The Medical Minute: Vaccinations are not just for kids

By John Messmer
Penn State Milton S. Hershey Medical Center
Penn State College of Medicine

Polio. Diphtheria. Measles. Mumps. German measles. Illnesses that once were a major source of worry for parents and doctors are little more than an afterthought today. Vaccination programs now have safeguarded roughly three generations of children from a host of illnesses, and they continue to keep kids safe from nearly a dozen diseases.

Currently children are vaccinated against 11 different afflictions before they start school: diphtheria, pertussis (whooping cough), tetanus (lockjaw), polio, rubeola (measles), rubella (German measles), mumps, varicella (chickenpox), hepatitis B and two causes of meningitis: H. flu and Pneumococcus.

But vaccinations are not just for children. It is important that adults keep their vaccinations up to date. Experience in other parts of the world shows that epidemics start when the population's immunity against certain diseases is allowed to wane. The best way to make sure these troublesome illnesses remain distant memories is to keep everyone inoculated properly. So, grown-ups, here are a few vaccinations to keep in mind.

Tetanus shots should be given every 10 years -- sooner if you have a cut contaminated with soil. Contrary to popular belief, rust does not cause tetanus. Rusty metal often is in contact with soil where tetanus bacteria live, thus the confusion. Most doctors give tetanus boosters combined with a diphtheria vaccine.

Diphtheria is characterized by a severe respiratory illness along with heart and nerve damage. It has not been a significant threat since the early 20th century, but there have been outbreaks in Russia caused primarily by decreased attention to public vaccination against the disease.

Any adult who might come into contact with blood or blood products -- health-care and laboratory workers, for instance -- should receive the three-shot series for hepatitis B. Currently all children are being immunized against hepatitis B to reduce the risk of liver cancer associated with hepatitis B. The vaccine is quite safe and since hepatitis B also can be transmitted through sexual contact, it is reasonable for any adult to get the hepatitis B vaccine.

Influenza vaccine is recommended for people older than 65 and for people with chronic medical problems. It also is good for anyone who wants to reduce the risk of contracting the flu. Those exposed to the public regularly -- teachers, child-care workers or health-care professionals, for example -- might benefit in particular.

Many different types of bacteria can cause pneumonia, but the strep bacterium can cause death in older people in just a few days. Risk of serious strep pneumonia increases after age 50 or in anyone chronically ill. Although it is offered for healthy people over 50, a pneumonia vaccine is strongly recommended for everyone over 65 and anyone with diabetes, heart or lung disease or weakened immune systems.

Meningitis can be caused by several bacteria and viruses. Close living arrangements, such as college dorms and military barracks, increase the risk of infection with meningococcus bacteria. College students living in a dorm should receive a meningitis vaccination to reduce the risk of meningitis. In fact, it is now a law in Pennsylvania for students to be vaccinated against meningitis.

Adults with weakened immune systems should have Haemophilus influenza (H. flu) type B immunization. This has been administered to children for many years, but adults may be susceptible to this cause of meningitis. (Note the "influenza" in the name has nothing to do with the flu.)

Studies are being done to test the benefit of boosting immunity to the bacterium that causes whooping cough. While adults develop whooping cough or pertussis infections with prolonged and distressing cough, it can be fatal in infants. Adults serve as carriers and immunization of adults would serve to reduce the risk to infants.

Debate on the need for smallpox vaccination continues as the risk of biologic warfare is considered. People born before 1972 and those who have served in the military received routine smallpox vaccinations. Immunity lasts at least 10 years, more if revaccinated. At this time, there is no reason for anyone to receive smallpox vaccinations since the risks of complications from the vaccine far outweigh the risk of the disease. While the disease has been pushed into the public consciousness since Sept. 11, 2001, there have been no reported cases of smallpox in the United States for generations.

Just about every adult has had chickenpox. Those who have not had it should consider getting immunized, since chickenpox in adults can be very serious. A blood test can determine if someone has had chickenpox.

If you plan to do international traveling, you may need vaccinations for hepatitis A, cholera, yellow fever or other diseases depending on your plans. Recommendations change frequently. Your physician will consult the Centers for Disease Control for current information.

Hepatitis A vaccine is recommended for certain groups. Details can be found at http://www.cdc.gov/nip/publications/VIS/vis-hep-a.rtf on the Web. Although the CDC has not officially recommended it, anyone exposed to human waste regularly should consider it.

Whether you travel or not, the easiest way to stay current in your immunizations is to see your doctor regularly and ask if your shots are current. Staying in tune with your vaccination record is the best way to keep you and the public safe from the microbial dinosaurs of the past.

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Last Updated March 19, 2009