The Essential Children’s Health Checklist
As kids head back to school, an expert shares an easy guide to the annual checkups, screenings, and vaccines children need at every stage.
Across the country, children — from toddlers attending day care to teens heading into high school — are back in the classroom. As schools continue to loosen restrictions, fall is a great time for parents to review their child’s vaccination and checkup schedule.
Health Matters spoke with Dr. Melissa Stockwell, director of the Child and Adolescent Health Clinical Service at NewYork-Presbyterian/Columbia University Irving Medical Center and chief of the Division of Child and Adolescent Health at Columbia University Vagelos College of Physicians and Surgeons, to understand the doctor visits, screenings, and vaccines children and adolescents need to stay healthy.
Checklist for Toddlers
If your child is entering a day care or preschool setting, it’s likely you’ll need to provide up-to-date health forms. “No matter a child’s age, I recommend parents bring to their child’s pediatrician any school health forms and medication administration forms that their child needs in order to attend school,” says Dr. Stockwell. It’s a good way to ensure kids are caught up on all health checks and vaccinations and are safe while they’re at school.
Well checkups: The frequency of pediatrician visits varies with age. Between 12 and 18 months, children should have a well-visit with their pediatrician every 3 months. For ages 18 months to 3 years, it’s every 6 months.
Vaccinations: Every child should receive routine vaccinations throughout childhood.
Measles, mumps, rubella (MMR) and varicella: To safeguard against measles, mumps, and rubella, the Centers for Disease Control and Prevention recommends a dose of MMR vaccine between the ages of 12 to 15 months, and another dose between 4 and 6 years of age. The same timeline applies for vaccinating children against varicella (chickenpox).
Hepatitis A: To protect against hepatitis, children are recommended to receive two doses of the hepatitis A vaccine between the ages of 12 and 23 months, separated by 6 months.
Remember that in this age range, kids might also be receiving sequential doses of vaccines that were administered earlier in infancy. For example, subsequent doses of the diphtheria, tetanus, and pertussis (DTaP) vaccine, haemophilus influenzae type b (Hib) vaccine, and pneumococcal vaccine would be administered during this time.
“It’s important kids are up-to-date not only on their routine vaccinations, but also their flu and COVID vaccines,” says Dr. Stockwell, who is also an attending pediatrician at NewYork-Presbyterian Morgan Stanley Children’s Hospital and associate professor of Pediatrics at Columbia University Vagelos College of Physicians and Surgeons and of Population and Family Health at Columbia University Mailman School of Public Health. “Every child should have their annual flu shot, especially during back-to-school season, and remain up to date on the COVID vaccine, which is now available for children 6 months and older.”
Dental checkups: For young children, their first visit to the dentist usually occurs when they turn 1. “After that first visit, the cadence of checkups can be determined by your dentist,” says Dr. Stockwell.
Vision and hearing screening: Beginning at age 3, annual vision and hearing screenings can help keep eyes and ears healthy. This may be done at a child’s pediatrician visits. Many school health clinics also offer these screenings.
Checklist for Preschool and Elementary School Children
As young children begin to attend full school days, it’s important to establish a bedtime routine, says Dr. Stockwell. “Make sure they’re getting a healthy breakfast before school and getting plenty of exercise.” Also consider limiting your child’s screen time.
Teaching kids good hand hygiene is also important, especially with COVID-19 and its subvariants still circulating. Establish habits like washing hands for 20 seconds, sneezing into an elbow and using a tissue to prevent the spread of germs. “As for masking, make sure you’re following the COVID-19 guidelines for your school and community. And if your kid is sick, they should stay home,” says Dr. Stockwell.
Well checkups: Visit the pediatrician once a year.
Vaccinations: Children receive a booster shot of these vaccines between the ages of 4 to 6.
- DTaP vaccine: Protects against diphtheria, tetanus, and pertussis (whooping cough)
- Polio vaccine: Protects against polio
- MMR vaccine: Protects against measles, mumps, and rubella
- Varicella vaccine: Protects against chickenpox
- Annual flu vaccine
- COVID-19 vaccine: Complete the primary series and stay up to date on booster doses, as applicable for your child’s age.
Keep in mind, kids with chronic health conditions may need more or fewer vaccines, shares Dr. Stockwell. “Parents should talk with their pediatrician about which vaccines they need to stay protected.”
Dental checkups: Visit the dentist once a year.
Anxiety screening: Due to an uptick in anxiety in children in the United States, new recommendations encourage parents to have their children screened for anxiety beginning at age 8. This screening can take place during pediatrician visits.
“Anxiety is one of the most common behavioral health disorders in kids,” says Dr. Stockwell. “While back-to-school jitters are completely normal, if there is something more serious going on, it’s helpful to have early screening in place so that it can be treated early.”
Checklist for Middle School and High School Adolescents
To prepare for the typically long hours of high school, getting an adequate night’s sleep is key, says Dr. Stockwell. “At this stage, I also encourage parents to talk with their kids about things like vaping, marijuana use, alcohol, and other things that their peers may be doing. The teenage [years are] a crucial time in brain development, and substance abuse can really impair that process. Having open, honest communication can help kids stay not only healthy but safe.”
Well checkups: Visit your child’s primary care physician once a year. For adolescents ages 12 and above, these visits should include a screening for depression.
Vaccinations: In this age range, you can expect to introduce new protections, as well as boosters to uphold protections from previously received vaccinations.
HPV vaccine: Now’s the time to get the human papillomavirus (HPV) vaccine. It protects against developing certain cancers later in life, such as cervical cancer. As per the CDC, it is recommended children get the vaccine series between ages 11 and 12 so that they can finish the series before they turn 13, well before they are ever exposed to HPV. However, it can be administered as early as age 9.
“Younger kids have a more robust immune response and generate higher levels of antibodies to protect them from the virus,” says Dr. Stockwell. “So, if you start the HPV series before age 15, they only need two doses. If you start after 15, they need three. Starting them according to the vaccine schedule saves them a vaccine dose.”
Meningococcal vaccine: When your child is 11, ask about receiving this vaccine, which protects against meningitis. A booster is recommended at age 16.
Routine boosters: Adolescents still need vaccine boosters every few years. These will be given at their doctor visits, or sometimes at school. These vaccinations can include:
- Tdap vaccine
- Annual flu vaccine
- COVID-19 vaccine: Consult with your pediatrician as to if and when boosters may be needed.
OB-GYN visits: A visit to the obstetrician-gynecologist is optional. According to Dr. Stockwell, pap smears and pelvic exams for girls are not routinely needed until age 21. However, some teens might want to establish a routine gynecologist visit starting around ages 13 to 17. During these visits, families and patients can receive general information on how to stay healthy, along with contraceptive counseling.
Sexual health screening: If a young person is sexually active, they should use contraception and get regular sexual health screenings where they can get tested for sexually transmitted infections (STIs).
Melissa S. Stockwell, M.D. M.P.H, is chief of the Division of Child and Adolescent Health and associate professor of Pediatrics at Columbia University Vagelos College of Physicians and Surgeons and of Population and Family Health at the Mailman School of Public Health. Her research, which concentrates on underserved children and adolescents, focuses on translational interventions to improve vaccinations with an emphasis on health technology and health literacy. Dr. Stockwell is the medical director of the NewYork-Presbyterian Immunization Registry (EzVac) and director of the Columbia University Primary Care Clinician Research Fellowship in Community Health. Additionally, she is a pediatrician at NewYork-Presbyterian Morgan Stanley Children’s Hospital and a NewYork-Presbyterian-affiliated community clinic. Dr. Stockwell is the associate director of the American Academy of Pediatrics (AAP) Pediatric Research in Office Settings (PROS) practice-based research network. She also serves on the New York City Department of Health and Mental Hygiene’s Immunization Improvement Team.