How Immunizations Provide Disease Prevention

Well its fall again and questions about adult immunizations ("shots") are on the rise. This has been triggered in part by an outbreak of St. Louis encephalitis in the New York City area. While there is no vaccine available to prevent this disease, there are other immunizations that are recommended for adult patients.

In adults the need for immunizations depends upon age, the presence of diseases which may increase risks for both the development and the outcome of disease, workplace, foreign travel and alternate lifestyles. Recommendations for immunizations are based on reports from the CDC (Centers for Disease Control).

Diseases and Immunizations

If you or a family member have any of these diseases, check with your primary care provider to see whether or not they would recommend these shots for you. I will list in alphabetical order the immunizations and the diseases they prevent and then the high risk conditions where they are recommended. The shots cannot cause the disease.

Hemophilus influenza type b (Hib) shots prevent the development of infections spread by hemophilus influenza type b. It is a different illness from the "FLU" (see below). HIGH-RISK illness include Hodgkins Hepatitis B shots help prevent the development of an illness spread by both medical and social contact with blood and body fluids. It can cause liver failure, liver cancer and death from liver failure. There are both HIGH-RISK illnesses and HIGH-RISK lifestyles that can lead to exposure to this virus. HIGH-RISK illnesses include kidney dialysis, hemophilias, HIV/AIDS, and other sexually transmitted diseases, homosexual males, persons with multiple sexual partners, people who work with the developmentally disabled, heath care workers police EMS and firefighters. The vaccine is given in a series of three injections spread out over several months. All three injections are required for complete protection. The vaccine was made from human serum in its early days and was thought by some to be a risk for the AIDS virus. It is now made from bakers yeast and offers no risk of AIDS. Influenza shots help prevent the development of certain types of influenza (FLU). Scientists who study this disease must predict each year which types of FLU they expect to occur that year. You must get a new flu shot each year. For those in HIGH-RISK categories, the most common cause of flu related death is due to pneumonia. The flu shot is recommended for everyone over the age of 65. Under age 65, it is recommended for patients with certain diseases such as cancer, diabetes, heart disease, sickle cell anemia, thalessemia, Hodgkins, HIV/AIDS, kidney disease, asthma and emphysema. If you live or work with people who are HIGH-RISK, you should be vaccinated to prevent you from spreading the virus to them. Patients allergic to eggs should not get this shot unless directed by their doctor. Pneumococcal shots help prevent the development of infections in the lung and blood, most commonly pneumonia. These bacteria can cause serious, life threatening illness and sometimes death in patients who are in HIGH-RISK categories. Pneumococcal vaccine should be given to everyone 65 years of age or older. You only need to get the shot once. HIGH-RISK categories for pneumococcus include alcoholism, asthma, cancer, diabetes, emphysema, heart disease, HIV/AIDS, kidney disease and liver cirrhosis. Tetanus shots help prevent an infection of the nervous system known to the general public as LOCKJAW. Tetanus is a preventable illness, which is almost always fatal. Everyone is at risk for this illness. Older patients who may have had allergic reactions to tetanus made from horse serum can still get the new shots without serious side effects. You should get a tetanus shot every ten years for everyday protection and within the past five years for a dirty wound. Diphtheria shots an illness that was rare for years, but is slowly recurring as fewer people become re-vaccinated as they get older. You should be re-immunized every ten years. It can be given in the tetanus shot. It is especially common in the former Soviet states and has occurred in some nursing homes in the USA. Diphtheria begins a throat infection but can cause serious injury to the heart and lungs.

These are the most common vaccines that I am asked about in the Emergency Department. I encourage you to talk with your doctor if you are in any of the high-risk categories, or simply wish to know more about the immunizations. There are some other categories of immunizations that are far less commonly provided adults, but may be indicated for foreign travel or certain occupational exposures. Your doctor can provide you with the information you need to make decisions regarding you need for immunizations.