Tip/Thought of the Day

An Overview Of Recommended Vaccines

Now that we know why it’s so important to get vaccinated, lets talk about specific vaccines recommended by the CDC and the National Institute of Health:

Flu vaccine:

Influenza is a serious disease that can lead to hospitalization and sometimes even death. During flu season, flu viruses circulate at higher levels in the U.S. population. “Flu season” in the United States can begin as early as October and last as late as May. An annual seasonal flu vaccine is the best way to reduce your risk of getting sick and spreading it to others. It takes 2 weeks before the vaccine becomes effective so illness can still occur during that time. That’s why it’s imperative to get it early in the fall before flu season takes hold.

Every flu season is different, and the influenza infection can affect people differently. Millions of people get the flu every year, hundreds of thousands of people are hospitalized, and tens of thousands of people die from flu-related causes every year. Even healthy people can get very sick from the flu and spread it to others. The CDC estimates that flu-related hospitalizations since 2010 ranged from 140,000 to 710,000, while flu-related deaths are estimated to have ranged from 12,000 to 56,000. Of those who died, 80% were not vaccinated and 40% of children had no risk factors for complications. When more people get vaccinated against the flu, less flu can spread through that community. Everyone 6 months of age and older should get a flu vaccine annually.

A flu vaccine is needed every season for two reasons. First, the body’s immune response from vaccination declines over time, so an annual vaccine is needed for optimal protection. Second, because flu viruses are constantly changing, the formulation of the flu vaccine is reviewed each year and sometimes updated to keep up with changing flu viruses. There is still a possibility you could get the flu even if you got vaccinated. The ability of the flu vaccine to protect a person depends on various factors, including the age and health status of the person being vaccinated, and also the similarity or “match” between the viruses used to make the vaccine and those circulating in the community. If the viruses in the vaccine and the influenza viruses circulating in the community are closely matched, vaccine effectiveness is higher. If they are not closely matched, vaccine effectiveness can be reduced. However, it’s important to remember that even when the viruses are not closely matched, the vaccine can still protect many people and prevent flu- related complications. Such protection is possible because antibodies made in response to the vaccine can provide some protection (called cross-protection) against different, but related, influenza viruses.

According to the CDC, people with egg allergies can receive any licensed, recommended age-appropriate influenza vaccine and no longer have to be monitored for 30 minutes after receiving the vaccine. People who have severe egg allergies should be vaccinated in a medical setting and be supervised by a health care provider who is able to recognize and manage severe allergic conditions.

Hepatitis B vaccine:

Although the Hepatitis B vaccine is made from parts of the Hepatitis B virus, it cannot cause Hepatitis B infection. The vaccine is usually given as 3 or 4 shots, over a 6-month period.

Infants should get their first dose of hepatitis B vaccine at birth and will usually complete the series at 6 months of age.

All children and adolescents younger than 19 years of age who have not yet gotten the vaccine should also be vaccinated.

Hepatitis B vaccine is recommended for unvaccinated adults who are at risk for Hepatitis B virus infection such as healthcare and public service providers, those with chronic liver disease, kidney disease, diabetes or are immunocompromised. There are no known risks to getting the Hepatitis B vaccine at the same time as other vaccines.

Mumps, measles, rubella vaccine:

The CDC recommends that people get MMR vaccines to protect against measles, mumps, and rubella. Children should get two doses of MMR vaccine, starting with the first dose at 12 to 15 months of age, and the second dose at 4 through 6 years of age. Teens and adults also should also be up to date on their MMR vaccination. Children may also get the MMRV vaccine, which protects against measles, mumps, rubella, and varicella (chickenpox). This vaccine is only licensed for use in children who are 12 months through 12 years of age.

MMR vaccine is given later than some other childhood vaccines because antibodies transferred from the mother to the baby can provide some protection from disease and make the MMR vaccine less effective until about 1 year of age. Teenagers, healthcare personnel, and adults who do not have evidence of immunity against measles should get two doses of MMR vaccine separated by at least 28 days.

Women of childbearing age should check with their doctor to make sure they are vaccinated before they get pregnant. Women of childbearing age who do not have evidence of immunity should get at least one dose of MMR vaccine. It is safe for breastfeeding women to receive MMR vaccination. Breastfeeding does not interfere with the response to MMR vaccine, and the baby will not be affected by the vaccine through breast milk.

DTaP (Diphtheria, Tetanus, Pertussis) vaccine:

DTaP vaccine can help protect your child from diphtheria, tetanus, and pertussis.

• DIPHTHERIA (D) can cause breathing problems, paralysis, and heart failure. Before vaccines, diphtheria killed tens of thousands of children every year in the United States. Starting in the 1920s, diphtheria rates dropped quickly in the United States and other countries that began widely vaccinating. In the past decade, there were less than five cases of diphtheria in the Unites States reported to CDC. However, the disease continues to play a role globally with 7,321 cases reported to the World Health Organization in 2014.

• TETANUS (T) causes painful tightening of the muscles. It can cause “locking” of the jaw so you cannot open your mouth or swallow. About 1 person out of 5 who get tetanus, dies. Before vaccines, an average of 500-600 cases occurred annually. There were about 30 reported cases per year between 1996 and 2014. Nearly all cases of tetanus today are in people who never got a tetanus vaccine, or adults who don’t stay up to date on their 10-year booster shots.

• PERTUSSIS (aP), also known as Whooping Cough, causes coughing spells so bad that it is hard for infants and children to eat, drink, or breathe. It can cause pneumonia, seizures, brain damage, or death. Before whooping cough vaccines became widely available in the 1940s, about 200,000 children got sick with it each year in the United States and about 9,000 died as a result of the infection. After this, whooping cough cases reached an all-time low in the 1980s. But due to lack of vaccinations, it started making a comeback in the 1990’s.

Most children who are vaccinated with DTaP will be protected throughout childhood. Many more children would get these diseases if we stopped vaccinating.

Before vaccines, as many as 200,000 cases of diphtheria and hundreds of cases of tetanus were reported in the United States each year. Adults should also get a one-time dose of Tdap to protect themselves, their families and friends, and infants they may be in contact with. Td vaccine can protect adolescents and adults from tetanus and diphtheria. Td is usually given as a booster dose every 10 years, but it can also be given earlier after a severe and dirty wound or burns.

Pneumococcal vaccine:

Vaccines help prevent pneumococcal disease, which is any type of infection caused by Streptococcus Pneumoniae bacteria. There are two kinds of pneumococcal vaccines available in the United States:

• Pneumococcal conjugate vaccine (prevnar)

• Pneumococcal polysaccharide vaccine (pneumovax)

The CDC recommends pneumococcal vaccine for all children younger than 2 years old,  for all adults 65 years or older and people 2 through 64 years old who have a long-term health condition such as diabetes, asthma or heart, lung, and kidney disease. Adults 19 through 64 years old who smoke cigarettes should also get the vaccine.

Adults age 65 years and older should receive both Prevnar and Pneumovax but not at the same time. You should receive a dose of Prevnar first (if possible), followed by a dose of Pneumovax 1 year later. If you’ve already received any doses of Pneumovax, the dose of Prevnar should be given at least 1 year after receipt of the most recent Pneumovax dose. If you’ve already received a dose of Prevnar before age 65 years, another dose of Prevnar is not recommended. Talk to your healthcare provider to find out if you need one or both of these vaccines.

Shingles vaccines:

Read the post on Postherpetic Neuralgia to learn more about Shingles and the vaccine.

HPV vaccines:

HPV vaccines protect against infection with human papillomaviruses (HPV). HPV is a group of more than 200 related viruses, of which more than 40 are spread through direct sexual contact. Among these, several HPV types cause general warts, and about a dozen HPV types can cause certain types of cancer—cervical, anal, oropharyngeal, penile, vulvar, and vaginal.

The Food and Drug Administration (FDA) has approved Giardisil to prevent infection with HPV types 16 and 18, two high-risk HPV’s that cause about 70% of cervical cancers. Giardisil prevents an even higher percentage of some of the other HPV-caused cancers and provides protection against types of HPV that cause 90% of genital warts.

All children aged 11 or 12 years of age, young women through age 26, and young men through age 21 should get the HPV vaccine. No additional doses are required after completing the initial series.

Meningococcal vaccine :

Meningococcal disease is a serious illness caused by a bacterium. It can cause meningitis, which is an infection of the brain and spinal cord, and it can also cause blood infections. The infection can cause death or lifelong disability.

Anyone can get meningococcal disease, but it is most common in infants less than 1 year of age. Teens are less likely to be infected than infants, but disease levels increase in adolescence starting around age 11, and peak around 19 years of age.

About 375 people get the disease each year, and about 10 to 15 out of 100 people infected with meningococcal disease die. Of those who survive, up to 20% will have permanent disabilities, such as deafness, brain damage, loss of limbs, or seizures.

Meningococcal disease is spread by contact with secretions (saliva or spit) from the nose and throat. Kissing, drinking directly from the same container, and having close social contact (living in the same household or dormitory) are examples of how this disease spreads. All 11 to 12 year olds should be vaccinated with a meningococcal vaccine and given a booster dose at 16 years old.

As we discussed in the last post, keeping up on vaccinations ensures all of us stay healthy and safe. Ask your healthcare provider which are appropriate for you.

-Dr. Courtney

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