Vaccinations are given to help prevent spread of diseases or at least reduce the severity of a certain disease if it is contracted. Immunizations are generally stressed for children due to immune systems that have not been fully developed and close exposures that can happen in day cares and schools. The recommended children vaccine schedule is defined by the Centers for Disease Control and Prevention (CDC). The CDC also has a recommended schedule for adults to help you protect yourself.
Vaccine schedule for adults is not the same as the ones for children and can be altered by your health care provider especially if you have certain health conditions as in pregnancy or allergies to components of the vaccine. The following list are some of the key vaccines you may need after 18 years of age.
1. Shingles vaccine
Shingles can be an incredibly painful nerve infection that strikes adults and is caused by the varicella-zoster virus. This is the same virus that causes chicken pox in children. The virus hibernates in your nerves and can reappear later in life. The current rate of shingles is one out of three people will get shingles in their lifetime. The CDC recommends you should get the zoster vaccine (Zostavax) if you are age 50 or older, even if you have had shingles before. It is a two injection series with the second dose given 2-6 months after the first dose. There are two versions of Zostavax one that has no live virus in it and the other has an attenuated live vaccine. The live vaccine is no longer available in the United States but some countries overseas do utilize the live vaccine.
2. Human Papillomavirus (HPV)
This vaccine is aimed at young adults for the prevention of penile cancer in men and cervical and vaginal cancers in women. It is estimated one out of every 4 people are infected with HPV. This vaccine is on the preteen schedule but the CDC also has an alternate young adult schedule for those who did not receive the vaccine as a child. The young adult vaccine schedule is three doses between 15 to 26 years of age. The second dose is generally 2 months after the first dose and the third dose is 6 months after the first dose. There are several variations of the schedule in the literature but this is the most recommended schedule as of late.
3. Influenza (Flu Shot)
It is recommended everyone that is greater than 6 months of age and not allergic to components of the vaccine to get a flu vaccine annually. The seasonal virus that can cause fever, coughing, pneumonia and other symptoms. A person will not build up immunity over the years because the flu virus changes strains from season to season. The influenza rates have decreased over the last 2 years due to COVID precautions but it is still a prevalent pathogen.
4. Pneumococcal Disease (PCV13 and PPSV23)
This disease can lead to a number of potentially fatal infections, especially for older adults. They include pneumonia, meningitis, and bloodstream infection, and they kill close to 20,000 seniors each year. PCV vaccine is given to younger patients but there are 2-vaccines usually administered for those aged 65 or older. These are the pneumococcal conjugate vaccine (PCV13) and a pneumococcal polysaccharide vaccine (PPSV23). Both cannot be given during the same time. If you received a PPSV23 before age 65 then a second dose is given after the age of 65 and 5 years after the previous PPSV3. The PCV would be given one year after PPSV3.
5. Hepatitis A
This vaccine for adults can prevent serious liver disease caused by the Hepatitis A virus which is spread through close personal contact or contaminated water or ice. It is highly recommended for people who travel.
The source notes that adults who contract Hep-A are more likely to display symptoms than children. These symptoms can last for weeks and include fever, fatigue, jaundice, nausea, and severe stomach pain. It can be fatal in rare instances. It is a two dose series with the second dose 6 months after the first dose.
6. Tetanus, Diphtheria, and Pertussis (Td/Tdap)
This vaccine has three components to it. These can be life-threatening diseases but are covered by one combination vaccine. Tetanus enters the blood through a wound and commonly causes lockjaw; diphtheria affect the respiratory system making it difficult to breathe and pertussis is whooping cough, which is especially dangerous for babies but can be life threatening for adults also.
The Tdap vaccine for adults is given every 10 years but if there is an injury with potential tetanus exposure it will be given at the time of injury if the previous immunization is greater than 5 years previous.
7. COVID-19
COVID-19 vaccination is available to all adults now and is strongly recommended that people receive this vaccine. There are several vaccines available and now a booster is also recommended for people. The virus is highly contagious and very unpredictable and immunized people do have a better chance of fighting the virus than those that are not immunized.
The FDA has authorized Pfizer vaccine use in ages as low as 5 years old. It is a 2 dose series with second dose given 21 days after the first dose and a booster after 6 months from completion of the first series.
The Moderna vaccine is still being given under emergency use authorization, which means the FDA has not authorized it yet. It is a two shot series with 28 days between the doses. A booster is recommended 6 months after completing the first series.
COVID-19 vaccines and treatment are rapidly changing and improving. It is still recommended to use proper hand hygiene and limit exposure to others- particularly when you feel ill.
All vaccines do have potential adverse reactions that some, but not all, people experience. Prior to obtaining any vaccine be sure to be informed of what to watch for and what to do if you do experience an adverse reaction. Your local Public Health and Primary Care Providers can perform these immunizations as well as provide information. There are many more vaccines on the routine schedules for adults. The ones listed are highest priority at this time. All information in this article was sourced from the Centers of Disease Control, WebMD, UptoDate and Department of Health.
Travis Preszler, PA-C