“Some vaccinations, such as the tetanus booster, are given to adults to boost the immunity response of childhood vaccines, while some vaccines are given for diseases seen in adults only like the shingles vaccine,” says Ashish Parikh, MD, FACP, Associate Program Director of the Internal Medicine Faculty Program at Saint Barnabas Medical Center. “Unfortunately, not all adults receive the vaccinations they need.”
There are many reasons why some adults do not get all the recommended vaccinations, including the unintentional failure of health care providers to offer appropriate vaccines, lack of public awareness and pervasive fear of adverse events following vaccination. Cost is also an important issue, since different insurers cover adult vaccines differently.
Currently, Pertussis, or “whooping cough”, which is highly contagious and spread by coughing and sneezing, is epidemic in California. More than 2,774 cases have been confirmed in 2010 putting the state on track for the worst outbreak in 50 years. Among other factors, the Center for Disease Control attributes the rise in Pertussis to the fact that immunity wears off, especially in adults.
Dr. Parikh advises that vaccinations should be an integral part of health care in the adult population. “Receiving appropriate immunizations plays a crucial role in preserving and promoting public health, especially in older populations,”
1. Tetanus, diphtheria and acellular pertussis (Td/Tdap)
Tetanus is a wound infection that also causes muscle paralysis; Diphtheria is a bacterial infection of the upper airway that can lead to damage of the brain and heart; Pertussis, or “whooping cough”, resembles symptoms of bronchitis. A Td (tetanus, diphtheria) booster vaccine is recommended for all adults, every 10 years, for life. Since Pertussis has become increasingly common in adults, one of the adult Td boosters given between the ages of 19-64 years should be replaced by a Tdap (tetanus, diphtheria, pertussis) injection.
2. Herpes zoster vaccination
Herpes zoster, or “shingles”
3. Seasonal influenza vaccine
Commonly known as flu, influenza is a highly contagious viral infection that occurs in outbreaks, usually in the winter season. Serious complications can develop in people with influenza, including fatal pneumonia. Vaccination is recommended for all persons over 50 years of age and any younger persons who would like to decrease their risk for influenza. Also persons with certain medical condition, such as diabetes, asthma, kidney disease, pregnancy or chronic lung, heart, kidney, or liver problems should get vaccinated regardless of their age. The flu shot should be taken yearly in the fall or early winter.
4. Pneumococcal polysaccharide (PPSV) vaccine
Pneumonia is a serious lung infection that can be fatal, especially in elderly people and those with weakened immune systems. Pneumococcal vaccine (or pneumonia vaccine) reduces the risk of developing pneumonia due to the germ call streptococcus pneumonia. It does not prevent all individuals from getting sick, but it does decrease severity of symptoms if one does catch pneumonia due to this germ. A one-time vaccination is recommended routinely for everyone over 65 years of age. It should be given earlier to those with chronic medical conditions such as heart, lung, kidney, liver or immune system problems. In these people a one-time revaccination is advised at age 65 (if they were vaccinated >5 years previously).
5. Human papillomavirus (HPV)
Human papillomavirus causes more than 99 percent of cases of cervical cancer in women and genital warts in both men and women. Ideally, vaccine should be administered before potential exposure to HPV through sexual activity; however, females who are sexually active should still be vaccinated starting at age 11 through 26 years. Recently, HPV vaccine has been approved for males aged 9 through 26 years to reduce their likelihood of acquiring genital warts.
According to Dr. Parikh, the vaccinations listed are basic guidelines for immunization and exceptions exist for each one. There are additional vaccinations that certain individuals may require depending on their pre-existing conditions, including Hepatitis B, Meningococcal vaccination and others. He adds that most vaccines are safe and cause few if any serious side effects. Dr. Parikh encourages individuals to speak to their physician regarding which vaccines may be appropriate.
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The Internal Medicine Faculty Practice (IMFP) at Saint Barnabas is a teaching practice affiliated with Saint Barnabas Medical Center, a leading community teaching hospital. Through association with the Medical Center, IMFP patients have access to all the advanced technology, resources and research activities available at Saint Barnabas. The practice offers comprehensive medical care with an emphasis on prevention and health maintenance for both healthy persons and those with multiple, complex medical problems in a newly renovated, spacious office space. It is an NCQA recognized Level 3 Patient Centered Medical Home. Being an academic teaching practice, each patient is thoroughly evaluated by both a resident and an attending physician and therapeutic decisions are made utilizing evidence-based medicine. To learn more, please call 973-322-6256 or visit saintbarnabas.com and select Saint Barnabas Medical Center from the facilities list.