Resources

Ask the Geriatrician: Adult Immunization

Ask the Expert

Moira Fordyce MD, MB ChB, FRCPE, AGSF

Adjunct Clinical Professor
Stanford School of Medicine

 

Q:  What vaccines are available to protect adults?
A:  There are vaccines (immunizations) for influenza (flu), pneumococcal disease and hepatitis B.  Some adults also need to be protected against measles, mumps, rubella (German measles), hepatitis A, tetanus, diphtheria, and chicken pox. The US Public Health Service has identified certain people who should be vaccinated against these diseases.

Q:  Should all adults be immunized?
A:  Yes. As a general rule, all adults require measles, mumps, rubella, tetanus, and diphtheria immunizations. All adults age 65 and older and people with diabetes and chronic heart, lung, liver, or kidney disorders need vaccines for influenza and pneumococcal disease.

 Hepatitis B vaccine is recommended for:

• Health care workers and people who have multiple sex partners are at high risk for hepatitis B. 

Hepatitis A vaccine is recommended primarily for:

• Travelers visiting developing countries where hepatitis A is common and clean water, good sanitation, and proper sewage disposal are not available
• Adults who have chronic liver disease or blood clotting-factor disorders
• Those who use illegal drugs
• Men who have sex with men

Adults who have not had chickenpox should think about being tested to see if they are immune. If they are not, they should be vaccinated.

Q:  How often do I need to be immunized?
A:  The below is a brief general schedule of adult immunizations.  You may have additional medical conditions that will affect your need for repeated immunizations. 

• Pneumococcal disease vaccine and the measles, mumps, and rubella (MMR) vaccine
  • Usually given once, and may protect you for life.
  • It may be repeated if you are at risk for problems resulting from pneumococcal disease, especially if it has been five or more years since your first vaccination.

• Measles vaccine
  • Some people born after 1956 may need a second measles vaccination.

• Influenza vaccine
  • Since new strains of the flu develop constantly, the Flu vaccine must be given yearly due to new strains of virus which are not contained in previous vaccines.

• Tetanus and Diptheria vaccines
  • In adulthood, immunization for tetanus and diphtheria (Td vaccine) must be supplemented with a booster shot every 10 years for life, throughout life.
  • Some experts believe that if you received the complete series of tetanus vaccinations as a young person, you may be protected with a single booster shot at or about 50 years old.

• Hepatitis B vaccine
  •  Administered in three doses over six months.

• Hepatitis A vaccine
  • Two doses of hepatitis A are needed 6 to 12 months apart to ensure long-term protection.

• Chicken Pox Vaccine
  • Two doses of chickenpox vaccine are suggested for people 13 years and older who have not had the disease.

Q:  Where can I get immunized?
A:  Contact your health care provider or local health department for a list of doctors who give these shots. Your city or county health department or local hospital may operate clinics that provide these vaccines.

Q:  How much do vaccines cost?
A:  It will depend on your insurance coverage. Check with your health care provider or clinic and your health insurance for exact cost rates. Medicare Part B pays for influenza and pneumococcal shots. 

Q:  Are there side effects to vaccines?
A:  Vaccines are some of the safest medicines around. Some common side effects include

mild soreness in the arm or a low fever.  All medicines, including vaccines, pose the rare chance of serious side effects, even death.  But, for most people, the risks from the diseases are far greater than the risks from the vaccines.  You should speak with your health care provider about possible side effects.

Q:  What vaccines do I need if I'm traveling abroad?
A:  Speak with health care provider or health department as early as possible to find out what vaccines you will need.  The time it takes to complete them will depend on whether you need one dose or many doses to be immunized.  There are many books designed for travelers that give general health tips for people going abroad.  They also include information on the particular vaccines required by different countries for travelers. You can also call the Centers for Disease Control and Prevention travelers’ information line at (404) 332-4559.

Q:  Should I carry a personal immunization record?
A:  Yes! You should record all vaccines received. It will help you and your health care provider make sure that you are protected against diseases that vaccines can prevent. It can also help you avoid needless revaccination when you change providers and during health emergencies.  Ask your provider for a copy of this record. Be sure to take it with you to his or her office so vaccinations can be listed each time a new one is received.

 

Updated:  March 2012
Posted:  March 2012