Adults also need vaccinations

Chickenpox

Chickenpox, also known as varicella, Is a highly contagious disease. Caused by a virus, varicella Infection can occur after direct contact with an Infected person or with airborne droplets from an infected person. Prior to the availability of a vaccine in 1995, approximately 100 people died from chickenpox complications each year in the U.S. The number of oases has since declined by nearly 70%. Adults who get chickenpox often get a more severe case than children and have more complications. For example, adults are 25 times more likely than children to die from the disease or its complications. Adults who have not had chickenpox should consult their physicians regarding vaccination.

 

Hepatitis B

 

Hepatitis B is a serious liver disease caused by the hepatitis B virus (HBV). It Is spread by contact with blood or other body fluids of an infected person. Though some infected persons have no symptoms, about one out of three will be very ill, with nausea, yellow-tinged skin and eyes, headache, and abdominal pain. Some people develop chronic HBV Infection, which can lead to liver failure or liver cancer. About 5,000 people In the U.S. die each year from HBV-related Illness.

 

Hepatitis B vaccine Is recommended for all Infants, children, and teens. It Is also recommended for adults at increased risk for infection, including health care workers likely to have blood exposure, certain travelers, dialysis patients, men who have sex with men, people who have more than one sex partner In six months, people who Inject illegal drugs, and household members and sexual contacts of persons with chronic HBV Infection.

 

Hepatitis A

 

Hepatitis A is a viral infection of the liver that can cause fever, yellowing of the skin and the whites of the eyes, loss of appetite, nausea, and abdominal pain. It is usually spread by the fecal-oral route after close personal contact with an Infected person (e.g., a household member or sexual partner). You can also become Infected by eating contaminated food or drinking contaminated water. CDC estimates that about 90,000 new cases occur each year in the U.S.

 

Hepatitis A vaccine is recommended for some International travelers (Including those traveling to Mexico), persons In communities with a history of high hepatitis A rates and periodic outbreaks, men who have sex with men, street drug users, recipients of certain blood products, and Individuals with chronic liver disease.

 

Meningococcal disease

 

Menlngococcal disease Is caused by bacteria that infect the blood or membranes surrounding the brain and spinal cord. It can lead to brain damage, hearing loss, loss of limbs, and death. The bacteria are spread through airborne respiratory droplets or direct contact. Certain adults should be vaccinated, Including those who are planning to travel to an area of the world where the disease is common or who have certain health conditions (e.g., a damaged or absent spleen). College freshmen, particularly those who live in dormitories, have a slightly increased risk of the disease and should consider vaccination.

 

Everyone needs vaccinations!

 

If you need more information, can't afford shots, or don't know where to get them, contact your local or state health department, or call the National Immun­ization Hotline at (BOO) 232-2522. You can also get more information on the Web at

www.immunlze.org www.vacclneintormatlon.org

www.cdc.gov/nip www.cdc.gov/hepatitis

Immunization Action Coalition

1573 Selby Avenue, Suite 234

St. Paul, MN 55104

phone: (651) 647-9009

fax:(651)647-9131

 

The New York State Department of Health created this brochure and gave IAC permission to modify It. CDC reviewed the final text for technical accuracy. It may be reproduced without permission. If you alter It, please acknowledge that It was adapted from the Nlaw York State Department of Health and IAC.

 

Lots of people think "shots" or immunizations are just for kids. They're notl As an adult, you need to be protected against measles, mumps, rubella, tetanus, diphtheria, pneumococcal disease, influenza, and varicella. You may also need protection against hepatitis A and 8. Your best protection against these diseases? immunization.

 

Many people think diseases like diphtheria, mumps, and measles have been wiped out. This Is not the case. During 1995, at least 39 percent of all reported measles cases in the United States occurred in persons 20 years of age or older.

 

If you were never Immunized or never had these vaccine-preventable diseases, you are at risk. If you were Immunized as a child, you may need updating because some Immunizations lose their effectiveness over time. To find out what shots you may need or where to get immunizations, contact your doctor or local health department.

 

Remember...Immunizations are not just kids' stuffl

 

Measles

 

Though the number of cases of measles is at a record low, adults account for about one-third of cases. Measles is caused by a virus that is spread through the air or through direct contact with an Infected person. Symptoms of measles usually include a high fever, rash, runny nose, red eyes, and cough.

 

Measles can lead to serious complications such as pneumonia and encephalitis (Inflammation of the brain). A pregnant woman who contracts measles is at Increased risk for miscarriage or premature labor.

 

The measles vaccine Is routinely administered as part of the combination measles, mumps, and rubella (MMR) shot. Two doses generally provide lifelong protection.

 

Mumps

Mumps Is caused by a virus that Is spread by direct contact with an Infected person or through the air. The use of MMR vaccine accounts for the dramatic decline In the incidence of mumps In the U.S. However, one In five adults Is estimated to be susceptible to mumps (meaning they have neither had mumps nor been vaccinated against It). Adults who develop disease are more likely to have serious complications than are children. Mumps vaccine is recommended for children, teens, and susceptible adults and Is routinely given as part of the MMR shot.

Rubella
Rubella virus Is spread by contact with an Infected person or with articles they have used. Up to 50% of persons Infected with rubella may not have symptoms. Pregnant women who get rubella, especially during the first three months of pregnancy, may miscarry or their babies may be born with birth defects or even die.
Many Immigrants to the U.S. were never vaccinated. If you are unsure if you are Immune to rubella, consult your health care provider. Rubella vaccine Is routinely given as part of the MMR shot.

Tetanus and diphtheria

 

Tetanus, also known as lockjaw, Is caused by bacteria that enter the body through a break In the skin (often a puncture wound or other Injury). Tetanus causes painful muscle contractions, especially In the jaw. In recent years, fewer than 50 cases of tetanus have occurred annually In the U.S. Adults over 60 years of age are at highest risk for tetanus and complications of tetanus, Including death.

 

Diphtheria bacteria are spread from one person to another in the droplets released when an Infected person coughs or sneezes. Symptoms of diphtheria include sore throat, fever, and swollen neck glands. As the disease progresses, a membrane forms In the throat that obstructs breathing and may cause death.

 

While the disease is rare In the U.S., It still occurs in other parts of the world.

Adults should have completed a primary series of three shots that protect against tetanus and diphtheria. They then need a tetanus-and-diphtherla (Td) combination shot every 10 years thereafter.

 

Polio

 

The risk of getting polio Is very small in the U.S. today because of the widespread use of polio vaccines. Adult Immunization is usually not recommended unless you are traveling to a part of the world where polio still occurs. Polio virus Is usually spread by the fecal-oral route.

 

Influenza

 

A very contagious disease that affects at least 10% of the population annually, influenza kills an average of 36,000 people In the U.S. each year. More than 90% of those who die are over 65 years of age. The symptoms of influenza Include fever, chills, headache, sore throat, dry cough, runny nose, and body aches. Influenza is spread by direct contact with an infected person or through contact with the airborne virus.

 

Influenza vaccine is strongly recommended every fall for all people age 50 and over, for people 6 months of age and older who have chronic diseases, and for their close contacts. In addition, anyone who wants to reduce the risk of becoming III with influenza can be vaccinated. Vaccination against Influenza can be given at any time during the autumn or winter but Is best when It Is given In October to November, before the Influenza season begins.

 

Pneumococcal disease

Pneumococcal disease Is caused by bacteria that can lead to life-threatening Infections, such as pneumonia, bacteremla, and meningitis. It Is spread when someone comes In contact with the airborne droplets of an Infected person. Influenza and pneumonia together account for nearly 66,000 deaths each year In the U.S. Up to 20,000 of these are estimated to be due to pneumococcal disease. A single dose of adult pneumococcal vaccination Is recommended for all people age 65 and over, as well as for people of any age with certain chronic Illnesses.
Vaccinations for Adults

You're NEVER too old to get immunized!

Getting immunized is a lifelong, life-protecting job. Don't leave your healthcare provider's office without making sure you've had all the vaccinations you need.

Age ® Vaccine ¯	19-49 years	50-64 years	65 years & older
Influenza	You need a dose yearly if you have a chronic health problem,* are a healthcare worker, have close contact with certain individuals,* or you simply want to avoid getting influenza or spreading it to others.	You need a dose every fall (or winter).
Pneumococcal	You need 1-2 doses if you have certain chronic medical conditions.*		You need 1 dose at age 65 (or older) if you've never been vaccinated. You may also need a 2nd dose.*
Tetanus, diphtheria, pertussis (Td-Tdap)	If you haven't had at least 3 tetanus-and-diphtheria-containing shots sometime in your life, you need to get them now. Start with dose #1, followed by dose #2 in 1 month, and dose #3 in 6 months. All adults need Td booster doses every 10 years. If you're younger than age 65 years and haven't had pertussis-containing vaccine as an adult, one of the doses mat you receive should have pertussis {whooping cough) vaccine in it — known as Tdap. Be sure lo consult your healthcare provider if you have a deep or dirty wound.
Hepatitis B (HepB)	You need this vaccine if you have a specific risk factor for hepatitis B virus infection* or you simply wish to be protected from this disease. The vaccine is given as a 3-dose series (dose#1 now. followed by dose #2 in I mourn, and dose #3, usually given 5 months later). I                                                                                                 !
Hepatitis A (HepA)	You need this vaccine if you have a specific risk factor for hepatitis A virus infection* or you simply wish to be protected from this disease. The vaccine is usually given as 2 doses, 6-18 months apart. i                                                                            !
Human papjllomavirus(HPV)	You need diis vaccine if you are a woman who is age 26 years or younger. The vaccine is given in 3 doses over 6 months.
Measles, mumps, rubella (MMR)	You need at least 1 dose of MMR if you were born in 1957 or later. You may also need a 2nd dose.*
Varicella (Chickenpox)	If you've never had chickenpox or you were vaccinated but only received 1 dose, talk to your heahhcare provider about whether you need this vaccine.
Meningococcal	If you are a young adult going to college and plan to live in a dormitory, you need to get vaccinated against meningocQccal disease. People with certain medical conditions should also receive this vaccine.*
Zoster(shingles)			If you arc age 60 years or older, you should get this vaccine now.

* Consult your healthcare provider to determine your level of risk for infection and your need for this vaccine.
Do you travel outside the United States? If so, you may need additional vaccines. The Centers for Disease Control and Prevention (CDC) operates an international traveler's health information line. Call (877) 394-8747 or visit CDC's website at www.cdc.gov/travel for informa­tion about your destination. You may also consult a travel clinic or your healthcare provider.
Administering Vaccines to Adults: Dose, Route, Site, Needle Size, and Preparation

Vaccine	Dose	Route	Site	Needle Size	Vaccine Preparation
Tetanus, Diphtheria (Td) with Pertussis (Tdap)	0.5 mL	IM	Deltoid	22-25g. I-IW	Shake via] vigorously to obtain a uniform suspension prior to withdrawing each dose. Whenever solution and container permit, inspect vaccine visually for participate matter and/or discoloration prior to administration. If problems are noted <e.g., vaccine cannot be resuspended), the vaccine should not be administered.
Hepatitis A (HepA)	<18yrs-Q-5mL >19yrsj:LOmL	IM	Deltoid	22-25g, i-lW
Hepatitis B{HepB)	<19yrs^a5mL >20yriL: 1,0 jaL	IM	Deltoid	22-25°, \-\W
HepA+HepB (Twinrix)	>18 yrs.: 1.0 njL	IM	Deltoid	22-25g, I-IW
Human papiHomavirus (HPV)	0.5 mL	IM	Deltoid	22-25g, l-l'/z"
Influenza trivafent inactivated (IW)	Q-5jnL	IM	Deltoid	22-25g, 1-1W"
Pneumococcal	O^raL	M	Deltoid	22-23g. 1-1%"
potysacchande (PPV)		SC	Fatty tissue over triceps	23-25g, 5/«"
Menmgococcai,	0.5 mL	m	Deltoid	22-25g. 1-1%"
Menfngococcai, pofysaccharide (MPSV4)	OjmL	sc	Fatty tissue over triceps	23-25g. 5/8"	Reconstituie just before using. Use only the diluent supplied with tbe vaccine. Inject the volume of the diluent shown on the diluent label into the vial of lyophilized vaccine and gently agitate to mix thoroughly. Withdraw the entire contents and administer immedi­ately after lEconstitntion. Discard single dose MPSV4, varicella, and zoster vaccines if not used within 30 minutes after reconstiinlion. Note: Unused reconstituted MMR vaccine and multidose MPSV4 vaccine may be stored at 35-46°F <2-S°C) for a limited time. The reconstituted MPSV4 vaccine must be used within 35 days; the reconstituted MMR vaccine must be used within 8 hours. Do not freeze either reconstituted vaccine.   .
Measles, mumps, rubella (HWffi)	OJinL	SC	Fatty tissue over triceps	23-25g, 5«"
Zoster (Zos)	0.65 mL	sc	Fatty tissue over triceps	23-25g, 5/8"
VariceHa (Var)	G.5niL	sc	Fatty tissue over triceps	23-25g, 5W
influenza, five, attenuated (LAIV)	flL2mL<OJnaL into each nostril)	spray	Inlranasal	NA	Consult package insert.

Please note: Always refer to the package insert included with each biologic for complete vaccine administration information. CDC's Advisory Committee on Immunization Practices <AOP) lecomtnendaiions for the particular raecine should be reviewed as welL Access the ACIP recommendations at www.ii]uiuuuze.oig/aci|).

By Dr. Neharikaa