendations cancers of the penis, anus, and for your child’s health. back of the throat in men.

December, 2016 | CS269453B

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nurse ifyour childfeelsdizzy, orlight-headed. faint, share withalltheirpatients. thisinformation Tell thedoctoror consistentlyreminds doctorsandnursesto CDC vaccination. about preventing fallsandpossibleinjuriesfrom faintingafter changed prescribing toincludeinformation information FDAWhen faintingwasfoundtohappenaftervaccination, prevent falls. canbecausedby faintingandinjuriesthat canhelp lying downforabout15minutesafteravaccination ismore commonamongadolescents.getting ashot Sittingor many medicalprocedures, Fainting includingvaccination. after Brief faintingspellsandrelated symptomscanhappenafter nausea,andheadache. given), dizziness, fainting, or swelling inthearea oftheupperarmwhere thevaccineis similar, includinginjection-sitereactions (suchaspain,redness, commonly reported symptomsamongfemalesandmalesare HPV vaccinesoccasionallycauseadverse reactions. Themost might causesideeffects Like anyvaccine ormedicine,HPVvaccines penis andanusaswell asgenitalwarts. with theHPV-types cancausecancers that ofthemouth/throat, canhelppreventHPV vaccination boysfrom gettinginfected boysHPV vaccine for isrecommendedandsafe www.cdc.gov andtypingVFCinthesearchbox. can findoutmore abouttheVFCprogramby goingonlineto Native.Medicaid-eligible, AmericanIndianorAlaska You for children ages18years andyounger, whoare uninsured, The Vaccines program forChildren (VFC) provides vaccines How canIgethelppaying thesevaccines? for problems. whichcouldcausepretermher cervix, delivery orother pre-cancercervical couldput awoman riskforproblems at with could leave awoman unabletohave children. Treatment for cancer (hysterectomy, chemotherapy, forexample) orradiation, in awoman cancer, leadstocervical thetreatment ofcervical vulnerable toHPVcancers. Ifpersistenthigh-riskHPVinfection problems. However, gettingHPVvaccineleaves not people There HPVvaccinecausesfertility that isnoevidence tosuggest fertility HPV vaccines don’tnegativelyaffect | ADOLESCENT VACCINE SAFETY| INFORMATION FOR PARENTS PARENTS FOR INFORMATION Control andPrevention Centers for Disease Health andHuman Services U.S. of Department

CS 249472_B HPV Vaccine forPreteensand Teens DISTRIBUTED BY: also prevent genitalwarts. penis, andthemouth/throat area. can HPVvaccination prevent cancausecancers HPVinfectionsthat oftheanus, and themouth/throat area. to BoysneedHPVvaccination cancausecancersthat oftheanus, vagina,vulva, cervix, topreventGirls needHPVvaccination HPVinfections What elseshouldIknowaboutHPVvaccine? clinic. beforeremaining you shots leave thedoctor’s office or they needistomakeanappointmentforthe of theshots months. Thebestway toremember togetyour childall given isaseriesofshots overHPV vaccination several about gettingitforthemassoonpossible. your thevaccineyet, teenhasn’t talktotheirdoctor gotten immune response inpreteens thaninolderadolescents. If HPVvaccinealsoproducesexposed tothevirus. ahigher age11or12sotheyare beforegirls at protected ever being The HPVvaccineisrecommended forpreteen boysand When shouldmychildbevaccinated? menandwomen. inboth warts HPV canalsocauseanalcancer, throat cancer, andgenital and vulvarcancers inwomen andpenilecancer inmen. HPV eachyear. vaginal, HPVinfectioncancausecervical, million people,includingteens, becomeinfectedwith they have person. About14 sexualcontactwithanother spreads that betweenis avery commonvirus peoplewhen infection.HPV (HPV) humanpapillomavirus caused by fromThis vaccineisforprotection mostofthecancers Why doesmychildneedHPVvaccine? Last updatedJULY 2015 Medicine. of Pediatrics, andtheSocietyforAdolescent Healthand Academy ofFamily Physicians, theAmericanAcademy Disease Control andPrevention theAmerican (CDC), isrecommendedHPV vaccination theCentersfor by recommended foranyonevaccine isnot whoispregnant. severe allergies, oryeast. to latex HPV includinganallergy totellthedoctorornurseifyourimportant childhasany Serious sideeffectsfrom theHPVvaccineare rare. Itis couldhappenwhilefainting. any that injury Thiscanhelppreventminutes aftertheshot. faintingand andstay forabout15 likethat down whentheygetashot Preteensvaccine orany andteensshouldsitorlie shot. Some preteens andteensmightfaintaftergettingtheHPV andnausea. dizziness wasgiven,include paininthearmwhere theshot fever, adverse events (sideeffects) duringthesestudies reported studies showed noserioussafetyconcerns. Common,mild HPV vaccineshave beenstudiedvery carefully. These www.cdc.gov/vaccines/teens Vaccines forPreteens andTeens website at or nurse.More isalsoavailable information onCDC’s vaccines forpreteens andteens, talktoyour child’s doctor For more about HPVvaccinesandtheother information Where canIlearnmore? www.cdc.gov andtypingVFCinthesearchbox. can findoutmore abouttheVFCprogramby goingonlineto Native.Medicaid-eligible, AmericanIndianorAlaska You for children ages18years andyounger, insured, whoare not The Vaccines forChildrenprogram (VFC) provides vaccines How canIgethelppaying thesevaccines? for |DISEASESandthe VACCINES THAT PREVENT THEM | INFORMATION FOR PARENTS PARENTS FOR INFORMATION Control andPrevention Centers for Disease Health andHuman Services U.S. of Department .

DISEASES and the VACCINES THAT PREVENT THEM Updated December 2016 As parents, you do everything you can to protect HPV vaccination is recommended us your children’s health for now and for the future. for preteen girls and boys at age Today, there is a strong weapon to prevent several types of cancer in our kids: the HPV vaccine. 11 or 12 years All preteens need HPV vaccination so they can be HPV and Cancer protected from HPV infections that cause cancer. HPV is short for Human Papillomavirus, a common Teens and young adults who didn’t start or finish apillomavir HPV virus. In the United States each year, there are the HPV vaccine series also need HPV vaccination. about 17,500 women and 9,300 men affected by Young women can get HPV vaccine until they are 27 HPV-related cancers. Many of these cancers could be years old and young men can get HPV vaccine until prevented with vaccination. In both women and they are 22 years old. Young men who have sex with other men or who have weakened immune systems Human P men, HPV can cause anal cancer and mouth/throat (oropharyngeal) cancer. It can also cause cancers of can also get HPV vaccine until they are 27. the cervix, vulva and vagina in women; and cancer of HPV vaccination is a series of shots given over several the penis in men. months. The best way to remember to get your child For women, screening is available to detect most cases all of the shots they need is to make an appointment of cervical cancer with a Pap smear. Unfortunately, for the remaining shots before you leave the doctor’s there is no routine screening for other HPV-related office or clinic. cancers for women or men, and these cancers can

also known as cause pain, suffering, or even death. That is why a Is the HPV vaccine safe? vaccine that prevents most of these types of Yes. HPV vaccination has been studied very carefully cancers is so important. and continues to be monitored by CDC and the Food and Drug Administration (FDA). No serious More about HPV safety concerns have been linked to HPV vaccination. HPV is a virus passed from one person to another These studies continue to show that HPV during skin-to-skin sexual contact, including vaginal, vaccines are safe. oral, and anal sex. HPV is most common in people The most common side effects reported after HPV in their late teens and early 20s. Almost all sexually vaccination are mild. They include pain and redness active people will get HPV at some time in their lives, in the area of the arm where the shot though most will never even know it. was given, fever, dizziness, and Most of the time, the body naturally fights off HPV, nausea. Some preteens and before HPV causes any health problems. But in some teens may faint after getting cases, the body does not fight off HPV, and HPV can a shot or any other medical cause health problems, like cancer and genital warts. procedure. Sitting or lying Genital warts are not a life-threatening disease, but down for about 15 minutes they can cause emotional stress, and their treatment after getting shots can help can be very uncomfortable. About 1 in 100 sexually prevent injuries that could active adults in the United States have genital warts at happen if your child were any given time. to fall while fainting.

Why does my child need this now?

HPV vaccines offer the best protection to girls and boys who complete the series and have time to develop an immune response before they begin sexual activity with another person. This is not to say that your preteen is ready to have sex. In fact, it’s just the opposite—it’s important to get your child protected before you or your child have to think about this issue. The immune response to this vaccine is better in preteens, and this could mean better protection for your child. ❖

DISTRIBUTED BY: 12/16/2016 CS HCVG15-PTT-111 Serious side effects from HPV vaccination are rare. Children Help paying for vaccines with severe allergies to yeast or latex shouldn’t get certain HPV The Vaccines for Children (VFC) program provides vaccines vaccines. Be sure to tell the doctor or nurse if your child has any for children ages 18 years and younger who are uninsured, severe allergies. Medicaid-eligible, or American Indian/Alaska Native. Learn more about the VFC program at www.cdc.gov/Features/VFCprogram/ Whether you have insurance, or your child is VFC-eligible, some doctors’ offices may also charge a fee to give the vaccines.

Jacquelyn’s story: “I was healthy—and got cervical cancer.”

When I was in my late 20’s and early 30’s, in the years The bottom line is they caught the cancer early, but the before my daughter was born, I had some abnormal Pap complications continue to impact my life and my family. smears and had to have further testing. I was told I had the For the next few years, I have to get pelvic exams and Pap kind of HPV that can cause cancer and mild dysplasia. smears every few months, the doctors measure tumor markers, and I have to have regular x-rays and ultrasounds, For three more years, I had normal tests. But when I got my just in case. I have so many medical appointments that are first Pap test after my son was born, they told me I needed taking time away from my family, my friends, and my job. a biopsy. The results came back as cancer, and my doctor sent me to an oncologist. Fortunately, the cancer was at an Worse, every time the phone rings, and I know it’s my early stage. My lymph nodes were clear, and I didn’t need oncologist calling, I hold my breath until I get the results. radiation. But I did need to have a total hysterectomy. I’m hopeful I can live a full and healthy life, but cancer is always in the back of my mind. My husband and I have been together for 15 years, and we were planning to have more children. We are so grateful for In a short period of time, I went from being healthy and our two wonderful children, but we were hoping for more— planning more children to all of a sudden having a radical which is not going to happen now. hysterectomy and trying to make sure I don’t have cancer again. It’s kind of overwhelming. And I am one of the lucky ones! Ultimately I need to make sure I’m healthy and there for my children. I want to be around to see their children grow up. I will do everything to keep my son and daughter from going through this. I will get them both the HPV vaccine as soon as they turn 11. I tell everyone—my friends, my family—to get their children the HPV vaccine series to protect them from this kind of cancer. ❖

What about boys?

HPV vaccine is for boys too! This vaccine can help prevent boys from getting infected with the types of HPV that can cause cancers of the mouth/throat, penis and anus. The vaccine can also help prevent genital warts. HPV vaccination of males is also likely to benefit females by reducing the spread of HPV viruses. Learn more about HPV and HPV vaccine at www.cdc.gov/hpv

For more information about the vaccines recommended for preteens and teens: 800-CDC-INFO (800-232-4636) www.cdc.gov/vaccines/teens

You’re not opening the door to sex. You’re closing the door to cancer.

HPV vaccine is cancer prevention. Talk to your child’s doctor about vaccinating your 11–12 year old against HPV. www.cdc.gov/vaccines/teens

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CS249586-E

YOU WOULD DO ANYTHING TO PROTECT YOUR CHILD FROM CANCER. BUT HAVE YOU DONE EVERYTHING?

HPV vaccine is cancer prevention for boys and girls. Just two shots at ages 11–12 provide safe and lasting protection against the infections that cause HPV cancer. Ask your child’s doctor or nurse for HPV vaccine.

vaccine www.cdc.gov/HPV is CANCER PREVENTION

JAN 2017

If there were a vaccine against cancer, wouldn’t you get it for your kids?

HPV vaccine is cancer prevention. Talk to the doctor about vaccinating your 11–12 year old sons and daughters against HPV. www.cdc.gov/vaccines/teens

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CS249946-C

Q A Pertussis: What you should know VACCINE EDUCATION CENTER Volume& 5, Spring 2015 Outbreaks of pertussis (whooping cough) have sickened thousands and led to the deaths of several infants less than 3 months of age over the last few years in the United States. Although outbreaks of pertussis typically occur every three to five years in the United States, the recent outbreaks have brought attention to two important points — immunity to pertussis is not life-long, and pockets of unimmunized people in a community make controlling outbreaks extremely difficult. fever, headache, fatigue, and pain and swelling at the site of injection) Q. What is pertussis? were common in anyone 7 years of age or older. Fortunately, researchers found that by reducing the quantities of A. Pertussis, or whooping cough, is caused by a bacterial infection. diphtheria and pertussis proteins contained in the DTaP vaccine, The disease occurs in three stages. The first stage appears similar teenagers and adults didn’t experience the high rate of side effects. to the common cold, with runny nose, sneezing, low-grade fever This newer version for teens and adults, called “Tdap,” reflects and coughing. After a week or two, illness progresses to the second the fact that it contains lower quantities of diphtheria (hence the stage where coughs worsen, often ending with a big intake of air lowercase “d”) and pertussis proteins (hence the lowercase “p”) as or a “whoop.” The fits of coughing can be so violent that blood compared with the childhood version, known as DTaP. vessels can rupture and ribs can break. Infants, whose windpipes are narrower than those of older children, often turn blue during coughing spells because of lack of oxygen. This stage can last up to Q. Who should get DTaP? two months. During the final stage, which also often lasts for weeks or months, coughing spells will gradually decrease in frequency and A. DTaP is the version of diphtheria, tetanus and pertussis vaccines intensity. Pertussis used to be called the “100-day cough” because of used for infants and young children. The first three doses, typically how long the cough lasted. given at 2 months, 4 months and 6 months of age, will protect most infants from these diseases. Unfortunately, infants who have not received all three doses are among the most vulnerable to pertussis Q. Is there a vaccine to prevent pertussis? infections. An additional dose at 15 to 18 months and another at 4 to 6 years are given as boosters. A. Yes. The history of pertussis vaccines in the United States is long and complicated. In the 1920s, vaccines to protect against diphtheria, pertussis and Q. Who should get Tdap? tetanus became available. In the 1940s, these three vaccines were combined into a single shot (called DTP). A. Tdap is recommended for all adolescents beginning at 11 or 12 years of age. The pertussis component of the DTP vaccine was made by killing whole pertussis bacteria with the chemical formaldehyde. The Adults, including those 65 years and older, should receive a single pertussis part of DTP was called “whole-cell” pertussis because dose of Tdap to replace their next tetanus booster. Because healthcare whole bacteria were used to make it. The vaccine was given to young workers are at increased risk of contracting pertussis, they should children and dramatically reduced the incidence of hospitalizations get the vaccine as soon as possible. Likewise, people who will be in and deaths caused by pertussis. However, the vaccine also rarely contact with infants younger than 12 months of age should get the caused side effects that could be severe, such as seizures, high fever vaccine at least two weeks before coming into contact with the baby. and persistent crying. Pregnant women should get the vaccine between 27 and 36 weeks gestation during each pregnancy. Any woman who does not get the In the 1990s, a safer pertussis vaccine became available. This vaccine vaccine during pregnancy should get it before going home. was made by purifying several pertussis proteins and inactivating them with formaldehyde. Because this new pertussis vaccine was By giving Tdap vaccine to pregnant women during the late second purer and didn’t contain whole bacteria, it was called the acellular trimester or third trimester, antibodies generated by the mother pertussis vaccine (or aP). This new pertussis vaccine was combined can be transferred to the baby before birth most efficiently. Because with the diphtheria and tetanus vaccines in a combination called babies less than 2 months of age are most likely to die from pertussis DTaP. The new DTaP vaccine caused fewer and less frequent side — an age before they would have received the first few doses of effects, so it replaced DTP and was recommended for all young vaccine — this strategy of immunizing pregnant women is most children. Unfortunately, the DTaP vaccine couldn’t be used in likely to protect babies from dying from pertussis. teenagers and adults because side effects from the vaccine (such as more

For the latest information on all vaccines, visit our website at vaccine.chop.edu Pertussis: What you should know

Q. Are the DTaP and Tdap vaccines safe? Q. Can people get the Tdap vaccine if they recently had the Td vaccine? A. Yes. About one of every three babies and young children will have pain, redness or swelling at the injection site, mostly after the doses A. Yes. A vaccine to prevent tetanus and diphtheria, called Td, is also around 1 and 5 years of age, and a small number will develop a fever available for teenagers and adults. Many people have already gotten following the DTaP vaccine. For those who get the Tdap vaccine, this vaccine. Because Td doesn’t protect against pertussis, Tdap is still about half will experience pain or swelling at the site of injection, recommended regardless of when Td was given. and a small number will develop headaches and fatigue. Although about one of every 10,000 children who get the DTaP vaccine will experience a frightening reaction such as uncontrollable Q. Can Tdap be given at the same time as other vaccines? crying, high fever or seizure, none will be permanently harmed. However, a child who has a severe reaction to the vaccine should not A. Yes. get additional doses.

Q. Why is pertussis more serious in babies? Q. Do DTaP and Tdap prevent pertussis? A. Because an infant’s windpipe is much smaller than that of A. Yes. In medical studies, both DTaP and Tdap have been shown older children and adults, babies are much more likely to die from to protect about 80 to 85 of every 100 people who receive them. pertussis. Babies typically catch the disease from teenagers and adults However, data from recent outbreaks have indicated that immunity living in the same home. wanes, so children become increasingly susceptible between the kindergarten and adolescent doses. These data have emerged Approximately 15 to 20 babies in the United States die every year following the change from the whole cell to the acellular pertussis from pertussis. Almost all are younger than 4 months of age — too vaccine in the mid- early to have been fully protected by the DTaP vaccine. 1990s. We now know Because young babies get sick from pertussis and because they are that the price paid for not fully protected until they have had several doses of the DTaP increased safety was vaccine, healthcare providers recommend that older children and decreased protection. adults who will be around newborns be protected; this is known as However, until a better cocooning. pertussis vaccine is developed, the current Teens and adults who will be around young infants should get a dose vaccine affords the of the Tdap vaccine in anticipation of the baby’s arrival. best opportunity for protecting ourselves Mothers should request the Tdap vaccine between 27 and 36 weeks and our families from gestation during each pregnancy or before leaving the hospital if they pertussis, so continued did not receive Tdap during pregnancy. use is important. To address waning immunity, the CDC may recommend additional booster doses in the future.

VACCINE EDUCATION CENTER

This information is provided by the Vaccine Education Center at The Children’s Hospital of Philadelphia. The Center is an educational resource for parents and healthcare professionals and is composed of scientists, vaccine.chop.edu physicians, mothers and fathers who are devoted to the study and prevention of infectious diseases. The Vaccine Education Center is funded by endowed chairs from The Children’s Hospital of Philadelphia. The Center does not receive support from pharmaceutical companies. The Children’s Hospital of Philadelphia, the nation’s first pediatric hospital, is a world leader in patient care, pioneering research, education and advocacy.

©2015 The Children’s Hospital of Philadelphia, All Rights Reserved. 15VEC0011/NP/04-15 CS 249472C DISTRIBUTED BY: protect littlekidsfrom.protect preteen orteenfrom DTaP thesamediseasesthat shots your helpsprotect that (Tdap) vaccineisaboostershot for seriousillness. The tetanus-diphtheria-acelluar pertussis towearstarts off.Thiscanput your preteenat risk orteen But askidsgetolder, from theprotection theDTaP shots from diphtheria,tetanus, (whoopingcough). andpertussis calledDTaPBabies andlittlekidsgetshots them toprotect Why doesmychildneedTdapvaccine? Last updatedJUNE2014 Tdap Vaccine forPreteensand Teens • • • who gettetanusdies. hospital inintensive care. As many as1outof5people preteen orteenwithtetanuscouldspendweeks inthe spasms cancausebreathing problems andparalysis. A jaw muscle(lockjaw) andthroughout thebody. The cause spasmswhichare painfulmusclecrampsinthe scratches, orpuncture wounds intheskin.Tetanus can found insoil.Thebacteriaenterthebodythrough cuts, Tetanus like preteens orteens, peopleinthefamily. or other get whoopingcoughfrom orsisters, theirolderbrothers have from protection theirownvaccines. Oftenbabies cough canbedeadlyforbabieswhoare tooyoung to activities. Whooping and teensmissschoolother cough canlastformany weeks, whichcanmakepreteens for airaftercoughingfits. makessomeonegasp This that Itcancauseabad cough through coughingandsneezing. (whoopingcough) Pertussis diphtheria willdiefrom it. failure.and heart About1outof10peoplewhoget hard tobreathe orswallow. Itcanalsocauseparalysis on thebackofnoseorthroatcanmakeit that Itcausesathickcoating through coughingorsneezing. be very dangerous. Itspreads from personto Diphtheria is caused by atoxin iscausedby bacteria (poison)madeby is not ascommontetanusbutcan isnot spreads very easily Society forAdolescent HealthandMedicine. Physicians, theAmericanAcademy ofPediatrics, andthe and Prevention theAmericanAcademy (CDC), ofFamily It isrecommended theCentersforDiseaseControl by hasbeenstudiedvery carefully andissafe. The Tdapshot What elseshouldIknowaboutthevaccine? getting itforthemrightaway. yet, talktotheirdoctorabout theshot old andhasn’t gotten 12 years old.Ifyour teenis13years oldupthrough 18years whentheyareAll preteens 11or shouldgetoneTdapshot When shouldmychildbevaccinated? Preteens andTeens website at may need.There onCDC’s isalsoinformation Vaccines for vaccinesyourabout theTdapvaccineandother child Your child’s doctorornursecangive you more information Where canIlearnmore? to can findoutmore abouttheVFCprogramby goingonline Native.Medicaid-eligible, AmericanIndianorAlaska You for children ages18years andyounger, insured, whoare not The Vaccines forChildrenprogram (VFC) provides vaccines How canIgethelppaying thesevaccines? for are rare.Tdap shot Serioussideeffectsfrom reactions tothe getting theshot. andthenforabout15minutesafter when theygetashot avoid preteens andteensshouldsitorliedown fainting, Toafter gettingtheTdapvaccineoranyshot. other help fever, ortiredness. Somepreteens andteensmightfaint soreness wasgiven, inthearmwhere theshot headache, cancausemildsideeffects,The Tdapshot like redness and |DISEASESandthe VACCINES THAT PREVENT THEM | www.cdc.gov andtypingVFCinthesearchbox. INFORMATION FOR PARENTS PARENTS FOR INFORMATION Control andPrevention Centers for Disease Health andHuman Services U.S. of Department www.cdc.gov/vaccines/teens

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Q A Influenza: What you should know VACCINE EDUCATION CENTER Volume& 12, Fall 2016 Seasonal epidemics of influenza (flu) occur every year in the United States, beginning in the fall. Typically, the epidemics cause thousands to tens of thousands of deaths and about 200,000 hospitalizations each year. Since the 1940s, a vaccine has been available to prevent influenza; unfortunately, the vaccine is not used as much as it should be. To prevent the hospitalizations and deaths caused every year by influenza virus, the Centers for Disease Control and Prevention (CDC) has recommended that all U.S. citizens more than 6 months of age receive the influenza vaccine.This recommendation has the potential to save thousands of lives.

Q. What is influenza (flu)? Q. How is the vaccine made?

A. Influenza (flu) is a virus that infects the nose, throat, windpipe and A. In recent years, more types of influenza vaccines have become lungs. The virus is highly contagious and is spread from one person to available: another by coughing, sneezing or talking. Influenza infections typically occur • Trivalent inactivated influenza vaccine – This is the traditional between October and April each year. influenza vaccine shot that has been used in the past; it is made by taking three different influenza viruses, growing them (individually) in eggs, purifying them and completely inactivating them with the chemical formaldehyde. A few brands of this vaccine are available with specific Q. What are the symptoms of influenza? ages for use; however, this version is typically given to the broadest group of individuals, including infants. • Quadrivalent inactivated influenza vaccine – This version is made A. Typical symptoms of influenza include fever, chills, muscle aches, in the same way as the trivalent version; however, it contains four types congestion, cough, runny nose and difficulty breathing. Other viruses can of influenza viruses. This vaccine is given as a shot and can be used for cause symptoms similar to influenza. But, influenza virus is a more common people 6 months and older. cause of severe, fatal pneumonia. • Cell culture-based influenza vaccine – This version currently contains Most, but not all, people who die from influenza are older than 65. Sadly, three different influenza viruses and is made in a manner similar to each year about 50 to 150 children die as a result of influenza. Children the other inactivated vaccines; however, instead of growing the viruses younger than 4 often require hospitalization because of high fever, wheezing, in eggs (avian cells), they are grown in mammalian cells. This vaccine croup or pneumonia. represents an advance in technology because it contains less egg protein Because influenza is a virus, it can’t be successfully treated with antibiotics. than the version grown in eggs. It is given as a shot. While some antiviral medications are available by prescription, not all strains • Recombinant influenza vaccine – This version of influenza vaccine of influenza are susceptible to them, and they work best when used early in contains only one surface protein of the virus known as hemagglutinin. the infection. The protein is produced by inserting the gene for hemagglutinin into an insect virus that then produces large quantities of the hemagglutinin protein. The protein is purified and used as the vaccine. First available in the fall of 2013, this version represents an advance in technology because Q. Who should get the influenza vaccine? it is the first egg protein-free influenza vaccine. This version is given as a shot and can be used in people between 18 and 49 years of age. It currently A. The influenza vaccine is recommended for everyone 6 months of age contains three types of influenza virus. and older. A“live, weakened” influenza vaccine given Children under 9 years of age require two doses of influenza vaccine as a nasal spray was previously available. separated by four weeks if they have never received an influenza vaccine or However, in recent years, people who got have an uncertain vaccination history. this version were not adequately protected against influenza. Therefore, beginning in the fall of 2016, experts at the Centers for Disease Control and Prevention no longer recommend this vaccine.

more4 For the latest information on all vaccines, visit our website: vaccine.chop.edu Influenza: What you should know

Q. Does the influenza vaccine work? Q. What is the difference between epidemic, or seasonal, influenza and pandemic influenza? A. The influenza vaccine typically prevents about 70 of every 100 people who receive it from developing moderate-to-severe influenza infection. A. Every year in the United States and throughout the world, influenza Even though the vaccine might not completely prevent influenza infection, it viruses cause epidemics. Because many people have some immunity, yearly will still lessen the length and severity of the illness. epidemics don’t infect everyone. A pandemic is a worldwide epidemic caused when new strains of influenza virus form. This happens when genetic material from both human and animal strains of influenza mix. Because virtually no one is immune to these Q. When should I get the influenza vaccine? new viruses, they have the potential to sweep across the world unchecked. Typically, many more people become ill and die during pandemics than A. Immunizations should be administered throughout the season during yearly epidemics. because the peak incidence of influenza can occur as late as February In 2009 a pandemic centered on the novel H1N1 strain. Luckily, this new or March. strain was not as fatal as some previous pandemic strains. Still, 60 million people in the United States became ill, 270,000 were hospitalized and about 12,000 died. Of those who died, between 1,100 and 1,200 were children, about 10 times the number who die during a normal influenza season. Q. If I got the influenza vaccine last year, do I need this year’s influenza vaccine? Q. Can pregnant women get the influenza vaccine? A. Yes, getting the current vaccine is still of benefit for a few reasons. First, some people are not protected after getting the vaccine, so another dose A. Yes will increase their chance of being protected. Second, antibody levels wane, , in fact, this is one of two vaccines that pregnant women are urged particularly in the elderly, so another dose will boost antibody levels before to get during pregnancy; the other is Tdap. Because pregnant women are the start of influenza season. Finally, sometimes influenza viruses change more likely to experience complications and hospitalization as a result of significantly from one year to the next, so immunization or natural infection infection with influenza, it is important for them to be immunized. In the previous year is not protective. addition, studies have shown that babies of women who were immunized with influenza vaccine during pregnancy are less likely to be infected with influenza during the first six months of life, before they are old enough to be vaccinated. Q. Are the influenza vaccines safe? Q. Can I avoid getting the vaccine and the virus by A. Yes. Influenza vaccine shots can cause pain, redness or tenderness at the washing my hands and staying away from others who site of injection as well as muscle aches and low-grade fever, but because are ill? the vaccine viruses are completely inactivated or the vaccine contains only individual proteins, they cannot possibly cause influenza. A. While careful hand-washing, covering Although most versions of the influenza vaccine are made in eggs and some coughs and sneezes, and staying home when people are severely allergic to eggs, the quantity of egg proteins is typically ill can help prevent the spread of disease, we insufficient to cause a severe allergic response. But just to be sure, it is cannot be certain that others will do the same. suggested that people with egg allergies remain at the provider’s office for Further, not everyone infected with influenza 15 minutes after vaccination. realizes they are transmitting it since infected people begin to spread the virus a day or two before they have symptoms. So, while these measures can reduce your chance Q. Does the influenza vaccine contain thimerosal? of getting influenza, and in fact helped to stem transmission during the pandemic of 2009, they can only do so much to prevent influenza A. Some multi-dose preparations of the inactivated influenza vaccine infections. The reality is that the only way to given as a shot still contain a small quantity of the mercury-based ensure protection from a specific disease is to have immunity acquired preservative known as thimerosal. However, the quantity contained in through immunization or previous exposure to the disease. vaccines does not cause harm. Influenza infections can cause severe illness and death, so the benefits of receiving the vaccine clearly outweigh the theoretical risks. VACCINE EDUCATION CENTER

vaccine.chop.edu This information is provided by the Vaccine Education Center at The Children’s Hospital of Philadelphia. The Center is an educational resource for parents and healthcare professionals and is The Children’s Hospital of Philadelphia, the nation’s first pediatric hospital, composed of scientists, physicians, mothers and fathers who are devoted to the study and prevention is a world leader in patient care, pioneering research, education and advocacy. of infectious diseases. The Vaccine Education Center is funded by endowed chairs from The Children’s ©2016 The Children’s Hospital of Philadelphia, All Rights Reserved. • 17VEC0083/NP/07-16 Hospital of Philadelphia. The Center does not receive support from pharmaceutical companies. CS 249472_E DISTRIBUTED BY: Flu vaccinescanbegiven topreteens andteensintwo ways: What elseshouldIknowabouttheflu vaccine? http://vaccine.healthmap.org clinicnear a fluvaccination at you withthevaccinefinder urgent care clinics, grocery stores, andschools. You canfind pharmacies, places likethelocalhealthdepartment, other yourat child’s doctor’s office orclinic,andsometimes flu season,even in orlater.January Fluvaccineis available shouldcontinuethroughout vaccination the circulating, October.ideally by However, are aslongfluviruses Preteens andteensshouldgetthefluvaccineevery year, When shouldmychildbevaccinated? spreads easilywhensickpeoplecough,sneeze,ortalk. body aches, (tiredness) fatigue andsometimesfever. Flu runny the flu.Thefluusuallycausesacough, orstuffynose, the flu,buteven healthy adolescents canget sickfrom very and 2)orasthma,are agreaterfrom at riskforcomplications teens whohave chronic healthproblems likediabetes(type1 or pneumonia(aseriouslunginfection).Preteens and of weeks, like sinusinfections, somewillgetcomplications and teenswhogetsickwiththeflu recover withinacouple Whilemostpreteensand insomecasesitcancausedeath. people coughorsneeze.Flucancausemildtosevere illness, Fluspreads influenzaviruses. caused by wheninfected infectsthenose,throat,andlungs The fluisanillnessthat Why doesmychildneedtheflu vaccine? Last updatedJUNE2014 Flu Vaccine forPreteensand Teens • • get theflushot. should conditions, likeasthma,diabetes, disease orheart the nose.Preteens andteenswithchronic health but weakened, Thisvaccineissprayed fluvirus. up The nasalspray fluvaccine ismadewithlive, isgiven that inthearm. vaccine isashot areMost madefrom flushots This killedfluviruses. NOT getthenasalspray vaccineandinstead .

to chicken eggs. to chickeneggs. doctor ornurseifyour preteen orteenhasasevere allergy type offluvaccineare rare. totellthe Itis important very or two Serioussideeffectsfrom aftervaccination. either throat, orcough.Thesemildeffectsusuallygo away aday runnyflu vaccinemightcausecongestion, nose,sore are asore armandalowfever orachiness. Thenasalspray symptoms. Themostcommonsideeffectsfrom aflushot fluvaccinescansometimescausemild,flu-like Both Medicine. of Pediatrics, andtheSocietyforAdolescent Healthand Academy ofFamily Physicians, theAmericanAcademy Practices,Committee onImmunization the American for DiseaseControl andPrevention Advisory (CDC) is recommended forpreteens theCenters andteensby causetheflu.Theannualfluvaccine are safe.Theycannot typesoffluvaccinehaveBoth beenstudiedcarefully and is bestforyour preteen orteen. Talk toyour child’s doctorornurseaboutwhichfluvaccine www.cdc.gov/vaccines/teens CDC’s Vaccines forPreteens andTeens website at needs. There ismore aboutthesevaccineson information the fluvaccineandanyothervaccines yourpreteen orteen Talk toyour child’s doctorornursetolearnmore about Where canIlearnmore? (www.cdc.gov). homepage or typingVFCinthesearchbox oftheCDC visiting www.cdc.gov/vaccines/programs/vfc/index.html Native. You canfindoutmore abouttheVFCprogramby uninsured, Medicaid-eligible,AmericanIndianorAlaska vaccines forchildren ages18years andyounger, whoare The Vaccines forChildrenprogram (VFC) provides How canIgethelppaying thesevaccines? for |DISEASESandthe VACCINES THAT PREVENT THEM | INFORMATION FOR PARENTS PARENTS FOR INFORMATION Control andPrevention Centers for Disease Health andHuman Services U.S. of Department .