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Kindergarten:

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As most children entering kindergarten are between 4 and 6 years old, this age range commonly has children receive their subsequent doses of multiple vaccines. Most often, the children in this age group need their:

• Fifth dose of DTaP
• Fourth dose of IPV
• Second dose of MMR
• Second dose of Varivax

Managing multiple dosing schedules and administering more shots can be challenging for both parents and healthcare providers. To ensure each patient is up-to-date and to make this process easier, healthcare providers can administer combination vaccines. The two combination vaccines that can be used at this visit for this age group are Sanofi’s Quadracel (DTaP/IPV) and Merck’s ProQuad (MMRV).

Middle School & Junior High School:

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Preadolescents entering middle school and/or junior high school are typically between the ages of 9 and 14. This age group also needs multiple vaccinations at this time.

The Advisory Committee on Immunization Practices (ACIP) recommends that children 11 to 12 years old receive Adacel (Tdap), MenQuadfi (Men ACWY) and start the Gardasil (HPV) series if it has not been started.

Gardasil can be given as early as 9 years old, so check to see if the patient has already received one or two doses. Gardasil has a two-dose schedule for patients 9 to 14 years old. The two doses need to be at least six months apart. Patients 15 years and older have a three-dose Gardasil schedule – give the first shot, the second shot is two months later, and the third shot is six months later.

High School:

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Adolescents entering high school also have vaccinations that the ACIP recommends they receive. Around the age of 16, patients should receive their second dose of MenQuadfi (Men ACWY). This is also a perfect time to review whether the patient has completed their Gardasil (HPV) series.

Additionally, physicians should discuss with the patient to determine if receiving a meningococcal B vaccine is recommended. Please see the CDC’s handout on Shared Clinical Decision-Making for meningococcal B vaccines here.

The two meningococcal B vaccines that are currently available are Pfizer’s Trumenba and GSK’s Bexsero. Both vaccines are a two-dose series with doses administered six months apart. Meningococcal B vaccines are not interchangeable. Therefore, make sure to document which manufacturer’s meningococcal B vaccine the patient receives.

If the patient is going to receive both the second dose of MenQuadfi and qualify for their first dose of Pfizer’s Trumenba vaccine, providers can offer Pfizer’s Penbraya (pentavalent meningococcal vaccine ABCWY) at this visit instead of giving the two shots separately. A second dose of Trumenba should be given six months after the first dose or when the patient reaches 18 years of age.

Healthcare Providers’ Role as Children and Adolescents go Back-to-School

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During back-to-school season, health providers should seize the opportunity at well-child checks to schedule any necessary follow-up visits for additional vaccine doses. You can also schedule or remind patients to come in for influenza and/or COVID-19 vaccines in the fall.

Teach office staff to take advantage of every opportunity to bring patients up to date on vaccines. A patient’s vaccination status should be reviewed at every visit, whether they are sick or well, to ensure they have completed all necessary vaccines. Many vaccines can be given if a patient is only mildly ill.

To view a copy of the CDC’s most current recommended child and adolescent immunization schedule, click here.

What PCA Can Offer Healthcare Providers

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PCA members get the best possible prices on these vaccines with our Vaccine Purchasing Programs through Merck, Pfizer and Sanofi. If you would like to find out more or sign up for one of these programs, you can contact Amy Bullock by email at abullock@primarycarealliance.com or call (801) 369-3933.