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Adolescent Health Visit

This fall thousands of adolescents and young adults are starting middle school, high school and college.  Before they start school, they should visit their Pediatrician or Family Practice provider.  Adolescents go through physical and emotional changes that can be distressing to them and their parents.  Many times adolescents are afraid or embarrassed to ask their parents questions about these sensitive issues like pubertal changes and sex.  I encourage the parents to speak to their children about these issues but the reality is that most parents are not sure how to even start the conversations.  Unfortunately most teens get their information and misinformation from their friends and the Internet.  There are many studies that show that if parents are more actively involved with their teens there would be less likelihood of drug use, high-risk sex, and pregnancy.  As parents our children look to us for guidance and even though they appear to not listen, they really are paying attention.

To make your visit to your Pediatrician or Family Practice provider as productive as possible, we recommend that the parents and the teen write down all the questions they have before the visit.  In addition, we have the parents step outside for a few minutes so that the teen can have some privacy to ask questions they may feel uncomfortable asking in front of their parents.  We tell the parents and the teens that the questions brought up are private and will not be shared with the parents.  This helps build trust with our teens and gives them a chance to open up.  Most of the time parents respect this rule but occasionally they ask what we discussed in private but we have to decline.  When appropriate we discuss issues such as sex, abstinence, sexually transmitted diseases, STD prevention, and birth control.  A useful tool that parents can use to start the discussion is a DVD on sexuality.  In addition to these issues, we discuss topics such as school, study habits, and future plans.  We are surprised that many teens just “go through the motions” of school and really don’t know what they want for their futures.  Most of the Pediatricians in our office encourage the parents to discuss these issues with their children.  One book that I recommend to parents of teens is Your Adolescent.  It is written in a simple straight-forward manner and offers great advice.  I have noticed that parents who are actively involved in their children’s academics often have high achieving students regardless of their economic status.

Recently there are new vaccine recommendations outside the routine Tetanus booster.  Immunization is the single most important method of preventing disease today.  Now we have vaccines that can prevent cancer in women as long as they are vaccinated early enough in life.   Today’s vaccines have been extensively tested for safety and efficacy.  Pseudo-science advocates have perpetuated many of the concerns like autism; research has shown no link, in fact studies are pointing to a genetic link for the cause of autism.  Teens and young adults frequently miss their annual physical exams because for the most part they are very healthy.  But this is an important time to discuss important developmental changes with their physician such as sexual behaviors, drug experimentation, and physiologic changes in the body.  Vaccines are often overlooked because these important visits are missed.

Before visiting your Pediatrician or Family physician, make sure your child are up to date with the following vaccines:

  • Tdap
  • Meningococcal vaccine
  • HPV vaccine
  • Hepatitis A
  • Hepatitis B
  • Chicken pox (Varicella)
  • Influenza
  • Polio
  • MMR

Tdap vaccine

This vaccine is a combination vaccine that prevents Tetanus, diphtheria, and pertussis.  The major brand names are Boostrix and Adacel.  Boostrix is approved for 10-64 year olds and Adacel is approved for 11-64 year olds.  Because of the recent rise in Pertussis cases, there has been a push to vaccinate not only the infants, but also the young parents and their caretakes.

Meningococcal vaccine

Meningoccocal disease can be devastating and cause meningitis and permanent brain damage.  Adolescents, military recruits and college students are especially susceptible because of the close contacts.  There are 2 forms of this vaccine available in the United States: Menactra and Menveo.  It is believed that Menactra may offer longer protection.

HPV vaccine

The Human Papilloma Virus (HPV) has many strains and can cause cervical cancer and genital warts.  There are currently 2 licensed vaccines in the U.S. Gardasil and Cervarix.  Gardasil is approved for both males and females.  Cervarix is only approved for females.  It is extremely important to vaccinate before they are sexually active.  Our office usually starts vaccinating at 11 years of age.

Hepatitis A

This disease is transmitted by eating contaminated undercooked foods such as raw seafood or contaminated fruits and vegetables.  Although this is usually a short-lived infection, it can occasionally cause severe liver damage.  Most young children are vaccinated for this disease but it is important to make sure they are vaccinated already and to update them.

Hepatitis B

Hepatitis B is a disease that is transmitted by blood, sexual activity, or during delivery if the mother is already a carrier. This is another type of Hepatitis virus that can cause liver damage, in addition, carriers may develop cirrhosis of the liver and liver cancer.  Most children are now vaccinated at birth and are fully immunized.  Some immigrant children may not had been vaccinated in their country and will require this vaccine.

Chicken Pox

Since most children had been vaccinated at 1 year of age, the incidence of this disease has dropped significantly.  It was initially believed that the immunity from the vaccine would last at least 20 years.  Now studies have shown that the immunity starts to wane after a few years and children are getting a booster at 4 to 5 years of age.  If your child or teen has only one dose of the Varicella vaccine, he or she should get a booster.


Every fall season a new Influenza vaccine is released to protect against the predominant influenza strains that the scientists predict will be present.  Although the young children, the elderly and patients with chronic health conditions are the most susceptible, vaccinating teens can help prevent the spread of the flu.  Last flu season, the H1N1 strain caused problems more for the young adults than infants and elderly.

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