Navigating the Health Care System

Advice Columns from Dr. Carolyn Clancy

Former AHRQ Director Carolyn Clancy, M.D., prepared brief, easy-to-understand advice columns for consumers to help navigate the health care system. They address important issues such as how to recognize high-quality health care, how to be an informed health care consumer, and how to choose a hospital, doctor, and health plan.

For many children, August marks the end of summer vacation and the return to school. For parents, it's a good time to make sure their children are up to date on vaccines—or shots—that prevent serious diseases.

Because these diseases can easily spread to others, vaccines protect the health of others in your family, in your child's school or day care, and in your community.

We need to do a better job making sure very young children get the shots they need, recent data from the Agency for Healthcare Research and Quality's 2011 National Healthcare Quality Report show. Fewer than 70 percent of children between the ages of 19 and 35 months got the vaccines recommended by the Healthy People 2020 program.

Some of this may be due to gaps in access to care. Children in lower income families are less likely to receive recommended shots compared to children in families with higher incomes. If your child isn't covered by a health insurer, find out if you can enroll in your state's Children's Health Insurance Program. These programs cover all needed shots for infants and children.

You may have heard confusing messages about vaccines. Some people wonder why we still need shots for diseases that we don't hear much about any more. Others worry whether shots are safe.

It's true that diseases like polio and diphtheria have become rare in the United States. And smallpox was eliminated more than 30 years ago. Much of that is due to the shots we get to prevent these illnesses. If we stop giving the protection that comes with vaccines, more people will become infected.

We know this because it already happened in Japan in the late 1970s when people stopped getting the shots that prevented whooping cough. This was followed by a major outbreak of the disease, which hit 13,000 people and caused the Japanese government to start the vaccine program again.

We have the safest and most effective vaccine system in the world. Childhood vaccines prevent an estimated 14 million infections and save 30,000 lives each year, Federal data show. Shots can cause temporary discomfort, but these side effects are typically very mild and limited to the site where the shot was given.

Depending on your child's age, your doctor will tell you which shots your child needs. But make sure to ask questions if you don't understand why or when shots should be given. An easy-to-read schedule for infants and children up to age six is available from the Centers for Disease Control and Prevention (CDC) and groups that represent family doctors and pediatricians. 

Children and teens ages 7 to 18 need additional or "booster" shots to be fully protected from preventable diseases. Another handy, up-to-date schedule from the CDC describes which shots are needed for older children.

One of the vaccines for this age group prevents a serious infection of the membrane that covers the brain and spinal cord. The meningitis vaccine is recommended at age 11 or 12, with a booster shot at age 16. But only 54 percent of teens between the ages of 13 and 17 had ever received this vaccine, AHRQ data show.

We have come a long way from the days when diseases like polio and smallpox caused death and life-long disability. Yet we have work to do in making sure that children get the shots they need when they need them. Their lives depend on it.

I'm Dr. Carolyn Clancy, and that's my advice on how to navigate the health care system.

Resources

Agency for Healthcare Research and Quality
Questions Are the Answer
http://www.ahrq.gov/questions/

National Healthcare Quality Report, 2011: Chapter 2: Effectiveness of Care
http://www.ahrq.gov/qual/nhqr11/chap2b.htm#fig222
http://www.ahrq.gov/qual/nhqr11/chap2b.htm#fig227

Children's Health Insurance Program (CHIP)
http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Childrens-Health-Insurance-Program-CHIP/Childrens-Health-Insurance-Program-CHIP.html

U.S. Department of Health and Human Services
Healthy People 2020, Improving the Health of Americans
http://www.healthypeople.gov/2020/default.aspx

Healthy People 2020, Immunizations and Infections
http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=23

Centers for Disease Control and Prevention
Vaccines: Why Immunize?
http://www.cdc.gov/vaccines/vac-gen/why.htm

Smallpox Disease Overview
http://www.bt.cdc.gov/agent/smallpox/overview/disease-facts.asp

2012 Recommended Immunizations for Children Birth Through 6 Years Old
http://www.cdc.gov/vaccines/parents/downloads/parent-ver-sch-0-6yrs.pdf

Recommended Immunization schedule for persons aged 7 through 18 years, United States, 2012
http://www.cdc.gov/vaccines/schedules/downloads/child/7-18yrs-schedule-pr.pdf

Page last reviewed August 2012
Internet Citation: Get Up-to-Date on Shots Before Summer Ends. August 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/columns/navigating-the-health-care-system/080712.html