Question for those who *do* immunize - this is about an older child...

[Colleen]

FYI, this is not intended to be a discussion about the pros and cons of immunizations. My guys do get the standard immunizations (MMR, DTP, oral polio, Hib, Hep B). They've also had varicella vaccines. Any-hoo, my oldest (12) needs a tetanus booster and he's getting that tomorrow. I am wondering if your children in this range have received other immunizations or boosters.

And come to think of it, at what age did you stop going in to the examining room with your child, esp. of the opposite sex? Our GP is a personal friend and we're very comfortable with him, so no worries there. But I don't know that I'm ready for my son to go it alone. What have you done?

[Ria]

The tetanus booster is given every 10 years or so after the 12-yr booster. I just had one this fall. Recent studies have indicated that kids who received the varicella vaccine (chicken pox) need a booster around ages 10-13. Not sure about any others off the top of my head.

Ria

[Jean in Newcastle]

We've had the tetnus booster. I think now they recommend a booster for the varicella vaccine, depending on when it was given him. And they also recommend one for Hep A which is a relatively new one.

At our last visit, my ds10 used one of those white lap blanket things for the first time. He didn't want me to leave, but he did ask me to turn my back while he changed. I'm leaving it up to him. The doc. talked directly to him for part of the exam and then talked to me for part of it. I would suppose that would be the same even if I went out for part of the exam, but I'm not 100% sure on this - maybe it depends on the Dr.

[j.griff]

I'd stay as long as no one asked me to leave. I don't leave 13yod alone though, not that she would want me to. She kind of gets nervous and mumbles when other adults are asking her direct questions of a personal nature, LOL.

[Chris in VA]

Ds 16 had some sort of hep shot when in residential (geez, pardon me for being a crpppy mom--kid in resi *and* I can't remember what shot he had), along with tetanus.

I still go in with my kids, except when ds have physicals. I occasionally offer the dr. more info than they share, but basically let them do the talking. With ds16, I have to stay for security reasons (you know, not his personal security, but real security--afraid he'd bolt or take something).

I know a lot of people want their kids to feel free to discuss sexual stuff with the dr., and some think kids won't talk and ask questions with their parents there. I don't agree. But, people's experiences differ.

[Liz CA]

FYI, this is not intended to be a discussion about the pros and cons of immunizations. My guys do get the standard immunizations (MMR, DTP, oral polio, Hib, Hep B). They've also had varicella vaccines. Any-hoo, my oldest (12) needs a tetanus booster and he's getting that tomorrow. I am wondering if your children in this range have received other immunizations or boosters.

And come to think of it, at what age did you stop going in to the examining room with your child, esp. of the opposite sex? Our GP is a personal friend and we're very comfortable with him, so no worries there. But I don't know that I'm ready for my son to go it alone. What have you done?

I would still accompany a 12 ds to the room. I recently wanted to stay back with my now 16 yo ds and he wanted to to come along - but it was only for a broken finger.
A 12 yo may not remember or even understand everything the doctor says and the doctor may not repeat everything to you. Some info could get lost.

[mcconnellboys]

My oldest has had all his immunizations, including this booster. I still go into the doctor's visit with him (he's now 15). I step out when the doctor is ready to do that part of the exam that will require him to be more disrobed. I believe that when he got this booster, they gave it in his arm, so there was no reason for me not to be there for that.... I am talking to the doctor during most of the visit about concerns or he's asking me questions, etc., so I'm not sure how we'd get a thorough exam done if I wasn't there for part of the time....

Regena

[KAR120C]

We also did a Hep A vaccine last time DS was in. It was optional, but there's a good chance of travel in his near-ish future where Hep A immunity would be an excellent thing. And I seem to remember something about a meningitis vaccine that I think is recommended for high school ages (not there yet).

[Amy in NY]

Pertussis has been added for adolescents and adults to age 60 or 65 for dtaP. Google Adacel - this is the brand name of one of the new tetanus/diptheria/pertussis vaccines.

I'm not sure about any other booster shots at this age. At least, you won't have to worry about Guardisil.

Amy

[Jill, OK]

I think my son is just a little older than yours (almost 13), and I made to leave, this past time, when it was time for the 'turn your head and cough' part, but the doc asked me to stay. (Not sure if this is for liability, or what). I don't think my son minds either way, but if it were a choice, I'd ask him.

The doc asked him the routine questions with me present (don't do drugs, don't smoke, etc.); same with my almost-14yo dd.

My older kids are due for a meningitis vac, but I'm still considering whether or not I'm going to wait until later in high school for that. (We get most of the standard vaccinations, just on a delayed schedule.)

[Eliana]

And come to think of it, at what age did you stop going in to the examining room with your child, esp. of the opposite sex? Our GP is a personal friend and we're very comfortable with him, so no worries there. But I don't know that I'm ready for my son to go it alone. What have you done?

We just do tetanus, so I'm no help on the first question...

I've been playing it by ear and using my children's comfort levels as an important indicator. Both my elder daughters (14.5 and 13) wanted me to come in with them for their most recent check-ups and since they are so rarely sick, I felt better being part of the check-in with the doctor. My ds (11) also wanted me to be there, though he participated actively in the discussions.

I think the next step might be to be there for the talking parts at the beginning and end and step out for the actual exam.


Does your son have any thoughts on the issue? Is he generally pretty comfortable discussing his health and his body with you? (If he weren't I'd be concerned that he might not feel comfortable answering all the dr's questions candidly.)


Eliana

[Crissy]

I don't recall my older son getting any boosters other than tetnus.

Jeffrey, at 13, recently asked to go in for his sports physical alone, and I was perfectly comfortable with the situation. Like you, I know our doctor well, so that certainly has something to do with it.
I think I might still sit in if he goes for a 'sick' visit, since I am generally the one who keeps track of medications, etc.

[mcconnellboys]

Yes, I think we've had those. He's had everything, including the new nasal spray for flu this past fall.....

Regena

[Amy in Orlando]

We did the tetanus booster around 11-12. The older boys are now looking at Hep A, meningitis and varicella (though they all had chicken pox so we won't do that one).

I stay for their exams but they don't care - they know I'll leave if they ask. We've had the same ped forever and I'm comfortable doing it either way.

[Stephanie in FL]

We just went through this with my 11 and 12 year olds. They had their tetanus booster and the ped. wanted them to get their meningitis but she said we could wait until just before college for that one.

My oldest started seeing the GP by himself when he was 14, but the GP did a follow up with dh or I afterward to let us know of any concerns, etc.

[Pam "SFSOM" in TN]

FYI, this is not intended to be a discussion about the pros and cons of immunizations. My guys do get the standard immunizations (MMR, DTP, oral polio, Hib, Hep B). They've also had varicella vaccines. Any-hoo, my oldest (12) needs a tetanus booster and he's getting that tomorrow. I am wondering if your children in this range have received other immunizations or boosters.

And come to think of it, at what age did you stop going in to the examining room with your child, esp. of the opposite sex? Our GP is a personal friend and we're very comfortable with him, so no worries there. But I don't know that I'm ready for my son to go it alone. What have you done?

Meningitis before dorm life (which was quite young for ds, before camp two years ago for dd), and the standard boosters. Guardasil for dd, as well.

I started asking whether or not they wanted me when they hit 13. Ds would pick and choose visits that he wanted me along, and of course I stepped out for "turn your head and cough." I think last time I went in with him was a year ago... two? I think it was the checkup before his senior year. Dunno why he wanted me to go with. Before that, he mostly went in by himself through the teen years, maybe that one exception.

Dd (15) still wants me to go in, but I always ask.

And oh, yeah, Hep A because we're now in a high incidence area.

[Alice]

Full disclosure, I'm a pediatrician. I usually try not to post on medical issues where people are asking opinions but this was a more factual question so...

Tdap (Tetanus, diptheria, pertussis booster) at 11 yrs old. If didn't receive then should get whenever the next tetanus booster is given. Tetanus should be given every 5-10 years (even for adults :)).

Varicella booster is now recommended for all kids. Given at age 5 or older if didn't receive then.

Menactra (meningococcal) vaccine is officially recommended to age 11. It's required by almost all colleges. I usually recommend it around 13 or 14 when going into high school (the rate of meningococcal disease beings to increase in high school..about 1 in 100,000 which is not that rare given that it is a terrible deadly disease).

Hepatitis A is now recommended for all kids over the age of 1 yr. Most didn't get it then so can get "caught up" at any time. It's a series of 2 shots given 6-12 months apart.

And the famous Gardisil for girls...but since you have a boy no issues there.

For the other question...about when to leave the room. At 12-13 I usually see the patient with the parent and then ask the patient if they would like privacy during the exam, especially for the "private parts". Sometimes kids have questions they want to ask but are too embarrassed to ask with parents there. Usually these aren't anything shocking but are about things like acne, body odor, bedwetting in older kids, etc. Having a little time alone gives the kids a chance to ask. And if they kids want the parent to stay then that's fine too. For older adolescents we usually bring the patient back alone, and then have the parent join in at the end of the exam. If I have a parent who really wants to come back with them for the whole thing, it's ok.

[imeverywoman]

:)

[readwithem]

I occasionally offer the dr. more info than they share, but basically let them do the talking.


This is what I do (and why I do it) as well.

[Alice]

Chris and readwiththem...you are absolutely right. Even when I see adolescents alone I always ask the parent to come back too and if they have any questions. Invariably the Mom will say something like..."Did you ask the doctor about the headaches?" And the kid will say "No" And I'll start asking about the headaches and find out they are missing school three times a week for debilitating headaches but somehow forgot to mention that. :D It always amazes me how many parents of teens I have in my practice that don't want to come back at all...I almost have to make them be part of the visit.