What Vaccines Are Required for School?

Back-to-school checklists can be extensive. There are clothes to buy, books to read and supplies to purchase. After you’ve taken care of the backpack, lunchbox, folders, binders, glue sticks and markers, next on the list is reviewing any vaccines your child might need.

“Vaccines help prevent really serious illnesses that can lead to long-term complications for children, as well as hospitalization and even death,” says general pediatrician Kim Giuliano, MD. “We give vaccines to prevent those most severe cases, the kinds that can cause serious types of complications.”

In general, vaccines work by introducing your body to a portion of an illness-causing organism. This might take the form of a protein, or it might be a dead version of the virus. “When your body sees that, it produces antibodies that serve as your protection and defense,” explains Dr. Giuliano. “The components of the vaccine eventually leave your body, but you’re left with these antibodies moving forward.” These antibodies will help your body fight infection in the future, should it encounter an organism that causes disease.

Why are immunizations important?

Staying up to date on vaccines is important for people of all ages, although immunizations are especially important for children. “The younger child is, the less mature their immune system is,” notes Dr. Giuliano. “If they were to come in contact with one of these diseases they’re not immune to, they are much more likely to have a severe case of — or devastating outcomes from — the illness. It’s important that we equip these young bodies with the protection that they need to be able to fight off these organisms.”

Due to their age, younger children also might not have encountered potentially harmful diseases before. “However, older children and adults may have been exposed to them during prior illnesses,” says Dr. Giuliano. “Their bodies have ongoing antibodies that help them fight off illnesses in the future. The very first time that you’re exposed to it, your immune system is naive. You’re at a much higher risk.”

The complete immunization schedule

The complete vaccination schedule is designed to protect children from 16 potentially harmful diseases. Not all immunizations are the same. Some require just one shot, while others involve multiple shots over a period of time. Plus, everyone ages 6 months and up should receive a yearly flu shot.

Different shots for school are best given at different ages. For example, from birth to age 6, it’s recommended children receive vaccines to prevent 14 diseases. “The next time children receive routine vaccinations is around age 11 or 12,” says Dr. Giuliano. At that age, it’s recommended they have a T-dap shot, which protects from tetanus, diphtheria and whooping cough, and vaccines for HPV and meningitis.

Older teens between ages 16 and 21 are also now slated to receive a second meningitis vaccine, for meningitis B.

“We don’t routinely immunize adults against meningitis unless they are at higher risk because of their underlying health conditions or their occupation,” says Dr. Giuliano. “But it’s routinely recommended for adolescents.”

She adds that’s because teens are more likely to be in those “close-quarter types of communities,” such as college dorms or military barracks. “Typical teenage behavior, such as attending parties and sharing water bottles, also make them a little bit more susceptible to meningitis than adults.”

The COVID-19 vaccine is also available for all kids ages 6 months and older. Timing and number of shots vary by age, brand and health of your immune system. It’s best to talk to your child’s doctor for recommendations specific to your child.

Why you should follow the immunization schedule

While it might be tempting to try and schedule vaccines all at the same time — and having a doctor’s appointment where your child receives multiple shots occasionally happens — Dr. Giuliano stresses that parents need to follow the age guidelines for immunizations.

“Vaccines are given at strategic ages, where we know that a child’s body is going to be able to mount an appropriate antibody response — and an antibody response that is going to stick with them,” she says. “For instance, we don’t give the MMR (measles, mumps and rubella) or the chickenpox vaccine until kids are over the age of 12 months old. At a younger age, their immune system is not going to mount a lasting antibody response.”

At the same time, doctors also don’t recommend waiting to get your child vaccinated if they’re eligible for certain shots. “The longer a child goes without certain types of vaccines, the longer they remain susceptible to diseases that could cause problems,” cautions Dr. Giuliano. “We want to get them immunized as young as possible with the vaccines that their bodies are equipped to respond. That way, they’ll have protection before they run the risk of contracting the illness.”

Should you be concerned about your child and vaccines?

Dr. Giuliano says some parents might worry that having too many vaccines might overwhelm their child’s immune system, especially if they get multiple shots in the same doctor visit. “There are concerns that perhaps this might be too much for somebody’s body to handle, and so we should either spread those vaccines out, or pick and choose which vaccines we’re going to give.”

However, parents can rest easy that there’s no evidence that having the normal recommended course of vaccines is harmful. “There are more antigens on your skin right now than in all of the vaccines that we give in childhood put together,” Dr. Giuliano explains. “If your body can handle what’s going on in my environment at this very moment, your body can also handle all of the vaccines that are recommended.”

At other times, Dr. Giuliano says parents might be concerned about a vaccine impacting their child’s development or causing long-term side effects and complications.

“I certainly understand why some parents could have that concern because you’re giving children vaccines at a time that they are growing and developing,” she says. “And if development starts to slow down or seems to stop at some point, it’s only natural to think about what’s potentially changed in your child’s life. Chances are, they’ve had vaccines around that time because children are frequently getting vaccines at an early age.”

However, Dr. Giuliano reassures that there are multiple studies showing vaccines aren’t the cause of these changes. “There is no evidence vaccines contribute to developmental challenges in children.”

Dr. Giuliano says parents also don’t have to worry that vaccines reduce a child’s ability to fight off all future infections. “Parents sometimes think that if a vaccine teaches their child’s body how to respond to certain types of viruses and bacteria, their child’s body isn’t going to know what to do after encountering a virus or bacteria that’s not in one of those vaccines,” she continues. “They’re worried their child’s body is becoming reliant on vaccines, or losing an innate ability to fight off infections.”

That’s not true either, says Dr. Giuliano. “Our immune system responds and develops memory to things that we’ve encountered multiple times. For example, over time, when you are exposed to cold viruses or skin infections, your body starts to develop antibodies to respond to them.”

Talk to your child’s doctor about vaccines

Dr. Giuliano notes that vaccine recommendations can vary from state to state and be different depending on the type of school settings. For example, daycares may have some specific immunization requirements, while older kids heading off to college also need certain shots.

“If you have specific questions, it’s always best to talk to your child’s pediatrician or family medicine physician,” says Dr. Giuliano. “We’re there to help parents raise healthy children and separate facts from fiction. Pediatricians are really attached to their patients and families, and give them the same advice that they give to their own families and children.”

Keeping up with the recommended vaccine schedule can feel overwhelming. If you’re not sure whether your child is up to date on their vaccines ― or if your child has missed shots — Dr. Giuliano recommends talking to your pediatrician about getting back on track. “The sooner that we get your child protected, the better,” she says, “because the longer you go without the vaccine, the longer you go susceptible to the diseases.”