Vaccine Hesitancy
Like other doctors, DeStefano sees parents who are hesitant to vaccinate their children.
“The most effective methods to address vaccine hesitancy are specific to addressing each individual parent’s concerns,” he said.
“My grandparents lived in a world with few vaccines and cars with no safety features,” he tells parents with vaccine concerns. “Our desire to protect ourselves and our children has led to an increase in the number of vaccines against deadly diseases in the same way it has led our cars to have seatbelts, airbags, side airbags, and backup cameras,” he tells them.
PCSing
As for children who are making permanent changes of station (PCSing) with their families, DeStefano recommends the standard battery of age-appropriate vaccines.
Additionally, he recommends an early MMR vaccine in children 6-11 months old who are PCSing to Europe and the Japanese encephalitis and typhoid vaccines for those PCSing to Asia.
DeStefano suggests parents check the CDC’s travel site for the specific country to which they are being stationed to get the exact vaccination requirements.
College-age Vaccinations
Dr. Prabha Gupta, an internist at Kenner Army Health Clinic in Fort Lee, Virginia, recommends that college-age patients get a tetanus/acellular pertussis (whooping cough) combination because, “for some, it’s been more than 10 years since their last tetanus shot, and they may not have had the whooping cough vaccine before,” she said.
“I definitely recommend an influenza shot and a COVID-19 vaccination,” she added.
“We know the patterns of influenza” every year, but it would be a “double whammy if a patient got flu and COVID-19 together,” she said.
Her approach to the COVID-19 vaccination question is to “tell you the facts, the evidence, and why it’s important, and my advice, but say, ‘It’s up to you, the patient, to decide whether to get the COVID-19 vaccine.” She said “nine out of 10 walk out of the room with the shot.”
Other immunizations for college-age patients are the meningitis vaccine, which is not mandatory, but a student who doesn’t take it has to sign a waiver, she said.
Additionally, Gupta double-checks that her patients have received the MMR vaccine and have proof of that vaccination. If not, they must have a blood test to check for MMR antibody levels in their blood.
HPV is the most “under-discussed” vaccine, Gupta said. “I discuss it” because the vaccine is recommended for those up to 26 years of age.
“I don’t know if pediatric health care promoted the vaccine or not,” Gupta said, “so I give them the option of a three-dose regimen.”
DeStefano is an enthusiastic proponent of the HPV vaccine because it prevents cervical cancer in women and throat and anogenital cancers in both sexes. The HPV vaccine “targets the highest risk strains of HPV, which account for over 90% of cervical cancer,” he said.