With the back to school shopping season in full swing, it is also important to arm area children and teens with other tools they need to have a good school year- like medical exams. These are critical to good health and should take place before or shortly after the start of the new school year, and include a routine doctor's exam to confirm that all immunizations are up-to-date, a dental check-up, and a vision exam.

Richard Lafleur, medical director, Anthem Blue Cross and Blue Shield in New Hampshire, notes that this is a good time of the year for parents to talk to their child's medical provider about the specific examinations their child should receive. "As parents prepare their children and teenagers for the transition back to school, they need to make sure each child gets the recommended immunizations, along with an eye exam and dental cleaning," he said.

Dr. Lafleur, who in addition to serving as Anthem's medical director, maintains an active internal medicine practice in Derry. He recommends the following:


According to the Centers for Disease Control and Prevention (CDC) there are many recommended vaccines for children and teens, including influenza, which should be given to all school-age children from six months to 18 years. Other immunizations include:

* The meningococcal vaccine, which is recommended for those who are age 11-12 and at age 13-18 if not previously vaccinated.

* The tetanus, diphtheria and pertussis (Tdap) vaccine, which is recommended for all adolescents age 11-12 who have not received a tetanus and diphtheria toxoids vaccine (Td) booster dose. Adolescents between age 13-18 who missed the 11-12 Tdap dose or received Td only are encouraged to receive one dose of Tdap five years after the last Td/DtaP dose.

* The varicella (chickenpox) vaccine. All children should receive two doses of the chickenpox vaccine at age 12-15 months and 4-6 years. Since the risk for transmission can be high among school-aged children and teens, those without evidence of immunity should receive two doses of the chickenpox vaccine and those who received one dose previously should receive a second dose.

* The measles, mumps and rubella (MMR) vaccine. All children should receive two doses of the MMR vaccine. A first dose is recommended at ages 12-15 months and a second dose at ages 4-6 years. If not previously vaccinated, children and teens age 7-18 should be vaccinated.

* The human papillomavirus (HPV) vaccine, which is recommended for girls beginning at ages 11-12. The HPV vaccine is a three-dose series administered over a six-month period.

For the 2010-2011 flu season, which begins in the fall of 2010, the seasonal flu vaccine will include protection against the 2009 H1N1 strain. All children through age 18 should be immunized. Younger children who have never had a seasonal vaccine will need two doses. Additional information about the flu is available at flu.gov and cdc.gov.

The message seems to be hitting home locally. According to a StateHealthFacts.org report, 85% of New Hampshire's children between the ages of 19 and 35 months were immunized in 2008, compared to the national average that year of 78%


According to the American Academy of Pediatrics (AAP) Bright Futures, 3rd Edition, school age children should be evaluated for visual difficulties at their annual visit and formally screened according to the AAP's recommended schedule.

In addition, the American Public Health Association (APHA) recently reported that one-in-four children in kindergarten through sixth grade has a vision problem. Some studies indicate that 80 percent of learning in children occurs visually; therefore, getting regular routine eye exams should be a major part of the back to school preparation. Undiagnosed vision problems can lead to difficulty with schoolwork, resulting in poor performance.

According to the American Optometric Association's (AOA) 2009 American Eye-Q® survey, 60 percent of children identified as "problem learners" actually suffer from undetected vision problems and in some cases have been inaccurately diagnosed with attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD).

"Good vision is essential to a positive learning environment and can make all the difference in how a child performs in class," said Dr. Lafleur. "On the other hand, poor vision can have a negative impact."


Interestingly, many parents do make sure their child is current on their immunizations and vision exams; but, a visit to the dentist is oftentimes an afterthought. However, when children and teens get routine dental exams, many problems or issues can be caught early and possibly corrected.

The American Dental Association (ADA) and the American Academy of Pediatric Dentistry (AAPD) suggest parents take their child to a dentist as soon as the first tooth appears, or at least by his or her first birthday. And then start a regular routine of visiting the dentist for a dental exam in a schedule recommended by the dentist.

According to the CDC, more than 51 million school hours are lost each year nationwide because of dental-related illness, and more than half of children aged five to nine have had at least one cavity or filling, with 78 percent of 17-year-olds having experienced tooth decay.

Anthem provides coverage for most vaccines and exams. However, policyholders should confirm their specific benefits by calling the toll-free number listed on their insurance card.

"Getting these basic exams is a great way to help our kids start the school year off on the right foot from a health perspective," Dr. Lafleur noted. "By getting the recommended immunizations, and having their eyes and teeth examined, they can better focus on school, sports, and the many activities during the year."