Grown-ups need vaccines too

Debates and discussions around booster vaccinations usually focus on infants or children. But grown-ups should be rolling up their sleeves,too.  Unfortunately, far too few adults are getting booster shots.

There are several reasons why not.  Adult immunization hasn't been on the radar screen. When we talk only about vaccines in kids, we may be sending the message that it's not important for adults.  Some doctors don't mention boosters to their patients.  Some health professionals don't know which vaccines to recommend and how often.  Adults don't get the same coordinated immunization programs that kids get.

Annual physicals used to be a good for figuring out what shots you need.  But some provinces no longer pay for them.  Do you have an up-to-date record of immunization?  It's hard to know where to begin without one.  And let's not forget cost. It's easier to roll up your sleeve when the province pays.  The out of pocket cost of herpes zoster and human papillomavirus vaccines may be prohibitive.  Some adults may believe those who say vaccines are unsafe.

Everyone needs a tetanus and diphtheria booster every ten years. Adults born after 1970 who weren't immunized need to get one shot of measles, mumps and rubella or MMR vaccine.  For whooping cough, adults 18 years and older need one dose of acelluar pertussis-containing vaccine (found in Tdap).  As for polio, most Canadians are immune, but non-immunized adults should get the full series of shots.  

Healthy adults up to the age of 24 should get meningococcal vaccine and adults age 65 and up should get one for pneumococcus.  Chicken pox vaccine should be given to susceptible adults age 18 to 40.  HPV is for women and men up to the age of 26, and to those at risk of ongoing exposure age 27 and up.  The HPV vaccine recommended for women is somewhat different than the one for men.  The shingles vaccine is recommended for adults age 60 and older. 

Here are the vaccines recommended by the Public Health Agency of Canada.

If you're thinking of taking a pass on adult immunizations, considers the stakes. If there's a local outbreak of whooping cough, you may no longer be protected even though you received the vaccine as a child. Getting your shots up to date helps protect your kids especially babies too young for vaccines.  If there's a local outbreak of measles, and you weren't fully immunized as a child, you might end up getting the disease.  Adults who get measles and mumps are more likely than kids to have serious complications, and to end up in hospital.  Some countries won't let you in if you don't have a record of completed immunizations.  If you don't get your shots, you won't be a good role model to your kids who have no say in the matter.  If you develop a chronic disease like heart failure or lung disease, not getting a timely immunization might mean having to be hospitalised.
 
How to boost adult immunization rates is a major concern among public health officials. The Public Health Agency of Canada says there are a number of encounters between health professional and patient when adult immunization can be discussed. The list should include any first time visit, especially new immigrants.  The first prenatal pregnancy visit is another good opportunity, but keep in mind that pregnant women should wait until after 26 weeks to get a dose of pertussis vaccine, and should wait until after the baby is born to get MMR.  Immunization should be discussed every time an adult is admitted to hospital or to a long-term care facility.  When parents bring their kids for immunizations, it could very effective to discuss the subject with the parents as well.  

The most obvious one occurs when the patient asks for travel advice.  Every time I travel overseas, I have my vaccination record updated.  I urge you to talk to your health professional about updating your immunizations.

Program Note:

Last week, I visited Campina Grande, a city of just under 400,000 people in the Northeastern province of Paraiba.  Campina Grande is ground zero for the Zika virus.  I went to the local hospital where they're taking care of close to 300 pregnant women infected with Zika and where they've seen close to 40 babies born with microcephaly and other serious birth defects.  I visited the obstetrician who was one of the first to make the link between the virus and microcephaly.  I also spent Easter with a mother of five who is struggling to care for her two-month old son Samuel who was born with microcephaly. I also visited Rio de Janeiro, where health professionals are gearing up to take care of an even larger number of affected babies - now and into the far future.

I'll have those stories in the days ahead on The Current.