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Adults Need Vaccines Too

Gregor Halenda

As a parent, you've probably read up on the vaccines that your child needs, keeping a careful record to make sure that your child is up-to-date on all of his shots. But when was the last time you considered your own immunization status? Every year, 40,000 to 50,000 people in this country die from diseases that might have been prevented by vaccines. Still, millions of American adults go without routine and recommended vaccinations. A recent report from The Trust For America's Health, a health advocacy organization, reveals some surprising stats:

  • Only about one-third of adults are vaccinated against the seasonal flu
  • Only about 10 percent of eligible adult women have had the human papillomavirus (HPV) vaccine
  • Only 2 percent of adults have had recommended tetanus/diphtheria/whooping cough vaccine

So why aren't more adults properly vaccinated? Many think vaccines are a kid thing and assume the shots they got way back when will protect them for life. But some adults may not have completed the recommended schedule of vaccines as children; others may not have had access to some of the newer vaccines when they were growing up. Even for adults who got every shot they needed before they were 18, immunity can fade over time.

"Ideally, your doctor should review your vaccine status with you at every check-up, but sometimes vaccines aren't at the forefront of those visits," says Lance Rodewald, M.D., director of the immunization services division at the Centers for Disease Control and Prevention in Atlanta. "If your doctor doesn't bring it up, ask if you need any vaccines at this visit. If you're contemplating becoming pregnant, ask if there are any vaccines you should get before you conceive."

Not sure which shots you got as a kid, and which ones you didn't? You'll need to dig up or track down your old medical records. If you can't, blood tests can check for immunity from some diseases, or you can talk to your doctor about being re-vaccinated, which won't harm you.

Here, what you need to know about adult vaccines recommended by the CDC:

Flu (Influenza) Vaccine

When recommended: One dose every year for all adults in the fall or early winter

What you should know: The recommendations on who should get the flu vaccine have evolved over the last ten years. The list initially just including people age 65 and older and those who work in health care and/or have special health risks; now the shot is recommended for everyone ages six months and older. Why the change? "Time and research has shown us that everyone can benefit from this vaccine," says Dr. Rodewald. "The risk of influenza is very real for everybody. Influenza is a contagious disease and if you're vaccinated, you're much less likely to participate in a chain of transmission that continues to spread the infection. Over the years this vaccine has been shown to be very safe."

Possible side effects: Soreness, redness, or swelling at the injection site; Less common: hoarseness; sore, red or itchy eyes; cough; fever; aches that may begin soon after the shot and last 1-2 days.

HPV (Human papilloma virus) Vaccine

When recommended: For girls at age 11 or 12 in three doses, 2-3 months apart, and women up to age 26 who are not yet vaccinated (it has not been studied in women older than 26)

What you should know: HPV is extremely common in sexually active people, so many adults assume that the HPV vaccine is only effective if you haven't done the deed yet. However, there are over 120 strains of HPV, and even if you've contracted one strain, the vaccine might protect you against another. There are two types of vaccines, Gardasil and Cervarix, that protect against strains of HPV that cause cervical cancer and are recommended for females up to age 26. Cervarix protects against two strains of human papilloma virus (HPV) known to cause cervical cancer; however, it won't protect against genital warts. Gardisil is a quadrivalent vaccine; it protects against four strains of HPV -- the two covered by Cervarix, plus two others that are known to cause genital warts.

Possible side effects: Redness and pain at injection site, mild fever, headaches, muscle/joint pain, nausea/vomiting.

MMR (Measles, Mumps, Rubella) Vaccine

When recommended: If you have a record of receiving a live measles vaccine in the 1960s or later, you do not need to be revaccinated. If you were vaccinated prior to 1968 with a vaccine other than the live vaccine, you should be revaccinated. Generally, anyone 18 years of age or older who was born after 1956 should get at least one dose of MMR vaccine unless they can show that they have had either the vaccines or the diseases. Women should wait at least four weeks after the vaccine before trying to conceive.

What you should know: If you were born in 1956 or earlier, you do not need the MMR vaccine because you were most likely exposed to the diseases themselves in your youth. If you have had one or two of the conditions that the MMR vaccine prevents, but not all three, you should still get the MMR vaccine if you didn't as a child. The reason? Single vaccines for the individual diseases are no longer available. If you are already immune to one or two of the conditions, and you receive the MMR vaccine, your immune system will simply kill off the vaccine virus against the disease you've already had. But, if you were susceptible to measles, mumps, or rubella, the vaccine will replicate and trigger that immune system to protect you from those diseases in the future.

Possible side effects: Pain at the injection site, fever and, less commonly, a rash one to two weeks after receiving the vaccine.

Varicella (Chicken pox) Vaccine

When recommended: Anyone 13 years of age or older who has never had the chicken pox or the varicella vaccine (introduced in 1995) should get two doses at least 28 days apart of the varicella vaccine.

What you should know: Many people regard chicken pox as a harmless childhood illness, but adults are more at risk for a severe case and complications than children are. The varicella vaccine can raise the risk of getting shingles, a painful skin rash, slightly, but not as much as getting the chicken pox themselves. "No one should avoid getting the varicella vaccine for fear they will get shingles later," says Dr. Rodewald.

Possible side effects: Soreness at injection site, fever, mild rash

Herpes Zoster (Shingles) Vaccine

When recommended: A single dose of the shingles vaccine is recommended for people ages 60 and over.

What you should know: The shingles vaccine is a much stronger version of the varicella vaccine. That's because both shingles and chicken pox are caused by the varicella virus. If you contract chicken pox, once your blisters clear up, the virus stays dormant in your body. In some people, the virus becomes reactivated later - usually many years later - in the nerve cells, causing the sometimes severe pain of shingles. The varicella vaccine can raise the risk of getting shingles slightly, but not as much as getting the chicken pox themselves. "No one should avoid getting the varicella vaccine for fear they will get shingles later," says Dr. Rodewald.

Possible side effects: redness, soreness, itching at injection site and headache

Tdap (tetanus, diphtheria, acellular pertussis) vaccine and Td (tetanus) vaccine

When recommended: One Tdap shot two years or more after last Td shot followed by a Td shot every ten years. New moms who have never had a Tdap shot (introduced in 2005) should get a dose as soon as possible after delivery.

What you should know: This vaccine protects against three bacterial infections: tetanus (lockjaw), diphtheria and pertussis (whooping cough) which causes severe coughing spells that can lead to weight loss, incontinence, vomiting, and fractured ribs. Dr. Rodewald notes that pertussis is still pretty common in and adults and teens can spread the disease to many who are too young to vaccinate. Diphtheria, which can lead to breathing problems, paralysis, heart failure and death, and pertussis are spread from person to person through coughing and sneezing. Tetanus which causes painful muscle spasms all over the body and extreme tightening of the jaw muscles, killing about 20 percent of infected people enters the body through cuts, scratches, or wounds, and can lead to tightening of the jaw muscles that affect normal opening of the mouth or swallowing. For years, doctors told adults simply that they needed to get a tetanus booster shot every ten years, while only children were vaccinated against diphtheria and pertussis. Outbreaks of pertussis (whooping cough) among adolescents and adults alerted scientists that the protection provided by the childhood pertussis vaccine wanes with time, making this older age group vulnerable. Today, the recommendation is for adolescents and adults - especially parents and caregivers to babies -- to have one Tdap shot, followed by a tetanus booster alone every ten years. That recommendation may change with time to make all of the boosters Tdap. Studies are ongoing.

Possible side effects: From either vaccine: Pain, redness or swelling; mild fever; headache. From Tdap: Fatigue; nausea, vomiting, diarrhea, stomach ache; chills, body aches, sore joints, rash, swollen glands (uncommon)

4 Other Vaccines to Know About

Other vaccines are recommended for certain people who may be at increased risk of severe illness should they contract one of the diseases. These vaccines include pneumococcal vaccine, Hepatitis A and B vaccines, and meninogococcal vaccine. In addition, international travel may require you to get vaccinated against other illnesses. Check with your doctor to be sure that you don't fall into any of the "at-risk" groups for whom additional vaccines are recommended.

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