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Not for Kids Only
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What you need to know about adult vaccinations
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By Beth Howard
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MediZine's Healthy Living Summer 2009
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 Think vaccine and you might imagine tearful children at the pediatrician’s office. But adults also should be rolling up their sleeves from time to time.
The truth is that the protection of childhood vaccinations diminishes over time, although the need for them never ends. Unfortunately, about 50,000 adults in the U.S. die each year from vaccine-preventable diseases or their complications, according to the National Foundation for Infectious Diseases (NFID).
“Most people are familiar with the need for vaccinating children,” says Gina Mootrey, D.O., M.Ph., associate director for adult immunizations at the Centers for Disease Control and Prevention (CDC) in Atlanta. “They don’t realize there’s also a need for vaccinating adults.” Why the disconnect? Although schools require proof of immunization and pediatricians keep records of children’s vaccine histories, grown-ups don’t always have such prompts.
What’s more, “vaccines aren’t always covered by health insurance, so you have to make a financial outlay,” says William Schaffner, M.D., chair of preventive medicine at Vanderbilt University School of Medicine in Nashville and president-elect of the NFID. “Medicaid and Medicare programs don’t handle vaccinations adequately either.”
But keeping your vaccine protection up-to-date is important to prevent you and those around you from getting sick. Why? Although some vaccine-preventable diseases pose little threat, others require vigilance. Luckily, says Dr. Schaffner, “deaths and illness associated with many infections are largely avoidable with vaccines.” Here are a few of the key adult vaccines.
The influenza vaccine guards against the flu, a viral illness characterized by high temperature, sore throat, chills, cough and headache. It claims, on average, 36,000 lives every year. Health-care workers and adults age 50 and older are among those advised by the CDC to get an annual flu shot. Ideally, folks should get the vaccine as soon as it becomes available, usually in October or November. This should allow the vaccine to take effect before flu season begins. “However, because flu season often peaks as late as February or March,” says Dr. Mootrey, “we recommend that people continue receiving the vaccine as long as the influenza virus is circulating.”
Adults have long been advised to get a booster shot for tetanus every 10 years. But public health officials have become so alarmed by recent outbreaks of whooping cough (pertussis) that they now recommend one of those boosters be a newer vaccine, DTaP, which offers protection against three threats: tetanus, whooping cough and diphtheria.
Characterized by a hacking cough that can persist for weeks or months, whooping cough can lead to hospitalization. In babies who have yet to receive the vaccine, it can be downright deadly. “It’s important for everyone who has contact with an infant to create a cocoon of protection around it,” says Dr. Schaffner. Although both tetanus and diphtheria are rare, they occasionally do occur—with grim consequences. Diphtheria (seen in the U.S. only in travelers returning from undervaccinated destinations, such as Haiti and the former Soviet Union), which causes a thick coating in the nose and throat, can lead to breathing problems, heart failure or death. Tetanus triggers painful muscle spasms and lockjaw, a condition in which a person cannot open the mouth or swallow.
Caused by a bacterium, pneumococcal disease can trigger pneumonia, meningitis, middle ear and sinus infections and the blood infection bacteremia. The vaccine has existed for more than 25 years, but only about two-thirds of older Americans have received it.
Pneumococcal vaccine is recommended for adults age 65 or older. Last year, the CDC added two new groups of people who should get the shot: smokers and those with asthma.
Human papilloma virus (HPV) is responsible for the majority of cases of cervical cancer that occur each year. But a recently developed HPV vaccine is about 70 percent effective in preventing cervical cancer.
The vaccine won’t work in women already exposed to the strains of the virus linked to cervical cancer. That’s why it’s recommended for young females—all those under age 27.
Shingles is caused by the same virus responsible for chicken pox. After
chicken pox, the virus is dormant in the system and can reemerge years
later in people whose immune systems are weakened. “Risk also increases
with age,” says Dr. Mootrey.
Shingles can cause painful blisters on the trunk or face and leave
patients with nerve pain that lasts for years. “It can be profoundly
life-altering,” says Dr. Schaffner. “It disrupts patients’ sleep,
appetite and mood.” A vaccine for shingles, indicated for adults age 60
and over, was licensed in 2006.
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