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Adult Immunizations: Are You Up to Date?

Although children receive the majority of the vaccinations, adults also need to stay up to date on a range of vaccinations, from the flu to tetanus to varicella. Here's why: Adults who have never received childhood vaccinations can have serious complications from these diseases. And for adults who did receive all the recommended vaccines as children, immunity against some diseases can gradually fade away over the years, meaning that booster shots are needed. Vaccines contain dead or weakened germs that trigger the immune system to respond and build immunity. Ask your doctor which of the following shots you may need.

Pneumococcal ('pneumonia') vaccine

This vaccine protects against serious infections caused by a specific bacteria called Streptococcus pneumoniae. These infections are often referred to as pneumococcal disease. This bacterial infection can cause:

  • Pneumonia. Pneumonia is a serious infection of the lungs that frequently leads to death in older adults.

  • Septicemia. This is an overwhelming bacterial infection in the bloodstream. It can be fatal.

  • Meningitis. This is a bacterial infection of the covering of the brain and spinal cord. It is a serious illness that can be fatal. 

According to the CDC, about one in 20 people who get pneumococcal pneumonia dies from it. Three in 10 people who get meningitis also die. Anyone can get pneumococcal disease, but the people at greatest risk are those who are 65 and older, very young people, and people with special health problems. 

You should get the pneumonia vaccine if you are 65 or older. If you are younger than 65, you should get this shot if you have a chronic illnesses, such as diabetes, heart or lung diseases, sickle cell disease, alcoholism, or cirrhosis. Other people who should get this shot are people with a weakened immune system, such as those with kidney failure, a damaged spleen or no spleen, HIV/AIDS, or certain types of cancer. Alaskan Natives and certain American Indians are also at higher risk. Adults who smoke cigarettes also should be vaccinated. The vaccine usually is given once. People who are 65 and older who received their first pneumonia shot before they were 65 and people with certain medical conditions need a second shot if it has been at least five years since the first dose. Others who will need a second immunization include people whose spleen has been removed and those with sickle cell disease, HIV/AIDS, some cancers, kidney failure, or organ or bone marrow transplants.

Influenza

This shot protects against the seasonal influenza, or flu, virus. The flu virus causes chills, headache, sore throat, dry cough, runny nose, and body aches. Most of the people who die from the flu are adults older than 65, the CDC says. The best time to get your annual shot is as soon as the vaccine becomes available in your community. Healthy adults younger than 50 who aren't pregnant can get the flu vaccine as a nasal spray, which contains live, weakened flu viruses that do not cause the flu.

Who should receive it? Nearly everyone older than 6 months, unless there is a specific reason not to get it, such as an allergy to the ingredients in the shot. Healthy adults up to age 49 may receive either a nasal spray version, which contains weakened, live virus, or the shot. Adults 50 and older, including pregnant women, should receive the injected form of the vaccine. A newer, somewhat stronger version of the flu shot is also available for older adults who may not respond to flu shots as vigorously as younger people.

You should avoid getting a flu shot if you developed Guillain-Barré syndrome within six weeks of getting a previous flu shot, or if you have a severe allergy to eggs. If you are currently ill, wait until your symptoms improve before getting a vaccination.

Measles, mumps, and rubella (MMR)

This shot protects against measles, mumps, and rubella. Rubella is also called German measles.

You should get this shot if you are a woman of childbearing age and your immunity to MMR is low. This can be determined by a blood test. If your immunity is not up to par and you're considering pregnancy, you'll need a shot three months before conception. Women should avoid getting pregnant for at least four weeks after getting the MMR vaccine. Pregnant women should wait to get this shot until after they have given birth.

If you are at least 18 and born after 1956, and you don't know whether you have had the vaccine or the diseases, you should get at least one dose of the MMR vaccine.

You should avoid getting this shot if you are ill at the time the immunization is scheduled, or if you have had an allergic reaction to gelatin, neomycin, or a previous dose of MMR. The vaccine also should not be given to people with certain medical conditions. Check with your doctor if you have questions about this vaccine.

Hepatitis A

This vaccine protects against hepatitis A, a liver infection.

You should have this shot if you live, work, or travel to countries where hepatitis A is prevalent. Also get this shot if you are military personnel, a food-service worker, or a day-care center employee. These people should also get this vaccine: men who have sex with men, intravenous drug users, those with chronic liver disease, and those with clotting-factor disorders such as hemophilia. You should also get this vaccine if you work or live in an institution or group home. This vaccination is now given to all children. Because of this, fewer adults will need hepatitis A vaccine in the future.

Hepatitis B

This series of shots protects against a potentially deadly liver disease that can lead to liver cancer.

This vaccine is routinely given to newborns. All unvaccinated teens 18 and younger should get the full series of vaccinations. People who are at least 19 years old and who have not had the vaccinations should have the series if they travel to countries where the hepatitis B virus (HBV) is common. You should also get this series if you have a job in which you may be exposed to blood or blood products. An example would be a laboratory or hospital worker. Other people who should have this vaccine are intravenous drug users, men who have sex with men, those who have had more than one sexual partner in the past six months, and those who have a sexually transmitted disease. You should have this vaccination if you live in a household with someone who has HBV. Clients and staff of these institutions should also have the immunization: facilities for the developmentally disabled; kidney dialysis; sexually transmitted disease treatment; HIV testing and treatment; drug-abuse treatment and prevention; injection-drug user treatment; end-stage renal disease programs; and correctional programs.

Human papillomavirus (HPV)

HPV is a common sexually transmitted disease that can cause genital warts called condylomas, which can occur on the inside or outside areas of the genitals and may spread to the surrounding skin or to a sexual partner. Because HPV infection does not always cause warts, the infection may go undetected. Women with some types of HPV infections have an increased risk of developing cervical cancer. Regular Pap tests can detect HPV infection, as well as abnormal cervical cells. But the HPV vaccine can help prevent cervical cancer. The vaccine is best given at age 11 or 12, but women who did not complete the childhood series can receive the vaccine up to age 26. The vaccine is also given to boys and young men ages 9 through 26 to reduce their chances of getting genital warts and possibly other cancers related to HPV.

Tetanus, diphtheria, and pertussis booster

Most children receive a series of tetanus, diphtheria, and pertussis shots. The last in the primary series is typically given by age 6. Teens and adults should then have one tetanus-diphtheria-pertussis booster (Tdap) and then a tetanus-diphtheria (Td) booster every 10 years afterward.

Varicella-zoster

This shot protects against chickenpox, a contagious viral infection that can be fatal in adults.

The CDC recommends a single dose of the vaccine for children 12 months to 12 years old. Teens 13 years and older and adults not immunized should have two doses, usually given four to eight weeks apart. A person born in the U.S. before 1966 is likely to have had chickenpox as a child—and already have immunity.

The CDC also recommends that any child, adolescent, or adult immunized before 2006 be reimmunized to boost waning immunity. 

You should not have this vaccination if you're pregnant or are planning to become pregnant within four weeks of getting the vaccine.

Zoster (shingles)

This vaccine should be given to all adults ages 60 and older to help prevent shingles, a painful reactivation of the chickenpox virus that lies dormant within the body. Exceptions to that recommendation are for those who have medical conditions or are taking medications that affect the immune system. The vaccine is also approved for adults ages 50 to 59. 

Meningococcal vaccine

This shot protects against bacterial meningitis caused by Neisseria meningitidis. All young children now get this vaccine.

College freshmen, especially those who live in dormitories, are at higher risk for meningococcal disease. If you are a college freshman, ask your health care provider about this vaccine. You should also consider getting this vaccine if you travel to countries where Hib is common.