By Robin Drucker, M.D.

Many parents think of infants and young children when they hear the word "immunization." However, there are two immunizations that are important for adolescents as well: pertussis (whooping cough) and meningitis.

Pertussis is an increasing health problem among adolescents and young adults. It causes a prolonged cough, otherwise known as "the cough lasting 100 days," and causes students to miss a lot of school and after-school activities. The condition is due to the waning effects of the infant/toddler pertussis vaccines, or DTaP, which kids receive up until 5 years of age. It has taken time to deliver a safe vaccine to older kids.

Previously, all 11- to 12-year-old kids received a dT booster (diptheria plus tetanus) during their physical exams, but now receive the Tdap (tetanus, diptheria and pertussis) vaccine instead. There is a higher incidence of swelling, redness and a low-grade fever (100 to 101 degrees) with this newer vaccine than with the older dT booster.

Students who received the dT booster in the past should get the next Tdap five years after the dT shot. The vaccine should be given at their 16- to 18-year-old well visit, usually performed just before heading to college to give them protection against pertussis. (It is preferable not to give the shot earlier than five years because there is a greater chance of high fever, swelling and pain. However, doctors will make exceptions to this rule if there is a local epidemic of whooping cough, which does happen frequently in the Bay Area.)

Meningitis is another important vaccine for adolescents. From 1991 through 2002, the highest rate of meningococcal meningitis occurred among infants under 1 year of age and those 11 to 19 years of age.

Meningitis is spread through contact with respiratory secretions (such as sneezes and coughs) from someone infected with the disease. An individual infected with meningitis will develop a high fever and flu-like symptoms between one to 10 days after exposure, most commonly within four days.

Meningitis can be very serious. Ten to 14 percent of people with the illness die from it, and 11 to 19 percent of the survivors experience a neurological disability, limb loss or hearing loss.

In January 2005, a new vaccine (MCV4) for meningococcal meningitis was approved for use among individuals 11 to 55 years of age. The national Centers for Disease Control and Prevention (CDC) and the Society for Adolescent Medicine are now recommending routine vaccination of young adolescents (ages 11 and 12) at a pre-adolescent health care visit, before starting high school (ages 14 and 15) or just before entering college.

Routine vaccination is also recommended for college freshmen living in dormitories and for other populations at increased risk for meningitis. This includes military recruits, travelers to areas with high rates of meningitis, other adolescents and college students, and people infected with HIV.

Side effects from the meningitis vaccine are usually mild and the most frequent reaction is pain and redness at the injection site, which usually lasts one to two days. Severe reactions are rare, occurring in less than 0.1 out of 100,000 people who are vaccinated.

Dr. Robin Drucker is a pediatrician at the Palo Alto Clinic.