Back-to-School Health Checkup

Here's a primer on exactly what your child needs to have a safe and healthy school year.

Medically Reviewed by Michael W. Smith, MD on July 28, 2004
5 min read

Whether your child is entering school for the first time or about to graduate, back-to-school time is a good opportunity for parents to check up on their children's health and make sure they're protected against common childhood diseases and illnesses.

First on the list should be immunizations. Vaccination requirements can vary by state or school district. To find out exactly what's required at your child's school, contact the local school board.

Below are the recommended guidelines that have been approved by the CDC's Advisory Committee on Immunization Practices, the American Academy of Pediatrics, and the American Academy of Family Physicians.

Vaccination series for the following should be completed by age 2 in all children:

Annual influenza vaccinations are recommended for all infants aged 6 to 24 months since this age group is at substantially higher risk for complications from the flu that may require hospitalization.

A series of hepatitis A vaccines may also be recommended starting at age 2 for children in some high-risk groups or areas. Check with your doctor or local public health department for more information. Annual flu vaccines are necessary because immunity to the flu virus does not persist and the strains of the flu virus change from year to year.

Boosters are recommended between ages 4 and 6 for the following vaccines:

  • DTaP

  • Polio

  • MMR

Children younger than 9 years who have not previously received the flu vaccine need two doses of the vaccine, given more than one month apart. If possible, the second dose should be given before December. Annual vaccination is recommended after that point.

Annual influenza vaccination is recommended for children who are at increased risk for complications from the flu, including those with asthma or other lung disease, sickle cell anemia, HIV, diabetes, and heart or kidney disease.

A visit to the pediatrician is recommended at age 11 to 12 to review all vaccinations and make sure all necessary vaccines have been given. A series of hepatitis B, MMR, or varicella vaccines may be given if they were missed or incomplete at earlier ages.

In addition, a combination booster for tetanus and diphtheria (Td) should be given if at least five years have passed since the last Td vaccine.

Although flu vaccines are not specifically recommended for this age group, any child at increased risk for complications from the flu, including those with asthma, sickle cell disease, HIV, diabetes, and heart disease, should receive an annual flu vaccine.

For more information on current vaccination schedules, guidelines, shortages, and answers to frequently asked questions, visit the CDC's National Immunization Program web site or call the National Immunization Hotline at (800) 232-2522 (English) or (800) 232-0233 (Spanish).


Once a child is infected with lice, the tiny bugs can spread quickly to other children though close contact or sharing personal items such as hairbrushes, combs, scarves, and hats. Symptoms include itching, and tiny brown or white eggs called nits may be seen on shafts of hair (although you may need a magnifying glass to see them). If you suspect lice, you can try a nonprescription product to kill the lice or contact a health professional to confirm the diagnosis.

Lice do not usually cause any serious health problems. But contact a doctor if your child develops signs of a skin infection, such as fever, pain, swelling, or redness at the infestation site, or a discharge of pus.

Food Allergies

Although most school cafeterias have been instructed to avoid serving items that might cause a severe allergic reaction, there are still potential pitfalls at school that parents of children with food allergies should prepare for.

Food allergies are more common in children than in adults, although many will outgrow them. The most common foods that cause allergies in children are those with a high protein content, such as peanuts, milk, wheat, soy, and eggs.

If your child has food allergies, you should instruct him to avoid sharing food with classmates or friends at school, and at other events such as bake sales, class outings, or parties. Provide your child with his own food and snacks for field trips and other school-related events where they may encounter problem foods.

In addition, alert the school nurse if your child has a life-threatening food allergy. Your doctor may also prescribe an EpiPen for the nurse to have on hand in case of a severe reaction. These pens deliver a shot of epinephrine (a.k.a. adrenaline) that can open up the airways and allow the child to breathe until medical help arrives.


Conjunctivitis, also known as pinkeye, can spread like wildfire in classrooms once a child becomes infected.

Symptoms of pinkeye include redness of the eye, swollen eyelids, itching, discharge or unusual drainage from the eye, and sensitivity to light. Most cases of pinkeye among children are caused by viruses for which there are no medical treatment -- the infection resolves slowly on its own.

That's why it's important to stop the spread of the infection when it appears.

Poor hand washing is the main cause of spreading pinkeye. Sharing an object with someone who has pinkeye can also spread the infection. Children with pinkeye should not attend school until symptoms improve. Most cases clear up within a few days.

Backpack Problems

Overloaded backpacks could injure your child's back. According to the American Chiropractic Association, a child's backpack should weigh no more than 10% of his or her body weight.

If your child routinely lugs around more than what's recommended for her weight, try purchasing a backpack with wheels or one with a support belt to help distribute the weight more evenly.