BOZEMAN -- Want to give your child the best shot at avoiding serious illness? Health care professionals at Montana State University-Bozeman suggest parents not only make sure their children's required immunizations are current, but also that families consider optional inoculations now recommended by state health officials.
Sandi Burgard, professor of nursing at MSU-Bozeman, says that Montana is not isolated from outbreaks of contagious disease. She recommends that parents of students ranging from pre-school to college seriously consider optional immunizations, particularly Hepatitis B inoculations for teenagers.
"Illness knows no boundaries," said Burgard, coordinator of the MSU College of Nursing's nurse practitioner program. "Particularly as Montana becomes more of a travel spot, illness can easily be brought here from other locations."
Burgard, who herself was a pediatric nurse practitioner in Arizona before returning to her native Montana, says that most parents are diligent about updating children's shots in infancy during regular well-baby check-ups as well as meeting another set of required immunizations when a child enters school at kindergarten.
"It's (older) school age children where parents forget about immunizations," she said.
Many of those parents are now discovering that Montana law now requires a second Measles-Mumps-Rubella (MMR) shot for children beginning middle school. That shot is now routinely given to infants, but the state began the requirement two years ago to protect older children who missed the booster when younger, Burgard said. All colleges and universities in Montana also require the second MMR, said Jim Mitchell, director of MSU-Bozeman's Student Health Services.
Tetanus boosters are recommended every 10 years, and Burgard said health professionals suggest that a booster be given at age 14 or 16, or whenever a child is playing a sport with a risk of injury. Mitchell said MSU-Bozeman requires that students receive a booster within 10 years prior to beginning class.
Hepatitis B immunizations, a series of three shots to protect against the blood-borne illness, are also routinely given to infants now. While Hepatitis B is not currently required for adolescents, state health officials recommend the battery be given to teenagers, who likely didn't receive the shots when babies. Burgard said the vaccine is particularly important for adolescents because Hepatitis B can be sexually transmitted.
Mitchell said Hepatitis B is "strongly recommended" for students beginning to take classes at MSU-Bozeman, and it is required for all students enrolled in the health sciences fields.
Health care professionals, and students in health-related fields, are also now required to receive annual tuberculosis tests. Burgard said a resurgence in TB has resulted in a recommendation that everyone, students and adults, receive a TB test every one or two years. MSU requires a TB skin test within one year of beginning class.
Chicken pox vaccines are not yet required in Montana, but Burgard recommends them, particularly for working parents of children ages one and over.
"You have to weigh the cost-benefit ratio of the shot, which is expensive (about $60), and the time you'll have to take off work to be with your child if they get chicken pox," Burgard said,. She said a child is contagious for 24 hours before the chicken pox blisters appear until the time they scab over, which can be at least a week. Burgard said while the chicken pox vaccine is relatively new in the U.S., it has been used effectively in Japan for a decade. Officials do not yet know, however, if a booster will be needed in the future.
Burgard has similar advice about the cost/benefit ratio of flu shots, which are annually given in the fall. Burgard recommends them for not only children old enough to receive them, but particularly for parents.
"You don't want to catch the flu and then pass it on to your kids," she said.
When it comes to state law requiring shots, few people are immune. MSU's Mitchell said immunization waivers are given to students with a health reason preventing them from receiving the shot because of an allergy, pre-existing condition or illness. Waivers are also given for religious reasons.
Burgard said all recommended immunizations are available from both health care professionals and county health department clinics throughout Montana, so there is little reason to avoid shots. And for the patient who is afraid of shots, Burgard, who admits to a needle phobia herself, has a few tips.
Burgard said nurses prefer an "up-front" approach with reluctant children. While a parent may not want to bring up the certainty that the child is going to receive a shot during a visit to a health care professional, the parent should be honest if the child asks.
"Say, Yes, that is something we have to do today.'"
Children needing the shots for kindergarten will often be more accepting if they are told that the shots are needed for the child to go to school, she said. She also suggests telling the child " I know you don't feel sick now and this is to keep you well.
"Put it in context. Tell them it will hurt for just a minute, but sickness can last a long time."
Burgard said parents should never tell a child visiting a health care professional that is they aren't good, the nurse is going to give the child a shot.
Burgard said schools no longer offer mass immunizations, as they once did. However, shots are readily available from personal medical professionals and most county health departments offer immunization clinics.
She advises anyone with questions about required immunizations to contact their health care professional, or the county health department, for more information.
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