This month--and it's more than half over--is Back to School Safety Month. Most parents are considering all the things their children need for a great start of the first weeks of school. Parents are especially focused on the requirements of young children and those who will attend school for the first time: how to keep them safe on their journey to and from school and how to keep them safe around other children in school.

Immunizations are a hot topic of conversation. Which vaccinations do children attending school in your state's school district require in order to enter school? Before calling your local physician or primary care provider to make an appointment, it is a good idea to call the school your child will attend. Simply ask for the school's nurse or the principal's office and request the vaccine requirements for your particular school for your children's age(s). Since this is a frequently asked question by parents, the answer may even be found on your school's website!

Much having to do with the administration of vaccines has changed in recent years. At one time, only the DPT (Diphtheria, Pertussis and Tetanus) vaccine was required in addition to small pox and polio vaccines. The small pox vaccine was an injection and the polio vaccine was administered on a cube of sugar! There were tine tests for TB, and that was the sum total of the required precautions fifty years ago. It's little wonder that until the Measles, Mumps, and Rubella (MMR) vaccine was developed, there were epidemics of measles, mumps, and rubella in children.

Now, the DPT vaccine is more effective than ever and there are vaccines against Hepatitis as well as Haemophilus Influenza type b (or Hib). "Hib" is an important one, especially for parents of young children, to learn about. According to Pediatric's Vincent Ianelli, MD, children should receive the Hib vaccine at:

• 4 months of age
• 6 months of age
• And 12-15 months of age.

The reason it is important for children to receive the Hib vaccine is that your child can get Hib simply by being around other children or adults who have it. Your child may not become visibly sick, but if Hib bacteria remains in a child's nose and throat and proceeds to the lungs or bloodstream, serious problems can occur. Before the Hib vaccine, Hib was the principal cause of bacterial meningitis in children. Meningitis, a disease affecting the brain and spinal cord, can cause permanent brain damage and even death. Prior to the development of the vaccine, more than 20,000 children under 5 years old became ill in the U.S. annually, and approximately 1,000 people died from disease-related to Hib each year.

As with any vaccine or medication given to children, parents need to be aware there can be a reaction and should closely monitor children following vaccination. If parents or caregivers observe any high fever, behavioral changes, change in skin pallor (to pale or red), rash or redness of the skin at the injection site, hives, swelling of the airway, difficulty breathing or wheezing following a vaccination, take your child to the Emergency Room immediately or contact your physician. Adverse reactions to any vaccine should be reported to your child's physician.