Should Schools Require Vaccinations for Teens?

July 27, 2005 -- Middle schools and high schools should consider requiring students to be vaccinated against infectious diseases before attending classes, a CDC official said Wednesday.

Public health officials have been alarmed by an astonishing 300% rise in cases of pertussis, also known as whooping cough, among teens in the past three years. Just under 19,000 pertussis cases were reported last year.

Most infants receive pertussis vaccinations before their third birthday, but immunity wears off by the time children reach their teens.

The FDA this spring approved a pair of new vaccines designed to re-establish immunity in older kids.

Many states require young children to have complete vaccinations before entering elementary school. In September, thousands of District of Columbia students were barred by officials from attending classes because of missing immunizations.

Stephen L. Cochi, MD, acting director of the CDC's national immunization program, told reporters yesterday that health officials are "still struggling" with rising cases of pertussis.

"The main message is that the pertussis bacteria is still circulating widely out there," he said.

Wednesday, Larry K. Pickering, MD, Cochi's senior adviser, said states should consider extending vaccination requirements to also cover older kids in middle schools and high schools. While he did not endorse the policy, he listed it as one of his recommendations -- along with better vaccine education and tracking -- for extending vaccinations to teens.

"We'll have to see the direction that we take as far as requirements for entry into various schools," Pickering said at a conference sponsored by the National Foundation for Infectious Diseases. The group is sponsored by six pharmaceutical and vaccine manufacturers.

Pickering credited requirements for student meningococcal vaccinations at many colleges and universities for helping to control the frequency of bacterial meningitis at U.S. campuses.

In May, the CDC recommended that children receive a newly approved meningitis vaccine at ages 11-12 or before high school or college.

Nine states require vaccinations for freshmen entering college dormitories. Eighteen more require universities to provide students with education on meningitis, according to the National Conference of State Legislatures.

Meningitis kills 10%-15% of the 2,600 people who contract it each year, according to the CDC.

Experts also await the approval of a vaccine against human papilloma virus (HPV), a known cause of cervical cancer. HPV is sexually transmitted, and young, sexually active women are thought to be at particular risk.

SOURCES: Stephen L. Cochi, MD, acting director, national immunization program, CDC. Larry K. Pickering, MD, senior adviser to the director, national immunization program, CDC. National Conference of State Legislatures.