As parents prepare their children for a new school year, it's a good time to check with the pediatrician to see if it’s time for an annual physical, or well-child visit. UR Medicine pediatrician Dr. Sean Frey shares what you need to know about school physicals.
Health Matters: Along with the typical back-to-school supplies, why do schools require kids to have proof of their health physicals?
Frey: School physical forms verify that a child has been seen for a routine, well-child visit. Schools want to ensure that a child’s immunizations are up to date, that he or she is healthy and ready for school, and that he or she has received the proper screenings.
Health Matters: What immunizations are necessary at each grade level?
Frey: Once they’ve turned 4 years old, children entering Pre-K or Kindergarten are typically due for the Measles/Mumps/Rubella vaccine, a Varicella (chicken pox) vaccine, and DTaP (Diphtheria), Tetanus, and Pertussis) and Polio booster immunizations.
Kids going into Grade 6 (around age 11) are also usually due for some immunizations as well as Tetanus and Pertussis boosters. State law requires that all children entering the 7th grade additionally receive the Menactra vaccine, which protects against a form of bacterial meningitis. We recommend immunization with the HPV (Human Papillomavirus) vaccine for all children after they turn 11 years old. In addition, your child may be due for other immunizations that have been missed along the way.
Health Matters: What else goes on at school-physical visits?
Frey: Depending on the age of the child, your pediatrician may recommend certain screenings, like hearing or vision testing, or screening blood work to test for things like cholesterol levels or anemia. An annual health visit is also a good time to talk about diet, nutrition, sleep, school- or behavior-related issues, or other particular concerns about recent injuries or illnesses.
If your child has a chronic medical condition, such as asthma or epilepsy, your pediatrician may provide the school with guidelines for care of the particular medical condition while your child is at school. For example, a child with asthma should have a “rescue inhaler” at school with permission for the school nurse to administer when a child is having particular symptoms.
Health Matters: When should families look to schedule their physicals?
Frey: I urge parents to talk with their pediatrician’s office to confirm their child's most recent physical and see if it's time to schedule one. You may think your child is due for a routine well-child visit, when they are actually up to date on medical care.
If you are not able to be seen for a physical by the first day of school, it’s okay. The school’s nurse will usually provide some leeway for families who can’t get in by the first day of school. Scheduling well-child visits around the time of a child’s birthday can help some families beat the back to school rush.
Health Matters: Is there anything extra that students who play sports need to know?
Frey: Check with your pediatrician’s office to see if a separate sports physical visit is needed. Often, a sports participation physical may be combined with the routine annual physical. It’s important to let your pediatrician know about any recent injuries, especially concussion, that may impact return to sports play and guide advice regarding safety during sports participation.
Health Matters: What happens if a family refuses immunizations?
Frey: Accurate information and education is essential, especially for families who are hesitant about immunizations. It is important to address any underlying concerns or fears about immunizations and provide sound guidance and advice with about immunizations. There is much misinformation online regarding immunizations, so often your pediatrician can provide you with the resources to guide an informed decision. If parents choose not to immunize, schools typically have a religious or personal exemption that the parent will need to complete.
Sean Frey, M.D., is a UR Medicine pediatrician and an assistant professor of pediatrics at the University of Rochester Medical Center.