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A Guide to Adult Vaccinations

August is National Immunization Awareness Month

We’ve all heard about how important it is to get a flu vaccine each year, but did you know there are a number of other vaccines you should also receive in adulthood to keep you as healthy as possible? Dr. Jon Pomeroy, an internal medicine physician with Shore Physicians Group’s Margate office, offers this helpful guide to what vaccines you should get, why, and when to get them.

Recommended Adult Immunization Schedule
Vaccination recommendations for adults were developed by the Centers for Disease Control and Prevention, Advisory Committee on Immunization Practices, American Academy of Family Physicians, the American College of Physicians, the American College of Obstetricians and Gynecologists, and the American College of Nurse-Midwives.  The information provided here are brief statements on current vaccinations.  It is important to note there are certain contraindications and possible side effects to consider with these formulations.  Complete information regarding each vaccine can be found at http://www.cdc.gov/vaccines/default.htm.  Also, speak to your primary care provider about further information regarding your particular healthcare needs.  To download a quick, easy-to-read printable guide to vaccines from the Centers for Disease Control, click here.

Influenza vaccination
The “flu” is caused by influenza viruses.  It can spread by coughing, sneezing, and close contact with sick people.  The virus can cause fever, chills, sore throat, headache, cough, and can cause pneumonia.  Annual influenza vaccination is recommended for all people aged 6 months or older.  There are multiple forms including the live and inactive vaccine.  Non-pregnant persons from age 2 to 49 years without risky medical issues can choose either intra-nasal live vaccination or inactivated influenza vaccine.  Adults older than 65 can receive the standard-dose or the high-dose formulation of the inactivated influenza vaccine.

Tetanus, diphtheria, and acellular pertussis (Td/Tdap) vaccination
Diphtheria, tetanus, and pertussis are bacterial diseases.  Diphtheria and pertussis are spread person to person. Tetanus can enter the body via infected wounds.  Diphtheria causes a thick infectious coating in the throat and can lead to breathing difficulty, heart disease, paralysis, and death.  Tetanus can cause painful muscle tightening and can cause a condition called “lockjaw.”  Pertussis can cause severe coughing (whooping cough) and can lead to complications such as pneumonia, seizures, and death.   Tdap should be given to persons 11 years or older who have not received Tdap vaccine or vaccine status is not known.  This should be followed by tetanus and diphtheria toxoids (Td) booster every 10 years.  A dose of Tdap should also be given to pregnant women during each pregnancy regardless of last Td or Tdap vaccination.

Varicella (Chickenpox) vaccination
Varicella (Chickenpox) is a common viral infection in children.  However, the virus can also affect adults and can cause serious illness including skin infection, pneumonia, and death.  All adults without evidence of varicella immunity should receive two doses of varicella vaccine.

Human papillomavirus (HPV) vaccination
HPV is a viral infection that causes genital warts and is usually sexually transmitted.  The virus can lead to cervical, vaginal, and vulvar cancer in females and anal cancer in both males and females.  For females, either bivalent HPV vaccine (HPV2) or quadrivalent HPV vaccine (HPV4) is recommended at age 11 or 12 years and for those aged 13 through 26 years.  For males, HPV4 is recommended at age 11 or 12 years and for those aged 13 through 21 years. Males aged 22 through 26 years can also be considered for vaccination.

Zoster (Shingles) vaccination
Zoster (Shingles) is a viral infection that can cause a painful, blistering rash.  It can also cause complications including pneumonia, hearing problems, blindness, brain inflammation, and death.  Zoster vaccine is recommended for adults aged 60 years or older regardless of whether they have a history of shingles.

Measles, mumps, rubella (MMR) vaccination
Measles is a virus that can cause rash, cough, fever, pneumonia, seizures, and death.  Mumps is a virus that can cause headache, fever, muscle aches, swollen glands, meningitis, swelling of the ovaries and testicles.  Rubella or German measles is a virus that can cause a rash, arthritis, fever, and can lead to miscarriage in pregnant women.  Adults born before 1957 are considered immune to measles and mumps.    Adults born after 1957 without evidence of immunity require one or more doses of MMR vaccine.

Pneumococcal vaccination
Pneumococcal disease is a bacterium that can cause pneumonia, meningitis, and bacteremia (blood infections).  23-valent pneumococcal polysaccharide vaccine (PPSV23) is recommended for all adults 65 years and older.  This vaccine is also recommended in people aged 2 through 64 years of age with certain health problems or a weakened immune system.  Adults 19 to 64 years who smoke or have asthma should be considered for vaccination.  13-valent pneumococcal conjugate vaccine (PCV13) vaccine may also be recommended for some older adults.

Meningococcal vaccine
Meningococcal disease is a bacterium that can cause meningitis and bacteremia.  Meningococcal conjugate vaccine (MCV4) is the preferred vaccine for people 55 and younger.  Meningococcal polysaccharide vaccine (MPSV4) is for people older than 55.  MCV4 is recommended for people 11 to 18 years of age.  People at increased risk for disease include college freshmen living in dormitories, lab personnel, military, travelers to locations where meningococcal disease is common (i.e. Africa), people without spleens, people with immune system disorders, and people exposed to meningitis outbreak.

Hepatitis A
Hepatitis A is a viral liver disease spread by close contact with food or drinking water containing the virus. The hepatitis A vaccine should be considered in men who have sex with men, people who use street drugs, people with chronic liver disease, people who are treated with clotting factor therapy, people who work with hepatitis A in a lab, people in households planning to adopt a child from a country where hepatitis A is common,  and travelers to locations where hepatitis is common.

Hepatitis B
Hepatitis B is a viral infection that affects the liver.  It can also lead to chronic liver disease, liver cancer, and death.  All adults at risk for hepatitis B infection should be vaccinated.  People at risk for hepatitis include sex partners of individuals with hepatitis B or have multiple sex partners, men who have sex with men, people who inject drugs, people with chronic liver and/or kidney disease, people younger than 60 years of age with diabetes, people with jobs that expose them to blood or body fluids, contacts of infected people, dialysis patients, travelers to countries where hepatitis B is common, people with HIV.  Vaccination can also be considered in adults older than 60 with diabetes.  Any individual can also request vaccination.

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