Thursday, June 9, 2016

Let's Talk Adult Vaccinations

There's a lot of talk about vaccinating children, but we don't hear a lot about vaccinations for adults. The conversation drops off the map, as if once a child has finished his or her scheduled vaccines, that's it, that's all. But that's not it, and that's not all.

The need for vaccines continues as we age, and then become even more important again when we enter the so-called senior years. And for those who want to travel to other parts of the world, some countries won't allow you to visit if you haven't had their required vaccines.

What types of routine vaccines should adults have? Health Canada and the Centers of Disease Control (CDC) have similar recommendations. To make things easier for me, I'll focus on Health Canada.

In general, Health Canada recommends that adults who have been vaccinated as children, should continue with the following schedule, unless recommended otherwise by their physicians:

  • Tetanus toxoid- reduced diphtheria toxoid (Td): 1 booster dose every 10 years.
  • Tetanus toxoid- reduced diphtheria toxoid- reduced acellular pertussis (Tdap): 1 dose 
  • Pneumococcal polysaccharide 23-valent:  1 dose at age 65 or older
  • Herpes zoster (shingles): may receive 1 dose at 50 to 59 years of age, recommended 1 dose
  • Influenza:  1 dose annually recommended for all adults without contraindications

There are also other vaccines, such as those for hepatitis A and B, which are recommended for people who are at risk of contracting the diseases.

Tetanus: Many people I speak with don't realize that they should get a tetanus booster every 10 years. I've heard many times, "Oh, I get a tetanus shot in the ER or at urgent care if I get a bad cut." But tetanus doesn't need a bad cut to take hold, so the booster route is a really safer route. I won't kid you, the tetanus shot does tend to be a bit more "uncomfortable" than many vaccines. But it is only once a decade. Perhaps you can bribe yourself with a nice treat after?

Pneumonia: The pneumococcal vaccine is primarily to help prevent pneumonia, although it does prevent other infections too. According to the National Foundation for Infectious Diseases,

It is estimated that about one million US adults get pneumococcal pneumonia each year. About 5-7% of them will die, and the death rate is even higher in those age 65 years and older. Fewer people will get pneumococcal meningitis or bloodstream infection, but the mortality rate for these infections is even higher.

So, while pneumococcal vaccine doesn't prevent all pneumonias, it does reduce the risk of this one, which can cause serious illness. It's particularly important for people who smoke, or who have respiratory diseases, such as COPD.

Shingles: I've had shingles; I was 44. One of my kids had shingles at only 21. I've known several people who had them before the age of 50. You don't want shingles. If you've ever had the chicken pox as a child, you are at risk of getting shingles. Remember, you don't want them. It's a horribly painful, uncomfortable virus that can knock you flat. There is also a complication called post-herpetic neuralgia, which can leave you with constant pain along the nerve line for years.

There is a treatment for shingles, but you have to recognize that you have the virus early enough for the treatment to work, and it really just knocks off a couple of days of suffering. It doesn't just get rid of the shingles. If you're on the fence about getting the vaccine, remember, you do not want to get shingles.

Influenza: The influenza vaccine seems to be the most controversial of the adult vaccination recommendations. Many people I know and love don't believe it in and refuse to get it. It's true that the vaccine isn't always effective. But I've seen what the flu can do, so the annual flu vaccine is a personal choice I make. Because I get so ill so fast with anything respiratory, I try to reduce my risk as much as possible.

Hepatitis A and B: I received this vaccine many years ago - it was required that nurses be vaccinated. I'm due for it again though, as it's supposedly worn off by now. The risk of getting hepatitis A is mostly for people who travel, but there is a combination vaccine that will protect you from both A and B at the same time. There is no vaccine for hepatitis C.

So, just because we're all grown up now doesn't mean we don't have to think about vaccinations.

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