We hear endlessly about the importance of vaccinating our kids. No competent pediatrician sends a child home without up-to-date shots, and immunization records are a must for admission to school or summer camp. Thanks to these efforts, diseases that once left thousands of children dead or disabled each year are now rare. But they’re still killing grown-ups. In the United States, according to government statistics, adults are 100 times more likely than children to die of vaccine-preventable illnesses. Flu, pneumococcal pneumonia and hepatitis B are the biggest killers, together claiming more than 30,000 lives annually. Other hazards range from Lyme disease to tetanus. Vaccines offer cheap, reliable protection, but don’t expect your doctor to know when you need one. According to Dr. Gregory Poland of the Mayo Clinic, internists and family physicians rarely track adult patients’ immunization status. In short, it’s up to you.
Everyone needs protection from tetanus and diphtheria. Though best known for causing lockjaw, tetanus kills one patient in three, and diphtheria can lead to paralysis and heart failure. Both diseases are now rare, thanks to childhood vaccination. But because the DTP (diphtheria-tetanus-pertussis) vaccine provides only temporary immunity, staying safe requires an occasional booster. If you didn’t get DTP shots as a child–or you haven’t had a booster in more than a decade–talk to your doctor about the Td (tetanus-diphtheria) vaccine. It’s administered in a three-dose series, followed by a booster every 10 years.
Some experts oppose vaccinating children against chickenpox, since the disease itself rarely causes them serious harm. But the 5 to 10 percent of kids who dodge the disease should definitely be immunized as adults. Adult chickenpox is always serious, and one patient in 50 develops complications such as brain swelling or varicella pneumonia. (Vaccination may also help previously exposed adults avoid shingles.) Measles, mumps and rubella are less worrisome. Most Americans born before 1957 have had these diseases, and most born since have been vaccinated. Women who missed out on the rubella vaccine should consider getting it before pregnancy, since the infection can damage a growing fetus.
The need for other vaccines depends on your age, race, health, occupation and lifestyle. Hepatitis B shots are a must for medical workers and people with multiple sex partners, and a good precaution for anyone under 18. The liver-damaging hep B virus spreads by the same routes as HIV, but it’s 100 times more infectious. For seniors and people with chronic illnesses, flu and pneumonia are the big concerns. In addition to getting an annual flu shot, people in these groups should consider PPV, or pneumococcal polysaccharide vaccine. The inoculation protects against 23 varieties of strep, including Streptococcus pneumoniae,a bacterium that causes up to 14,000 pneumonia deaths each year. Federal health officials recommend PPV not only for seniors and the infirm but also for smokers and for African-Americans, who suffer disproportionately from strep.
Should you get the new vaccine against Lyme disease? It depends on where you live. People in the Northeast, the upper Midwest and along the California coast are at greatest risk for this tick-borne scourge. Studies suggest the three-dose regimen cuts the risk of infection by 75 percent, but critics believe it may cause arthritis. The evidence to date doesn’t support that suspicion. Further studies are underway.
Given what they do, vaccinations are a bargain. Prices range from $20 for a flu or pneumococcal shot to $83 for the chickenpox vaccine. Discounts may be available through health departments, community clinics and college health services. If you want more information, try the CDC’s National Immunization Program (), the National Network for Immunization Information (immunizationinfo.org), the National Foundation for Infectious Diseases (nfid.org), the National Coalition for Adult Immunization (nfid.org/ncai) or the Immunization Action Coalition (immunize.org). And if you’re searching online, be alert: slick sites preaching the antivaccine gospel abound. “There’s room for informed refusal,” says Poland, “but you’ve got to have the facts to decide.” Vaccines rarely cause anything worse than a sore arm. The diseases they prevent can leave you dead.
