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What questions should parents and caregivers be asking their child’s health care providers at well-child appointments as they get ready to send their children back to school?

Barry: Parents should ask about their child's overall physical and mental health and should bring up concerns or questions to their child's health care provider. Parents should be looking for the best ways to keep their children healthy and safe, both physically and mentally.

Berger: Parents should be asking their health care providers about vaccinations, sports forms and any other school concerns. Many schools require forms to be filled out for medication use at school or school accommodations for learning disabilities. These can be presented at the time of their checkup to discuss issues and plans.

Bowden: It's important to remember that your doctor may not know what concerns you have for your child from the previous year, so make a list before you go the visit. Your doctor will complete the physical and ask you some questions about your child's social and emotional development. You may want to have your child's hearing and vision checked, and it's important to make sure that your child is up to date on their vaccines. 

Hudson: Well-child check-ups provide the opportunity to discuss your child’s physical, intellectual and social/emotional development. Check-ups are also a time to highlight the importance of healthy behaviors and impact of health risking behaviors, especially among adolescents who are becoming more personally responsible for their behaviors. 

Savoy: We may have been to the doctor’s office a lot for illnesses or injuries and don’t realize that there is not always time to review all the prevention options for which your child may be due. During your back-to-school wellness visit you can talk about not only what needs to get done today but also what is coming up in the next year.

Yaun: Parents and caregivers should bring up any concerns they have about their child’s health at their well-child appointment as they get ready for school. Especially bring up any school-related concerns. Consider your child’s sleep, school performance, mental health, nutrition, physical activity and more. Pediatricians can help provide guidance around these topics and provide needed intervention or treatment for any issues. Parents and caregivers should use every visit to ensure their child is up to date on vaccinations, both for school entry requirements and to ensure that we are all doing our part to keep all children safe from vaccine-preventable diseases.

Why should children beginning at 9-years-old receive the HPV vaccination?

Barry: There are several good reasons to vaccinate against HPV at the first opportunity, which is at age 9 in the U.S. Since the vaccine is preventive, giving it well before the potential for exposure to HPV is ideal. In addition, the body's immune system produces a more robust immune response to the HPV vaccine the earlier it is given. Giving the HPV vaccine at age 9 also separates it from Tdap and meningococcal vaccines, which are required for school. Not to mention, vaccinating at age 9 moves the HPV vaccine to its own schedule, rather than giving it concurrently with Tdap and meningococcal vaccines. When recommending three vaccines together, I have often seen parents refuse the HPV vaccine on the grounds that their child is getting "too many vaccines."

Berger: I recommend the vaccine at 9 years old because the data supports better immune response when children receive the vaccine at younger ages versus waiting until later. I also discuss that we want cancer prevention before adolescents could be exposed to the virus.

Bowden: The HPV vaccine is safe and effective for kids starting at age 9. To be fully protected, the vaccine requires 2 or 3 vaccines over a 6-month time frame. By starting at age 9, your child will only have to receive 2 vaccines and can be fully vaccinated by the time they need their other 7^th grade vaccines. 

Hudson: Starting HPV vaccination at age 9 provides good immune response and HPV cancer protection and reduces the number of vaccinations historically administered at the adolescent 11–12-year well-check visit. Parents also may not focus on the sexually transmitted nature of the infection when advised for HPV cancer prevention in a prepubertal child.

Savoy: Life gets busy and often we can’t make it back to visits as often as we should. Also, for some families having multiple shots on the same day can be stressful. We know at the 11-year-old visit there will be a Tdap and meningococcal vaccine. We can add HPV to that visit too or we can get it out of the way with a dose at 9 and 10 years.