Immunizations: They’re Not Just for Children

By Lenny Pacholski, Parish Nurse

Although most adults realize immunizations play an important role in keeping infants and children healthy, many are unaware that readily available vaccines offer a safe, cost-effective way to prevent serious illnesses and death among adults. As many as 50,000 adults in the U.S. die each year from vaccine preventable diseases or their complications. Vaccinations save many healthcare dollars by keeping people healthy and avoiding expensive hospitalizations. Immunizations help reduce absences at work, school and social events and decrease the spread of illness in the home, workplace and community.

This month we will focus on less common immunizations for adults (19 or older) that are recommend by The Advisory Committee on Immunization Practices (ACIP) and the Centers for Disease Control (CDC): Hepatitis B; Hepatitis A; Measles, Mumps, Rubella (MMR); Varicella and Meningococcal.

Hepatitis B is caused by a virus that can result in lifelong infection, cirrhosis of the liver, liver cancer, liver failure and death. According to the CDC, an estimated 1.25 million Americans are chronically infected and 5000 people die each year from Hepatitis B. It is found in blood and certain body fluids and is spread through unprotected sex, sharing needles when “shooting” drugs, needlesticks on the job or from an infected mother to her baby during birth. Exposure to infected blood in any situation can be a risk for transmission. Hepatitis B vaccine is recommended for the following individuals:

• People with more than one sex partner in a 6-month period
• Persons diagnosed with a sexually transmitted disease
• Men who have sex with men
• Sex partners of infected persons
• Injecting drug users
• People living with someone who has chronic Hepatitis B
• Immigrants and children of immigrants from Asia, Africa, the Pacific Islands, Eastern Europe, the Middle East and the Amazon Basin.
• Healthcare and public safety workers who might be exposed to blood    
• Chronic hemodialysis patients
• International travelers who will be in countries with high or intermediate rates of chronic HBV infection (as above) for longer than 6 months

Vaccination is the best prevention. It consists of a series of three injections once in your lifetime.

Hepatitis A  is a serious liver disease also caused by a virus found in the feces of infected individuals. It is spread by sexual contact or close household contact and by contaminated food or water. Hepatitis A does not cause long-term or chronic infection; once you have had it, you can’t get it again. People at risk include:

• Persons with clotting factor disorders or chronic liver disease
• Household contacts of infected persons
• Sex partners of infected persons
• Persons traveling to countries where hepatitis A is common (everywhere except Canada, Western Europe, Japan, Australia and new Zealand)
• Men who have sex with men
• Injecting and non-injecting drug users

There is no treatment for Hepatitis A. Vaccination is the best means for prevention and is recommended for all adults who are at risk. The vaccine consists of two injections administered 6 to 12 months apart. Additional preventive measures include washing hands with soap and water after using the toilet, changing a diaper and before preparing and eating food.

Measles, Mumps, Rubella (MMR). During the first few months of 2006, there were 2597 reported cases of mumps in the U.S. As a result, recommendations for the MMR vaccine for certain adult populations were updated. Adults born before 1957 are considered immune to measles and do not require the vaccine. Who should get the MMR vaccine? If you were born after 1956 and never had an MMR vaccination as a child, you need one dose now. The following people need two doses:

• Anyone recently exposed to measles
• Health care providers
• Individuals vaccinated with killed measles vaccine or an unknown type of vaccine between 1963 to 1967
• International travelers
• College students
• People whose blood test shows no immunity

You should not get an MMR vaccination if you have a weakened immune system.

Varicella (chickenpox) is caused by the varicella zoster virus, which also causes shingles. Chickenpox is usually a mild disease, but in adults and children with weakened immune systems it can cause serious complications and death. A vaccine is now available to prevent chickenpox. For adults, the vaccine consists of two doses given four to eight weeks apart. Who should get the varicella vaccine?

• Anyone who has never had or is not sure if s/he had chickenpox
• Anyone who is considering becoming pregnant and doesn’t know if s/he is immune to chickenpox

You should not get the vaccine is you are pregnant or have a weakened immune system.

Meningococcal disease (meningitis) is an infection of the spinal cord fluid and the fluid surrounding the brain, caused by a viral or bacterial infection. Knowing whether it is caused by a virus or bacterium is important because viral meningitis is generally less severe and resolves without specific treatment, while bacterial meningitis can be quite severe and may result in brain damage, hearing loss or learning disability. It is also important to know which bacteria is causing the meningitis because antibiotics can prevent some types from spreading and infecting other people. Most healthy adults do not require this vaccine, but it is recommended for certain populations, including

• College freshmen living in dormitories
• Military recruits
• Microbiologists who routinely work with meningococcal bacteria
• Anyone traveling to a part of the world where the disease is common
• Adults with damaged spleens
• Adults with terminal complement component deficiency (an immune system disorder)
• Anyone who might have been exposed to meningitis during an outbreak.

Review the immunizations you have received and talk to your doctor about any additional ones you may need. To take an on-line assessment of your need for adult immunizations, visit www2.cdc.gov/nip/adultImmSched. Further information can be obtained from www.cdd.gov and www.acip.org.