My Doctor Online The Permanente Medical Group

Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

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Children

Teaching your children good health habits now will give them a solid foundation for growing strong and healthy. We offer resources to support you as a parent and help you handle the challenge of raising healthy kids.

Overview and Benefits

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Overview

One of the best ways to keep your child healthy is to stay up to date with your child's recommended immunizations (vaccinations).

Immunizations are given to prevent diseases that are still common in our communities but are preventable with vaccination. Timely immunizations prevent disease and keep your child, your family, and the community healthy.

A vaccine is made from weakened or killed bacteria or viruses that cause a specific disease. When your child gets a vaccine, his or her immune system will make antibodies to fight the disease. If your child is later exposed to that disease, the antibodies will help his or her immune system prevent the bacteria or viruses from causing an infection.

Vaccine benefits

Adolescents need to keep up with their vaccinations so they can stay healthy. Immunizations are safe and prevent serious, sometimes life-threatening diseases. In fact, serious side effects are no more common than those from other types of medication. There are several reasons for older children to be vaccinated:

  • Immunity from some childhood vaccines (such as tetanus and pertussis, or whooping cough) can decrease over time, so it is important that your child get another dose of these vaccines during the preteen years.
  • As children move into adolescence, they are at greater risk of catching certain diseases, like meningitis and human papillomavirus (HPV). If your teen did not get these vaccines at age 11 or 12, schedule an appointment to get them now.
  • It is much more dangerous for a child to risk getting the diseases than it is to risk having a reaction to the vaccine.

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Recommended Vaccines

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As children get older, the childhood vaccines they received can begin to wear off. Help your child transition into adolescence in a healthy way by staying up to date with preteen and teen vaccines.

We follow the Centers for Disease Control and Prevention's (CDC) recommended immunization schedule for vaccines for children 7 to 18 years of age.

Older children need the following vaccines:

  • Diphtheria / tetanus / pertussis (DTaP and Tdap). Protects against diphtheria, tetanus (lockjaw), and pertussis (whooping cough). This shot is given 5 times between birth and 6 years, with a booster shot at 11 to 12 years of age. The vaccine your child received when he or she was entering kindergarten wears off over time. It is important for all preteens and teens to get a booster shot (Tdap) to make sure they remain protected against both tetanus and whooping cough. State law requires proof of a recent Tdap vaccination for all students entering 7th grade.
  • Human papillomavirus (HPV).  The HPV vaccine protects against the types of HPV that most commonly cause cervical cancer and genital warts. The vaccine can also prevent penile, anal, and throat cancers. This vaccine is recommended for pre-teens and is most often given during their 11 and 12 year old well visits. Ideally, pre-teens should get 3 doses of this vaccine before their first sexual contact when they could be exposed to HPV. If your teenager missed the vaccine at 11 or 12, ask us about getting it now. For more information on the HPV vaccine, see Frequently Asked Questions about the HPV Vaccine (Gardasil).
  • Meningococcal. Protects against bacteria that can cause severe illness and meningitis, an infection of the fluid around the brain and spinal cord, and sometimes of the blood. Preteens should receive the first dose of this vaccine during their 11- or 12-year-old checkup. A booster dose is also recommended between the ages of 16 and 18. (For those teens who received the vaccine for the first time after age 15, no booster dose is needed.)
  • Influenza (flu). Protects against common strains of flu. All children 6 months to 18 years old should receive a yearly flu vaccination. Children with certain chronic illnesses are especially vulnerable to serious complications from influenza. This vaccine may be given as an injection or a nasal spray.
  • Hepatitis A (HAV). Protects against the hepatitis A virus, which causes liver disease. This vaccination can be given to all children starting at age 1 year and to children ages 2 to 18 who have not been previously vaccinated. There are 2 shots in this series.
  • Hepatitis B (HBV). Protects against hepatitis B virus, which causes liver disease and can increase the risk of liver cancer. This vaccine must be given 3 times, usually between birth and 2 years. California law requires that all children get the HBV vaccine before they enter 7th grade.
  • Varicella zoster (chickenpox). Children who have never had chickenpox should get 2 doses of the vaccine: one at 12 to 15 months, and another booster dose before kindergarten. Anyone 13 and older who has never had chickenpox or the vaccine needs 2 doses at least 1 month apart. If your child has not had chickenpox or the varicella vaccine, ask your doctor to schedule this shot as soon as possible. The varicella vaccine is required before a child can enter school or childcare.

Whooping Cough Booster Required for School

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California law requires all students entering 7th grade to show documentation that they received a Tdap (tetanus, diphtheria, and pertussis) booster shot before starting school. A Tdap vaccination protects your teen against tetanus, diphtheria, and whooping cough. 

  • Whooping cough is a serious disease that is now an epidemic in California. Whooping cough can cause small children to cough so much they can’t breathe, and several babies have died in the past few years.
  • Teens themselves may not feel all that sick, but they can transmit the disease to younger children in the family or community. 
  • Make sure your teen is up to date with all shots well before school starts. If your child needs immunizations but is not due for a well check appointment, many clinics offer shots on a drop-in basis. 
  • If your teen has already had the Tdap vaccine, we will provide proof for the school. You can also view and print your child's immunization record if you are signed up to manage your child's health care online (Act for a Family Member). 
  • If you are not able to set up access online, please call our Appointment and Advice line for this information.
  • It is also important to keep a personal record of your child's immunizations and remember to bring it with you to your child's next well check appointment with us, especially if your child is new with us. It helps us confirm the accuracy of your child's shot record.

Side Effects

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Your child may experience mild side effects such as redness and soreness at the site of the injection. There are some home treatments that can help lessen side effects:

  • Apply a cold compress to injection site (after 24 to 48 hours, heat may feel better).
  • If the area is sore, we recommend regular activity to decrease pain at the site.
  • A warm bath before bedtime can be soothing.

Remember, it is much more dangerous for a child to risk getting the diseases than it is to risk having a mild reaction to the vaccine.

Vaccine Safety

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Many parents have questions about immunizations. Are they safe and effective? Why so many shots?

Vaccines are held to the highest standard of safety. The United States has the safest, most effective vaccine supply in history. Years of testing are required by law before a vaccine can be licensed. Once in use, vaccines are continually monitored for safety and efficacy.

Immunizations, like any medication, can cause reactions. However, a decision not to immunize a child also involves risk. It is a decision to put the child and others who come into contact with him or her at risk of contracting a disease that could be dangerous or deadly. Consider these key facts:

  • Medical experts are constantly reviewing the safety and effectiveness of vaccines. As experts develop new vaccines and refine existing ones, the recommended schedule of shots gets continuously updated. Giving your child the right immunizations at the right time protects against serious diseases.
  • Diseases like measles, whooping cough, and chickenpox are still common in our communities but are preventable with vaccination. Kids who are not immunized can become very sick from these diseases and infect others. The single best way to prevent these and other illnesses, like the flu, is by getting your child immunized.
  • All vaccines currently being given to children under 3 years old are FDA-approved preservative-free (that is, they contain no mercury). The only frequently used vaccine that now contains detectable amounts of the preservative thimerosal, which contains mercury, is the flu shot for adults and older children. It’s important to know that several major studies, including a recent one in which Kaiser Permanente participated, have shown no connection between thimerosal and autism.   
  • While autism is a serious public health concern, vaccines do not cause it. Over the last decade, the rates of autism have risen dramatically in many countries, including the United States. Some people have claimed that vaccines are the cause. However, hundreds of studies have shown no evidence that any vaccine or combination of vaccines causes autism. Do not postpone or avoid vaccines for your child. If you're concerned about autism, I encourage you to talk with me.

With so much information easily accessible through the Internet, it is difficult to know what sources to trust. I am here to answer any questions you may have.

Check out the list of dependable resources about vaccines at the end of this article. These resources have the latest and most accurate information about vaccine safety and the recommended immunization schedule.

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If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.

This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.

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