And you thought vaccination was only for children

When we are kids, our parents protect us from many bad things in life, including fearsome diseases in adulthood. This they do by getting us vaccinated at the right time. We are too young to either remember the instance or realise the importance. And as we grow up, vaccinations don’t ever feature in our healthcare plans [unless we are planning to go abroad]. Many of us aren’t even aware that there are vaccinations for adults that are a must.

Vaccinations for adults are of three types:

1. Routinely recommended: These vaccines are routinely advocated after 65 years of age. These include pneumococcal vaccine, influenza viral vaccine and herpes zoster vaccine.
2. Catch up vaccines: These can be taken if the person has not been vaccinated till 18 years of age. They are tetanus, diphtheria, pertussis and HPV vaccine [Human Papiloma Viral vaccine].
3. Special vaccines: Typhoid, cholera, rabies, hepatitis B, chickenpox and MMR vaccine can be grouped into vaccines that are advocated in special circumstances.

Let us discuss each one and understand their importance.

Pneumococcal vaccine: Pneumonia is a severe disease in the elderly. It is associated with high rates of hospitalisations and death. Adults above the age of 65 are particularly prone to this disease. It is recommended that you get this vaccine even though you may have received it as a baby because the pneumonia vaccine for children offers protection from 13 or 10 subtypes of pneumococci, while this one protects you from 23 types of pneumococci.

Further, the vaccine for children requires four doses while the one for adults needs just one dose and costs much less than the paediatric vaccine. It is effective for at least three years.

Influenza vaccine: Influenza [flu] is a viral infection seen in those below the age of five years and those above 65 years of age. It is more severe in asthmatics. In most countries, the infection is seasonal. Since the virus changes structure almost every year, you can’t rely on the same vaccine to protect you for long and you thus need to get vaccinated every year before influenza season. When you do, ensure that the vaccine is from the ‘year specific’ batch. If you are above 65 or asthmatic, getting a shot of this vaccine isn’t optional. Those who suffer from severe egg allergy should avoid taking this vaccine.

Tetanus vaccine: A tetanus vaccine is effective for 10 years. So if it’s been longer since you were last vaccinated against tetanus or don’t remember when you’re vaccinated, opt for this vaccine. A tetanus vaccine is also administered before surgery, and after injuries. Pregnant women are recommended this vaccine after seven months of pregnancy.

Usually, a three-dose schedule is advised in which the second shot is given after six weeks and the third after six months.

In cases of severe injuries in an unvaccinated person, discuss with your physician about getting the tetanus immune globulin along with the regular tetanus toxoid [TT] injection as it offers quicker protection.

With diphtheria infection making a comeback, it is advisable to replace a TT vaccine with a Td vaccine [it contains tetanus plus a small dose of the diphtheria vaccine]. It is recommended for pregnant women and after injury. A recent addition to this group of vaccines is the ‘Tdap’ vaccine that has a small dose of pertussis vaccine. It is recommended as a booster dose and is usually given at 16 years of age. Only one dose of this vaccine is recommended and it is not to be used for protection of injuries and for pregnant women.

Rabies vaccine: This is given in case you are bitten by an animal especially a dog or some other canine. It is mandatory if the dog is a stray, or a pet that hasn’t been vaccinated. The current vaccine is administered in five doses spread over 28 days, as against the previous vaccine, which required 14 injections to be administered in the stomach.

Chickenpox: If you haven’t suffered from chickenpox in childhood, you must take this vaccine as chickenpox in adults is much severe than it is in children. Take it on priority if you’re in close contact with a person with chickenpox or you’re a healthcare worker.

Hepatitis B vaccine: Hepatitis B gets transmitted sexually or via infected blood. Hence, the vaccine for adults is recommended for those working in healthcare, those suffering from chronic kidney failure [especially those who are on dialysis] and sexual partners of hepatitis B positive patients.

MMR vaccination: MMR is a combination vaccine against measles, mumps and rubella. These diseases are more severe in adults than in children. The MMR vaccine is a must for pregnant women as this infection can adversely affect the baby. The vaccine is recommended even if a dose has been administered in early childhood.

HPV vaccine: Cervical cancer is one of the commonest cancers in women. The virus causing this infection is transmitted sexually. Vaccination against HPV is now available and is strongly recommended in the age group of 9 – 16 years. Women above 16 and below 26 too can opt for this vaccine and derive equal benefits, especially if they do so before they become sexually active. It is okay to take the vaccine between 26 and 46 years of age, but it is less effective.

Varicella zoster vaccine [herpes]: Herpes is a painful condition involving blisters on the skin, along the course of a nerve. It is caused by reactivation of dormant [sleeping] varicella virus, the same virus that causes chickenpox. Although it is treatable, some patients complain of nerve root pain that persists long after the infection has been resolved. A vaccine against herpes zoster is most suitable for people above 60 years of age. Unfortunately, it isn’t yet available in India.

This was first published in the March 2012 issue of Complete Wellbeing.