Not Just for Kids — Important adult vaccines

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From Harvard Health Review

Not Just for Kids — Important adult vaccines

When you think of serious threats to your health, heart disease, cancer, or maybe even serious injuries might come to mind. But you probably don’t think about infectious diseases. Often underestimated, infectious diseases can be overlooked, but are a leading killer in the United States and worldwide.

You’ve probably been vaccinated against a number of infectious illnesses. In the United States, vaccination is required for entry to schools, many camps, colleges, and some occupations. But even as an adult, it is important to review your vaccination status. There are a number of reasons adults need vaccination:

You may not have received any or all vaccines as a child. Newer vaccines may not have been available when you were a child. Immunity can wane over time. As you age, you become more susceptible to serious disease caused by common infections. You may travel to areas where rare infectious diseases are much more common. You may come in contact with people who have been exposed to unusual infectious diseases.

The FDA is understandably cautious and demanding before it will license a new vaccine. Most recently it has licensed several new vaccines: human papillomavirus (HPV), varicella-zoster virus, and meningococcus (a second meningococcal vaccine). The FDA has also approved a preliminary bird flu vaccine in case of a bird flu pandemic.

Do you need the HPV vaccine? The HPV vaccine was licensed in June 2006 and is recommended for females beginning at age 11 or 12 through age 26, although it can be administered to girls as young as nine. This vaccine protects against the four most common HPV strains, which are responsible for 70% of cervical cancers and 90% of genital warts. Ideally, girls should receive the vaccine before they become sexually active. Studies that included 11,000 girls and women, ages nine to 26, showed that the vaccine was safe and had no serious side effects. However, no vaccine is 100% protective. Because the vaccine doesn’t protect against all viruses that can lead to cervical cancer, women should continue to have regular Pap smears. Although males are also carriers of HPV, currently there are no recommendations to vaccinate boys or men.

Do you need the varicella-zoster vaccine? The FDA licensed the varicella-zoster virus vaccine for shingles in 2006. (Shingles is caused by the chickenpox virus, which remains in the body after an initial bout of chickenpox and may emerge many years later to cause the painful condition known as shingles.) The Centers for Disease Control and Prevention (CDC) recommends the varicella-zoster virus vaccine for people over age 60 to prevent shingles and to reduce shingles-associated pain.(Not recommended for HIV+)

Do you need the hepatitis A vaccine? Children are routinely vaccinated for hepatitis A but many adults have not been vaccinated because the vaccine is relatively new. The Advisory Committee on Immunization Practices (ACIP) recommends it for all people and especially for those with chronic liver disease, people who receive clotting factor concentrates, individuals traveling to countries where hepatitis A is common, men who have sex with men, or people in occupations that might expose them to the virus.

Do you need the meningococcus vaccine? A further addition to the existing vaccine arsenal is the meningococcal conjugate vaccine (MCV4), which was licensed in 2005 to combat bacterial meningitis. This vaccine is recommended for adolescents and some adults, including students entering college and people traveling to areas where they are likely to be exposed.

What about bird flu? The bird flu vaccines will not be available to the public except in case of a pandemic. Although the number of human deaths attributable to bird influenza strains has been low thus far, there remains the very real fear of a pandemic should the viral strains mutate sufficiently to pass easily from person to person.

What about smallpox? Smallpox vaccine is routinely given to health workers, military personnel, and other persons in professions where the unlikely threat of bioterrorism employing the smallpox virus may put them on the front line of exposure. If you think you fall in this category, check with your clinician about vaccination.

Other vaccines you may need. Even if you have received all your childhood vaccinations, ask your doctor whether you need any booster shots, for example:

The tetanus shot should be repeated every 10 years. Get a flu shot each year. If you have never had chickenpox and have never been vaccinated, now is the time. Check whether you need a booster for measles, mumps, and rubella. If you travel, make sure to check for needed immunizations. Adults over age 65 need the vaccine for bacterial pneumonia Those age 60 and up need the zoster vaccine against shingles.

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