Middle School and College Vaccination

By the pre-middle school visit, the child should have already received 3 or 4 doses of IPV (only 3 are required if the last dose was given after the age of 4 years); 3 doses of hepatitis B vaccine; 2 doses of MMR vaccine; 2 doses of varicella vaccine; and 2 doses of hepatitis A vaccine.

If the child is fully vaccinated up to this point, the 3 vaccines to focus on are:

•Tdap

•HPV vaccine (Figure 5).

•MCV4 (Figure 6).

The 3 vaccines of particular interest at the pre-college visit also include Tdap, MCV4, and HPV. *

Figure 5 - Human papillomavirus types 6 and 11 have a predilection for external genitalia, where they cause condylomata acuminata.

(Courtesy of the CDC.)

Figure 6 - The photomicrograph above depicts Neisseria meningitidis group B bacteria using a Gram stain culture(magnification 31150) (A). The petechial papules on the hand of this child are a manifestation of invasive meningococcal infection (B).

(Photo A courtesy of the CDC; photo B courtesy of Sharon J. Markling, MD, Michael R. Warner, MD, and Charles Camisa, MD.)