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Health & Wellness: Immunizations

Health & Wellness: Immunizations

Whether you’re parenting a new baby, sending a child off to school or planning an overseas trip, you have decisions to make about vaccines. With these decisions often come a lot of questions: Which ones do you or your children need? Are certain ones required or just recommended? Are there vaccines that you’ve never heard of that might prevent disease?

Understanding immunizations can be terribly confusing. According to Andrea Waner, public information officer for the Columbia/Boone County Department of Public Health and Human Services, the most common mistakes people make are forgetting about vaccinations altogether or thinking immunizations won’t benefit them.

Columbia Home is here to help. Three local experts weigh in on what you need to know about vaccines and why.


Why do immunizations matter?

Dr. James Garb has been practicing pediatrics since 1978. He believes vaccines are critical for children and benefit the greater good. “As soon as you instill fear in people, and they stop getting immunized, we will have much bigger problems,” he says. Garb credits vaccines for the fact that he hasn’t seen a case of meningitis in his office since 1986.

“Pediatricians are in the business of prevention, and vaccines are the most important medical benefit we’ve had in the last 200 years to help prevent disease,” he says.


What vaccinations are required?

The pneumococcal vaccine (PCV) is required for day cares and preschools, Garb says, but not for entry into kindergarten. PCV helps prevent pneumonia in infants and small children, which is one of the most common causes of death in America for a vaccine-preventable disease.

According to the 2015 Missouri Immunization Requirements, in addition to PCV, there are six other vaccines needed to enter preschool and kindergarten. The number and time of doses differ for each one, but all are required. Here’s a glimpse of the six routine childhood immunizations:


  • DTaP protects against three bacterial diseases: diphtheria, tetanus and pertussis, also known as whooping cough. It is approved for children under the age of 7.
  • The IPV vaccine helps prevent polio, an infectious disease caused by a virus that lives in the throat and intestinal track.
  • The hepatitis B vaccine guards against this common liver disease, which is transmitted through the exchange of blood or bodily fluid and can become chronic.
  • The Hib vaccine prevents Haemophilus influenzae, a serious disease caused by bacteria that usually affects children under the age of 5.
  • Varicella vaccine helps protect against chickenpox, which annually plagued more than 4 million people in the United States prior to the development of the vaccine.
  • MMR guards against three serious viral diseases: measles, mumps and rubella.



Which immunizations are recommended?

Garb strongly encourages the Rotavirus vaccine (RV) for babies and young children. Developed by Dr. Paul Offit from the Children’s Hospital of Philadelphia, the RV vaccine protects against severe diarrhea that can lead to dehydration and even hospitalization.

Vaccinating for hepatitis A is highly recommended by the City Health Department for children heading to kindergarten. Hepatitis A affects the liver and is one of three strands of hepatitis common in the United States. It is transmitted in a fecal-oral manner and can be prevented by practicing good hand washing. Hepatitis A can also be prevented with a vaccine.


Are there vaccinations I might not be aware of?

There are several vaccines the public is often surprised to learn about. According to Warner, the HPV and meningitis vaccines are two of the biggest ones.

“Most parents don’t know that the meningococcal vaccine is recommended for children at age 11 to 12 and again at age 16 to 18 because this age group is at the highest risk for contracting meningitis,” Warner says.

Meningitis is a contagious infection of the fluid surrounding the brain and spinal cord. According to the Center for Disease Control, it infects several thousand people in the U.S. each year. The CDC targets college freshmen to receive the vaccine, so it is recommended for entry into most universities and even required for some.

Human papillomavirus (HPV) is the most common sexually transmitted virus in the United States. According to the CDC, 6.2 million people get infected each year. Although most HPV infections do not cause any symptoms, the virus can cause cervical cancer and other complications. The HPV vaccine has been around for less than 10 years, so many parents don’t know it exists or misunderstand the benefits.

“Many parents choose to delay the HPV vaccine because their child isn’t sexually active yet,” Warner says. “What they don’t realize is that this vaccine works best if it’s given before an individual becomes sexually active. It is the only cancer prevention vaccine available and is also recommended for boys.”

The Health Department recommends girls receive this immunization between the ages of 11 and 26 and boys between the ages of 9 and 26.

Do adults need immunizations, too?

According to Dr. Cynthia Hayes, a family medicine physician at Cynergy Health, the hepatitis B vaccine can be helpful for adults. “Many adults are not immune to hepatitis B and aren’t aware there is a vaccine,” she says.

Hepatitis B is a contagious liver disease, spread through blood and bodily fluids. It can be mild or become a serious, lifelong illness. The routine vaccination of children was only started in 1991, Hayes says, so most people born before then haven’t been routinely vaccinated.

The hepatitis B vaccine can also be combined with the hepatitis A vaccine, recommended for children and those traveling to underdeveloped countries.

Because outbreaks are becoming more and more common, Hayes also suggests that anyone who is around newborns have an updated Tdap immunization. Tdap is a variation of the DTap vaccine given during childhood, which includes protection against whooping cough.

The pneumococcal vaccine is another useful vaccine and helps prevents pneumonia in adults. The Columbia Health Department recommends this shot for those over the age of 65, those experiencing a serious long-term health issue or those who have a low resistance to infection. This is the same vaccine mentioned earlier (PCV) that is recommended for infants and toddlers.

The Health Department also recommends that everyone 6 months or older get their annual flu shot, that both kids and adults get vaccinated for chickenpox and that adults don’t neglect their tetanus booster every 10 years, especially if they’ve had spider bites or puncture wounds.


Where do I get vaccinated, and what records should I keep?

Although Garb believes it’s the parents’ or patients’ responsibility to make sure they get immunized, he feels strongly that doctors are there to partner with parents in the prevention of disease.

Hayes encourages patients to keep a personal immunization record and bring it with them to their annual appointment. “This way your physician can see at a glance if you are up to date,” she says. She also encourages international travelers to carry their vaccination records with them.

Most pediatricians and doctors can give immunizations in their offices and pull up and print the patient’s records whenever needed. The Health Department also gives vaccinations at 1005 W. Worley, from 8 a.m. to 4:30 p.m. Monday through Friday, with no appointment necessary.


Are there any resources to help?

For more information on immunizations and the diseases they prevent, both Warner and Garb recommend or These websites contain information from the Centers for Disease Control and the Advisory Committee on Immunization Practices.

Columbia Public School’s website ( has the list of immunizations needed to attend school in Missouri, as well as the number of required doses for each vaccine.

The CDC also offers several apps for your smartphone that will keep all the immunization information you need right at your fingertips. Search “CDC” in the app store to find several apps with vaccine schedules to choose from.

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