Essential Vaccines for 3-Year-Olds: What Parents Need to Know

excuse me?

Hello, Doctor:
I would like to ask what additional vaccines, aside from the mandatory 5-in-1 vaccine, should a child over 3 years old receive that are not covered by insurance?
1.
What additional vaccines should a child over 3 years old receive that are not covered by insurance, aside from the mandatory 5-in-1 vaccine?
2.
Is the Hepatitis A vaccine necessary? If the first dose is given in May, does the second dose need to be exactly six months later? If it is given after 7 or 8 months, will it affect the vaccine's efficacy?
3.
Since the second dose will be around late October or early November, when the flu vaccine is also due, how long should be the minimum interval between the second dose of the Hepatitis A vaccine and the flu vaccine?
Thank you!

winnie, 30~39 year old female. Ask Date: 2009/05/03

Dr. Xiao Kaiwen reply Pediatrics

1.
Children who are at least 3 years old can receive a pneumococcal vaccine and two doses of the hepatitis A vaccine at their own expense.

2.
The pediatrician's stance is that as long as there are vaccines available and the family can afford it, vaccination is recommended as it is beneficial and harmless.
Currently, most adolescents and children lack antibodies against hepatitis A.
Contracting hepatitis A in adulthood can lead to symptoms such as loss of appetite, nausea, vomiting, and jaundice, with a small percentage experiencing fulminant hepatitis.
Although children may exhibit mild symptoms, they can be highly contagious and transmit the virus to other children or adults.
The second dose should be administered "at least" six months apart; receiving the second dose after 7 to 8 months will not affect its efficacy.

3.
Both the hepatitis A vaccine and the influenza vaccine are inactivated vaccines, and they can be administered simultaneously at different sites or spaced apart by any duration.

Reply Date: 2009/05/03

More Info

When it comes to vaccinations for children, especially those around the age of three, parents often have many questions regarding both mandatory and optional vaccines. In the United States, the vaccination schedule can vary slightly from state to state, but there are general guidelines that parents can follow to ensure their children are adequately protected against various diseases.

Essential Vaccines for 3-Year-Olds
1. Mandatory Vaccines: In the U.S., children are typically required to receive a series of vaccinations by the time they reach school age. The "5-in-1" vaccine you mentioned usually refers to the DTaP vaccine, which protects against diphtheria, tetanus, and pertussis (whooping cough). By the age of three, children should also have received their MMR (measles, mumps, rubella) vaccine and the varicella (chickenpox) vaccine.

2. Recommended Optional Vaccines: Beyond the mandatory vaccines, there are several optional vaccines that parents may consider for their three-year-olds:
- Pneumococcal Vaccine (PCV13): This vaccine protects against pneumococcal diseases, which can lead to pneumonia, meningitis, and bloodstream infections.

- Hepatitis A Vaccine: The Hepatitis A vaccine is recommended for children starting at age one, and it is given in two doses. This vaccine is particularly important for children who may travel or live in areas where Hepatitis A is more common.

- Influenza Vaccine: Annual flu shots are recommended for children aged six months and older. It’s important to get this vaccine every year as the flu virus changes.

Hepatitis A Vaccine Timing
Regarding your question about the Hepatitis A vaccine, it is indeed recommended for children. The first dose is typically given between 12 to 23 months of age, with the second dose administered at least six months later. While it is ideal to stick to the six-month interval, a delay of seven to eight months for the second dose will not significantly impact the vaccine's effectiveness. The key is to ensure that both doses are completed to provide full protection.

Co-administration with Influenza Vaccine
As for the timing between the second dose of the Hepatitis A vaccine and the influenza vaccine, there are no specific contraindications to receiving these vaccines close together. Both vaccines are inactivated (killed) vaccines, which means they can be administered simultaneously or at different times without any adverse effects. However, it is generally recommended to administer them in different injection sites if given on the same day.

Conclusion
In summary, for a three-year-old, the essential vaccines include the mandatory DTaP, MMR, and varicella vaccines, along with optional vaccines like the pneumococcal and Hepatitis A vaccines. The influenza vaccine is also highly recommended annually. Parents should consult with their pediatrician to discuss the best vaccination schedule tailored to their child's health needs and any specific risks based on their environment or travel plans. Keeping a record of vaccinations and discussing any concerns with a healthcare provider can help ensure that children are protected against preventable diseases.

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