Immunisation for older children

Older children and teenagers also need immunisation. This section describes the free immunisations provided through schools or general practice, and other immunisations that can be purchased from general practice or pharmacies.

11 and 12 year old immunisations

Children are offered free immunisations at around age 11, against tetanus, diphtheria and whooping cough (pertussis), and at around age 12, against human papillomavirus. In most of the country, these immunisations are usually given at school during years 7 and 8.  Parts of the South Island provide Year 7 immunisation through general practice and Year 8 at school.

The Public Health Nurse will visit participating schools and give children consent forms to bring home for their parents to sign, for each vaccine. Parents need to fill out the forms and say whether or not they consent to the vaccine, sign the form and return it to school.

Tdap vaccine (Boostrix)

The Tdap vaccine boosts the protection children receive as babies, against tetanus, diphtheria and whooping cough (or pertussis).  Following the full course of immunisations, protection is expected to last at least 20 years against tetanus.  Protection against whooping cough wanes after five years.  The Tdap vaccine is given as one injection.

HPV vaccine (Gardasil 9)

The HPV vaccine protects against nine* strains of human papillomavirus responsible for cervical and some other cancers, and genital warts. Protection is long-lasting. The HPV vaccine is given as two injections, spaced out over at least six months, to those aged 14 or under.  Those aged 15 or older will need three doses.

While getting immunised at school is convenient for most families, the vaccines are also available through general practices.

*The vaccine Gardasil 9 protects against nine strains of HPV, and is used in schools.  The quadrivalent Gardasil vaccine, which protects against four strains, will continue to be used in general practices until stocks run out.

Immunisation videos

You can watch the videos telling Year 7 and 8 students about the immunisations here:

Transcript: Immunisation - What it does and why you need it

Chapter 1: Immunisation - What it does and why you need it

Duane and Hinetaapora are trying to get their camera to work – kids are playing soccer in the background.

[Duane] Alright, are we going to do this camera thing?

[Hinetaapora] Well OK, but how does it work?

[Duane] Well you just mount the camera on this pod and boom! There you have it!

[Hinetaapora] That is so cool.

[Duane] Hey I’m Duane.

[Hinetaapora] And I’m Hinetaapora.

[Hinetaapora] Did you know that like a soccer ball, diseases can get passed around from person to person?

[Duane] Diseases? Gross.

[Hinetaapora] They are so nasty, that we are going to tell you how to avoid getting them… and passing them on.

A soccer player runs by and takes the camera from Duane and Hinetaapora.

[Hinetaapora & Duane] HEY – COME BACK HERE!

[Duane] Give my camera back!

[Hinetaapora] Because diseases can get passed around, it’s important that you get immunised to protect yourself and to stop diseases spreading.

Duane yells at the kids playing soccer.

[Duane] Pass it man! You should have passed it.

[Duane] My Mum and Dad said I was immunised when I was a baby.

[Hinetaapora] True, but around year 7 you need a top-up just to make sure. It’s called Boostrix.

[Duane] So if you have missed out on any shots as a baby, now is a great time to catch up, right?

[Hinetaapora] Right.

[Duane] What does immunisation do, exactly?

[Hinetaapora] It does two important things: it protects us and it protects everyone else.

[Duane] Ok, I get it how it protects me…but how does it help to protect other people?

Goalie on the soccer field appears to be unwell.

[Hinetaapora] Well, look at the goalie - he’s really unwell. He is so sick right now that he can’t be immunised. This makes him vulnerable.

[Hinetaapora] Now imagine that the soccer ball is a nasty disease. The blue team can protect the goalie and keep the disease away – stop it from scoring - because they’re all immunised.

[Duane] Ahhh, I get it! They protect the goalie, because they stop the disease from spreading.

[Hinetaapora] Right. The more people who get immunised, the less chance of these diseases getting passed on. 

So we shouldn’t get immunised just for our own sakes, but for everybody’s.

[Hinetaapora] Immunisation is how they got rid of lots of nasty diseases in the old days.

[Hinetaapora] People are much healthier in New Zealand now than when our nanas and granddads were kids or even our mums and dads.

[Duane] But we can’t be too careful. That’s why we’re going to get ourselves immunised.

[Duane] So, these days, what do we need to get immunised for?

Chapter 2: What are the immunisations for?

Hinetaapora grabs a tablet computer showing pictures of diseases.

[Hinetaapora] OK Duane, take a look at these diseases, but I’m warning you they’re really gross.

[Hinetaapora] This is diphtheria, see?

[Duane]  Gross all right.

[Hinetaapora] It attacks the throat. It can even cause someone to be paralysed or suffocate.

Those orange things are what diphtheria germs look like.

[Duane] How about this?

[Hinetaapora] It’s tetanus. It gets into your body through cuts and grazes and makes your muscles seize up.

[Duane] Oh wow, no soccer for them. What about this one?

[Hinetaapora] That’s the germ that gives you pertussis.

[Duane] Whooping cough?

[Hinetaapora] Yip. It’s still quite common and for older people mostly it’s just a bad cough. But it’s very contagious and if a baby gets it, it can be deadly.

[Duane] I’d rather have an injection than risk passing that on to them, I reckon.

Chapter 3: How does immunisation work?

[Duane] This immunisation stuff sounds really cool. The only thing is ….

[Hinetaapora] What?

[Duane] Nothing.

[Hinetaapora] Come on!

[Duane] I don’t like injections.

[Hinetaapora] You scared?

[Duane] Nuh, course not. Not me. You ask anybody.

[Hinetaapora] Well the nurses know what they’re doing. They’ll make it easy as. All it is, is one injection that can help us and everyone else from these three serious diseases.

[Duane] And it’s better than getting one of them, eh?

[Hinetaapora] Definitely. Do you know how that injection works?

[Duane] I know it helps your immune system. The immune system makes special blood cells and antibodies that attack any harmful bugs that get into your body.

What I don’t know is, how does that little injection help?

[Hinetaapora] So, when you’re immunised, the nurse injects a tiny amount of the bug into your arm.

[Duane] But that would make you ill!

[Hinetaapora] No Duane. It’s like soccer.

[Duane] What?

[Hinetaapora] Each team wears a different coloured shirt, so you know who’s on your side and who isn’t. You can recognise an opponent right away and deal with them.

That little bit of the bug you get from the nurse has been specially treated so it’s too small and harmless to give you the disease. But it’s just like the team yellow shirt.

It’s all your immune system needs to recognise the opposition.

If you ever get the germ for real, your immune system already knows what it is and can kill it before it can harm you.

[Duane] Wow! That’s amazing. Tell you what, let’s go and see the school nurse now.

[Hinetaapora] Good idea, she can tell us more about it. Oh grab this.

Duane and Hinetaapora grab their camera.

Chapter 4: What to expect when you get immunised

Duane and Hinetaapora walk into the Nurse’s room with their camera.

[Duane] Hi nurse.

[Ella - Nurse] Hey guys, how’s it going?

[Both]  Good.

[Ella] What you got there?

[Hinetaapora] It’s our camera.

[Ella] Can I have a go? Cool, what do I do with it?

[Hinetaapora] Just move around.

Ella grabs the camera and moves it around

[Ella] Whoa – it makes you feel sick.

[Duane] We hoped you’d tell us a bit more about immunisation.

[Hinetaapora] So we can boost our immune systems.

[Duane] To protect against diphtheria, tetanus and…per…per…

[Hinetaapora] Pertussis, you know, whooping cough.

[Ella] Sounds like you know a fair bit already! But sure, I can give you some tips for when you come back next time.

[Hinetaapora] Thanks.

[Hinetaapora] I’ve heard some kids can react badly to an injection.

[Ella] Hardly ever, but it can happen.

You probably won’t have any side effects at all.

A few people feel a little dizzy, sick or get a fever or a headache after their vaccination. This is normal, and should get better on its own.

[Ella] There are things you can do to help.

Make sure you have breakfast or lunch before your injection. Even a snack before or afterwards will help stop you feeling faint. 

The injections are done in your upper arm, so wear a loose shirt, preferably with short sleeves.

Take things easy afterwards. Your nurse will keep an eye on you after the vaccination and will provide you with all the advice you need.

If you’ve reacted badly to an injection before, or even if you’ve just been ill lately, somebody in your family should ask the doctor or practice nurse if it’s OK for you to have the immunisation.

If you have asthma, allergies, or you’re getting over something not too serious like a common cold, you can still be immunised. Your parents can talk to the nurse if they would like more information.

But the important thing is that the benefits of immunisation are huge compared to the risks.

[Duane] Not that I’m scared or anything, but—

[Hinetaapora] Yes you are!

[Ella] You want to know if it hurts, right?

[Hinetaapora] It doesn’t really hurt. It’s over quickly and it just feels a little tender.

[Ella] And that’s really normal, let’s go and see what some other kids thought.

Short interviews with kids about their immunisation experiences

I thought it was going to be really, really sore but it’s actually like a little pinch.

I thought the needle was going to be about this big, but it was actually this big.

I was a bit nervous, I think everyone was but it was fine. The nurses were really nice.

I looked away and she put the needle in and she took it out and I said are we going to do it now and she said, it’s done.

I had a bit of sore arm for a few hours but it didn’t last very long.

So I didn’t even know she was doing it.

[Ella] See? Not a problem.

Still, in about 1 in a million cases an allergic reaction can occur. But we nurses are trained to deal with it and, as I said before problems are very rare indeed.

They’re all covered off in this form.

All kids will get one to take home, so you can get consent from your parents.

Chapter 5: Getting your parents’ consent

[Duane] OK nurse. You’ve convinced me. I’m ready.

[Ella] It’s great you’re so keen Duane, but I can’t do it yet.

[Hinetaapora] He has to get approval from home, eh? That’s what I had to do.

[Ella] That’s right Hinetaapora. We can’t immunise any kid until the parents or guardians let the nurses know whether or not you can have the vaccines.

That’s why all kids get a consent form to take home.

[Ella] It has everything they need to know. It has to be filled in, signed and brought back to school before we can do your immunisation.

Duane shows the consent form to his parents. Duane’s Mum fills in the form.

Tell your parents to fill in Section A to get the immunisation done at school or Section B if they don’t want you to get it.

Either way, they must sign the form, and you have to bring it back to school.

But if your parents or guardians aren’t sure about anything, don’t worry they can talk to me or any school nurse, the doctor or the practice nurse.

They can even watch this video for themselves online at www.health.govt.nz/immunisation

[Ella]  Now you’d better get on back to the soccer.

I’ll see you again soon, OK?

[Hinetaapora] Thanks nurse.

[Hinetaapora] So you’re not scared anymore?

[Duane] Never was.

[Hinetaapora] Were.

[Duane] Was not.

[Hinetaapora] Were too.

Duane and Hinetaapora leave the room.

 

Transcript: Immunisation - What it does and why you need it

[Hinetaapora] Hi! I’m Hinetaapora. I’m going to talk to you about being immunised against HPV.

That's short for human papillomavirus.

A group of viruses that can live in skin cells

They’re passed on in different ways through skin to skin contact and they’re pretty common. Did you know, four out of five people get them in their teenage years? Most of the time you wouldn’t even know that they’re there and they usually go away on their own.

But sometimes they hang around, and then they can be really nasty.

Hi

[Ella] Oh, hi Hinetaapora, how can I help?

[Hinetaapora] I would like to know about the HPV immunisation.

[Ella] Well we give you this HPV immunisation, at school, about age 12 because we know that’s the best time for you to be protected. This is the age where you produce the best antibodies after your vaccinations.

Most people will be infected with HPV at some point in their lives. This can lead to genital warts, and for a few, this can cause cancer, especially cervical cancer.

More than 50 women in New Zealand die of cervical cancer every year, and lots more need hospital treatment.

[Hinetaapora] Right, so it’s pretty serious.

[Ella] It is.

[Hinetaapora] Is it just girls who can get HPV?

[Ella] No, boys get it too. They don’t get cervical cancer, but they can get cancer in other parts of their body if they get infected.

[Hinetaapora] So how does Immunisation work?

[Ella]  The immune system protects us against germs by making special blood cells and antibodies.

The first time your body meets a germ, your body takes time to make the blood cells and antibodies to fight off that germ.

It’s during this time that the germs can sometimes make you unwell. But a healthy immune system will eventually fight off the germs.

Once your immune system has encountered a germ, it can recognise it the next time it sees it. Your immune system is able to fight off the germs before you become unwell. This is called immunity.

HPV immunisation works by making your body recognise the most common kinds of HPV that can cause cervical cancer and genital warts. The HPV vaccine contains little particles that look the same as some of the particles on the outside of the real virus.

Because they are only particles and not the real virus you can’t get HPV from the vaccine. They’ll just help your immune system fight the HPV virus in the future.

[Hinetaapora] I’ve heard some kids can react badly to an injection.

[Ella] Hardly ever but it can happen.

You probably won’t have any side effects at all.

A few people feel a little dizzy, sick or get a fever or headache after their vaccination. This is normal, and should get better on its own.

[Ella]  There are things you can do to help.

Make sure you have breakfast or lunch before your injection. Even a snack before or afterwards will help stop you feeling faint. 

The injections are done in your upper arm, so wear a loose shirt, preferably with short sleeves.

Take things easy afterwards. Your nurse will keep an eye on you after the vaccination and will provide you with all the advice you need.

If you’ve reacted badly to an injection before, or even if you’ve just been ill lately, somebody in your family should ask the doctor or practice nurse if it’s OK for you to have the immunisation.

If you have asthma, allergies, or you’re getting over something not too serious like a common cold, you can still be immunised. Your parents can talk to the nurse if they would like more information.

But the important thing is that the benefits of immunisation are huge compared to the risks.

[Ella] It will take 2 injections a few months apart to be fully protected.

In very rare cases a problem can occur. But we nurses are trained to deal with it and, as I said, problems are very rare indeed.

They’re covered off in the form you will get to take home.

[Hinetaapora] So once you’ve been immunised. You’re covered right?

[Ella] Actually, that’s not the end of the story.

When girls become adults, they should get a smear test done every few years. This is another way to protect against the risk of cancer.

[Hinetaapora] So to get immunised, kids need to get the form signed, right?

[Ella] That’s right Hinetaapora. We can’t immunise any kid before the parents or guardians let the nurses know whether or not you can have the vaccines.

We’re handing these out to all kids to take home.

It has everything they need to know.

It has to be filled in, signed and brought back to school before we can do your immunisation.

Tell your parents to fill in Section A to get the immunisation done at school or Section B if they don’t want you to get it.

Either way, they must sign the form, and you have to bring it back to school.

But if your parents or guardians aren’t sure about anything, don’t worry.

They can talk to me or any school nurse, the doctor or the practice nurse.

They can even watch this video for themselves – online at www.health.govt.nz/immunisation

[Hinetaapora] You want to keep yourself healthy, right? Get your parents to sign the form so you can be immunised against HPV.

Find out more about why HPV immunisation is important for boys as well as girls.

Video title: HPV Immunisation - now free for boys and young men

[Graphic - HPV Vaccine (Human papillomavirus Vaccine) Helps prevent cancers caued by HPV infection]

Voiceover: Human papillomavirus or HPV, is a common disease which can lead to serious health issues for some people in later life.

[Various shots of young people with doctors and nurses preparing to receive their immunisation.]

Fortunately, girls and now boys as well can be vaccinated against HPV.

[Title: A doctor's view of HPV]

[Dr Kiriana Bird sitting in her clinic.]

Dr Kiriana Bird: Kia ora! I’m Dr Kiriana Bird. We’ve had HPV immunisation for New Zealand girls since 2008, but now it’s free for boys and young men as well. So I’m here today to tell you why HPV immunisation is important for our tāne. Let’s start by understanding just what HPV is.

HPV is a really common virus that lives in our skin cells and is passed on through intimate contact.

[Shots of kids playing football.]

Without immunisation about four out of five of us, men and women, will catch HPV, usually in our late teens or early adulthood. Most of the time it gets better on its own and we don’t even notice - but we can still pass it on to others, and if it doesn’t get better, it can lead to cancer later in life. HPV can also cause genital warts.

[Boy sitting with nurse preparing to be immunised.]

The good news is you can immunise against HPV, and the really good news is that it’s now free for boys as well as girls.

[Graphic shows the parts of the body affected if HPV is contracted.]

Cervical cancer is the most common cancer caused by HPV, which is why HPV immunisation was provided first for girls. But the virus causes cancers in other body parts as well. About a third of all HPV cancers affect men, most commonly in the throat and mouth, and rates for male HPV cancers are rising. HPV cancer can also affect the genital area.

[Title - A patient's experience with HPV]

[Dr Andrew Miller arriving at his hotel, sitting in Doctor's clinic]

Voiceover: Dr Andrew Miller has arrived in Auckland for cancer surgery. It will be invasive, but he’s decided to let us in as a warning about the need to vaccinate against the cancer-causing virus HPV.

[Graphic showing 80% of the population infected with HPV]

80% of New Zealanders at some point will acquire HPV. 4 out of 5. The only real way of protecting is to be immunised.

Of that 80%, all but around 10% will shake that infection off, but those that don’t are the worry.

[Graphic showing HPV affecting both women and men.]

And what most of us don’t know is that HPV isn’t just a cancer risk to women, it’s a cancer risk to men as well.

Dr Andrew Miller: There is a very obvious and well-known link between an HPV and causing cervical cancer, but you know if you talk to head and neck surgeons they’ll be seeing a big rise in head and neck cancers caused by HPV as well.

I’ve been diagnosed with a thing called a squamous cell carcinoma inside my nose. Umm it’s ended up going from the inside of my nose down into my jawbone and round the other side there, and it’s going to require some fairly extensive treatment to get it out.

[Andrew being weighed on an electronic scale]

Voiceover: But what he didn’t expect was the likely culprit, HPV.

[External shot of the Gillies McIndoe Research Institute building]

Voiceover: Dr Miller’s not alone. Health professionals and researchers are increasingly becoming aware of HPV’s role in cancers affecting men as well as women.

[Shots of Dr Swee Tan in his office and laboratory.]

Dr Swee Tan: Compared with other throat cancers, HPV positive throat cancers typically effect younger men. On average these men die 10 years younger than those with cancers not caused by HPV.

[Dr Swee Tan working in the lab, looking at a computer screen.]

Radiotherapy and chemotherapy is currently the standard treatment for throat cancers.

This profoundly effects the quality of life and the daily functioning of the effected individuals. They lose the sense of taste and smell and often have difficulty in swallowing and speaking.

The thing is these HPV induced cancers are preventable. The decision to include boys in the HPV immunisation programme wills save lives, prevent suffering and reduce the huge cost of treatment. we need to protect our children now for their future.

[Title: A Māori health advisor's view of HPV]

[Arthur Selwyn sitting at his desk, on the computer. External shots of the Ministry of Health building]

Arthur: Ko te aroha o tēnei mate pukupuku HPV, ko te pāmamae ki runga i o tātau whānau.

He mate kei te pā i o tātau mātua, i te wā e manaaki ana i o rātau whānau.

Kia kore e pā ēnei mate pukupuku HPV, otirā, kia wawe te whai oranga mo ēnei mate, ka roa ake, ka noho ora ake tātau katoa.  

Mehemea ka whāngaihia o tātau tamariki ki te rongoa i tēnei rā, ka noho ora mo ake ngā whānau whānui i ngā rā ki mua.

[Nurses sitting with children about to get their immunisation]

Voiceover: The HPV vaccine has an excellent safety record, with very few risks, similar to other childhood vaccines. You can find out more about the vaccine’s safety and common reactions on the Ministry of Health website.
    
Dr Kiriana: The best time to be immunised is at age 11 or 12, before our young people are at risk of getting HPV.

[Kids playing on a playground.]

At that age, their immune systems are really effective at making antibodies in response to the vaccine. Protection from the vaccine is long-lasting and is not expected to wear off over time.

[Graphic showing reduced disease rates for HPV infection, genital warts, High-grade Cervical Cell Changes and Low-grade Cervical Cell Changes.]

Over the last decade, diseases caused by HPV have fallen significantly among young people in countries like New Zealand that offer HPV immunisation.

That’s why, as health professionals, we recommend HPV immunisation, as does the Ministry of Health.

[Various shots of kids sitting with nurses preparing to be immunisied.]

The HPV vaccine is available free at school for Year 8 girls and boys. It is also available free at your local doctor or health clinic for anyone, male or female, aged from 9 – 26 years of age.

[Title: To find out more, talk to your doctor, practice nurse or health clinic, or phone 0800 IMMUNE (466 863)]

For more information, talk to your doctor, practice nurse or health clinic; visit www.health.govt.nz/hpv or phone 0800 IMMUNE.

[Graphic showing Immunise logo and 'our best protection' slogan.]

Other recommended immunisations

There are other vaccines recommended for older children, available through general practice and in some cases, pharmacists.

Chickenpox (varicella)

Chickenpox (varicella) is a virus that is usually mild, but can lead to serious complications such as pneumonia and problems with the kidneys, heart, joints or nervous system. Without vaccination, nearly all children will get chickenpox between the ages of 2 and 10 years old. Chickenpox is more likely to result in serious complications in those who catch it when they are older.  From 1 July 2017, varicella vaccine is free from general practices for those turning 11 years of age on or after 1 July 2017 who have not already had chickenpox or been immunised against it.

Measles Mumps and Rubella (MMR) vaccine

MMR vaccine protects against measles, mumps and rubella. Two doses are required for full protection, and the vaccine is provided at age 15 months and 4 years.  Children and young adults who have missed either or both of those doses can catch up free at their general practice.  If you are unsure whether your child has had both doses, check their Well Child Tamariki Ora health book, or call their general practice.

Around 90 percent of young children in New Zealand have had both doses of MMR vaccine, but older children and young adults are more likely to have missed out.  This age group was heavily affected by measles outbreaks in 2011-12 and 2014.  Many missed weeks of school or work, either while they were sick, or while the disease circulated in their community and were quarantined at home.

Meningococcal vaccine

Meningococcal disease is a bacterial infection that causes two very serious illnesses: meningitis (an infection of the membranes that cover the brain) and/or septicaemia (blood poisoning).

Vaccination against meningococcal C is available to purchase from general practices and many pharmacists, and is recommended for young people entering boarding school or other communal accommodation such as hostels or military barracks.

Influenza vaccine

Influenza vaccine is available to purchase during the autumn and winter, usually between March and July, from general practices and many pharmacists.  It is free for people with certain medical conditions, such as severe asthma. For more information, see www.fightflu.co.nz

 

In this section

Back to top