Four-year-old Layla wore her new Hello Kitty school shoes, waiting anxiously for what would come next: back-to-school shots.
Pediatricians' offices and clinics are fast becoming swamped with children getting their required immunizations.
"We actually scheduled ahead of time, but there was a three-week waiting period," said Layla's mom, Trisha Rountree.
To be allowed in class on the first day of school, students K-12 must be up to date on all required immunizations such as measles and whooping cough, also called pertussis.
"There's been a resurgence of pertussis," said Dr. Sheila Y. Owens-Collins, senior medical director of Community First Health Plans. "A few years back, there was a resurgence of measles, which caused us to reinstitute another immunization for measles. TB has sort of been on the rise. And, all these conditions were at one time almost totally eradicated."
Back-to-school shots aren't limited to grade school and middle school. This year, college students are required to show proof they've been vaccinated against bacterial meningitis.
Neighborhood drug stores are advertising on their billboards the availability for school vaccines.
This year, a change in state rules means children covered by private insurance that covers vaccines will no longer be eligible for the Texas Vaccines for Children Program available at city health clinics.
Metro health is offering vaccines at its locations around the city at low cost to those who are uninsured and eligible.
Parents are encouraged to check their child's records and with their health care provider soon to see what if any shots are needed before the start of school. As school gets closer, the lines for shots will get longer.
Parents may request an exemption for medical, religious or philosophical reasons.