It’s time for back-to-school shopping — and doctor visits. August is National Immunization Awareness Month for a good reason, as many schools require up-to-date immunizations before the first day of class.

Despite some concerns about safety, the 2015 outbreak of measles at Disneyland reinforced the importance of vaccinations. The disease was traced to a single non-immunized person and spread to 145 people in seven states and two foreign countries — giving new urgency to preventive health measures.

Any uninsured child can walk into a clinic and get shots free of charge.

The Centers for Disease Control and Prevention and the American Academy of Pediatrics recommend that healthy children get vaccinated against 14 diseases by age two. The government supports vaccines so strongly that any uninsured child can walk into a clinic and get shots free of charge.

School-aged children will likely be required to have immunizations for hepatitis B, rotavirus, DTaP (diphtheria, tetanus, pertussis), Hib (haemophilus influenzae), pneumonia, polio, MMR (measles, mumps, rubella), chicken pox, hepatitis A, and meningitis.

All teens and college students who have been previously up-to-date with their vaccinations should consider immunizations for influenza, DTaP (diphtheria, tetanus, and pertussis), human papillomavirus (HPV), and meningitis, according to Dr. Lisa Ashe, medical director of Be Well Medical Group in Alexandria, Virginia.

Related: Zika Vaccine Can’t Save Our Summer

The HPV vaccination is the least-used immunization, which can lead to serious — sometimes deadly — consequences. That’s why the Prevent Cancer Foundation recently launched an educational campaign, Think About the Link, about the connection between viruses and cancer.

The foundation also researched how the vaccine is perceived.

[lz_bulleted_list title=”The HPV Vaccine” source=”http://www.cdc.gov”]This common virus spreads via sexual contact|About 14 million people are infected each year|It causes numerous cancers|Protection must occur before exposure to virus[/lz_bulleted_list]

The results showed why parents refused the immunization. Fifty-four percent said they didn’t think their child was at risk, 50 percent didn’t think their child was sexually active, and 35 percent didn’t feel the child’s age made it appropriate.

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However, 53 percent of adults did not know HPV can lead to cancer and 57 percent are unaware the vaccine significantly reduces cancer risk.

“Unfortunately, the HPV vaccine is still not widely used in the U.S.,” Lisa Berry, of the Prevent Cancer Foundation in Alexandria, Virginia, told LifeZette. “Only 39.7 percent of adolescent girls and 21.6 percent of adolescent boys have received all three recommended doses of the vaccine. Vaccination rates in the U.S. are much lower than in other developed countries.”

There are three variants of the vaccination, but the 9-valent version protects against invasive cervical cancer and genital warts, as well as hepatitis B and C, which cause about 90 percent of liver cancers. HPV is a sexually transmitted virus.

Many parents resist the immunization by reasoning their child is not sexually active — but to protect a child, they may have to request the vaccine, said Dr. Ashe.

“The vaccine is offered at ages 11 and 12, so it’s hard to think of an 11- or 12-year-old having sex,” she said. “Yet it is important to get the child vaccinated prior to sexual relations. Prevention of HPV is also prevention of cervical cancer in women, genital warts in women and men, as well as cancer of the mouth and throat in women and men. The HPV vaccine is recommended in patients up to age 26 — so older teens and adults can get the vaccine, too.”

Only 7 percent of parents reported their health care provider recommended the vaccine for their child specifically to reduce cancer — another indicator that education might be lacking. Two of five pediatricians said they didn’t recommend the HPV vaccination because they identified the parents as being uncomfortable with the topic.

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For a community to be protected against a disease, 80 to 90 percent of the population should be vaccinated, says the CDC. For many reasons, including safety worries, some parents avoid vaccinating their children. Concerns about links between vaccinations and diseases such as autism have been refuted by research, according to the CDC.

Another deterrent is fear or dislike of needles, according to Dr. Amy Baxter, CEO of MMJ Labs LLC in Atlanta, Georgia.

“Prior to 1983, children only got one or two injections, and they got them before two years of age,” Dr. Baxter said. “The ability to create verbal memory, which is accessible when you’re older, forms around 28 months. Many people don’t remember routine vaccinations, but children today get 30 to 36 injections, and they’ve been spread out to age six.”

Related: Kids’ Vaccines Forced in California

Parents should avoid creating fear before the doctor visit, or overreacting themselves, said Baxter. For children who have needle phobias, Baxter’s company invented a pain-numbing product called the Buzzy, which numbs the injection area without drugs. It works with ice, vibration, and distraction. Although vaccinations are generally associated with children, adults should keep their immunizations current as well, notes Dr. Amesh A. Adalja, an assistant professor of critical care and emergency medicine at the University of Pittsburgh Medical Center.

“Adults need their booster immunization for DTaP [diphtheria, tetanus, pertussis] as well as the annual influenza vaccine,” he said. “Also, older adults should receive vaccinations against pneumococcus, as well as shingles.”

Pat Barone, MCC is a professional credentialed coach and author of the Own Every Bite! bodycentric re-education program for mindful and intuitive eating, who helps clients heal food addictions.