Are You Up-to-Date with Your Immunizations?

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Most of us make sure our kids get immunized against infectious diseases like measles, mumps and polio. But we aren’t so good at protecting ourselves. Each year, more than 60,000 adults in the US die of diseases that vaccines could have prevented. Compare that to fewer than 1,000 children a year.

About 20,000 adults die of influenza each year. Current guidelines call for everyone 65 or older to get a flu shot every fall, just before the influenza season starts. The guidelines also recommend flu shots for individuals with chronic diseases like heart or kidney disease, diabetes or HIV infection. Evidence suggests that flu shots may also benefit healthy individuals under age 65.

Flu shots don’t always work in elderly or chronically ill people, whose immune systems tend to be weaker. If you have an elderly or chronically ill friend, coworker or family member, be sure to get vaccinated yourself. By doing so, you’ll make sure they won’t catch influenza from you.

One important vaccine that few people seem to know about is for the bacterium pneumococcus. Each year, 500,000 Americans get pneumococcal infections, primarily pneumonia. Forty thousand die from them.

I think everyone over 65 should get the pneumococcus vaccine. So should younger people with chronic heart or lung conditions, liver disease or diabetes and people who have had their spleens removed.

People infected with the AIDS vims should get the pneumococcus vaccine as soon as they learn they’re infected. As their immune system declines, the vaccine is less likely to be effective. Unlike the flu shot, the pneumonia vaccine usually needs to be given only once in a lifetime. Even so, only 14% of those at high risk have received it.

The other vaccine many adults overlook protects against two infections tetanus and diphtheria. Current recommendations call for everyone to have a tetanus/diphtheria booster once every 10 years.

It used to be that people only got tetanus shots if they sustained a “dirty” cut and went to the emergency room. Recently, scientists discovered that many older people some of whom haven’t had a tetanus booster in decades have lost protection against this potentially fatal disease.

Consequently, the recommendations have changed. Now all primary-care doctors should see to it that their patients are up-to-date with their tetanus shots, whether they cut themselves or not.

Some vaccines not recommended for the general public are appropriate for people at increased risk of particular infections. German measles (rubella) is of particular concern for women of childbearing age. It can cause severe birth defects.

Women who might become pregnant who have not had the rubella vaccine should have their blood tested for rubella antibodies. If no antibodies are present, they should have the vaccine right away and avoid becoming pregnant for at least three months.

Hepatitis B causes fewer deaths than AIDS around 5,000 a year in the US but is almost 10 times easier to catch. Still, only about 10% of people at risk for hepatitis B have been vaccinated. IV drug users, sexually active gay men and anyone exposed to blood (health-care workers, dialysis patients, etc.) should get this safe and effective vaccine. The vaccine is also a good idea for sex partners of people with hepatitis B.

Vaccines are one of the great success stories of modern medicine.

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