Nicole Szyszkowski of Wayne holds her daughter Alexys, 3, as nurse Elizabeth Miller administers a flu vaccine at the Wayne County Health Department on Monday. / Ryan Garza/Detroit Free Press
What to know about vaccines
Required school vaccines: All sixth-graders must be vaccinated unless they have obtained waivers. The vaccines are for diphtheria, tetanus, pertussis (DTAP), measles, mumps and rubella (MMR), polio, hepatitis B, chicken pox, and meningococcal disease.
Recommended school vaccines: Vaccinations against human papillomavirus and influenza are recommended but not required by the state before heading back to school.
Michigan health officials this summer launched a $200,000 ad campaign aimed at mothers with children between the ages of 11 and 18 to underscore the link between HPV and ovarian and other types of cancer. For more information, visit the state HPV website, www.michigan.gov/hpv.
Several versions of the 2013-2014 flu vaccine protects against four strains of the influenza virus, one more than previous vaccines. To find flu vaccines, visit the CDC’s flu vaccine finder.
Getting the required vaccines for school soon might be as easy as a trip to the local drugstore or big-box retail center.
“It’s, ‘Look, I’m in Target getting school clothes, I might as well get my kids vaccinated, too,’ ” said Terri Adams, a manager in the immunizations division of the Michigan Department of Community Health.
About 1 in 10 Michigan kids lack one or more of the state’s required immunizations when they enter sixth grade, a benchmark year for public health officials tracking immunization coverage. That rate, in some ways, is better than the national average.
Still, those unvaccinated youths are a “real concern,” said Bob Swanson, who heads the immunizations division. Some parents have waivers because of religious and other reasons.But for some, it might be a matter of squeezing in a doctor’s appointment.
Under a plan that could be in place by next school year, the health department would partner with drugstores or retailers that have pharmacies, which could give required vaccines to an estimated 477,387 youths 12 and older who are covered by Vaccines for Children, a federally funded program that covers uninsured children and those who are eligible for Medicaid. Some insurers also are considering allowing members to take their kids to pharmacies for back-to-school shots as well.
Already, large pharmacy chains routinely administer flu shots to adults and children, a vaccine that is recommended, but not required by schools, Adams said.
When it comes to school shots to ward off diseases such as measles, mumps, pertussis and meningococcal disease, most parents have turned to doctors and public health departments. In 2011, 95% of vaccines given to Michigan adolescents were delivered in those two settings. Many of the remaining vaccines were given in school-based health clinics.
But corner pharmacies and retail chains more often these days are the source of treatment of minor illnesses, despite concerns from some doctors that care there is fragmented and pharmacy staff may not be equipped to deal with emergencies.
In a study earlier this year published in the academic journal JAMA Pediatrics, 1 in 4 parents sitting in 19 pediatric waiting rooms in the St. Louis area reported taking their child to a retail clinic at least once for sore throats, ear infections, colds and other minor illnesses.
The reason? The long waits for appointments at doctor’s offices and the inconvenient hours — something that critics of health care reform say will be an even bigger problem after millions of the nation’s uninsured become insured under health reform this fall.
It seems Michigan families, too, are rolling up their sleeves for a pharmacist — at least when they can.
Some Michigan insurers cover vaccines only when they are given in a doctor’s office.
But Blue Cross Blue Shield of Michigan, the state’s largest insurer, does provide coverage in some plans for vaccines given in pharmacies, and a spokeswoman said the numbers underscore that national trend toward pharmacy vaccines.
In a one-year period ending in September 2011, more than 29,000 vaccines were given out to Blues members in some of the 2,400 pharmacies in the insurer’s network. That was a sixfold increase over the previous year, said Blues spokeswoman Helen Stojic.
It’s unclear how many of those included children. The number includes flu shots and vaccines for adults, which most likely are the lion’s share of pharmacy immunizations, Stojic said.
Opening up pharmacies for back-to-school immunizations is complicated, said Carrie Germain, HealthPlus Senior Director of Pharmacy Services and chairwoman of the Michigan Association of Health Plans’ pharmacy committee.
Doctors worry whether staff at retail stores that also sell backpacks and laundry soap have the time to develop relationships with families or build medical histories that are crucial to understanding a child’s whole health.
In the national study this year, fewer than half of the parents had reported the pharmacy visit to their pediatrician or doctor.
Plus, will the counter pharmacist be able to differentiate between the occasional ear infection and something more serious? And when it comes to vaccines, are they prepared for those rare reactions?
Meanwhile, Michigan public health officials want to make sure that the data is entered into the state’s registry that alerts schools if kids are not up-to-date on their shots.
In the past, there have been lapses because pharmacies have not logged vaccines as required by law, Adams at the public health department said.
And for stores, it’s a business decision, said Germain, a longtime pharmacist.
“If they have a vaccine that comes in the bottle and they can give multiple doses and they use only one, then it sits there and expires. That’s expensive,” she said.