Think you’ve outgrown your need for vaccinations? Think again. You’re never too old to get immunized. Protecting yourself against disease is a lifelong job. “Vaccines are required from the cradle to death,” says Dr. Martin Luta, chief of the Bureau of Communicable Disease and Communicable Disease Prevention with the Delaware Division of Public Health.
Every year, 40,000 to 50,000 Americans die of diseases that could have been prevented with proper immunization, according to the Trust for America’s Health, a Washington, D.C.-based nonprofit dedicated to making disease prevention a national priority. Still, millions of Americans fail to keep current with the recommended vaccinations.
A recent report from the Centers for Disease Control and Prevention reveals some startling stats. In 2012, only 64.2 percent of adults were current on their tetanus shots, and only 20 percent of adults at high risk for pneumonia had received the pneumococcal vaccine. In addition, a mere 14.2 percent of adults had received the Tdap vaccination, which protects against tetanus, diphtheria and pertussis, commonly known as whooping cough.
Why aren’t more adults properly vaccinated? One reason: They make fewer doctor visits. “They only go when they’re sick, and [the subject] of immunizations may not come up because they’re sick,” says Luta. Another reason: Many adults believe the vaccines they received as kids provide lifetime immunity. Many do, but some don’t. Tetanus and diphtheria vaccines, for example, require booster shots every 10 years. Outbreaks of pertussis among adolescents and adults alerted scientists that the protection provided by the childhood vaccine weakens with time.
Still others avoid vaccines because they feel they are unsafe. This is especially true when a disease has faded from view. “Vaccines really have become a victim of their own success,” says Dr. Marci Drees, infection prevention officer and hospital epidemiologist for Christiana Care Health System. “We don’t see these terrible diseases anymore, so people think the risk of the vaccine must be worse than the risk of the disease.” Some adults have gaps in their immunizations either because they were never vaccinated as children or because certain vaccines were not available when they were kids. But vaccines are just as important for adults as they are for kids. As we age, we become more susceptible to serious complications from common infections like influenza.
Vaccines do more than just protect the individual. They protect the community as well by preventing the spread of disease to its most vulnerable members. This is a principle known as herd immunity or community immunity. The disappointing effectiveness of this year’s flu vaccine shows what can happen when people routinely fail to get immunized, says Luta. Here are the vaccines the CDC recommends for adults:
Influenza
The guidelines over who should get the flu vaccine changed during the past 10 years. Now, a yearly flu shot is recommended for everyone age six months and older. Getting more people immunized decreases the possibility of a chain of transmission that continues to spread the infection, says Luta. There are two options: the shot or nasal spray. The nasal spray can be taken by healthy adults—excluding pregnant women—up to age 49. High-dose flu shots provide better protection for those with weakened immune systems and are recommended for anyone age 65 and older.
MMR (Measles, Mumps, Rubella) Vaccine
Measles outbreaks, like the recent one in California, provide valuable information to epidemiologists about immunization rates in the community. We actually look at measles as the canary in the coal mine because it is such an infectious disease. It is a very good indicator of the level of coverage in society, says Luta. Individuals born before 1957 are considered immune and do not need to be re-vaccinated. The CDC does recommend that those born after 1957 who have not previously been vaccinated—or were vaccinated with a killed version of the vaccine or a vaccine of unknown type—receive at least one dose of the MMR vaccination unless they have had the disease or can prove immunity through a blood test. Additionally, adults in high-risk settings, including post-high school education institutions, health-care personnel, those who live in or near an outbreak location or traveling abroad, should receive two doses of the vaccine at least 28 days apart. Studies show that one dose of the MMR vaccine is 93 percent effective against measles, and the second dose increases the level of protection to 97 percent, says Drees.
Pneumococcal Vaccine
The pneumococcal vaccine prevents serious infections caused by Streptococcus pneumoniae bacteria, including pneumonia, meningitis, sinus infections and septicemia. There are two types of this vaccine. The pneumococcal polysaccharide vaccine (PPSV23) is recommended for adults age 19 to 64 years who smoke, have heart or lung disease, asplenia or weakened immune systems. This group should receive one or two doses of the vaccine given five years apart. The pneumococcal conjugate vaccine (PCV13) is recommended for adults 19 and older with asplenia, sickle cell disease, cochlear implants, cerebrospinal fluid leads or weakened immune systems. It is now recommended that adults age 65 and older receive both vaccinations: the PCV13 followed by the PPSV23 eight weeks later. If an adult has already received the PPSV23 vaccination, the individual should receive the PCV13 shot at least one year later.
Chicken Pox (Varicella) Vaccine
The chicken pox vaccine was added to the recommended childhood immunization schedule in 1996 but is also recommended for adults with no proven immunity against the disease. Anyone born before 1980 is considered immune. Individuals born after 1980 should receive the vaccine unless they can prove that they’ve had chicken pox or have received two doses of the vaccine at least one month apart. Health-care personnel and pregnant women are not considered immune for the purpose of determining whether they should receive the vaccine. Additionally, pregnant women should receive their first dose after the completion of their pregnancy.
Shingles (zoster) Vaccine
If you’ve had chicken pox, or been vaccinated for it, you’re at risk for developing shingles, according to the American Academy of Dermatology. That’s because the virus stays in the body, usually in the roots of nerves that cause sensation. Although the shingles rash is less contagious and less itchy than the chicken pox rash, it can cause more pain. Some people can experience the pain months—even years—after the rash clears, says Drees. The CDC recommends that all adults aged 60 and older receive the vaccine even if they’ve had a previous shingles infection.
Tdap (Tetanus, Diphtheria, Acellular Pertussis) Vaccine and Td (Tetanus and Diphtheria) Vaccine
This combination vaccine became available in 2005. All adults should receive a one-time dose of the Tdap vaccine and a Td booster every 10 years. The Tdap vaccine should be given to pregnant women every time they are pregnant, with the optimal time being during the third trimester.
