Measles, mumps, and whooping cough seem like quaint old illnesses confined to 19th century novels. But outbreaks of contagious diseases like measles and mumps have caused problems recently, especially in schools and on college campuses where large numbers of people are together in close quarters.

Why are more and more teens being exposed to these diseases? Part of the problem is that diseases like measles, which were on their way out in the United States, are making a comeback as they are brought in from other countries by travelers. These diseases wouldn't spread as quickly — or be as serious — if people were immunized against them. But that's the other part of the problem: Many teens aren't getting all the shots they need.

It's not your fault if you don't have all the immunizations (vaccinations) you need. In the past decade, doctors have added new immunizations — such as the varicella vaccine against chickenpox — to the list of shots little kids should be getting. But when you were a kid, these shots may not have been required, so you may not have had them.

Also, because some vaccinations are given as a series of shots, not just one single dose, some people may have missed getting all the required shots. Not getting a full course of a vaccine leaves a person unprotected and still at risk for getting the disease. Other vaccinations require a booster shot every few years to ensure that the level of immunity remains high.

Why Do I Need Shots?

Missing a shot may not seem like a bad thing — nobody wakes up in the morning thinking they'd love to go out and get a jab in the arm.

But missing out on shots puts you at more serious risk than you might think. That one little "ouch" moment protects you from some major health problems. For example, older teens and adults who get diseases like mumps may not feel too sick — but they could still be at risk for side effects of the illness, such as infertility (the inability to have children).

People sometimes mistakenly think that vaccinations are only for little kids or that they are for diseases that only kids get. But many of the diseases that we are vaccinated against when we're kids — like hepatitis B or tetanus — actually affect way more adults than kids. And those "kid diseases" like chickenpox? Anyone can get them — and they are far more dangerous to teens and adults than they are to little kids.

The best reason to get shots is because they could save your life. Hepatitis B attacks the liver and can eventually kill. The new HPV vaccine can protect girls from a type of cancer. And another great reason to stay current on your shots is because scientists are constantly working on new vaccines against diseases like HIV.

Which Vaccinations Do I Need?

So which vaccines should you be getting? Doctors now recommend that all teens should have received a full course of vaccination against the following diseases:

• diphtheria, tetanus, and pertussis (called the Tdap vaccine)
• measles, mumps, rubella (the MMR vaccine)
• hepatitis B
• meningococcal disease (e.g., meningitis)
• human papilloma virus (HPV) (for girls)
• varicella (chickenpox) if you have not had the disease
• polio

Ideally, people should be fully vaccinated against these diseases by the age of 11 or 12. But because new vaccines come on the market all the time (the HPV vaccine was only approved in 2006), there's a chance teens may have missed getting at least one of these.

The good news is you can still get a shot if you've missed it. And if you've missed some shots in a series of vaccines, you don't need to get the whole series again — you can simply pick up where you left off.

Some people may need additional vaccines. For example, people with illnesses like diabetes or asthma should get immunized against the flu. Those who have diseases that affect their immune system (like diabetes, HIV infection, or cancer) should get a pneumococcal vaccine. People at high risk of hepatitis A infection should get vaccinated against that disease. And if you're traveling abroad you may need to get special immunizations, depending on which country you'll be in. (Since vaccines can take a while to start working, ask your doctor well in advance which immunizations you'll need.)

How Do I Find Out If I've Had the Right Vaccinations?

Ask a parent to contact your pediatrician or family doctor so he or she can check your health records.

If you've already had a disease like chickenpox, you won't need the vaccine. And if it turns out you missed one or more of the required immunizations, you can still get them from your doctor — it's never too late. After getting a vaccination, it generally takes 10 days to 2 weeks for the body to build up immunity to a disease.

Once you have a certificate from your doctor that you've had all your shots, make sure you keep it filed away so you can find it easily later. If you plan to go to college, you will need to show proof that you've had a condition or been immunized. Some jobs also require proof of immunization — for example, if you are working or volunteering in a hospital.

Since some teens may have missed getting certain shots, this is one of those times when you need to take charge of your health: Bring up the subject of immunization when you see your doctor and ask if you've had all the recommended vaccinations (not easy, we know — but necessary!).

Are Vaccinations Safe?

Like any medicine, vaccines may cause side effects, but receiving one is far safer than getting the disease it prevents. The most common reactions include soreness, redness, and swelling in the area of the shot or a low-grade fever. Usually acetaminophen or ibuprofen will take care of these side effects.

It's rare to have any kind of bad reaction to a vaccine. If you've had reactions to vaccines in the past, let your doctor know.

Who Should Not Be Vaccinated?

People who have a weakened immune system (from AIDS or certain cancers, for example) need to talk to their doctors before getting shots. This is also true for those who receive treatments like chemotherapy or who take medication that can weaken the immune system. Girls who are pregnant should talk to a doctor or health clinic before getting any shots.

People with certain allergies may need to be careful with some vaccines. For example, the flu vaccine is developed using chicken eggs, and this can affect someone who's allergic to eggs. People who have severe allergies to gelatin or the antibiotic neomycin should be careful with the MMR and varicella vaccines. And if you're extremely allergic to baker's yeast, which is used to make bread, you should not get a hepatitis B vaccine.

Still Dreading That Shot?

We usually think of vaccines as shots, but not all vaccines are given that way. Some are given orally (by mouth) or in other forms like nasal sprays.

But it's impossible to escape the fact that some immunizations are just best given as shots. It's completely normal to dread getting shots. Here are some tips that can help things go easier:

• Distract yourself while you're waiting. Bring along a book or game — something you'll get completely caught up in so you're not sitting in the waiting room thinking about the shot. Or listen to a relaxing CD.
• Tell your doctor (or nurse) that you're nervous. Medical professionals are used to people who fear shots and they'll be able to help you relax.
• Concentrate on taking slow, deep breaths. Breathe all the way down into your belly. Deep breathing can help people relax — and focusing on something other than the shot can take your mind off it.
• Relax your arm. If you're tense — especially if you tense up the area where you're getting the shot — it can make it more painful.
• Promise yourself a treat. Give yourself a reward and some praise!

Remember, you're not alone; no one likes shots. But the good news is that the shot itself only lasts for a second, but you'll be protected for a long, long time after that!

Reviewed by: Elana Pearl Ben-Joseph, MD
Date reviewed: November 2006