Vaccination checklist: A shot in the arm

You were probably vaccinated years ago against a number of infectious diseases. Although most vaccinations are given in the first couple of decades of life, even adults need an occasional shot in the arm, for several reasons. Some of us were never vaccinated as children. Vaccines are available now that were not when today’s adults were young. As you age, immunity can fade, leaving you susceptible to serious disease caused by common infections. And you may find yourself traveling to areas where certain infectious diseases are much more common than they are where you live.

The US Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) has added several new vaccines to the list of those recommended for adults. Not everyone needs all of those vaccines. For example, the more recently approved vaccine against sexually transmitted strains of human papillomavirus (HPV) that cause cervical cancer is recommended only for girls and young women, age nine through 26 years old. That’s because it works best if given before a young woman becomes sexually active and is exposed to HPV. On the other hand, the zoster (shingles) vaccine is recommended for everyone over age 60 to prevent shingles and reduce its excruciating pain (post-herpetic neuralgia).

Vaccination protects not only you as an individual but also the entire community, through a phenomenon called herd immunity. When you become infected, your vaccine-primed immune system limits the time you remain contagious, which minimizes the risk that you’ll infect others. If everyone around you has been vaccinated, you’re less likely to get infected. And if enough members of a community have vaccine protection, everyone in that community  even the unvaccinated  is less likely to get sick.

The vaccination recommendations in today’s article are taken from the US Centers for Disease Control and Prevention (CDC), and they apply to healthy older adults. The outline follows the following sequence: name of the vaccine, who should get it and how often, and the benefit. I suggest you clip today’s column for future reference.

Influenza (FLU)

• Anyone who wants to reduce the risk of becoming ill with the flu or transmitting it to others. CDC recommends giving it to everyone, age 50 and older, once a year at the start of the flu season. The vaccine contains the strains of virus most likely to cause illness in that year. It should not be given to anyone who’s had an anaphylactic reaction to eggs or the vaccine itself, or anyone who contracted Guillain-Barre Syndrome within six months after a previous influenza vaccination.

• Protects against the flu, a respiratory illness that kills thousands of people annually from its complications. If you have a chronic condition like diabetes or asthma, it is especially important to be vaccinated. (This vaccine will not prevent H1N1 “swine” flu.)

Pneumococcal polysac charide vaccine (PPSV)

• Everyone age 65 or older, or if you have a chronic respiratory condition, like asthma, or you smoke. Anyone with a chronic illness, a weakened immune system, or a removed or damaged spleen, residents of nursing homes or homes for the aged, or anyone at high risk for pneumococcal disease. Should not be given to anyone who’s had an anaphylactic reaction to this vaccine. One or two doses of the vaccine per lifetime.

• Protects against pneumococcal bacteria, which can cause pneumonia, meningitis, or a bacterial infection in the bloodstream  all can be fatal.

Tetanus, Diphtheria, Pertussis (TD/TDAP)

• Adults, age 19-64, should receive a dose of Tdap as a substitute for the usual Td shot that is given every 10 years. Adults who were never vaccinated against these diseases need to be given three doses of the vaccine (the first two doses four weeks apart and the last, six to 12 months later). Should not be given to anyone who’s had an anaphylactic reaction to the vaccine.

• The Tdap is a booster vaccine that helps prevent tetanus (a bacterial disease that causes lockjaw, muscle spasms, and damage to the nervous system), diphtheria (a respiratory disease), and pertussis (whooping cough). The Td vaccine only protects against tetanus and diphtheria.

Herpes zoster (SHINGLES)

• A single dose for all adults, 60 and older. Should not be given to pregnant women, to anyone with a weakened immune system, or anyone who’s had an anaphylactic reaction to this vaccine.

• Protects against shingles, an itchy, painful rash caused by the varicella–zoster virus  the same virus that causes chickenpox. If you’ve had the chickenpox, you are at risk for getting shingles since the virus stays dormant in your nerve cells. The zoster vaccine decreases your chances of getting shingles by 50 percent.

Varicella (CHICKENPOX)

• Anyone, especially health workers, born before 1980, who haven’t had chickenpox or never been vaccinated against it. Two doses during your lifetime, four to eight weeks apart. Should not be given to pregnant women, to anyone with a weakened immune system, or to anyone who’s had an anaphylactic reaction to this vaccine.

• Protects against chickenpox.

Measles, Mumps, Rubella (MMR)

• For adults who have not had these childhood diseases; one to two doses per lifetime. People born before 1957 are considered to have immunity from measles, but getting vaccinated is still a good idea. Should not be given to pregnant women, to anyone with a weakened immune system, or to anyone who’s had an anaphylactic reaction to this vaccine.

Protects against measles, a virus that can cause fever, rash, and runny nose, and may lead to pneumonia or death; mumps, a virus that can lead to deafness, meningitis, or death; and rubella, also called German measles, which causes swollen lymph nodes, rash, and fever.

Hepatitis A

• Anyone who wants to be immune to hepatitis A infection; anyone with chronic liver disease, or a clotting factor disorder; people whose work or lifestyle exposes them to hepatitis A virus; certain international travelers and food handlers. Two doses per lifetime, six months apart. Should not be given to anyone who’s had an anaphylactic reaction to this vaccine.

• Protects against hepatitis A, an acute liver disease, contracted by ingesting contaminated food.

Hepatitis B

• Anyone wishing to become immune to hepatitis B infection; anyone with chronic liver disease, HIV infection, end-stage renal disease; people whose work or lifestyle exposes them to hepatitis B   especially adults with multiple sex partners, partners of infected people, and travelers to high-risk areas. Three doses, with four weeks between doses one and two, and eight weeks between doses two and three. Should not be given to anyone who’s had an anaphylactic reaction to this vaccine.

• Protects against hepatitis B, a liver disease caused by the hepatitis B virus, which is transmitted through body fluids. Hepatitis B can range from acute to long term and can cause liver cancer.

Meningococcal polysac charide vaccine

• International travelers to countries where meningitis is widespread; laboratory workers exposed to meningococcal bacteria; anyone with terminal complement component deficiency. One or more doses per lifetime. Should not be given to anyone who’s had an anaphylactic reaction or neurological reaction to the vaccine or any of its components, including diphtheria toxoid.

• Protect against infection from meningococcal bacteria, which can cause potentially fatal illness.