Fall is here, and that means Southern Nevadans soon will be making their yearly treks to the doctor’s office or neighborhood clinic for their seasonal flu shots.
But while you’re rolling up your sleeve, make room on your arm for a few other shots you may not have thought of in years.
Shots for whooping cough. Tetanus. Pneumonia. Hepatitis. Even vaccines of relatively recent vintage, such as that for HPV, or human papillomavirus.
Most adults probably think of immunizations as something for kids. But medical experts say adults, too, should hew to a regular schedule of immunizations and booster shots throughout their lives to offer insurance against several still-potentially severe diseases.
The U.S. Centers for Disease Control and Prevention each year updates its schedule of recommended adult immunizations (www.cdc.gov/vaccines/schedules/hcp/imz/adult.html). Dr. Joseph Iser, chief health officer for the Southern Nevada Health District, says adults should understand, first, that if you didn’t get your childhood vaccinations, there are adult versions that you should get, “assuming that the adult hasn’t had the disease in question since then.”
Surprisingly, not every child receives the full course of routine childhood immunizations. Some children don’t receive them for religious or cultural reasons, for example, and children who are home-schooled may not receive the shots that children entering school are required to have.
Then, Iser says, there are “newcomers to this country who may not have gotten (immunizations) as well.”
But even adults who received their full course of immunizations as kids will need a few more shots, including booster shots for the ones they received as kids, throughout their lives. For example, an adult who received the tetanus-diphtheria-pertussis (whooping cough) shot as a kid should receive at least one dose of the adult version of the shot as an adult, as well as a tetanus-diphtheria booster every 10 years, the CDC says.
That adults even have a vaccination schedule “could be news to people,” Iser says. But it’s probably already routine for people who are being treated on an ongoing basis for such conditions as lung or heart disease, diabetes, kidney disease or conditions that compromise the immune system.
“We make sure that on a regular basis we keep an eye on them,” says Dr. Matthew Carlson, an associate professor at Touro University Nevada College of Osteopathic Medicine. “If we see them, it’s actually pretty easy to say, ‘Hey, we’re coming up on this and you haven’t had it.’ ”
“Then, another group that gets pretty tight surveillance is pregnant women, because we want to make sure they’re getting their flu shots and then, also, the (vaccine against) whooping cough,” Carlson says.
Here are a half-dozen immunizations adults should discuss with their doctors or health care providers. Note, however, that these general recommendations can vary with such circumstances as the specific vaccines that are administered, medical conditions a patient has or has had, patients’ sexual history and lifestyle practices, and — in the case of additional vaccines travelers should receive — a patient’s travel itinerary.
Hepatitis A and Hepatitis B
Protects against: Hepatitis, a liver disease
Recommended for: Ages 19 and older
How often: Two or three doses for hepatitis A, three doses for hepatitis B
Hepatitis A usually is a food-borne illness caused by fecal-oral transmission, Carlson says, and those with it “can get significantly sick.”
It’s also preventable, Carlson says, and it’s wise for travelers to be immunized against it “regardless of where they’re going.”
Hepatitis B is transmitted through body fluids and blood. While health care workers routinely receive immunization against it, 0thers might benefit, too, and should discuss it with their doctors.
Human papillomavirus (HPV)
Protects against: Human papillomavirus, a sexually transmitted disease that has been linked with cancers in men and women.
Recommended for: Women and men up to age 26
How often: Three doses
The CDC calls HPV the “most common sexually transmitted infection in the United States,” which can cause cervical cancer in women, penile cancer in men and anal and throat cancers in both.
The HPV vaccine ideally is given to preteens, even before they become sexually active. It also can be given in young adulthood.
Protects against: Seasonal flu
Recommended for: Ages 19 and older
How often: One dose every year
Flu shots probably are the most common immunizations. While a bout of the flu is a minor thing for most people, it can be dangerous to older people or those with medical conditions.
Protects against: Pneumococcal disease, including pneumonia
Recommended for: Ages 19 to 64 who have certain risk factors, everybody age 65 and older
How often: One to three doses
Carlson says the vaccine comes in two varieties, and while “either one is good,” recent studies indicate that “a combination of the two … should be better coverage.”“
“People still die each year of pneumonia,” Carlson says, noting it’s preventable.”
Tdap and Td
Protects against: Tetanus, diphtheria and pertussis (whooping cough)
Recommended for: Ages 19 and older (women should receive a Tdap during every pregnancy)
How often: One dose of Tdap (which includes the adult whooping cough booster shot) in adulthood, followed by a Td (tetanus and diphtheria) booster every 10 years.
Carlson notes that whooping cough can reveal itself in otherwise healthy adults as “a little bit of a cough” or even with no symptoms. “If little kids get exposed — and adults can be carriers for that — (it) can cause some severe health problems for children,” he says.
Because whooping cough is considered highly contagious, getting an adult Tdap helps adults to protect the children — grandchildren, for instance — in their lives.
Tdap and Td vaccinations also protect against tetanus, a bacteria found just about anywhere in the environment, including in soil and dust, that can enter the body via punctures, cuts, lacerations or other wounds. It causes painful muscle tightening, locking of the jaw (tetanus often is referred to as “lockjaw”), breathing difficulties and can cause death.
While relatively uncommon, tetanus is “an incredibly preventable kind of thing,” Carlson says. “It can be very severe at any age, and it still kills people.”
Protects against: Shingles
Recommended for: Ages 60 and older
How often: One dose
Shingles, a painful condition related to the virus that causes chickenpox, typically appears in the form of a painful rash on the skin. Carlson says the zoster vaccine is “a pretty benign vaccine” that’s worthwhile for just about everyone 60 and older, whether or not they’ve had shingles.
“Again, I think it’s one of those things that are really preventable,” Carlson says. “Some people get the shingles vaccine and still end up getting it, but what we have found is the same as with the flu: You may get it, but usually its course is shorter and it’s not as bad.”