Which Vaccines Do College Students Need?

Michael J. Postelnick, BSPharm

Disclosures

September 04, 2012

Question

What vaccines are recommended for college students?

Response from Michael J. Postelnick, BSPharm
Lecturer, Department of Family and Community Medicine, Northwestern University School of Medicine; Senior Infectious Diseases Pharmacist; Manager, Research and Education, Department of Pharmacy, Northwestern Memorial Hospital, Chicago, Illinois

Major lifestyle changes often occur for the student entering college. Moving from the home environment to a dormitory or similar living situation may result in altered dietary and sleep patterns as well as contact with a much broader group of individuals from diverse geographic areas. These changes and the subsequent stresses involved may expose an individual to a wider variety of potential infectious pathogens than normally encountered in the home situation and may also negatively affect the usual host immune response. For these reasons as well as others, it is imperative that all college students are provided with the optimal protection from vaccine-preventable diseases.

Following are 4 vaccine areas emphasized by the Centers for Disease Control and Prevention (CDC) in their recommendations for College Students and Young Adults[1] as well as overall vaccine-related issues to consider before sending students off to college:

1. Meningococcal conjugate vaccine
Young adults in dormitory-like living conditions are at higher risk for meningococcal disease, including meningitis. Infection with this organism is almost always serious and can become fatal quickly. Meningococcal conjugate vaccine quadrivalent is recommended for those in this age group.[2]

2. Tdap (tetanus, diphtheria, and acellular pertussis) vaccine
Recent widespread outbreaks of pertussis (whooping cough)[3] have highlighted the importance of all young adults who have not received a dose of Tdap to receive this vaccine prior to college. This is in addition to the 4-dose primary vaccination series that occurs in early childhood. If this primary vaccination series did not occur or the history is unknown, the full series should be undertaken.[2]

3. Human papillomavirus (HPV) vaccine
HPV vaccine protects against the viruses that cause cervical cancer, anal cancers, and genital warts. Quadrivalent HPV4 vaccine is licensed for use in both males and females. A complete series consists of 3 doses: The second dose is administered 1-2 months after the first dose, and the third dose is given 6 months after the first dose.[2]

4. Seasonal influenza vaccine
The CDC recommends seasonal influenza vaccine for all adults. For the reasons discussed above, all college students should be vaccinated against seasonal influenza. Either the live-attenuated (inhaled) or the inactivated (injection) version of the vaccine is appropriate for the majority of college students. Vaccines administered early in the season (September-October) are likely to maintain an adequate immune response throughout the flu season, so vaccination should not be delayed.

In addition to these recommendations, the current CDC adult immunization schedule[2] should be consulted to make sure that all other immunization requirements are met prior to college. In the past, outbreaks of vaccine-preventable diseases such as measles and mumps have occurred in college-age individuals as well as in unvaccinated individuals exposed to travelers returning from high prevalence areas such as western Europe. This highlights the need for close attention to this schedule and vaccination or revaccination when indicated.

Finally, college students may require additional vaccinations if traveling during college. Before traveling to other countries for spring break or study-abroad programs, the CDC recommends that college students check with their local health department or travel medicine clinician 6-8 weeks prior to departure to determine whether any vaccinations are needed.[4]

Close attention to this important public health issue will help to facilitate an enjoyable and productive transition to college life for the new student.

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