Little coughs, feverish naps and runny noses.
Nothing tugs at the heartstrings more than a sick child. And it’s all the more troubling to contend with that when classes are in session. To best prepare, doctors are urging parents to check that kids’ routine vaccines are up to date before their first day of school.
Children should begin vaccinations against 15 potentially serious diseases before they turn 2, according to the Centers for Disease Control and Prevention. That includes annual shots against influenza and COVID-19.
Though children receive most of these shots during routine checkups, doctors say some pediatric patients are still behind after the pandemic interrupted wellness visits. Physicians encourage parents to make sure their kids are up to date before they head to class.
“It’s important for parents to remember these diseases, even though we don’t see them frequently … they’re still there,” said Dr. Kisha Davis, chief health officer for Montgomery County, Maryland. “Check in with your primary care doctor (about) what’s the right vaccine to get at what age and stage.”
Childhood vaccines: Still catching up
The Vaccines for Children program has brought about a record increase in vaccinations since it was established in 1994, although the pandemic hindered some of that progress.
In 2021, 92% of U.S. children under 2 had been vaccinated against measles, mumps and rubella, below the federal target of 95% the country achieved in the 2019-20 season, according to the CDC. In November 2023, the agency released another report that found nationwide vaccination for kindergarteners remained below pre-pandemic levels.
School districts around the country require a specific set of childhood vaccinations before kids can attend class, but enforcement of these requirements fell by the wayside during the pandemic. Instead of attending school, students were learning virtually at home, where there was less opportunity for disease transmission.
Educators were more focused on ensuring students had meals and laptops at home, said Davis, who is also a board member of the American Academy of Family Pediatrics. “Chasing you down for a vaccine became a lower priority.”
The pandemic interrupted routine wellness checkups, during which children typically receive these vaccines, said Dr. Glenn Fennelly, professor in the pediatrics department at Texas Tech Health in El Paso. Some patients are still catching up.
There has also been an increase in vaccine hesitancy since the pandemic, he said, leading states to allow more vaccine exemptions for non-medical reasons. During the 2022-23 school year, the number of families seeking vaccine exemptions increased in 41 states and exceeded 5% in 10 states, according to the CDC.
Recent outbreaks of measles, a highly transmissible disease that can be prevented with vaccines, show the importance of high vaccination coverage.
At least 13 outbreaks have been reported in 2024, according to the CDC, including one earlier this year in a Florida elementary school. Of the 219 cases reported this year, 40% were in children younger than 5, and 87% were among adults and children who were unvaccinated or whose vaccination status was unknown.
“These are devastating illnesses,” Fennelly said. “It’s a concerning trend.”
What parents should know about routine vaccinations
Most vaccines are delivered in multiple doses on a schedule. They protect against diseases such as hepatitis B, rotavirus, diphtheria, pertussis (whooping cough), tetanus (lockjaw), Hib (haemophilus influenza type b), pneumococcal disease, polio, measles, mumps, rubella, chickenpox and hepatitis A.
Vaccines are sometimes lumped together in a single vial, making it possible to protect against multiple viruses in one series of shots. For example, children need only one series of doses to protect against measles, mumps and rubella; diphtheria, tetanus and pertussis are also targeted jointly in a single series of shots.
Different shots are given to patients at a specific time of their life because studies have shown when the vaccine will be most protective, Davis said. Experts say, however, that if a child misses the window to get immunized, there are ways they can catch up.
They suggest parents have a conversation with their family doctor or pediatrician to create a schedule that works for them.
“Your primary care doctor’s job is to manage your health in the context of you,” Davis said. “Lean on them. We can figure this out together.”
Flu and COVID-19
Childhood vaccines are needed only once in a lifetime. But doctors also want parents to stay up to date on annual shots.
The CDC’s Advisory Committee on Immunization Practices recommends routine seasonal flu shots for everyone 6 months old and older that target the three dominating influenza A strains from last winter.
“Our top recommendation for protecting yourself and your loved ones from respiratory illness is to get vaccines,” said Dr. Mandy Cohen, director of the CDC. “Make a plan now for you and your family to get both updated flu and COVID vaccines this fall, ahead of the respiratory virus season.”
Like flu shots, the COVID-19 vaccines are also recommended for children 6 months and older. In early June, an advisory panel at the Food and Drug Administration recommended this season’s COVID vaccines target the JN.1 lineage of SARS-CoV-2.
JN.1 dominated cases this past winter; however, its subvariants – known as FLiRT – accounted for more cases during the summer months. As of Friday, the subvariant KP.3.1.1 made up nearly 28% of COVID-19 cases in the U.S., and KP.3 made up over 20%, according to CDC data.
In an update, the FDA recommended vaccine manufacturers also target the JN.1 sub-variant KP.2.
The FDA is expected to approve the vaccine in the coming weeks. The nation’s two largest pharmacy chains, Walgreens and CVS, told USA TODAY they expect shipments of the vaccines to arrive a few days after the approval.
Older children can typically get these shots at their local pharmacy, but most pharmacies won’t vaccinate children younger than 3. Davis suggested parents ask their providers if younger children can be vaccinated at the doctor’s office.
Vaccien mixup:Incorrect RSV shots given to 128 pregnant women and 25 babies, CDC says
Respiratory syncytial virus, RSV
The newest vaccine on the scene is the shot that protects against respiratory syncytial virus, or RSV.
RSV is a respiratory virus that infects the lungs and breathing passages, including the nose and throat, according to the CDC. In the U.S., about 58,000 children younger than 5 are hospitalized for RSV each year, and several hundred die.
The monoclonal antibody called Beyfortus, made by Sanofi and AstraZeneca, made its rocky debut on the market last year.
The shot is recommended for babies 8 months and younger entering their first RSV season. It can also be given to 8- to 19-month-old children who are at increased risk of severe disease if they’re entering their second season with the vaccination.
In the U.S., the RSV season typically starts in September and runs through January. Beyfortus has been shown to reduce the risk of RSV hospitalizations and health care visits in infants by about 80%, according to the CDC.
Last year, health officials were forced to reel back their recommendations about who was eligible to receive the infant shot amid a drug shortage that coincided with a surge in RSV cases.
At the time, Sanofi blamed “unprecedented demand” for the vaccine, but the drugmaker told USA TODAY its expanded manufacturing network will more than double the doses available this year. They should be ready by October, the manufacturer said.
It’s key to note, though, that RSV shots won’t be available at pharmacies, so health experts say parents should talk with their children’s doctor and create a plan for getting the shot as soon as their children are eligible.
Contributing: Eduardo Cuevas, USA TODAY
Adrianna Rodriguez can be reached at adrodriguez@usatoday.com.
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