Vaccines for Adults Are Underused
Many Americans haven't received new shots that guard against preventable illnesses
Shots just aren't just for kids, but grown-ups don't seem to know that. Just 2 percent of adults have gotten themselves immunized against tetanus, diphtheria, and whooping cough, according to data that the federal Centers for Disease Control and Prevention released yesterday. And just 2 percent of people over age 60 have received the new vaccine against shingles. Young women are doing a bit better; 10 percent of women ages 18 to 26 have availed themselves of the new HPV vaccine designed to prevent cervical cancer. Still, it's hardly a stellar showing.
"More and more people are taking about wellness," says Anne Schuchat, assistant surgeon general. Most adults know that they should be getting mammograms, colon cancer screening, and other preventive tests, she says. "We really need to think about vaccines in that same context."
The three newest adult vaccines, the Tdap, the shingles vaccine, and the HPV vaccine, are the latest in almost a dozen vaccines routinely recommended for adults by the federal government. The new ones are:
Tdap (for pertussis and other infections). Cases of whooping cough—also called pertussis—are on the rise among adults and teenagers, with about 25,000 cases annually. In adults, the bacterium causes a nasty cough that can linger for weeks, but the real concern is that adults can pass the bug on to unvaccinated infants, for whom the disease can be fatal. Adults have been told for decades to get a tetanus booster shot once every 10 years. The CDC now says one of those should be the shot known as the Tdap, which was licensed in 2005. It protects against tetanus, diphtheria (a bacterial disease that causes life-threatening throat infections), and whooping cough. Healthcare workers and people who have contact with infants should get the Tdap every two years to reduce the risk of spreading infection.
Caveats: Side effects in adults include pain or swelling at injection site, fever, headache, tiredness, and nausea. Tdap hasn't been tested for safety in people over age 65.
Shingles vaccine. The CDC says that people over age 60 should get this new vaccine to help avoid getting shingles, which causes a painful, lingering rash. About 1 million people in the United States get shingles each year, and the risk goes up with advancing age. The vaccine, licensed in 2006, also protects against a painful condition known as post-herpetic neuralgia, which can persist long after a shingles attack. In a clinical trial, the vaccine prevented shingles in 51 percent of participants, and post-herpetic neuralgia in 67 percent.
Caveats: The shingles vaccine contains a live virus and thus is too risky for pregnant women or people infected with HIV. Reported side effects include soreness and swelling at the shot site, as well as headache. It was more effective in people ages 60 to 69 than in older age groups. The vaccine costs about $160 and is covered under Medicare Part D, which means that private insurers decide whether or not to pay for it.
Human papilloma virus vaccine. Women up to age 26 should now get vaccinated against strains of HPV that most commonly cause cervical cancer. (It's believed to confer the most protection to women who haven't been previously exposed to those strains.) The vaccine was licensed in June 2006. It contains no live virus, which makes it generally safer.
Caveats: Side effects include injection-site discomfort and mild to moderate fever. The vaccine has not been tested for safety during pregnancy and thus isn't recommended for pregnant women. It takes three shots over six months to confer protection. The three shots cost a total of $360, and while large insurers are increasingly paying for it, not all health plans do.
Other vaccines that are routinely recommended for healthy adults protect against:
The CDC provides an online quiz that is helpful in figuring out what vaccines an individual needs. The agency's website also provides background on individual vaccines and their side effects.
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