How Vaccines Can Prevent Serious Diseases

The free gift that the San Francisco Giants offered to fans who showed up for a game with the Cincinnati Reds last August probably didn’t attract a big crowd, since it involved a procedure that most people shun whenever possible: It was a booster shot.

Throughout the game, California Department of Public Health nurses were administering the Tdap vaccination, which protects against tetanus, diphtheria, and pertussis (whooping cough), at first aid stations in the Giants’ AT&T Park. Although the shot stung, as a giveaway it was worth a lot more than a bobblehead doll or an inflatable baseball bat.

Like other vaccines designed for adults, the Tdap vaccine protects the people who get it, but also their friends, children and aging parents. The free Tdap clinic occurred in the midst of a public health tragedy in California -- the worst epidemic of whooping cough reported since 1947. The outbreak killed 10 babies and sickened more than 8,300 children and adults in 2010, and it continues in California and other states.

The Little-Known Benefits of Adult Vaccines

Tdap is one of several vaccines that offer adults a reasonably inexpensive and valuable protection against disease. We’re all aware of the fact that infants and toddlers are required to be vaccinated against bugs such as influenza, measles, mumps rubella, chickenpox, polio, pneumococcus, and viral hepatitis. But adults need protection from some of the same diseases.

In 2010, the CDC’s vaccine policy group, the Advisory Committee on Immunization Practices, recommended that everyone 6 months of age and older get an annual shot against influenza, or flu.  “Should you get the flu vaccine? The answer is yes,” said William Schaffner, MD, chair of the department of preventive medicine at Vanderbilt University. Besides young infants less than 6 months old, exceptions, he said, should include people with serious egg allergies. People who have had a life-threatening or serious allergic reaction to a previous flu vaccine or to any of its components should not be vaccinated.  Talk to your provider before getting the vaccine if you have ever had Guillain-Barre Syndrome or are moderately or severely ill.

Flu kills thousands of adults every year; people over 65 are among those at greatest risk for severe complications from flu, including death. Although the immune systems of the elderly may not respond as effectively to the flu vaccine and other shots, vaccination can still protect against serious complications. Another way to protect the elderly, it turns out, is to vaccinate their close contacts such as children and grandchildren. If the younger ones remain healthy, they are less likely to spread the flu to their elders.

Whooping Cough Returns

With whooping cough a growing problem in the United States, the CDC also now recommends that all adults get a one-time Tdap booster followed with Td (covering tetanus and diphtheria) booster every 10 years. In the past, adults were urged to get a Td booster only every 10 years. But it has become clear that pertussis bacteria continue to circulate.

By some estimates, there are up to a million cases of whooping cough in the United States each year. Most cases occur in adults and are similar enough to a humdrum cold or flu that they aren’t diagnosed by a doctor. That guy in the cubicle next to yours who hacked for three months? He may have had whooping cough without knowing it.

While the disease is rarely a critical illness in adults, they are just as capable as a sickly toddler of spreading the germ to infants, who can die or have serious illness as a result of it. Over half of babies younger than 1 year old with pertussis need to be hospitalized.

The Tdap shot can cause a sore arm or fever, but that’s a small price to pay for the children you’ll be protecting from the disease by not getting it yourself, says Poland.

“We’re having major outbreaks of pertussis in the United States today,” said Poland. “When we’ve looked at this problem and considered the best way to protect people, we’ve decided that a sore arm or a fever, or even a day in bed, was reasonable tradeoff to save the lives of a children.”

Recommended Protection, Shot by Shot

Some of the other vaccines recommended for adults include the following:

• Pneumococcal. Recommended for adults 65 and older and younger people with certain chronic diseases, weakened immune systems, and those who smoke or are residents of nursing home or long-term care facilities. The vaccine protects against complications like pneumonia, meningitis, or infection of the blood caused by the bacterium Streptococcus pneumoniae. A one-time booster may be given after five years for some people.
• Shingles. Recommended for adults 60 and over, this shot protects against shingles, the painful reactivation of chickenpox virus that lurks in our nerve cells. The risk of shingles grows as we age; young people rarely get shingles, but you have a 50-50 chance of getting it by age 85. The vaccine cuts the risk of the disease in half and further reduces the chance of developing post-shingles pain called postherpetic neuralgia that can be chronic and debilitating.  
• Human papillomavirus (HPV). This vaccine is recommended for women 19 to 26 years old. There are more than 100 types of HPV, and the HPV vaccine can help protect against infection from types responsible for most cases of cervical cancer. One of the available HPV vaccines can also protect against HPV types that cause the majority of genital warts in men and women.  
• Measles-mumps-rubella (MMR). Though most people in the U.S. are vaccinated as children, it’s a good idea for adults to get the MMR shot if they don’t have documentation of vaccination, evidence of immunity, past disease, or a medical reason not to be vaccinated. Infections can lead to serious complications.
• Meningococcal. Meningococcal disease is life-threatening. People at greater risk for infection include teenagers and young adults, especially those living in dormitories or military barracks. It is recommended for all first-year college students living in dormitories, military recruits, people with certain medical conditions, and people traveling or working in certain areas who haven't previously received the vaccine.
• Hepatitis A. This vaccine is recommended for men who have sex with men, people with chronic liver disease, people who use injectable drugs, people working with the virus in a research setting, and people traveling to endemic area. Hepatitis B is recommended for people who are sexually active and not in a long-term mutually monogamous relationship, persons with history of sexually transmitted diseases or those seeking evaluation for an STD, people with current or recent history of injection drug use, persons with chronic liver disease, end-stage kidney disease, HIV, and those who are risk for exposure, such as health care workers and those who are close contacts of people with chronic hepatitis B infection.