Do adults also need to be vaccinated?

 - Vinod Kumar 

Vaccination annually prevents ~6000000 vaccine preventable diseases worldwide. Vaccines contain the same germs or sometimes only a part of the germ that cause disease, but they have either been killed or inactivated to the point that they do not cause a disease but stimulate the immune system to produce antibodies, thus providing immunity from the disease.

“Prevention is better than Cure” is something that we have always known of. But did we know that the most effective way to prevent an infectious disease or its severe outcome, is vaccination? 

Diseases that used to be common around the world, including polio, measles, diphtheria, pertussis (whooping cough), rubella (German measles), mumps, tetanus, rotavirus and Haemophilus influenzae type b (Hib) can now be prevented by vaccination. 

However, when we think of vaccines, we envision teary-eyed children at the doctor’s clinic. Vaccines and immunization in India, so far, have been primarily directed towards infants and children, although, vaccination is as important for adults as it is for children. 

According to Dr. Vivek Nangia, Director, Pulmonology, Medical ICU and Sleep Medicine at Fortis Hospital, New Delhi , the adolescents and adults suffer a much a greater burden of illness and death due to vaccine preventable infectious diseases than do children. The success of our national childhood immunization program has resulted in the dramatic reduction in the incidence of vaccine-preventable infectious diseases in the younger population but for it to benefit the population at large it needs to be complemented by vaccination in adults.

The vaccine recommendations for the adults depend on factors like age, lifestyle, high-risk medical conditions, travel plans, and what vaccines one has received in the past.

Not everyone was, or is, fully vaccinated as a child. If one missed getting vaccines for diseases like Measles, Mumps, And Rubella or Chickenpox (or varicella) as a child -- or any of those diseases themselves – then one must get the vaccination as an adult.

Importance of adult vaccination:

You may think that vaccines are only for children and may not realize that even adults get sick from vaccines preventable diseases. You need vaccines throughout your adult life, more so in the later decades when your immune system starts getting weak and you are prone for more diseases. Vaccines are important to your health and here are some reasons why.

1. You may be at risk for serious vaccine preventable diseases that are still common

2. Chronic diseases like Diabetes, Heart disease, Kidney disease or Lung disease increases the risk of some vaccine preventable diseases:

Diabetics, in particular, are highly vulnerable to many infections.

3. You can’t afford to risk getting sick:

4. You can protect your health and the health of those around you by getting the recommended vaccines:

5. Immunization provides the safe and best protection against vaccine preventable diseases:

For diseases like Diphtheria, Tetanus, Pertussis (whooping cough) immunity is not lifelong. One may have received the DPT vaccine in childhood but a booster shot of Tdap and then Td vaccine is recommended every 10 years.

An estimated 43 million episodes of ARI (acute respiratory infections) are documented, of which 4–12% of respiratory illnesses, are due to influenza

Influenza (common Flu) spreads very easily and can be a serious illness. Besides being very debilitating, it can also be life threatening, especially, in those with a weak immune system. Influenza virus undergoes mutations and changes in its genetic constitution very often, thus creating new strains and rendering the previous immunity useless. Hence, each year a new vaccine is developed to protect against the three or four strains of influenza anticipated to be most commonly circulating in the upcoming flu season. All children, adolescents and adults must receive a Flu vaccine every year at the onset of autumn, if they do not have a medical reason not to receive the vaccine.

Herpes Zoster or Shingles is a disease primarily of the adults. It is caused by the same virus that causes chicken pox and can occur more than once. It manifests as a rash anywhere in the body including face and eyes with excruciating pain. This pain could interfere with day to day activities like eating, speaking, sleeping and could last for months. All adults more than 50 years must receive the shingles vaccine, even if they have suffered from the disease.

Hepatitis B is a severe liver disease. It is 50-100 times easier to be infected by hepatitis B than by HIV. It can be acquired by coming in contact with an infected person’s blood or other body fluids. This could happen during a sexual intercourse or just by sharing personal items like toothbrush and razors. Most infected people are symptom free in the initial stages, thus they appear normal and yet are capable of transmitting the disease to others. One’s partner may not appear ill, but could be carrying the disease. A 3 doses course of Hepatitis B vaccination is all it takes to acquire protection from this deadly disease. It also reduces the risk of liver cancer to some extent.

Human Papilloma Virus (HPV) is another common sexually transmitted viruses which is the most common cause of cervical cancer in women and oral and genital cancers in men and women as also of genital warts in both the genders. At least half of sexually active individuals get infected with HPV sometime or the other in their lives. The vaccine to prevent HPV is most effective when administered at the onset of puberty (12-13 years of age) but can be given to girls until the age of 26 years and boys up to the age of 21 years.

Pneumococcal disease is caused by a bacteria, and can lead to serious life threatening infection in the lungs, brain and bloodstream. It can also cause debilitating disease in the joints, heart, ears and sinuses. It is transmitted through droplets released by an infected person while talking, laughing, coughing or sneezing. Anyone can get pneumococcal disease. The risks are higher in elders (> 65 years of age), cigarette smokers and in those suffering from asthma, HIV, chronic diseases of heart, lungs, liver or kidneys and diabetes. Those suffering from cancers, leukemias, lymphomas, those on chemotherapy or immunosuppressive therapy are also vulnerable to acquiring this disease. India alone constitutes to around 43 million childhood pneumonia cases (23% of the world’s total) and the estimated incidence of 0.37 episodes per child-year for clinical pneumonia is predicted. 

There are two types of pneumococcal vaccines (PCV 13 and PPSV 23) that are now available and both must be given to all the elders. In the younger age group PPSV 23 or both may be given depending upon the medical condition.

Typhoid and Hepatitis A are diseases which are transmitted through contaminated food and water and can be easily and effectively prevented by appropriate vaccination.

For those traveling to Sub Saharan Africa and Tropical South America, it is mandatory to take the Yellow Fever vaccination.  A single dose is sufficient to protect against the disease for as long as 10 years.

Research has shown that cost involved in vaccination is significantly outweighed, by the long term benefits that it provides. In today’s busy and high pressure lives, missing work because of a preventable illness can result in major financial losses. With ever increasing costs of healthcare, the cost of the vaccine is only a fraction of what one would have to incur towards its treatment, leave alone the irreparable organ damage that the infection may leave behind, if one survives it. Vaccines work with the body's natural defenses to reduce the chances of acquiring certain infections and suffering from their complications. Unlike most medicines, which treat or cure diseases, vaccines prevent them. Vaccines are regarded as one of the top ten effective public health interventions. Gift yourself a vaccination program this festive season and lead a more confident, protected life. Remember, you are never too old to get vaccinated.