Karen Evans, an Scott County Health Department RN, prepares shots for a patient.

SIKESTON — With the start of school lurking around the corner, health officials say it’s time to make sure area children are caught up with their immunizations — even the big kids.

“Immunizations are very important, especially with the bioterrorism threat,” noted Marian Malone, registered nurse at the Sikeston Kindergarten Center. “We don’t really have anything here to be worried about, but you never know with terrorism.”

When children reach preschool age, they should have the meningitis and varicella (chicken pox) immunizations, Malone said. Kindergarten children should have the DTP (diphtheria, tetanus and pertussis); polio; MMR (measles, mumps and rubella); and hepatitis B vaccinations.

Immunizations are important for children due to the close quarters they’re are confined to in school, Malone said. “Things are spread so easily, especially with the little kids. They don’t wash their hands and don’t know the importance of it. There’s a real big potential for the spread of disease,” Malone said.

Malone said each year the school sends out letters to parents whose children’s shots aren’t on record. The school accepts religious and medical immunization exemptions; however, if the school doesn’t have a record of a child’s shots, he or she will not be allowed to enroll. Once children do get immunized, parents need to make sure the school has a copy of the records, she added.

Local health departments offer some free immunizations, but not all types. For instance, every Tuesday and Thursday, the New Madrid County Health Department officials can be found administering immunizations to county residents.

Immunizations for preschool and kindergarten children are available, said Christi Pipkin of immunization division for NMC Health Department. For teenagers and adults, they offer tuberculosis (TB) and hepatitis B, but they don’t have the meningitis vaccine, she said.

“It’s just as important for college students to receive immunizations as it is for younger students,” said Jacque Fernald-Leal, prevention nurse for the University of Missouri-Columbia.

For example, at Mizzou newly enrolled students are required to have received two doses of MMR within their lifetime. A TB screening is required only for those who have a high risk of contracting the disease, such as people who have been diagnosed with a chronic medical condition that may impair their immune system or if they’re a health care worker, etc. “The university is recommending all college students get a hepatitis B shot because so many were born before it was mandatory for kindergarten registration,” Fernald-Leal said.

Another recommendation by the university is that students have immunity protection of chicken pox, Fernald-Leal said. Chicken pox is fairly mild for kids, but can be quite serious for adults, she pointed out. Good history will tell if a student has immunity protection, she added.

“If your mother or you remember having chicken pox, then that’s considered good history. If it’s questionable whether you’ve had it, the university recommends you get the varicella immunization,” Fernald-Leal explained.

Another big issue among university campuses is meningitis, Fernald-Leal said. Any student in the congregational setting should consider receiving the immunization for meningitis, she said.

Moms on Meningitis, a national coalition of mothers whose college-age children have been disabled or killed by the disease, encourages college students to get immunized before school starts.

According to the Centers for Disease Control and Prevention, the chances of college students, especially freshmen living in dormitories, contracting meningitis have increased considerably — 60 percent since 1991.

Studies published in the Journal of the American Medical Association suggest that up to 80 percent of meningitis cases in the college age group may be prevented by a vaccine. “College life can run down the immune system and certain conditions such as sharing food and drinks, kissing and partying — all things college kids do — create opportunities for the immune system to become weaker,” Fernald-Leal explained.

For this reason, Mizzou’s Student Health Center distributes information on the importance of immunizations to the incoming students each year, Fernald-Leal said.

“Our emphasis here is on education. It’s our job to inform. Then we let the students make an informed decision,” Fernald-Leal said.

And it appears the students are listening to the sound of reason.

At Mizzou’s Summer Welcome, where approximately 90 percent of the incoming freshmen are invited to the campus for registration — and where vaccinations are available — 828 freshmen received the meningitis vaccine, Fernald-Leal said. Whether the students are big or small, the main thing to remember is not to fall behind on immunizations.

Malone emphasized: “If you don’t have your shots, you should get to your local health department or physician as soon as possible.”