“Vaccines save lives; fear endangers them. It’s a simple message parents need to keep hearing.” – Jeffrey Kluge
Although adolescent immunization is currently not covered by any of the government’s schemes it is an issue that deserves to be brought to light more substantially. Adolescents comprise 22% of India’s population and in the recent years paediatric training has placed special emphasis on the problems in this age group. While there is emphasis on providing health education in regard to sexual change, sexuality, gender related problems, psychological conflicts and vulnerability to addictive behaviours it is important to remember that adolescence is also the time for catch up immunisation and administration of some important vaccines. Sensitization of parents, teachers and support groups and establishing a linkage between health facilities will help increase the participation in this health initiative.
The Indian Academy of Paediatrics recommends “catch up” Immunization in adolescents from ten to eighteen years of age. Vaccines given after the recommended age constitute ‘catch-up’ immunisation compensating for overdue dosage and irregular schedules.
These are the list of vaccines that can be given to adolescents if they were missed during childhood.
- Measles Mumps and Rubella Vaccine: Two doses are to be taken with a 4-8 weeks interval.
- Hepatitis B vaccine: Three doses at 0, 1 and 6 months.
- Hepatitis A vaccine: Two doses at 0, 6 months
- Typhoid Vaccine ideally can be repeated every 3 years
- Children who have not had a natural exposure to chicken pox can get Varicella vaccination (two doses at 4-8 weeks interval) especially around board exams. Some experts recommend repeating the vaccine even if the child received one dose earlier.
- Influenza Vaccine One dose every year
- Children with compromised immune status due to illness or long term medication are required to repeat their vaccination for pneumococcal infections.
- Japanese Encephalitis Vaccine catch up before 15 years of age is recommended in the areas where this infection occurs frequently (parts of Maharashtra, Gujarat, Rajasthan and Madhya Pradesh are free from this infection)
These are the vaccines recommended for adolescents going abroad:
- Meningococcal Vaccine for USA / UK / and endemic areas (2 doses 4-8 weeks apart).
- Yellow fever vaccine is recommended for travel to endemic zones (concentrated in tropical Africa and South America) 10 days before.
- Oral Cholera vaccine can be taken prior to visiting endemic areas ( 2 doses 1 week apart) or in an outbreak.
- Japanese B encephalitis single dose vaccination (up to 15 years) in endemic areas.
- Rabies Vaccine can be taken as pre exposure prophylaxis by adolescents going on trekking (day 0, 7, 28 schedule)
Another very important vaccine is the one developed for genital human papillomavirus (HPV), the most common sexually transmitted infectious agent. Most HPV infections don’t cause any symptoms, and go away on their own. But some strains are associated with a propensity to cause cancer of the cervix in women. Unlike many other cancers, cervical cancer occurs early and strikes at the productive period of a woman’s life. Cervical cancer, mainly caused by Human Papillomavirus infection, is the leading cancer in Indian women and the second most common cancer in women worldwide and prevention by vaccination is emerging as the most effective option, with the availability of two vaccines for adolescent girls.