Adult vaccinations are your best shot at staying afloat in a sea of dangerous germs

[Guest guest]

I can't help but wonder if reporter Warren King has been excessively

wined and dined by the CDC's wel-funded section for promoting

vaccinations. IMO, the ever increasing abundance of vaccinations is

directly linked with ever increasing profits of pharmaceutical companies

and their stockholders, via adverse sequelae induced by the vaccinations

- eg, increase rate of shingles subsequent to varicella vaccination.

* * * *

September 28, 2005 - Page updated at 12:00 AM

Adult vaccinations are your best shot at staying afloat in a sea of

dangerous germs

By Warren King

Seattle Times medical reporter

http://seattletimes.nwsource.com/html/health/2002524716_healthadultshots28.html

Many adults believe they don't need to worry about vaccinations for

themselves. They're just for kids, they say.

That attitude worries the federal Centers for Disease Control and

Prevention (CDC), particularly with flu season just around the corner.

The CDC says some adults never got the shots or illnesses they think

they had as kids. Their memories may be faulty, some vaccines weren't

available back then and immunity to some diseases fades.

Then there's influenza, a perennial worry, particularly for those who

have more than a few score years behind them.

Every year in the U.S., about 36,000 people die from flu. They suffer

first through the chills, fever and aches and, finally, the

oxygen-depriving pneumonia that can follow.

About 90 percent of those who die from flu are elderly, and research

indicates at least half of those deaths might be avoidable with an

annual flu shot.

This winter's flu shots will become available next month.

Less than 70 percent of adults most at risk for flu and pneumococcal

pneumonia receive protective shots, says the CDC. When asked in a

Medicare survey, seniors' most frequent answer for why they didn't get a

flu shot was that they didn't know it was needed or had (unfounded)

concerns the vaccine could cause the disease*.*

*Information*

*Centers for Disease Control and Prevention:*

www.cdc.gov/nip/recs/adult-schedule.htm

<http://www.cdc.gov/nip/recs/adult-schedule.htm>

*Advisory Committee on Immunization Practices:*

www.cdc.gov/nip/ACIP/default.htm <http://www.cdc.gov/nip/ACIP/default.htm>

*Public Health -- Seattle & King County:*

www.metrokc.gov/health/immunization/

index.htm <http://www.metrokc.gov/health/immunization/index.htm> or

*Snohomish Health District:* The CDC site above. Or call

*Travelers:* Adults who plan to go abroad should check beforehand with

their physician or public-health department about shots they might need.

Aside from the flu vaccine, adults also often forgo vaccinations against

tetanus, diphtheria, chickenpox, hepatitis B and measles-mumps-rubella.

Compared with children, most adults at risk for disease complications

" are nowhere near up to date " with their immunizations, says Dr. Kathy

Neuzil, a vaccines expert with both the UW and PATH, a Seattle nonprofit

that promotes health care in developing countries.

Some adults " just don't think they need vaccinations. The message is not

getting across to them, " says Neuzil, who helps advise the CDC on

immunizations.

" Vaccines are effective, they're cheap and they're (mostly) one-time

interventions, " says Dr. Ed Marcuse, associate medical director of

Children's Hospital & Regional Medical Center and a member of the

committee that advises the CDC on immunizations.

The CDC recommends adults stay up to date on a number of vaccinations,

listed below. The flu gets special attention because the vaccine changes

each year. (This routine vaccination would not cover influenza that

scientists fear might spread to humans worldwide from chickens and other

birds in Asia.)

*Influenza*

*Vaccine recommended for:*

.. People age 50 or older

.. Nursing-home residents

.. Women who are pregnant

.. People with chronic illness, such as asthma, kidney disease or

immune-system problems

.. Anyone in close contact with those at risk for complications,

including young children

*When and/or how often:* Yearly, preferably in autumn. The flu season

can last from October to May.

*Availability:* A maximum of 97 million doses is expected in the U.S.

from four manufacturers this flu season, says the CDC.

*Effectiveness:* In healthy adults, the inactivated vaccine -- the shot

-- is 70-90 percent effective to age 60 and about 58 percent effective

or less in older adults, according to the CDC. The nasal-spray vaccine

has similar effectiveness.

A new analysis of studies by Italian scientists indicates the

inactivated vaccine was not significantly effective in preventing flu in

those 65 and older. But it did decrease their risk of dying from the

disease or its complications by about 47 percent, and it cut the risk of

hospitalization by about 25 percent. For nursing-home patients that age,

the vaccine also did not prevent the flu, but decreased the risk of

dying by about 60 percent and the risk of hospitalization by about 45

percent.

*Who gets priority:* The CDC recommends that people 65 and older and the

other risk groups (except ages 50-64) get priority for the vaccine from

Oct. 1, when it will become generally available, until Oct. 24. After

that, anyone is eligible.

Priorities were established to guard against a vaccine shortage like the

one that occurred last year. No one has predicted a problem this year,

but the CDC said this month that " uncertainties in doses and

distribution " still exist.

The priorities are only for the injected vaccine, which uses the

inactivated flu virus. A vaccine that uses a live, weakened virus is

available in a nasal spray but is recommended only for healthy,

non-pregnant people ages 5-49.

*Planning ahead:* Public-health departments in King and Snohomish

counties will begin scheduling immunization appointments for prioritized

patients in early October. The shot eventually will be available though

private physicians, some employers and some retail stores.

*Pneumococcal disease*

*Vaccine recommended for:*

.. People age 65 and older

.. Adults at high risk for complications, including those with

alcoholism, heart or lung disease, kidney failure, diabetes, HIV or

certain types of cancer

*When and/or how often:* At age 65, except for people with certain

diseases and conditions

*About the disease:* Caused by bacteria, pneumococcal disease is best

known as a form of pneumonia spread by respiratory secretions. But it

also can cause meningitis or a blood infection that can lead to organ

failure. The disease is fatal in about 5 percent of those with

pneumonia, 20 percent of those with blood infection and 30 percent of

those with meningitis.

*Tetanus, diphtheria, whooping cough*

*Vaccine recommended for:* All adults

*When and/or how* *often:* Every 10 years, because immunity fades

*About the diseases:*

*. Tetanus* is caused by bacteria found in soil and animal feces.

Commonly transmitted through puncture wounds, the infection results in

painful muscle tightening, usually all over the body. About 10 percent

of patients die.

.. *Diphtheria,* also bacterial, is spread through contact with an

infected person. It causes a thickening in the back of the throat and

can cause respiratory problems, paralysis, heart failure and death.

Both diseases are rare in the U.S.

.. *Pertussis:* In children and teens, tetanus and diphtheria vaccines

are given in combination with whooping cough (pertussis) vaccine. The

CDC's Advisory Committee on Immunization Practices (ACIP) is considering

recommending the combination for all adults every 10 years, according to

Marcuse, a committee member, because immunity to pertussis also fades.

It can be fatal to unimmunized infants, who can catch it from adults,

and the disease can cause months or weeks of painful coughing in adults.

*Chickenpox*

*Vaccine recommended for:* Adults who have not had the disease. Neuzil,

with PATH, said the ACIP recently recommended primary-care physicians

specifically ask adult patients whether they had chickenpox or give them

a blood test to find out.

*When and/or how often:* If adults haven't had the disease, or if a test

shows they don't have immunity, the ACIP recommends two doses of the

vaccine, four to eight weeks apart.

*About the disease:* Chickenpox, also called varicella, causes fever,

aching, sore throat and an itchy rash. It is so contagious, one can

contract it by being in the same room with an infected person. All the

effects of the disease are worse in adults than in children. The worst

complications include severe skin infection, pneumonia, brain damage or

death.

A relatively new vaccine is preventing many children from contracting

the disease, but the illness still is quite common.

After a person has chickenpox, the virus that caused it lies dormant in

nerve roots. It can reactivate years later as shingles, a painful rash

that typically emerges in a belt across the body, and is most prevalent

in older adults. Sometimes the rash can lead to postherpetic neuralgia,

in which the skin remains painful and sensitive to touch for months or

years.

*Hepatitis B*

*Vaccine recommended for:*

.. Adults who have more than one sex partner in six months

.. Men who have sex with other men

.. Sex contacts of infected people

.. People who inject illegal drugs

.. Household contacts of those infected

.. Health-care and public-safety workers who might be exposed to blood or

body fluids

*When and/or how often:* Anytime, followed by a second shot one to two

months later, then a third shot four to six months after the first.

*About the disease:* Spread by blood or bodily fluids of an infected

person, the virus causes diarrhea; vomiting; jaundice; loss of appetite;

fatigue; and pain in the muscles, joints and stomach. Over time, it can

cause damage to the liver, liver cancer and death.

*Measles-mumps-rubella*

*Vaccine recommended for:* Everyone born after 1956, unless they know

for certain they've had the diseases or were vaccinated for them

*When and/or how often:* Anytime, one dose

*About the disease:* All of the diseases are more severe in adults and

can have very serious complications. People born before 1956 likely had

the diseases and are immune, the CDC says.

/Warren King: or wking@...

/

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