Adult immunizations - an ounce of prevention...


Shots  –  they're not just for babies!Shots - they're not just for babies!

We hear a lot in the media about childhood immunizations and their safety. However, the fact is that we do a pretty decent job of keeping our kids' immunizations up-to-date, but a lousy job with our own shots as adults. The Morbidity & Mortality Weekly Report, released last week, says that adult vaccination rates are "unacceptably low." For example, only 12.5% of adults are current on the tetanus/pertussis booster, 15.8% for shingles, 20% for pneumonia among 19-65 year olds and 62.3% for pneumonia for those above age 65.

What shots are recommended for adults? The CDC's Advisory Committee for Immunization Practices (ACIP) just released their new adult immunization schedule in the February 1, 2013, issue of Morbidity & Mortality Weekly Report. Here are the key points:

·         Influenza vaccine – Hopefully you've had yours this year. (It's a bad year for the flu!) You need to get this one every year to be protected. It is usually released in the early fall and contains the predicted strains of the influenza virus for the coming season. Adults aged 18-49 can get the nasal spray (containing "live, attenuated" virus) as an alternative to the shot (containing inactivated virus), if they are healthy and are not pregnant. It's the shot, for the rest of us, either under the skin ("intradermal") or in the muscle ("intramuscular") for adults aged 18-64, and intramuscular (regular or high-dose) if 65 or older.

·         Tetanus, diphtheria, pertussis (Td/Tdap) – You need a Td booster every 10 years. However, your next one should actually be a Tdap, since we have seen outbreaks of pertussis recently. You should get the Tdap as soon as possible, regardless of when your last Td booster was. If you're pregnant, a Tdap is recommended in every pregnancy, between 27-36 weeks' gestation. This shot is so important, as you can get tetanus through a break in the skin, and it is an easily preventable but often fatal disease. Pertussis, or the "whooping cough," is rarely fatal in healthy adults, causing an annoying, persistent cough for weeks; but it can be more serious in vulnerable adults.

·         Varicella – Didn't catch chicken pox as a child? Better get the vaccine (2 shots, at least 4 weeks apart), because chicken pox can be really serious in an adult.

·         Zoster – If you did catch chicken pox as a child, you will forever be susceptible to getting zoster, or "shingles." Shingles is a painful rash caused by reactivation of the chicken pox virus in your system, and the pain ("post-herpetic neuralgia") can last for weeks or months after the rash is gone. The vaccine is expensive, and it is not always covered by insurance. Also, it is not a perfect vaccine: it only prevents shingles approximately 61% of the time, and the post-herpetic neuralgia 67% of the time. Nonetheless, it's all we've got, and anyone who has had shingles will probably tell you it's worth it to get the shot. So consider it if you are age 60 or older (even if you have had shingles before).

·         Pneumococcal – The pneumonia shot is recommended for everyone aged 65 or older. It doesn't prevent all types of pneumonia, but it is good at preventing one important bacterial cause of pneumonia. If you get the shot at 65 or older, you only need one shot for life. Prior to age 65, you would need a booster after 5 years and another at age 65. Folks younger than 65 should get this vaccine if they smoke or have chronic lung disease (like asthma or COPD), heart disease, diabetes, kidney or liver disease, other conditions affecting the immune system.

Other vaccines that you may need as an adult include the human papillomavirus, Hepatitis A, Hepatitis B, meningococcal and measles/mumps/rubella. There may be other vaccines that are required for international travel. For more information about vaccines, you can contact your primary care provider or the CDC website on vaccines and preventable diseases.

Because vaccines are an important part of staying healthy, many health insurance plans cover them under "wellness." Call your primary care provider to get updated on your vaccines today! 

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