Back to school: Pencils, pens, books -- and vaccines

School kids already unhappy at the thought of summer vacation ending may have another reason to dread the return to school. Most states require children to be immunized against certain diseases before they can enter a classroom -- and that means "shots," in kid-speak.

Although children may not like the pinch of the needle, parents can appreciate the fact that routine vaccination has almost eliminated many of the diseases that used to claim young lives. But outbreaks of those diseases can occur. The federal Centers for Disease Control and Prevention (CDC) reports that in 2010, there were more than 21,000 cases of whooping cough (pertussis) in the United States. In addition, there's been a record number of cases of measles reported in 2011.

Requiring vaccinations before children enter a classroom (and often before they enter day care) helps ensure that potentially deadly contagious diseases will not spread.

Although different jurisdictions vary as to when children must have their immunizations, the schedule required by the Chicago Public Schools is fairly typical:

  • Diphtheria, pertussis and tetanus (commonly called DTaP or Tdap) vaccine:

Four or more doses, the last (a booster) received on or after the child's fourth birthday. If 10 years have passed since the last booster shot, another booster is required.

  • Polio vaccine: Three or more doses, with the last received on or after the child's fourth birthday.
  • Measles, mumps, rubella (MMR) vaccine: First dose at 1 year or older. A second dose should be administered at least one month later.
  • Hepatitis B vaccine: Three doses -- the first at birth or later, the second at least one month after the first one, the third at least four months after the first dose.
  • Chicken pox (varicella) vaccine: Required for students going into preschool and kindergarten.
  • Haemophilus influenzae Type B (HIB): Mandatory for students entering any preschool or pre-kindergarten program. Only one dose is required if it's received after the child is 15 months old. This vaccine also prevents meningitis.

CDC has its own recommended vaccine schedule for young children in an easy-to-read visual format.

As of Sept. 23, 2010, the federal health care reform law requires all new insurance plans to cover the cost of these immunizations without charging a copayment or requiring a patient to meet a deductible. If your children don't have health insurance coverage, if they're covered under a pre-existing plan that doesn't cover vaccination costs, if they are eligible for Medicaid or if they are of American Indian or Alaskan Native heritage, they may be able to get free vaccines through the federal Vaccines for Children program. Health care providers may charge a nominal administrative fee to cover costs.

Many schools require physical exams before the school year starts. Your pediatrician should be able to tell you which vaccinations your kids will need before they can start school, or you can get that information from the school itself.