Vaccine Schedule Related Issues
Immunization record, what if I don't have one?
I recently moved to the U.S., and my son is now starting school. I have been asked to show an immunization record, but I do not have one. How can I get one?
First, you should contact your previous healthcare providers to be sure they do not have a copy that they can send to you. If you are still unable to locate a record, your doctor may consider your son to have had no immunizations and begin the appropriate immunization schedule.
Even if your son had some vaccines previously, the additional doses will not hurt him. Alternatively, the doctor may give your son a blood test to see if he is immune to certain diseases such as measles, mumps, rubella, chickenpox, tetanus, diphtheria, hepatitis A, hepatitis B, and polio. This may reduce the number of vaccines your son needs to get, but he may still require other vaccines depending upon his age and other factors.
Summer and vaccines: What you should know
With the end of school and the start of summer, we want to relax and vaccines tend to be the furthest thing from our minds. However, during the summer we are at increased risk of coming into contact with certain infections both because we tend to travel more and because we tend to be outside where we are more likely to suffer from bug or animal bites, and be exposed to organisms in the soil.
Which pathogens are spread by animal or insect bites or found in soil?
Some diseases are spread by the bites of bugs, particularly mosquitoes. Most of these are not common in the U.S., but are in other places.
- Japanese encephalitis (JE) virus is spread by the bites of infected mosquitoes and is most common in southeastern Asia. Immunization has decreased the prevalence of disease in developed Asian countries such as Japan, Taiwan and Korea.
- Plague is caused by bites from infected fleas. The fleas become infected when they bite infected rodents (such as rats). In the U.S. vaccination is not routinely recommended and, in fact, the vaccine is not available. Preventive measures should include maintaining conditions that decrease or prevent rodent access to homes, treating pets with appropriate insecticides, using DEET-containing insect repellents on clothing, and avoiding direct contact with or handling of sick or dead animals.
- Tick-borne encephalitis or TBE is most common in parts of Europe and Asia. As its name implies, the virus is transmitted to humans through ticks. TBE vaccine is commonly administered in central Europe, and people considered to be at high risk can consider the vaccine. In addition to people living in areas where the disease is common, people at high risk because of their jobs or outside activities, should also consider vaccination. Travelers to infected areas who will be camping, hunting, or hiking should consider getting the vaccine.
- Tetanus bacteria live in the soil and infect people through cuts or wounds. Because this disease is not transmitted from person to person, people cannot be protected simply because everyone around them is protected. That is to say, the concept of herd immunity does not apply to this infection.
- Rabies virus is spread by the bite of an infected animal. Animals that may be infected include dogs, wolves, foxes, coyotes, jackals, raccoons, mongooses, skunks, cats, or bats. Immunization of domesticated animals has helped to reduce the risk of disease in humans. Most people are not commonly recommended to get a rabies vaccine because the course of disease can be modified by vaccine following exposure. People in high-risk groups, such as veterinarians, animal handlers, researchers, some laboratory workers, some travelers, and people whose activities bring them into frequent contact with potentially rabid animals should consider being immunized.
- Yellow fever is transmitted to humans most commonly by infected mosquitoes and in some cases, monkeys. The disease is common in South America and sub-Saharan Africa. Some countries require proof of immunization against this disease prior to entry. Only certified centers throughout the U.S. can give this vaccine.
- Dengue is caused by the bite of an infected mosquito and is most common in tropical countries. Although there are vaccines in development, currently there is no vaccine available.
- Lyme disease is transmitted through the bite of a tick. In the U.S. there are three areas that have the highest incidence of disease including the Northeast from Maine to Virginia, the Midwest in Wisconsin and Minnesota, and the West, mostly in northern California. The disease is also commonly found in Germany, Austria, Slovenia, Sweden, Russia, China and Japan. Although there was a vaccine available in the U.S. between 1998 and 2002, it was removed from the market due to limited public acceptance. Current prevention methods rely upon use of protective clothing and tick repellants as well as personal inspection for ticks after potential exposure.
- Malaria is spread through the bite of mosquitoes that are infected. Most cases occur in Africa; however, transmission also occurs in parts of Central and South America, Haiti, the Dominican Republic, Asia, Eastern Europe and the South Pacific. Many countries have instituted environmental control strategies such as insecticides and bed nets; however, there is not currently a vaccine.
- Parasitic infections can be caused by hookworms, snails, or sandflies that are infected with the parasites. Similarly, ingestion of parasites through contaminated food or water can lead to these uncommon infections that tend to occur in developing countries.
What should I consider before traveling?
Travelers to other countries should consult a travel clinic at least four to six weeks prior to leaving for their trip. The professionals in these clinics can help determine whether vaccines or medications are needed based on travel destination, time of year, and activities during the trip.
Learn more about travel clinics near you»
The Centers for Disease Control and Prevention (CDC) has a travel website that is a great source of information.
In addition to being up to date on recommended vaccines for this country, there are some other diseases that can be encountered on trips to other countries:
- Cholera is spread through contaminated food and water. People in developing countries of Asia, Africa, and Central and South America are at particular risk. Travelers to these countries are also at risk.
- Hepatitis A is spread through feces from infected individuals. Often this occurs in lower socioeconomic settings or overcrowded areas; however, spread can also occur by means of contaminated food or water.
- JE virus, described above.
- Typhoid fever is spread through contaminated food and water and is still present in several countries in Africa, Asia and Latin America.
- Some countries require proof of immunization against yellow fever before allowing entrance into the country; see above.
- Several diarrheal diseases are spread through contaminated food and water, particularly in developing countries. Many of these can be avoided by following certain rules of food consumption on trips. These include eating foods that are freshly cooked and served hot; avoiding ice, reconstituted juices and milks, and foods washed with water but not cooked (e.g., salads); avoiding raw or undercooked foods; and consuming beverages that are bottled and sealed or which have been boiled or treated with iodine or chlorine. Learn more»
- Travelers who may be at risk for malaria during their trip can take antimalarial drugs prior to travel and can learn more about ways to protect themselves on their trip. Learn more»
In the same way that people plan ahead regarding where to stay, best methods of transportation and which activities to do and sights to see, they should also plan ahead for health-related considerations.
What do I need to consider before my child goes to sleep-away camp?
Make sure your child:
- Is up to date on recommended vaccines
- Understands good hygiene - hand washing, not sharing drinks or other items that come into contact with saliva or body fluids, etc.
- Knows not to share medications and how to take any prescribed medications (although camp staff should be aware of and involved in the latter)
- Is aware of health maintenance - eating healthy foods and getting enough sleep and exercise
- Knows what to do in the event of illness or injury
Updated: February 2013