The Facts on Vaccinations

Making recommendations about vaccines is something I do on a regular basis as an emergency physician, advisor to national and international organizations, and consultant to persons who travel all around the globe as first responders, scientists, explorers, or tourists. The most important message I can convey to you now is that vaccines have been one of the greatest triumphs of medical science’s effort to protect the public. The science is clear - vaccines save lives. Without vaccines, the world would likely suffer repeated, possibly horrific, epidemics of preventable diseases. Critics of vaccination are sometimes very vocal, but they are misinformed. While everyone is entitled to their opinion, in the case of vaccination, the facts unequivocally carry the day. It’s time to get out from under any cloud of skepticism about vaccines and move forward with an understanding of the irreplaceable value of vaccinations for protecting human health.

As an expert in my field, I do my best to lead by example, both in the clinic and classroom. I explain to my patients, and now to you, that all my children are fully vaccinated, and I am as well. Unless a person has a specific contraindication to being vaccinated, he or she should take full advantage of one of the best protections against disease that medicine has to offer. A fraction of an ounce of prevention is worth a limb, a life, and the health and safety of entire communities.

Despite the benefits of vaccination, there is significant room for improvement when it comes to eliminating vaccine-preventable illnesses, hospitalizations, and deaths. Part of the problem is that many people, including some health professionals, have low health literacy about vaccines. Health literacy – the ability to find, understand, evaluate, communicate, and use health information to make informed health decisions – is one of the keys to a healthy life. Low health literacy affects rich and poor, young and old, and people of all racial and ethnic backgrounds. People with limited health literacy are inclined to suboptimal health habits, less likely to get preventive screenings and vaccinations, and more likely to need hospitalization. It is my hope that by offering you comments and food for thought with this document, you will learn something and be inspired to take the time to learn even more. What you discover about the science and benefits of vaccinations (immunizations) may lead you to save lives, including your own.

Over the past century, vaccines have changed the nature of healthcare and saved countless lives. Time and again, they’ve been proven safe and effective. However, many adults and children are still not vaccinated. This happens because people, whether or not they understand the importance of vaccinations, don’t make the effort. Sometimes it is because people don’t appreciate the risk incurred by failing to obtain vaccinations, or they might believe that vaccines are ineffective or perhaps even harmful. Despite best intentions, they may postpone necessary visits to the doctor or clinic because they’re inconvenient, perhaps have been frightened by ill-informed messages about the risks of vaccines, or are worried about costs. Health care and public health experts, our schools, service organizations, and our government put forth continuous efforts to make vaccines safe, effective, affordable, available, and convenient. Still, too many people remain unimmunized. When a vaccine-preventable illness befalls them, it is too late. Consider the small child with measles encephalitis, the college freshman with meningitis, the fireman with hepatitis, the disaster victim with tetanus, and the grandmother with painful shingles. Because they were not immunized, they are suffering needlessly. There is every reason to comply with guidelines for immunization – to protect you, your family, your friends, and everyone around you.

It’s vital to follow the recommendations of the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices. You might benefit from an initial vaccine, booster shots, or one of the newer types of vaccines. Always check with your health care professional to best understand your needs and options, taking into account the most recent discoveries, vaccine approvals, and expert recommendations.

To help you have that conversation with your health care professional, here is an overview of vaccine recommendations for adults. This list comes from my colleagues at the CDC.

Influenza (the flu) is a very common infectious disease among adults. Everyone above the age of 6 months should receive a flu vaccination annually. People 65 and older should consider high-dose influenza vaccine.

Tetanus, Diphtheria and Pertussis: Tetanus and diphtheria are bacterial infections with potentially serious, or even life-threatening, complications. You may have heard of tetanus referred to as lockjaw. Pertussis, often referred to as whooping cough, may turn serious.  All adults under 65 years of age are recommended to be vaccinated with a single dose of TDaP vaccine (which contains the pertussis component) if they haven't or don't know if they have received this vaccine previously. This single vaccine offers protection against all 3 pathogens. Adults aged 65 years and older who will have close contact with young children may also need a dose of this vaccine. In addition, all adults should get a booster dose of vaccine (Td) against tetanus and diphtheria every 10 years.

Varicella (chickenpox) is a type of herpes virus that causes a skin rash. It is usually mild, but in rare cases can be more serious.  Adults lacking immunity for varicella should be vaccinated. Pregnant women should not receive this vaccine.

Measles (rubeola), Mumps, and Rubella (German measles) all result from a virus. People up to age 49 should receive one or two doses of the MMR (measles-mumps-rubella) vaccine if they cannot show that they have had the disease of that they have previously been vaccinated. Persons over age 50 may be advised to receive a single dose if some other risk factor (such as medical, occupational, or lifestyle) is present. Women who are pregnant and those with low platelet counts or conditions that affect the immune system, including cancer and HIV, should avoid the vaccine.

Herpes Zoster (shingles) is caused by a virus. One-third of the adult U.S. population will at some point develop shingles. This disease is caused by the varicella zoster virus (the same virus that causes chickenpox). The shingles vaccine reduces risk of getting shingles and is recommended for adults over 60 years of age. People with a weakened immune system, undergoing cancer treatment, and pregnant women should avoid the vaccine.

Human papillomavirus (HPV) is the most common sexually transmitted infection. Two HPV vaccines are available and they are typically recommended for women up to 26 years of age who were not vaccinated as girls. They are also now recommended for boys. Pregnant women should avoid the HPV vaccination.

Hepatitis A is a liver disease. Adults at risk for hepatitis A should receive the vaccine.

Hepatitis B is a liver disease. Children and adults should be vaccinated against hepatitis B.

Meningitis is an inflammation of the membranes that cover the brain and spinal cord. Bacteria, viruses, parasites, and fungi can cause meningitis. Meningococcal vaccine is specific and indicated for certain groups, such as students living in dormitory situations and persons traveling to countries with a high risk for exposure to this disease.

Pneumococcal disease describes a group of infections caused by pneumococcal bacteria. These infections include meningitis, blood infections and, commonly in adults, pneumonia. These conditions can be very serious or even fatal.  Adults 65 years or older and younger adults with long-term health problems (such as heart disease , kidney failure or end stage disease, chronic lung disease, diminished immune system, absent spleen, heart disease, diabetes, and others) should be vaccinated.

Each year, approximately 50,000 adults die in the United States from vaccine-preventable diseases. The reality is that we all need to pay attention to being immunized properly and according to approved schedules. It’s simple, cost effective, and safe to be immunized, and it could save your life.

I wish you all the best in your pursuit of optimal wellness.