Building immunity: A roundup of vaccinations required for kids heading back to school

No kid wants to hear their trip to the doctor will include shots. But if they are going to be ready for their first day of school, the state of Missouri requires children to have up-to-date immunization against various diseases, and their parents to provide the papers to prove it.

The requirement means many parents of soon-to-be kindergarten students must make time during the summer to get their children fully vaccinated. The shots given before starting kindergarten are often the final rounds of common vaccinations begun during infancy.

Before they can enter school, children must have had final doses of various vaccines on or after their fourth birthdays. The vaccines include Dtap, which protects against diphtheria, tetanus and pertussis, along with a third and final dose of IPV, which protects against polio, and a third dose of Hepatitis B vaccine. Two doses of MMR, which protects against measles, mumps and rubella, must also be completed before kindergarten, as well as two of the varicella vaccine, which protects against chicken pox, and two doses of the Hepatitis A vaccine.

Knowing that the summer months can be a busy time for parents readying their children for school, the Cape Girardeau County Public Health Center expands its schedule for providing the required vaccines in June, July and August, says Jennifer Volkerding, public health nurse and assistant director of the center.

The center's normal year-round schedule for offering the vaccines is four days each month.

"We are busier then, and we want to make sure we are available to give the vaccinations to all that need to come in for them," she says.

While the list of vaccinations required to start kindergarten seems lengthy, Volkerding says the combination vaccines the center offers for children can mean fewer overall shots are administered to children.

"There are some children's vaccines that manufacturers combine, so giving several in one or a few shots is possible," she says.

The center offers a variety of ways to pay for administering vaccines, including the use of government health care cost coverage programs. Volkerding says the easiest way for parents to check the available days for vaccines is to call the health center at 573-335-7846.

Vaccines like the ones needed to begin school are also available at pediatrician and general physician offices.

A yearly flu shot is also recommended for children by the Missouri Department of Health and Senior Services, but parents should not try to get their child a flu shot too early – and the summer is too early, says Abe Funk, a pharmacist at John's Pharmacy in Cape Girardeau, where flu shots are available for children ages 12 and older.

"What we don't want to see happen is that you get your flu shot in, say, August, and then the effectiveness wears down by the time we are actually in flu season," Funk says.

A good option for parents with children younger than 12 is to take them to a health center flu clinic or their pediatrician's office, Funk says, since often pharmacies in Missouri are limited on the vaccinations they can administer.

The health center also works in conjuction with public schools in Cape Girardeau County to offer flu shots for a set amount, usually around $20, that are administered to children at school with parental consent.

School administration requires the month, day and year of all immunizations documented and presented for students before attending school, unless a student is exempt for religious reasons, according to the Missouri Department of Health and Senior Services.

Some additional vaccines throughout childhood are also required to attend school, such as a round of the Tdap vaccine, which protects against tetanus, diphtheria and pertussis, before entering eighth grade.

Volkerding says the best resources for parents to check for a complete and updated list of required vaccines is to go online to their state's health department website. For Missouri, the list can be viewed at www.health.mo.gov.