Teen Health Supervision
The beginning of adolescence serves as a platform for vaccination. The term "platform" is used as the intention is for health providers to discuss with adolescents and their parents growth, puberty and mental development. Discussions with the parents should include communicating with and parenting adolescents, with a segue into vaccinations that provide additional protection for their adolescent.
For adolescents who do not receive an annual influenza vaccine, this set of vaccinations is often met with a great deal of trepidation. This is because the last time they were vaccinated was at 4-6 years of age, which for them was half a lifetime ago. In the interim, vaccination may become extremely painful in their mind and it is not unusual for adolescents to fight being vaccinated or to faint following vaccination. Clinic staff and parents should be reassuring but not be apologetic or castigating.
Currently, the adolescent vaccination platform consists of the Tdap (tetanus, diphtheria, acellular pertussis) booster, HPV9 (Human papillomavirus) series and meningococcal series.
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- It is important to be non-judgmental about both value issues and maturity issues. We all do stupid things and we don't know it all. Teens should feel comfortable sharing their mistakes.
- Behaviors should be termed as "healthy" or "unhealthy" and not as "good" or "bad". Good and bad have moral implications. A highly charged example is premarital sex. It is best to discuss the associated health risks and not the religious implications. Most providers know not to "scold" teens over morality issues but fewer know not to praise them. For instance, a provider may tell a teen that she is proud of the young lady for not having sex. Of course, if the girl misled the provider and is already sexually experienced or if she does have sex in the future, she will be reluctant to share this information to avoid disappointing the provider. A better conversation would have been, "not having sex is a healthy decision, so you don't have to worry about being pregnant or having an STI."
- The teen should be engaged in the discussion. For example, while talking about smoking, you might ask questions such as these: "Do people you know smoke?" "What do you think about that?" "Why do they smoke?" "Do you see any problems with smoking?" "What else could cigarette money be spent on?" "What do you know about what it does to hearts or lungs?" "Why don't smokers think it will happen them?" Sure, it is much quicker to say, "don't smoke because it is bad for you," but advising without engaging is often not effective. Everyone already knows smoking is bad.