Get an Early Start on School Health Requirements

By Jean Yaeger

As students gear up for summer break, it’s not too early to get a physical or the immunizations they’ll need before school starts again in August.

Incoming kindergarteners and seventh graders are due for routine vaccinations. Junior high and high school students need a physical before they can participate in athletics or marching band.

Cook Children’s neighborhood health centers and pediatric offices can help your family check these items off your to-do list. Make an appointment early in the summer, come in for the required shots or a physical examination, and beat the back-to-school rush.

Amy Medalie, RN, MSN, CPNP advises parents not to postpone scheduling those visits. She wants children and teens to stay on track for their vaccines – or get caught up if they’ve fallen behind.

“This is a topic we talk about all day,” said Medalie, a nurse practitioner at Cook Children’s Neighborhood Health Center Richland Hills. “I tell parents that vaccinations are our best defense at helping prevent illnesses.”

Vaccines to protect against certain contagious diseases – including measles, polio and chickenpox – are safe and effective at stopping the spread. The boosters required in Texas for kindergarten and for seventh grade can usually be administered in one visit to your pediatrician or neighborhood health center.

Before the final school bells ring this May, here’s a quick look at a few key points.

Immunizations

The 2024-2025 Texas Minimum State Vaccine Requirements chart lists in English and Spanish the number of doses that students need. If an incoming kindergartener has missed out on vaccines normally given at age 4, these additional vaccines are due now:

• MMR (measles, mumps and rubella)
• DTaP (diphtheria, tetanus and pertussis)
•  IPV (inactivated poliovirus)
•  Varicella (chickenpox)

And between the ages of 11-12 years, these additional vaccines are due:

• MCV4 (meningitis)
• Tdap (tetanus, diphtheria and pertussis)

How do vaccines work? If someone who’s been vaccinated comes into contact with that infectious disease, their immune system has already been primed to respond, Medalie said.

“Vaccines teach our bodies to recognize a certain bacteria or virus. If a person is exposed to those bacteria or virus, the immune system is already prepared to fight off infection,” she said.

Sites across Cook Children’s offer a Comfort Menu of items that help patients relax and feel less of a pinch when the needle goes in. Children can request cold spray or a buzzy tool on their skin for comfort and distraction. 

Medalie and her colleagues are happy to answer any questions to provide families with accurate information and reassurance about vaccines.

Sports Physicals

Early summer is also an ideal time to come to Cook Children’s for the physical exam UIL requires before participation in school athletics and activities such as cheerleading and marching band. The form contains two parts:

1. Medical history – a list of yes/no questions about headaches, dizziness, chest pain, seizures, allergies and more. This portion must be filled out every year by the student and parent or guardian.
2. Physical exam – performed by a health care professional to check the student’s lungs, joints, vision, weight, heart rate, blood pressure and more. UIL requires the physical exam before the 7th, 9th and 11^th grades. Some school districts require it annually.

The provider checks one of three options on the form: cleared for participation, cleared after completing additional evaluation or rehabilitation, or not cleared due to concerns.

Medale said the physical exams can identify issues such as irregular heartbeat, vision problems, spine curvature or uncontrolled asthma. A referral might be needed for follow-up testing, such as an electrocardiogram (EKG) if a possible heart rhythm disorder is noticed.

Sports physicals give also teens the chance to ask questions or report any problems that might impact their ability to practice or compete safely. Medalie urges her patients to speak up if something feels off … shortness of breath or a lingering sprain for instance.

“Be honest with yourself and your parents about how you’re feeling, so that you’re not just pushing through something that can contribute to reinjury,” she said.

As a mom, Medalie has seen in her own teens the endurance it takes for marching bands and drill teams to perform in the Texas heat. Connecting with student athletes for physicals early in the summer gives her the chance to remind them to stay hydrated, avoid excessive caffeine, and don’t skip meals.