Adult Immunizations: Protect Yourself and Others

Adult immunizations

By Dr. Christopher Ohl

Many of us think of immunization shots as a long ago childhood trauma, an ordeal we went through to get ready for kindergarten. At least then we got a lollipop or a sticker for our efforts.

But it turns out that some of these childhood immunities wear off. And today doctors recommend that older adults get a series of vaccines to protect them from once common childhood illnesses such as whooping cough and measles. We also recommend immunization against shingles, bacterial pneumonia and flu.

I’m an infectious disease specialist at Wake Forest Baptist Medical Center, which means that I study the ways in which vaccines protect individuals and as importantly the general public. We have safe and effective vaccines against so many serious illnesses. The trouble is that not enough of us get them.

Most school systems require children to be up-to-date on their immunizations as a requirement for starting kindergarten. That’s how we’ve done such a good job in this country wiping out polio, diphtheria and other contagious diseases. But we don’t require immunizations in adults, so think of your 50th birthday as the reminder for immunizations that have worn off since childhood or maybe weren’t available when you started kindergarten.

  • You may have heard about the 2010 outbreak of whooping cough in California. Whooping cough (also called pertussis) is a nasty disease for adults but it can be fatal in infants. In California more than 9,100 people got sick but even more tragically 10 infants died. Public health officials believe that those infants were infected by adults who caught the disease because their immunities had worn off. All adults who have not had a combined tetanus, diphtheria, and pertussis vaccine since childhood should get a booster vaccine. You should have the shot even if you are over the age of 65 and have contact with young children.
  • The vaccine against measles was developed in 1957. Adults born before 1957 are considered immune because they were probably exposed to the disease as children. But those of us born after 1957 and before 1989 may not be fully immunized because the vaccine then only came in one dose. Measles is mostly under control in the United States but there were outbreaks in Europe in 2011. People who are travelling overseas, even to Europe and those whose work puts them in close contact with others in places such as hospitals, clinics, nursing homes, and prisons are at increased risk. If you have such a risk and were born between 1957 and 1989 you should get a second measles vaccine. 
  • The vaccine against chicken pox has only been around since 1995, which means that most adults had the disease as children. But that doesn’t mean they’re immune to the Varicella Zoster virus, the chicken pox virus, which in adults comes back as shingles. In fact, the virus lies dormant in the nerve cells along the back and often strikes older adults when their immune system is weakened by stress or illness. Adults should consider a vaccine against Varicella at age 60.
  • These days, children get vaccinated against bacterial pneumonia but many adults were not vaccinated as children. Bacterial pneumonia can be fatal in older adults. Adults should be vaccinated at age 65, and even younger, if they smoke or have a chronic medical condition or disease.
  • The flu shot only works for a year at a time. That’s because the flu virus mutates almost every year; most years, pharmaceutical companies develop a new vaccine against the latest strain of flu. Adults – and children – should be vaccinated against the flu every fall. Your doctor offers a flu vaccine, but so do the local pharmacy, health departments and many employers.

In my role as a public health adviser, I think a lot about pandemics and the ways in which contagious diseases spread through populations. It turns out that the immune system is more complicated than we ever imagined. Vaccines work by exposing the patient to a small dose of a virus, bacteria or a protein that mimics the virus or bacteria that causes the disease. These foreign proteins trigger the body’s immune response to the illness and that patient becomes immune. But with many diseases, the immunity wears off over time, especially in cases where the disease has been nearly wiped out and few people are ever exposed to the live virus. That’s why we need a tetanus booster every ten years. And that’s why we need a whooping cough booster.

A lot of people worry about the dangers of vaccines. But I have not seen any credible evidence to persuade me that any of these vaccines have side effects more dangerous than a sore arm and rarely a short lived fever. If you are concerned about the side effects of vaccines or have questions on vaccines in general you should talk to your doctor.

I watched the recent outbreaks of whooping cough and measles with alarm because they show how vulnerable we remain to these potentially fatal diseases. It’s important for adults to protect themselves but it’s even more important for adults to be vaccinated to protect the most vulnerable among us. Remember that young infants may not have had their vaccines yet and can die from whooping cough or measles.

When our children are small and it’s time for their shots we comfort them with hugs and bribe them with a sweet treat. I don’t know of a bribe that works with 50-year olds. But think of these immunizations as favor to yourself and the rest of us. Thank you.

Learn more about infectious disease specialists at Wake Forest Baptist.

Dr. Christopher Ohl Dr. Christopher Ohl is an associate professor of infectious disease at Wake Forest Baptist Medical Center.

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Last Updated: 02-17-2014
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