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Pencils, notebooks, backpacks, new clothes — parents have a lot to stock up on before their child returns to school for another year of learning.

An essential part of any parent’s back-to-school checklist should also include making sure their child’s vaccinations are up to date.

Dr. Delaney Gracy, medical director of the Montefiore School Health Program, answers some of the most commonly asked questions about immunizations to help parents prepare their kids for optimal health in the new school year and beyond.

What are the benefits to vaccinating my child?

Vaccination can protect infants, children, and teenagers from harmful diseases.

Some of these can be very serious and may lead to hospitalization or death, especially in infants and young children.

“Some of the vaccine-preventable diseases cause deaths in children every year — these are diseases that are still around,” said Gracy. “The vaccines that we have can prevent a child from getting sick and from needing hospitalization.”

The number of children and adults who get sick or die from vaccine-preventable diseases has decreased greatly since doctors started vaccinating Americans, according to the National Institute of Allergy and Infectious Diseases.

Both the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics have schedules of recommended immunizations for everyone from children to adults.

Which vaccinations does my child need to go to school?

All states and the District of Columbia require students to meet minimum vaccination requirements in order to attend public schools. These vary from state to state.

ProCon.org reports that as of July 23, 2018, all 50 states and D.C. require the following vaccinations:

  • diphtheria, tetanus, pertussis (DTaP)
  • polio
  • measles and rubella
  • varicella (chickenpox)

In addition, 49 states require the mumps vaccination, and 43 states and D.C. require the hepatitis B vaccination.

Some states also require hepatitis A, flu, Haemophilus influenzae type B (Hib), meningitis, or pneumococcal vaccinations.

To find out which vaccinations your child needs for school, you can check your state’s department of health website, the CDC’s website, or call your child’s school directly.

Even if you have older children, you need to be aware of the vaccination schedules.

“People sometimes don’t realize that middle school and high school kids need certain kinds of vaccinations and boosters,” said Gracy, such as meningitis, HPV, and the tetanus booster.

She also recommends that parents have their child vaccinated each year for the flu, even if their school doesn’t require it.

“A lot of people think the flu is like having a bad cold, but it’s actually much more severe than that,” said Gracy. “It can hospitalize your child, or put them out of school for a week or two — which also means putting parents out of work.”

If your child hasn’t been vaccinated for whatever reason, they may still be able to “catch up” with some vaccines.

“For most of the vaccines, you can start late and still complete the series,” said Gracy. “But there are a few that we only give to babies.”

She recommends talking to your child’s pediatrician about which vaccines they’re eligible for.

How much do school vaccinations cost?

Vaccination is part of the standard care for children, so military insurance and most private insurance covers them at no cost or for a small copay.

Gracy said that if you don’t have insurance, your state may have a Vaccines for Children program that provides vaccines at no cost to lower-income children.

School health programs and local health departments are another option as well.

Where can I have my child vaccinated?

Gracy said the best option is to have your child vaccinated during a regular visit with their pediatrician because your doctor knows your child and their health history. This will ensure that your child gets the right vaccines for their age and health status.

The doctor will also screen your child for other things during this visit, like healthy growth and development, vision and hearing, and other problems that may interfere with your child’s learning.

“The annual well-child check is really important,” said Gracy. “A lot of kids don’t get these, so some health problems are missed that interfere with their ability to learn or have optimal health.”

Parents who can’t make it to a pediatrician because of work, transportation, or other reasons can have their child vaccinated at pharmacies, schools, health centers, or local health departments.

Do college students need vaccinations?

Teenagers and younger adults going to college or university should check with their school to see which vaccinations are required prior to enrollment.

“Meningitis is one of the most important ones,” said Gracy, “because you have situations where kids are in dorms and they’re in enclosed spaces.”

This life-threatening infection is more common in college-age students, but can be prevented with full vaccination.

Older students may also need a tetanus booster or the annual flu shot. They may also need the HPV vaccine if they didn’t start when they were younger or haven’t had all the doses.

What if vaccinations are against my religious beliefs?

Most states allow parents to opt out of vaccinations for their child due to medical or religious reasons.

The CDC tracks vaccination exemptions allowed by states.

The American Academy of Pediatrics finds that nonmedical exemptions to school-required immunizations are “inappropriate for individual, public health, and ethical reasons and advocates for their elimination.”

Gracy said that “as doctors, we know that people come from different backgrounds, and have different concerns or reasons for making the choices that they do. So we really try to work with families and respect that.”

Doctors will often talk to parents to find out their reasons for opting out of having their child vaccinated. This includes making sure parents are basing their decision on accurate information.

How can I get a copy of my child’s immunization records?

To find out which vaccinations your child has had, the CDC recommends that you check with:

  • the pediatrician or public health clinic where your child was last vaccinated
  • your child’s state health department
  • your child’s school, daycare center, or college

How can I protect my children from HPV-related cancers?

The HPV vaccine protects against not only the HPV virus, but also against cervical, throat, and other HPV-related cancers — in both men and women.

The CDC recommends that boys and girls be vaccinated for HPV between 11 and 12 years of age. They’ll need two or three doses, depending on the timing of when they received the first two doses.

Because HPV is usually passed through sexual contact, parents may be wary of their 11- or 12-year-old receiving this vaccine. But earlier vaccination offers them more lifetime protection.

“You need to get the vaccine — and ideally multiple doses of the vaccine — into the child before they’re ever exposed to HPV,” said Gracy. “So with this vaccine, there’s no reason to wait until later — you want to get ahead of this disease.”