I have wonderful memories of being a kindergarten student -- a caring teacher, new friends and, of course, recess.

Another strong memory of kindergarten is lying in my bed in a dark room for a long time (three weeks, I found out later) with the measles. I remember my eyes hurt, I had a fever, and the rash was pretty scary too. I recall the worried looks of my parents. Fortunately, because of effective immunizations, today many of us haven't seen the ravages of polio or suffered a bad case of the measles. It's easy to become complacent about vaccinations.

Before measles immunizations were available, nearly all children got measles by the time they were 15. According to the Centers for Disease Control, prior to the 1963 introduction of a measles vaccine, approximately 3 million to 4 million people contracted measles annually in the United States; roughly 48,000 were hospitalized and between 400 to 500 people died. But what a difference a vaccination makes. From 2000-2007, CDC reported an average of 62 measles cases per year in the U.S.

The CDC estimates that if vaccinations were stopped, each year about 2.7 million measles deaths worldwide could be expected. In the U.S., widespread use of measles vaccine has led to a greater than 99 percent reduction in measles compared with the pre-vaccine era. If we stopped immunizations, measles would increase to pre-1963 levels.

Measles is still one of the most infectious diseases in the world -- there are an estimated 20 million cases worldwide each year. Today, even after the elimination of ongoing measles transmission in the United States, imported measles has continued to create a substantial public health concern. In the first four months of this year, 64 confirmed measles outbreaks were reported in the U.S. This is the most by this date for any year since 2001. Only one of the 64 patients had been vaccinated and 54 of these cases had links to other countries. An outbreak in San Diego originated with an unvaccinated boy who contracted the virus while traveling in Europe -- where the bug was thriving among intentionally unimmunized people in Switzerland.

August is National Immunization Awareness Month. The city-county health department encourages parents enrolling their children in school and students entering college to catch up on their vaccinations. Public health officials and the CDC estimate that fully vaccinating all U.S. children born in a given year from birth to adolescence saves 33,000 lives, prevents 14 million infections and saves $10 billion in medical costs. Vaccinations not only protect the kids who receive the shots, but also protect those who haven't been vaccinated or those who can't receive them -- such as cancer patients with suppressed immune systems.

Immunizations are one of the most important ways we can protect our children against serious diseases. Because of the success of vaccines in preventing disease in the United States, parents are often unaware that their children are at risk for so many serious and life threatening diseases. The 2008 measles outbreaks illustrate the risk created by diseases imported into unvaccinated populations and those who come in contact with them.

What you need to know: Montana law requires children to be fully vaccinated (or in the process of being fully vaccinated) prior to entering school or daycare. The health department recommends the following:

- Kindergarteners (ages 5-6) need booster doses of DTaP (diphtheria, tetanus, and pertussis), IPV (polio), and MMR (measles, mumps, and rubella). A booster dose of VZV (varicella/chicken pox) is a great idea too!

- Youth (ages 12-13) entering seventh grade need a booster dose of tetanus containing vaccine called Tdap.

- Adolescents (ages 11-18) should have vaccines to protect them against meningitis and human papillomavirus (HPV). They may also need vaccines against hepatitis A, hepatitis B and varicella if they missed those in early childhood.

Make sure your children are up-to-date with their immunizations. Talk to your health care provider for more information.

School immunizations are available at the health department's walk-in immunization clinic every Monday, Wednesday and Friday from 11 AM to 4 PM at 1930 Ninth Avenue. Payment is determined on a sliding fee scale based on family size and income. Our public health nurses will send necessary records to the school, if requested. Questions? Call the School Shot Hotline at 457-8904 or CDC-INFO Center at 800-232-4636 or visit www.lewis-clark.mt.us/health or www.cdc.gov/vaccines.

Melanie Reynolds is the Health Officer at the Lewis and Clark City-County Health Department. The Health Department's mission is to improve and protect the health of all Lewis & Clark County residents.