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 According to the latest available data, about 44 percent of adults
over age 19 had a flu shot; 20 percent had a Tdap vaccine, which
protects against tetanus, diphtheria and pertussis; and 20 percent
of 19-to-64-year-olds at risk of pneumonia had that vaccine
(compared to 60 percent of those over 65).
Just 27 percent of those over age 60 were vaccinated against herpes
zoster, which cuts the risk of shingles in half, according to new
guidelines from the Advisory Committee on Immunization Practices (ACIP)
published in Annals of Internal Medicine.
“Vaccinations not only protect you. They also protect those around
you,” ACIP liaison Dr. Sandra Fryhofer said by email, yet,
“vaccination coverage rates for adults are abysmal.”
Fryhofer, an Atlanta physician and adjunct associate professor at
Emory University School of Medicine, also pointed to racial and
ethnic disparities in vaccination rates, with whites more likely
than all other groups to be vaccinated. And she noted that adults
with health insurance are two to five times more likely to be
appropriately vaccinated.
“It’s a double whammy for those without insurance. They don’t have
insurance coverage if they get sick and they don’t have insurance
coverage to pay for vaccinations that can help them stay well,” said
Fryhofer, who was also a member of the working group that came up
with the new guidelines.
Dr. Walter Orenstein, associate director of the Emory Vaccine Center
in Atlanta, called adult vaccine uptake “disappointing” and said it
is substantially below the rates achieved for most recommended
vaccines for young children.
“All adults should be vaccinated against influenza annually, receive
a booster of a tetanus vaccine every 10 years, two different types
of pneumococcal vaccine when they turn 65, and a vaccine to prevent
shingles when they reach age 60,” Orenstein said by email.
If you weren’t vaccinated as a child, you may need additional
vaccines, added Orenstein, who was not involved in the guidelines.
“All pregnant women should receive influenza vaccine, which protects
them and their newborns, as well as a dose of a vaccine that
protects their newborns against whooping cough,” he said.
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Some of the important changes made in the 2017 guidelines, according
to Fryhofer and Orenstein, include the recommendation that everyone
aged 6 months and older should still be vaccinated against flu, even
this late in the season, but should not use the nasal vaccine, which
has been found not to work very well.
Another new guidance says that young people vaccinated against human
papilloma virus (HPV) before age 15 need only two vaccine doses, not
three, given at least five months apart. If you’re 15 or older and
haven’t been vaccinated before, you still need three doses.
People with liver disease should get the hepatitis B vaccine, which
also protects against liver cancer. And those with HIV need two
doses of a meningococcal vaccine, and doctors should use the same
vaccine for all doses.
How well an individual responds to a vaccine - whether or not it
works - depends on the health of their immune system, Fryhofer said.
“The very young, the old, or anyone with a weakened immune system -
including pregnant women - don’t respond as well,” she noted.
“Healthy people are more likely to make the most protective
antibodies, and that’s another reason why it’s important for them to
get vaccinated. They need to stay protected so they won’t spread
infection to others who are not so healthy and could die if they get
sick,” she added.
The Centers for Disease Control and Prevention’s Vaccinations for
Adults web page (http://bit.ly/2fzDu1A) can help you determine which
vaccines you need, Orenstein said.
SOURCE: http://bit.ly/2kihPJM Annals of Internal Medicine, online
February 7, 2017
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