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Watch out, Utah tweens: School nurses want you to get four shots instead of one for seventh grade.

State law requires that students get the Tdap vaccine to protect against tetanus, diphtheria and pertussis for seventh grade.

But public health officials also recommend getting vaccinated against the flu, human papillomavirus, which can cause cervical cancer, and against meningococcal disease, which can cause meningitis along with blood infection and pneumonia.

Utah teens ranked below the national average for the latter, and Utah school nurses and other health officials want to boost their rates.

Supported by the pharmaceutical company Sanofi Pasteur, which makes one of the two vaccinations against meningococcal disease, nurses nationwide are urging parents to get their tweens or teens one of two meningococcal vaccines: MenACWY or MCV4.

"It can take a life in a single day," said Stacy Drew, a nurse with the Canyons School District, describing the rare form of the disease, in which the lining of the brain and spinal cord become swollen from a bacterial infection. "It's such a preventable death. I always encourage parents to get it."

Drew is also the state spokeswoman for the Voices of Meningitis awareness effort.

'At great risk' • Like most states, Utah doesn't require the meningitis vaccine for teens to attend school. And cases are rare enough that they aren't on parents' radar.

But it is recommended by the Centers for Disease Control and Prevention. The CDC has suggested since 2005 that all 11- to 12-year-olds be vaccinated against meningococcal disease. It recently suggested 16-year-olds get a booster dose after finding its effectiveness drops within five years.

According to the just released 2011 National Immunization Survey, 58.5 percent of Utah teens had at least one dose of the MenACWY vaccine, compared with 70.5 percent nationally.

The NIS is a random survey of parents of the immunization rates of the 13- to- 17-year-olds.

Utah's poor showing is what led the state's school nurses to join the campaign.

Drew says teens are vulnerable.

"We don't take them to routine health visits. We're missing out on protecting these children at a very vulnerable age. They're sharing straws, they're having sleepovers, they start kissing each other. … It puts them at great risk of meningitis."

Infants are most at risk for meningococcal disease, followed by teens.

The bacteria Neisseria meningitidis are spread through secretions like spit, but it isn't as contagious as the common cold or the flu, according to the CDC.

While the disease isn't common — about 1,000 cases occur a year in the United States — it is fatal up to 14 percent of the time and causes serious injury to 20 percent of patients, including brain damage, amputations and hearing loss, says the CDC.

While the symptoms are similar to common viral infections — such as sudden onset of fever, headache, stiff neck and vomiting — meningitis can turn deadly within hours. It can be treated with antibiotics if caught early.

Getting the word out • In Utah, there have been 17 cases of meningococcal disease in the past three years, according to the Utah Department of Health.

Four were meningitis cases; two people died.

Rebecca Ward, a health educator in the state epidemiology department, said Utah likely has a low vaccination rate because few people become sick with the disease.

Parents and providers "don't think about it until they hear disease rates going up," she said.

States that require the vaccination to enroll in school have the highest vaccination rates, but Ward doesn't expect that to happen in Utah.

Instead, groups like Community Nursing Services and the Salt Lake Valley Health Department are trying to raise awareness.

CNS holds vaccination clinics at schools that request them.

Mainly, it's to give the required Tdap shots, but the nurses also suggest the three other recommended vaccines.

Utah's vaccination against HPV is average: 53 percent of teen girls had received at least one in the three-dose series, according to the 2011 NIS. Data for boys aren't available.

"When the parents talk to them and say, 'Look, this is important to protect your health,' … most of them [the teens] are just great," said Mavis McAffee, director of CNS's immunization program.

As part of the national anti-meningitis campaign, Salt Lake County's Health Department has been asking every teen they see at their public health clinics if they have received the recommended vaccines, "just to make sure they're completely protected," said Audrey Stevenson, director of the department's Family Health Services.

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