With school back in session, families are juggling classes, homework and after-school activities. Making sure kids are up-to-date on vaccinations and prepared for the upcoming flu season is also important.

“Immunizations are our chance to prevent infections before they happen and keep our children healthy,” said Dr. Matthew Kronman, a pediatrician and associate professor of pediatric infectious diseases at Seattle Children’s. “Because children are around so many other kids at school, there is a high chance for passing infectious diseases from one child to the next.”

To make it easier for busy families, On the Pulse asked Kronman what parents should know about back-to-school vaccines, including recommendations for the 2019-20 flu season and information about the measles, mumps and rubella (MMR) vaccine, which he noted is especially important after this year’s measles outbreak.

The flu vaccine: Safe and effective

The Centers for Disease Control and Prevention (CDC) recommends that everyone who is 6 months and older should get the flu vaccine each year. This is because the flu is common, changes every year and can cause a wide spectrum of disease, from an uncomfortable illness to a serious infection requiring hospitalization and even leading to death.

Tragically, about 130 children died during the 2018-19 season from the flu. While about half of those children had a high-risk condition, the other half were previously healthy.

Families should try to be vaccinated against the flu as soon as they can to develop immunity. While people should aim to be vaccinated by the end of October, families shouldn’t be discouraged if they’re not able to get it until after October, since the flu circulates until spring.

This year, the American Academy of Pediatrics and the CDC recommend children get either the flu shot or the nasal flu mist. Families have many options for getting vaccinated in their community, including from their primary care provider, as well as local pharmacies, grocery stores and retailers.

“Some parents might worry that the flu vaccine makes people sick, which is a myth,” Kronman said. “Sometimes people will get the flu shot when they are already developing a cold, which is unrelated to the flu. Though the vaccine becomes available now, the influenza virus usually does not start circulating until later in the season. Also, the flu shot is made with a killed virus, so it’s unable to make people sick!”

Strategies for children who are afraid of shots include using numbing creams, breathing and distraction techniques (such as watching a funny video), cold packs, or opting for the nasal spray. However, certain people may not be able to use the nasal spray, such as kids under age 2, people with severe asthma and children who are immunocompromised.

The importance of the MMR vaccine

The CDC recommends that children get two doses of the MMR vaccine. The first dose should be at 12 to 15 months and the second at ages 4 to 6 years.

From Jan. 1 to Sept. 5, 2019, there were 1,241 cases of measles in the United States, the most cases reported since 1992, according to the CDC. Most people affected had not received the MMR vaccine. The CDC states that up to 90% of people who lack immunity and get close to someone with measles will also become infected. In addition, the virus can live in the air for up to two hours after an infected person coughs or sneezes, so it is possible to catch measles without ever knowing you have been around someone sick with it.

In May, Washington state law changed, removing the option to exempt children for parents’ personal or philosophical reasons from the MMR vaccine needed for entering school and child care. Medical or religious exemptions for the vaccine are still accepted.

“This limits the number of reasons parents can say that they don’t want to give the MMR to their children,” Kronman said. “The hope is that this will increase vaccine uptake in the community. That is important because not every person can receive the MMR vaccine.”

For example, children with immunocompromised conditions or on certain medical treatments, such as for cancer or bone marrow transplant, may not be able to receive the vaccine. In order to protect them against measles, the community needs to have a high rate – typically 95% or more – of people immunized against measles, Kronman said.

“We need to remain vigilant and make sure our communities have a high rate of vaccination so we can protect ourselves and those who can’t be vaccinated,” Kronman said. “About 1 to 3 out of 1,000 children who get measles die from it, and the disease can have long-lasting effects such as brain inflammation. To prevent deaths and long-term adverse effects, we need to ensure that everyone who can get the MMR vaccine does get the vaccine.”

Back-to-school basics

Babies and toddlers get many vaccines to build their immunity and protect them before they’re exposed to diseases. After that, kids get their next round of vaccines before school between ages 4 to 6, when they receive booster shots of certain vaccines. Preteens and teens need another set of vaccines to ensure protection through adolescence, including the HPV vaccine.

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