April 15, 2015 - Focusing on the prevention of adult illnesses such as shingles, Hepatitis A and B, some forms of pneumonia, human papilloma virus (HPV), and flu, is important for each of us individually, and collectively as a society.
In August 2012, I wrote about the importance of vaccination, particularly to avoid many of the childhood illnesses such as polio, mumps, measles, German measles, Pertussis, and tetanus. Now let’s see what can be done to help adults. Of course, there is some clinical overlap between children and adults and the list below represents just the highlights; it is not meant to be a comprehensive thesis on adult immunizations.
The reason for adult vaccination is that many serious diseases are largely be preventable. Each year, 226,000 people are hospitalized for flu and up to 49,000 die of its complications. There are also 32,000 cases of invasive pneumonia with about 3,300 deaths. Up to 1.4 million Americans have chronic hepatitis which can cause liver cancer. Finally, HPV causes about 17,000 cancers in women and about half as many in men, with 4,000 women dying each year of cervical cancer. All of this information is according to statistics compiled by the Centers for Disease Control and Prevention (CDC) in Atlanta.
Shingles—this painful rash is caused by varicella zoster, which is the same virus that causes chickenpox in children. Later in life the virus—which has been dormant—returns on one side of the body, with a painful band of fluid-filled vesicles around the face, trunk or leg. After the rash clears in four to six weeks some patients experience an uncomfortable burning neuropathic pain which just doesn’t let up. In general, the recurrence can be prevented by having a shingles vaccination at age 60 or older. The shot is approved starting at age 50 but most physicians recommend one decade later. (http://www.mayoclinic.org/diseases-conditions/shingles/expert-answers/shingles-vaccine/faq-20057859)
Hepatitis A and B—both of these forms of liver inflammation can initially cause fever, fatigue, nausea, abdominal discomfort, dark urine, jaundice, and then become dormant. The liver, however, remains infected and, ultimately, fails or develops into fatal liver cancer. Hepatitis A is usually spread by contaminated food. Hepatitis B is a blood born disease making healthcare workers and adults with certain chronic health conditions like diabetes, renal disease, chronic liver disease, or HIV infection, particularly at risk. If you have not been immunized for hepatitis as a child you should do it now.
Pneumonia—is caused by bacteria and viruses. Some forms of bacterial pneumonia can be life-threatening or result in long term problems, such as brain damage, hearing loss, or actual loss of arms or legs according to a recent CDC publication. Adults 65 or older should have one dose of conjugated pneumococcal vaccine followed by one dose of pneumococcal polysaccharide vaccine in their lifetime. Adults younger than 65 years who have certain chronic health conditions—heart disease, diabetes, lung disease, or who smoke—should also get pneumococcal polysaccharide vaccine. The same is true for those under 65 with a weakened immune system, HIV, or lack a spleen. There is no shot for viral pneumonia
Human Papillomavirus (HPV)—is relatively new in terms of vaccinations and although this article is directed to adults, the vaccinations are suggested for pre-teens and teenagers before becoming sexually active. HPV is the major cause of cervical cancer in women and can cause anal cancer, genital warts, cancer of the penis, and oropharynx (back of the throat including the base of the tongue and tonsils). We have an opportunity to change adult diseases by immunizing teenagers before they are exposed.
Influenza—this vaccination should be administered annually not only to protect yourself but to help those around you who could be seriously affected. This past season the flu shot was not as effective as it usually is due to the virus changing its immunological type. This migration happens every few years but is not a reason not to get immunized, as most often the flu shot is about 80% effective. What is equally important is the concept of “herd” immunity, where enough people do not get sick even though they are exposed and an epidemic can be avoided.
At NCH we offer all these vaccinations to our own employees and people we care for who desire to be protected. By getting the appropriate vaccinations you are helping yourself and those around you to live longer, happier, and healthier lives.
Past Health Advice Articles
Dr. Allen Weiss is CEO & President of the NCH Healthcare System. He is board certified in Internal Medicine, Rheumatology and Geriatrics, and was in private practice in Naples, Florida from 1977 - 2000. Dr. Weiss is active in a variety of professional organizations and boards, and has been published in numerous medical journals, including the American Journal of Medicine and the Journal of Clinical Investigation.