Vaccinations: Not Just Kids' Stuff
Disease and Vaccinations
Polio, diphtheria, measles, mumps, German measles... Illnesses that were once a major source of worry for parents and doctors are little more than an afterthought today. Vaccination programs now safeguard roughly three generations of Americans from nearly a dozen diseases. Currently children are vaccinated against 11 different afflictions before they start school: diphtheria, pertussis (whooping cough), tetanus (lockjaw), polio, rubeola (measles), rubella (German measles), mumps, varicella (chickenpox), hepatitis B and two causes of meningitis: H. flu and pneumococcus.
But vaccinations aren't just kids' stuff. It's important that adults keep their vaccinations up to date. Experience in other parts of the world shows that epidemics start when the population's immunity against certain diseases is allowed to wane. Each year in the United States, approximately 50,000 people die from vaccine-preventable diseases. The best way to make sure these troublesome illnesses remain distant memories is to keep everyone inoculated properly. So, grown-ups, here are a few vaccinations to keep in mind.
Tetanus booster doses should be given every 10 years -- sooner if someone has a cut contaminated with soil. Contrary to popular belief, rust does not cause tetanus. Rusty metal may have been in contact with soil where tetanus bacteria live, thus the confusion. Most doctors give tetanus boosters combined with a diphtheria vaccine. Diphtheria is characterized by a severe respiratory illness along with heart and nerve damage. It has not been a significant threat since the early 20th century, but there have been outbreaks in Russia, caused primarily by decreased attention to public vaccination against the disease.
Any adult who might come into contact with blood or blood products -- health-care and laboratory workers, for instance -- should receive the three-shot series for hepatitis B. Currently all children are being immunized against hepatitis B to reduce the risk of hepatitis B-associated liver cancer should they contract the disease in the future. The vaccine is quite safe and since hepatitis B also can be transmitted through sexual contact, it's reasonable for any adult to get the hepatitis B vaccine.
Influenza vaccine is recommended for people older than 65 and for people with chronic medical problems. It's also good for anyone who wants to reduce his or her risk of contracting the flu. Those exposed to the public regularly -- teachers, child-care workers or health-care professionals, for example -- might benefit in particular.
Pneumonia can be caused by many different types of bacteria, but the strep bacterium can cause death in older people in just a few days. Risk of serious strep pneumonia increases after age 50 or in anyone chronically ill. Although it is offered for healthy people older than 50, a pneumonia vaccine is strongly recommended for everyone older than 65 and anyone with diabetes, heart or lung disease or weakened immune systems.
Meningitis can be caused by several bacteria and viruses. Close living arrangements, such as college dorms and military barracks, increase the risk of contagion with meningococcus bacteria. College students living in a dorm should receive a meningitis vaccination to reduce the risk of meningitis. A new meningitis vaccine, Menactra, has been approved for people as young as 11 up to age 55. Meningitis is a required vaccine for children in Pennsylvania but could be considered for adults, too.
Adults with weakened immune systems should have Haemophilus influenza (H. flu) type B immunization. This has been administered to children for many years, but adults may be susceptible to this cause of meningitis. (Note the "influenza" in the name has nothing to do with the flu.)
Pertussis or whooping cough is thought of as a disease of infants. It causes a "whoop" with the cough as they try to catch their breath. It turns out that the organism that causes whooping cough causes disease in adults, too. They are not as sick as infants, but the cough can last a long time, and the disease is spread around the community by the constant coughing. Since immunity wanes about five to 10 years after infant immunization for whooping cough, there may soon be a booster shot that combines tetanus, diphtheria and pertussis for adolescents and adults.
Debate on the need for smallpox vaccination continues as the risk of biologic warfare is considered. People born before 1972 and those who have served in the military until the late 1980s received routine smallpox vaccinations. Immunity lasts at least 10 years, more if revaccinated. At this time, there is no reason for anyone to receive smallpox vaccination since the risks of complications from the vaccine far outweigh the risk of the disease. While the disease has been pushed into the public consciousness since 9/11, there have been no reported cases of smallpox in the United States for generations.
Just about every adult has had chickenpox. Those who have not had it should consider getting immunized since chickenpox in adults can be very serious. A blood test can determine if someone has already had chickenpox. For adults susceptible to chickenpox, two doses of the vaccine will reduce the risk of the disease. Shingles is caused by the chickenpox virus years after having had chickenpox. There may soon be a vaccine specifically to reduce the risk of shingles for people older than 50.
For those planning to do international traveling, vaccinations for hepatitis A, cholera, yellow fever or other diseases depending on itinerary may be suggested or required. Recommendations change frequently. Although the Centers for Disease Control has not officially recommended it, anyone exposed to human waste regularly should consider it. Since hepatitis A can be spread by food handlers or contaminated fresh produce as it was in the recent Chi-Chi's restaurant cases, any adult may consider elective immunization to hepatitis A. Usually hepatitis A is a mild disease, but it can occasionally be severe and could keep a person out of work for months.
Whether traveling or not, the easiest way to keep current immunizations is to have a primary care doctor to manage them. Consider keeping a personal immunization card. Keeping an up to date vaccination record is the best way to reduce the risk of many preventable illnesses and perhaps eradicate some of them once and for all.