A shot at college

The postsecondary world can produce curious intellectuals, but it’s also ground zero to some heinous germs. The solution? Vaccinate.
If your child is headed to college for the first time, you can allay some of your worries by ensuring they’re up to date on vaccinations. (For Spectrum Health Beat)

If you’re looking to help your burgeoning thinker prepare for the first year of college, you could do worse than start with a simple science lesson.

Think of the higher learning universe as a giant petri dish.

Your youngster will dive headlong into that glorious environment, seizing opportunities to broaden the intellect and test new ideas that challenge the status quo.

College is, however, a life-sized cauldron of cellular chaos, swimming with a frightening array of potentially deadly germs.

What important steps can parents take to ensure their college student is prepared for life on campus?

Above all else, make sure your child is properly vaccinated, said Mary Zimmerman, immunization program manager at Spectrum Health.

Does this mean you can’t spend this last month of summer scouting out the best deals on futons, bed sheets and mini refrigerators? No. It just means immunizations need to maintain their proper place at the top of the to-do list.

The CDC provides recommendations on the vaccinations children need at various ages.

Teens headed to college should be current on six vaccinations in particular—meningococcal serogroup B, meningococcal conjugate vaccine (serogroups ACWY), hepatitis A, Tdap, HPV and influenza.

Meningococcal serogroup B vaccine

Given their bustling social lives and close-quarter living, college students are uniquely prone to exposure of meningococcal disease, Zimmerman said.

And if there’s just one thing to remember about meningitis, it’s this: It is deadly serious.

“People who have had meningitis had flu-like symptoms and then they were dead within 24 hours,” Zimmerman said. “If you survive, it’s a long-term stay in the hospital.”

The disease kills 10 percent of its victims, she said. Of those who survive, 20 percent will suffer long-term consequences from infection, including brain damage, amputation or loss of hearing.

When the bacteria infect the brain and spinal cord, it’s known as meningitis. When it infects the bloodstream, it becomes septicemia. There are two different vaccinations for meningococcus—serogroup B vaccine and serogroup ACWY vaccine, also known as the conjugate vaccine—and they immunize against different groups of the disease.

The CDC requires children to receive the conjugate vaccination by age 12, with a recommended follow-up conjugate booster at age 16. It’s also recommended that children receive the serogroup B vaccine at age 16, when they get the conjugate booster, but it’s not required, Zimmerman said.

Only recently has there been growth in awareness about the serogroup B vaccine.

In Michigan, the family of Emily Stillman, a Kalamazoo College sophomore who died of meningitis in 2013 at age 19, has emerged as the vanguard in pushing for awareness about meningococcal serogroup B.

Stillman died within 36 hours of contracting bacterial meningitis. She had received the meningococcal conjugate vaccine in her youth and also the recommended conjugate booster at age 16.

She did not receive the serogroup B vaccine.

Why? In 2013, the serogroup B vaccine hadn’t been available in the U.S. Not until 2015 did it become available.

Zimmerman cautioned that parents may encounter circumstances, even today, in which a primary care provider doesn’t have immediate access to the serogroup B vaccination.

This should not discourage them from pursuing it further.

“Check first with your primary care provider,” Zimmerman said. “If they don’t carry the B shot, you can check with the local health department — they do have it.”

Don’t assume the serogroup B vaccination isn’t important simply because the CDC made it a recommended vaccination, as opposed to a requirement, said Mary Wisinski, immunization program supervisor at Kent County Health Department.

“Absolutely get the vaccine,” Wisinski said. “It’s a deadly disease.”

Meningococcal conjugate vaccine

All strains of meningitis are spread through secretions from the throat and respiratory system—coughing, kissing, sneezing, sharing cups and so forth. Simply living in the same environment as someone with the disease could put you at risk.

About 10 percent of people who carry the bacteria in their nose or throat won’t show symptoms of the disease. But they can spread it.

“That’s why it’s so scary,” Zimmerman said. “There’s no rhyme or reason as to who might get the disease and who might just be a carrier.”

This is why vaccinations are so critical, she said, especially for the age 16-to-24 group headed into socially rich environments such as universities.

While the CDC requires the conjugate vaccination by age 12, there are of course children whose parents may have opted them out of vaccines.

College is a great time to reconsider such views.

“A college student will think they’re just run-down, and then they have to be rushed off to the hospital,” Wisinski said. “There’s nothing they can do.

“People do survive it, but the infection can cause them to lose their arms or legs, or cause them to be deaf,” Wisinski added. “It’s not a pleasant thought. Especially when there’s a shot to protect against it.”

The Kent County Health Department follows the mantra, “Vaccinate before you graduate.”

“(Parents) are sending these kids off to college very unprepared and unprotected,” she said.

In recent years, there has been a grassroots push among certain parents to opt out of vaccinations, but that has only led to spikes in diseases that had virtually fallen off the threat radar.

In 2016 and 2017, for example, the CDC logged outsized jumps in the number of mumps cases—directly traced to university campuses. The two largest cases were in Iowa and Illinois.

A Michigan college hit with a recent mumps outbreak didn’t have the data they needed to tackle it, Wisinski said.

“They didn’t know the vaccination status of any of their students,” she said.

In respect to the meningitis conjugate vaccination, nearly half of all teens fail to get the follow-up booster shot recommended at age 16, Wisinski said.

“(In Michigan), 80 percent of our kids get the first meningococcal vaccine at age 12,” she said. “But they don’t come back. In Kent County, only 50 percent of the teens that are immunized with the first vaccine will get that second one. Nationally, it’s 30 percent.”

HPV vaccine

Stereotypes about college exist for a reason.

The Freshman 15 is a real thing. As is the student loan debt crisis. And the risk of sexually transmitted diseases among teens and young adults.

For about the past decade, the CDC has recommended children receive two HPV vaccinations starting at about age 11.

HPV is a sexually transmitted virus, with some strains causing various types of cancer. Much like other series of vaccinations, it’s important to have the complete series before any exposure, Zimmerman said.

HPV is a two-dose series if the first dose is administered before a child’s 15th birthday. If administered after the 15th birthday, three shots are required, Zimmerman said.

It’s important to remember the follow-up.

“Obviously, you get your best protection by completing the series,” she said.

Hepatitis A vaccine

The CDC recommends the hepatitis A vaccine for anyone traveling to other countries—and many a college student would fit this bill.

“So many college students are traveling abroad,” Zimmerman said. “It’s good just to be protected.”

Hepatitis A is a liver disease spread through contaminated food and water. The vaccination is a routine recommendation for children starting at age 1, but there are adults and older children who have never had it.

The hepatitis A disease rate has declined 95 percent since the vaccine became available in 1995, but don’t imagine for a second that it has magically disappeared in this country.

Southeast Michigan is currently battling a hepatitis A outbreak that has killed 10 people and infected nearly 200.

The disease incubates in the body anywhere from 15 to 50 days before manifesting itself, Zimmerman said. Adults who get the disease can be ill for up to six months, with symptoms including nausea, vomiting and jaundice.

“It’s a virus,” Zimmerman said. “You clear it from your system. If you have the disease, you then have immunity. But that’s the hard way to get it.”

The easiest route is vaccination.

Tdap vaccine

Babies and small children receive a series of shots called DTaP, which protect against diphtheria, tetanus and pertussis, also known as whooping cough.

As a child ages, the effectiveness of this vaccination wears off. Consequently, at about age 11 the CDC recommends children receive a Tdap vaccination, Zimmerman said.

It’s effectively a booster for the original shot.

“They get the maximum benefit from (receiving) doses at the proper time,” Zimmerman said.

Tetanus is caused by toxins from bacteria in the soil. Diphtheria and pertussis are spread through coughing and sneezing. According to the CDC, about 1 in 5 people who get tetanus will die and 1 in 10 who get diphtheria will die.

Pertussis is most dangerous for babies. They contract the disease from children or adults who haven’t been vaccinated.

“Pertussis won’t kill adults, but it does kill infants,” Zimmerman said.

Here again, the anti-vaccination crowd has given rise to pertussis outbreaks at levels not seen since the 1950s, according to CDC data. In 2012, more than 48,000 pertussis cases were reported—the most since 1955.

Researchers have blamed these developments on a reduction in herd immunity.

Influenza vaccine

A list of recommended vaccinations for any age group, infant to elderly, would be incomplete without the addition of the influenza vaccination.

“The annual flu vaccine is always recommended,” Zimmerman said.

Children from eligible families can receive free vaccinations through the Vaccines for Children program, Wisinski said. This applies to all vaccines, from birth to age 19. Children with medical insurance that does not cover certain vaccines can also receive vaccines, but they must get them at the health department or a qualified facility.

“If they have Medicaid or no insurance, or even insurance that doesn’t cover shots, they can get free shots,” Wisinski said. “It’s part of the VFC program.

“If someone from birth through age 18 has no insurance, or insurance that does not cover vaccines, the vaccine is free—but we do charge an administration fee on a sliding scale fee, from $0 to $23,”  Wisinski said.

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