During the third trimester of her pregnancy, Laurie and her husband had their whooping cough vaccinations (Tdap) updated, and they advised both sets of grandparents-to-be to do the same since they would be spending a great deal of time with the new baby.
Tdap stands for tetanus, diphtheria and pertussis, and if it’s been more than 10 years since you’ve been vaccinated, you too need another.
That information is particularly important for new parents and anyone planning to spend time around an infant. Incidence of pertussis or whooping cough has been steadily increasing since the 1980s, and babies under six months of age have virtually no protection from the disease and its consequences. About two thirds of children under one year of age who get whooping cough end up in the hospital; far too many die of a disease that can be prevented..
Unless you’re old enough to remember the time when smallpox and polio destroyed lives, you probably don’t spend much time worrying about your immunization schedule. You should.
Thanks to routine immunization, smallpox has been eradicated from the globe and polio, nearly so. Getting your recommended shots at the appropriate intervals is the best protection against infectious diseases–not only for you but for everyone around you.
Diphtheria killed 10,000 children a year in the 1920s; if you don’t worry about it much today, that’s because the system is working. But when you fail or refuse to take part in the system, for whatever reason, you are weakening herd immunity and increasing the chance that infectious diseases could once again become a menace.
To help new parents, pediatricians are there to keep track of shots that are needed and given. The hepatitis B shot is given at birth and then a series a shots at regular intervals–2, 4, 6, 12 and 15 months–to protect against hepatitis A and B, diphtheria, tetanus, whooping cough, pneumococcal disease, haemophilus influenzae type b, polio, rotovirus measles, mumps, rubella chickenpox and influenza.
Public schools require that immunizations be up to date by the time a child starts school. After that time, parents and individuals must take more responsibility for knowing what shots they’ve had and which ones they need.
CHILDREN AND ADOLESCENTS: Several new vaccines and some changes in the guidelines have been made for older children and adolescents.
Gardasil and Cervarix are new vaccines against HPV (human papillomavirus), a cause of genital warts and a major risk factor for cervical cancer. The vaccines prevent four HPV types, two of which are strongly associated with cervical cancer in later life.
About 40 percent of sexually active females between ages 14 and 19 have been infected with HPV, and the infection can be passed on without actual intercourse and even with the use of condoms.
Parents, of course, are not approving of their children having sex early by having their children immunized. To be effective, however, the vaccination must be given before any sexual contact has occurred.
Initially, the vaccines were recommended for females starting at age 11 or 12 with catchup shots for those between ages 13 and 26. This year, the guidelines were expanded to include young males starting at age 11 or 12. Studies have shown that it can prevent penile cancer in males and anal cancer in both males and females as well as cervical cancer in females.
Guidelines also recommend that adolescents be immunized with MCV4 to protect against meningitis. The initial shot should be given at age 11 or 12 with a booster at age 16. These are the ages when meningococcal disease rates are high.
The recent outbreak of whooping cough in some areas of the country has spotlighted the need for adolescents, as well as adults and babies, to be more vigilant about getting booster shots for Tdap at least once every 10 years. Anyone can catch whooping cough, and anyone who spends time around babies can spread the disease to those who are most vulnerable to its effects.
YOUNG AND OLD ADULTS: Adults often assume incorrectly that the shots they received as children will protect them for life. Immunity can fade over time, however, and aging sometimes increases a person’s vulnerability to infections.
An annual flu shot is now recommended for all adults except those who are pregnant or have high-risk medical conditions.
All adults with no evidence of immunization against varicella (chickenpox) should get vaccinated. Studies indicate that about 99 percent of American adults age 40 and over have had chickenpox, and these persons should worry about shingles, a reactivation of the dormant virus.
To protect against shingles, a single shot of herpes zoster vaccine is recommended for most adults age 60 and over, even those who have already had one attack of shingles. Shingles can be very painful and cause persistent or recurring problems. Approved in 2006, the shingles vaccine (Zostavax) reduced the risk of shingles by 51 percent, according to studies.
The pneumococcal vaccine is also recommended for all persons age 60 and over, who are particularly vulnerable to the effects of pneumonia.
The Centers for Disease Control recommends the vaccine for younger persons who smoke or have chronic medical conditions such as heart disease, lung disease, diabetes or a weakened immune system.
Women of child-bearing age with no evidence of immunity should be immunized against rubella or German measles. When a pregnant woman becomes infected, the effects to the fetus can be devastating–miscarriage, serious heart defects, mental retardation, loss of sight or hearing.
Other immunizations are recommended depending on the person’s medical history and other risks. First-year college students, military personnel and persons who travel in areas where meningococcal disease is prevalent (such as sub-Saharan Africa) should have the meningococcal vaccine.
Men who have sex with men and persons with chronic liver disease or who travel to certain countries should be immunized against hepatitis A. Hepatitis B vaccine is recommended for sexually active persons who are not in a long-term mutually monogamous relationship; persons on dialysis; those with chronic liver disease; and anyone (such as health care workers) who might be exposed to blood or bodily fluids.
For centuries, infectious diseases were a major cause of death and suffering. Today, their influence on our lives has lessened considerably because of routine immunization. Do your part by keeping your immunizations up to date.
REFERENCES:
Laurie Barclay, M.D., “AAP updates meningococcal vaccine/booster dose guidelines,” Medscape Medical News, December 7, 2011 (Pediatrics, 2011;128:1213-1218).
Meera S. Beharry, M.D., et al, “Adolescent immunization update,” Pediatric Infectious Diseases, 2011;30(9):787-790.
Centers for Disease Control, “2012 adult immunization schedule,” last modified April 11, 2012.
Centers for Disease Control, “2012 child & adolescent immunization schedules,” updated March 21, 2012.
Centers for Disease Control, “General recommendations on immunization,” MMWR, January 28, 2011.
Centers for Disease Control, “Recommended immunizations for babies,” updated March 8, 2012.
Immunization Action Coalition, “Vaccinations for adults,” “When do children and teens need vaccinations?”
Sandra A. Fryhofer, M.D., “New immunization guidelines 2011: changes for adults,” Medscape, January 31, 2011.
Emma Hitt, Ph.D., “Zoster vaccine well tolerated in adults,” Medscape Medical News, April 23, 2012 (Journal of Internal Medicine online April 23, 2012).
Robert Lowes, “All ages should get Tdap shots, says CDC panel,” Medscape Medical News, February 22, 2012.
Celeste Robb-Nicholson, M.D., “By the way, doctor: should I get the shingles vaccine?” Harvard Women’s Health Watch, August, 2010.
Carl Nierenberg, “3 changes to children’s vaccine recommendations announced,” MyHealthNewsDaily, February 2, 2012.
“Recommended adult immunization schedule–United States, 2011,” MMWR, 2011;60(4):1-4.
05/30/2012
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