Dr. Jon Hallberg: Immunizing kids for school

Many children and teens will need immunizations and checkups before they head back to the classroom this year.

MPR's medical analyst Dr. Jon Hallberg spoke about what to expect during these appointments with Tom Crann of All Things Considered. Hallberg is a physician in family medicine at the University of Minnesota and medical director of the Mill City Clinic.

An edited transcript of that interview is below.

Tom Crann: In broad categories, what brings kids in for these back-to-school visits?

Dr. Jon Hallberg: It's basically a school requirement. And it doesn't matter if they're starting elementary school, they're starting kindergarten or they're going off to college, they've got forms that need to be filled out. And it's just sort of an obligation that the parents need to fulfill, and we need to do our part as well.

Crann: Are there things here that are legally required, certain milestones where the shots have to be proven?

Hallberg: That's probably the biggest thing. Schools want to know that kids coming in are up to date on their immunizations. In fact, the paperwork we get is pretty standard. We go through it and we enter each and every immunization they've had since birth. There are certain numbers of those shots that have to be given. And if they aren't [given], we have to check off a box that the child is not up to date...

Or there is an opt out. Parents can be conscientious objectors about immunizations, and that's OK, they just have to fill out a certain section of the form indicating that.

Crann: How are these visits different from the normal visits, especially earlier in the child's life?

Hallberg: From the time a child is born, [visits are] really about the growth of this new little human being. Is this child growing appropriately? We're giving a lot of immunizations and getting them set. We're also asking questions about nursing, and what are they eating, and how are they sleeping and toilet training as they get older, a lot of advice and counseling and really pretty careful attention to their growth.

As kids get older, by the time they start entering into school, they're certainly growing, they're certainly developing but things are kind of slowing down a little bit, at least on some levels. The regularity of shots starts to decrease, they sort of space out.

Crann: Kids in school with allergies and asthma, is this part of the back-to-school visit?

Hallberg: It sure is. Aside from the shot part, the biggest reason we do this is to alert school officials, and school nurses more than anyone else, what the kids have that might result in a medical emergency. That's one of the things we have to fill out.

The biggies would be food allergies, asthma, maybe migraine headaches... And in the case of asthma, we have really good ways now of keeping track of kids, and we're almost obligated to do this in good clinical practice. We create an asthma action plan. And we have that in the clinic and the school will have that because there are times when kids have a flare up of something and the preventive medications haven't worked... They need to get something to help them breath or to stop the migraine or to treat an allergic reaction.

Crann: The school nurse would have this on file and their normal doctor would have it on file?

Hallberg: That's right. And they also would have the medications, where we write things [like that] a child can self-administer certain medications. It's really important that they're able to do that.

Crann: What's your advice here to parents to make these visits as productive and efficient as they can be?

Hallberg:The biggest thing is that parents will often come in with [forms] often completely blank, nothing is filled in.

My biggest plea on behalf of healthcare providers across the nation: when you bring your kids in for these visits, to fill out as much as you can. So much of it is really about the student, the student athlete, the parent's signature.

It will just make things go so much faster if they look through this and actually read the paperwork before they present it to us.

Interview transcribed and edited by MPR reporter Jon Collins.

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