Immunizations: Are You Protected?

From Flu To Tetanus, Why Adults Still Need Vaccinations

(WebMD)  While the injected vaccine is standard, Wasserman is impressed with the more recent inhaled flu vaccine. "It seems to work even better than the injected vaccine and causes fewer side effects," he says.

Hepatitis A. Hepatitis A is spread by contact with contaminated food or fluids and can cause serious liver disease. The CDC recommends vaccinations for adults who use injected street drugs, men who have sex with men, and people with liver disease and other illnesses.

Most cases of hepatitis A are mild but some result in severe illness, requiring an emergency liver transplant. "The hepatitis A vaccine protects against a rare but potentially devastating illness," says Wasserman.

Hepatitis B. Hepatitis B can lead to chronic liver disease and other problems. In the United States, 80,000 people get it each year and 4,000 to 5,000 die. Hepatitis B is spread by contact with bodily fluids, and is most commonly spread by sex or infected needles.

The CDC recommends the HBV vaccine for adults who have an increased risk of getting the disease because of their job or lifestyle.

Pneumococcal vaccine. The CDC recommends all people 65 and older get this vaccine, which protects against serious bacterial infection of the lungs, brain, and blood.

"I think that people who are middle-aged or older should get the pneumococcal vaccine," says Wasserman. "Pneumococcal pneumonia is a major cause of illness in older folks ... A lot of people who are said to die from flu actually die from the pneumococcal pneumonia that follows the flu."

Future Adult Vaccines

In addition to the vaccinations above, a few vaccines are likely to be available soon.

HPV (human papillomavirus). HPV is a very common virus which can be transmitted by physical and sexual contact. While it is not harmful in itself, certain strains can lead to cervical cancer, so a vaccine that prevents HPV has tremendous implications.

"It's amazing," says Wasserman. "What could be greater than a vaccine that actually prevents a form of cancer?"

The vaccine, Gardasil, is 100 percent effective against four common strains of HPV that cause about 70 percent of all cervical cancers. It's being reviewed by the FDA and a decision is expected soon. Another HPV vaccine, Cervarix, is in development.

Shingles. Shingles is a painful disease caused by the varicella virus, which also causes chickenpox. A new vaccine for shingles - Zostavax - is actually just a double dose of the chickenpox vaccine. As of May 2006 it has not yet been FDA-approved.

"The initial report on the shingles vaccine is very encouraging," says Wasserman. "Shingles is a terrible disease, especially for older people."

Many other vaccines are in much earlier stages of development, including:

Strep: Some preliminary research into a vaccine against Group A streptococcus shows promise. One study found that in a group of 28 healthy adults, the vaccine seemed safe and appeared to trigger an immune response.

Genital Herpes: Researchers are also working on vaccines against genital herpes. Two 2002 studies found that one vaccine radically reduced the rate of herpes infection in women who were not previously infected with the virus. However, in women who already had the common herpes virus that causes cold sores the vaccine had no effect. Strangely, the vaccine had no effect in men.

Taking Charge of Your Health

Given the importance of regular adult vaccinations it's crucial to keep track of your immunization history and stay current with your vaccinations.

Unfortunately, many people don't. They simply assume their doctor will tell them when they need a shot, but that's not necessarily the case. Most people change doctors many times in their lives and their current doctor may have no idea about their immunization history.

So from now on, make a note when you get a vaccination. If don't know which vaccinations you've had recently, talk to your doctor. To be on the safe side, it may be time for you to roll up that sleeve, stick out your arm, and wince.


Sources: Centers for Disease Control, National Immunization Program web site, "Polio vaccine: What you need to know," "Tetanus and diphtheria vaccine (Td)," "Pneumococcal polysaccharide vaccine: What you need to know," "Inactivated Influenza Vaccine: What you need to know," "Hepatitis B Vaccine: What you need to know," "Hepatitis A Vaccine: What you need to know." Centers for Disease Control web site, "Genital HPV Infection - CDC Fact Sheet." GlaxoSmithKline web site. Hildegund C. J. Ertl, MD, program leader, Immunology Program, the Wistar Institute, University of Pennsylvania. Kotloff, KL et al. JAMA, August 11, 2004; vol 292: pp 709-15. National Institute for Allergic and Infectious Diseases web site, "Understanding Vaccines: What They Are and How They Work." Ricardo U. Sorensen, MD, chair, department of pediatrics, Louisiana State University Health Sciences Center, New Orleans; member of the American College of Allergy, Asthma & Immunology Basic & Clinical Immunology Committee. Stanberry, LR et al, NEJM, November 21, 2002; vol 347: pp 1652-1661. Richard L. Wasserman, MD, PhD, clinical professor in the department of pediatrics at the University of Texas Southwestern Medical School; member of the Member of the American Academy of Allergy Asthma & Immunology. WebMD Medical News: "Cervical Cancer Vaccine Shows Promise." WebMD Medical News: "FDA Backs Shingles Vaccine."

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By R. Morgan Griffin
Reviewed by Louise Chang, MD
© 2006, WebMD Inc. All rights reserved.

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