Medical Edge Newspaper Column

Not Just for Kids: Vaccinations Important for Adults as Well

December 23, 2011
Dear Mayo Clinic:
What vaccines do you recommend for adults? I am 51 and get my flu vaccine each fall. Are there other vaccines that can keep me healthy?

Answer:
Getting a flu vaccination is an excellent first step. The Centers for Disease Control and Prevention and Mayo Clinic recommend that everyone 6 months and older receive the flu vaccination each year.

The flu vaccine protects you against influenza, a respiratory infection that can lead to serious lung problems, hospitalization and even death. Flu vaccines are the most effective way to prevent influenza and its complications. Getting an annual flu vaccination is important because new flu vaccines are released every year to keep up with rapidly changing flu viruses.

Every adult should also get a single Tdap vaccination. This vaccine protects against tetanus, diphtheria, and pertussis (whooping cough).

Pertussis causes severe spells of coughing that can interfere with breathing. In adults, it can cause a difficult-to-treat cough that can last months. In infants, pertussis can lead to pneumonia, long-lasting bronchitis, seizures and brain damage. Pertussis is more frequently diagnosed now than it was 10 years ago, in part because of better diagnostic tests, but infants can get the disease from adults who are no longer immune. Immunity from childhood vaccination wears off in 7 to 10 years, as does immunity that results from the actual disease.

Perhaps in the future, repeat doses of Tdap will be recommended. Right now we await studies that will help inform that recommendation. For now, every adult under 65 should get the Tdap vaccination once. Similarly, adults 65 years and older who are or plan to be in close contact with infants less than 12 months should get the Tdap vaccine. Otherwise, adults should get a Td every ten years to protect them against tetanus and diphtheria.

Tetanus, or lockjaw, is a bacterial disease that affects the nervous system and leads to painful muscle contractions, especially the jaw and neck muscles. Tetanus can interfere with your ability to breathe and can be life threatening.

Diphtheria is a bacterial infection that affects the mucous membranes of the nose and throat and causes a sheet of thick, gray material to form over the back of the throat. Before a vaccine against this disease was developed, many children died of diphtheria. Today, diphtheria is rare in the U.S., thanks to widespread vaccination.

At age 60, adults should also get a shingles (zoster) vaccine. This vaccine helps prevent a reactivation of the varicella-zoster virus, which causes chickenpox and can lead to shingles, a condition that involves a painful, band-like rash on the chest, back or face. In some cases, shingles may result in lingering nerve pain that can be severe and difficult to treat. It doesn't matter if you had chickenpox or if you have had shingles. Fifty percent of people living to age 85 will get shingles. You should get this vaccine when you turn 60.

At age 65, pneumococcal vaccine is recommended for all adults unless they have already received two doses of it in the past. The vaccine protects against pneumococcal infection, which can lead to serious health problems such as pneumonia, sepsis, and even death. The risk of invasive pneumococcal disease is four times greater in adults 65 years and older than adults at any other age.

It's a good idea to double-check all your childhood immunizations to make sure you've had the recommended vaccines. Some vaccines missed in childhood and adolescence are still necessary as adults. Most adults should have received two doses of the measles-mumps-rubella vaccine, as well as two doses of the chickenpox vaccine.

As one gets older, however, some vaccines routinely recommended for children are generally not recommended for adults. For example, polio vaccination is not recommended for most adults in the U.S., even if they missed the entire series as a child. This is because the risk of contracting polio in the United States is extremely low. On the other hand, travelers to certain parts of the world may need vaccination against polio.

Depending on your occupation, your medical history and if you travel internationally, additional vaccinations may be necessary. Have a conversation with your doctor to review your vaccine history and confirm that you've received all the vaccinations you need as an adult.

— Robert Jacobson, M.D., Employee and Community Health, Mayo Clinic, Rochester, Minn.