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Vaccinations: Which are Right for You?

Depending on your age and previous medical history, your doctor may recommend certain vaccinations for you throughout the year. These vaccinations attempt to prevent and lessen the severity of harmful, communicable diseases. Here is a list of commonly recommended vaccinations for adults, and why you might need each of them:

Influenza (“flu”) vaccine: Each autumn, a newly-formulated influenza vaccine becomes available to the public. This vaccine reduces your chances of getting influenza for the fall and winter seasons, when the virus is most severe and widespread. However, if you do still get the virus even after being vaccinated, the vaccine should lessen the severity and duration of symptoms. Because influenza increases the risk of hospitalization and mortality for many individuals each year, this vaccination is strongly recommended for anyone without a contraindication.

Pneumococcal vaccines: There are two types of Pneumococcal vaccines, PCV13 and PPSV23. Each vaccine provides protection against bacteria responsible for pneumonia, meningitis, and sepsis infections. An individual’s need for one or both vaccines, as well as the timing for each, depends on his or her personal medical history. Those with weakened immune systems may even require close monitoring or hospitalization if infected. Timely and accurate vaccination is strongly recommended.

All healthy adults are recommended to receive PCV13 once, beginning at age 65, and followed by PPSV23 one year later.

Adults aged 19-64 with the following medical conditions are recommended to  receive both PCV13 and PPSV23, administered at specific time intervals, depending on the particular medical condition. Conditions include: HIV, asplenia, chronic renal failure, nephrotic syndrome, immunodeficiency disorders, cerebrospinal fluid leak, cochlear implant.

Adults aged 19-64 with the following medical conditions are recommended to receive only PPSV23. When these individuals turn 65, they should then receive PCV13, and a repeat PPSV23 vaccination, five years after the initial PPSV23. Conditions include: chronic heart, lung, or liver disease, alcoholism, chronic tobacco abuse/smoking, diabetes mellitus.

*This information can cause confusion very quickly, and the above is only a concise overview. The Center for Disease Control (CDC) website has extensive information regarding pneumococcal vaccinations, if you should require more information.

Recombinant Zoster vaccine: The recombinant zoster vaccine (RZV), also called Shingrix, protects against the varicella zoster virus, which is responsible for a shingles (or herpes zoster) rash.

Your risk for developing shingles increases as you age; this rash may burn, itch or cause intense pain to a localized area of your body. While the rash should resolve in 7-10 days with proper treatment, complications from a shingles rash can last for months or years.

Preventing the rash all together through timely vaccination can prevent these unpleasant symptoms. Unless contraindicated, adults aged 50 and older should receive two doses of Shingrix, two to six months apart. Those with weakened immune systems may be recommended for Shingrix before age 50.

What if I’ve already had chickenpox? If you did have chickenpox (likely as a young child), you already contain inactive varicella zoster virus in your body. The same virus is responsible for both chickenpox and shingles. Shingrix is recommended for you to help prevent active viral infection as shingles.

What if I’ve already had Zostavax? Prior to the development of Shingrix, Zostavax was the recommended vaccine of choice for shingles prevention. Per the CDC, Shingrix is recommended for all individuals regardless of Zostavax history. In those with a contraindication to Shingrix, Zostavax may be substituted.

What if I’ve already had shingles? You should still get the Shingrix vaccine to prevent future outbreaks of the virus. While repeat outbreaks are uncommon, they do still occur in some patients.

What if I have shingles right now? You should wait for the viral rash to resolve, then let your doctor or pharmacist know you’re interested in the vaccine.

Varicella vaccine: This vaccine protects against Chickenpox; this should be given to adults who test negative for immunity to Chickenpox. If you were not infected with Chickenpox as a child, or did not receive the vaccine as a child, you will likely be recommended for this vaccine. This consists of two injections scheduled at 4-8 weeks apart.

Tetanus (“Tdap”) vaccine and “Td” vaccine: “Tdap” vaccine protects against Tetanus, Diphtheria and Pertussis infections; this vaccine should be given to adults and followed by “Td” vaccine as a booster for tetanus, every ten years. Tetanus infection commonly causes muscular spasms, including lockjaw; Diphtheria can cause fever, generalized weakness, respiratory symptoms; Pertussis, or “whooping cough,” can inflict serious respiratory illness and infect others.

HPV vaccine: This vaccine protects against Human Papillomavirus (HPV); certain strains of HPV may turn into cervical cancer in females, and having the virus will increase risk of future cervical cancer. Aside from cervical cancer, HPV can also cause vaginal, penile, anal, vulvar, rectal and oropharynx cancers. This 3-series vaccination is recommended in adolescents aged 15-26, both male and female.

MMR vaccine: This vaccine protects against Measles (fever, cough, red spots scattered throughout the skin), Mumps (salivary gland swelling; testicle or ovary swelling), Rubella (“German measles”, can cause birth defects if a pregnant woman is infected). This vaccine is administered to patients who do not have evidence of immunity. Immunity would include: born before 1957, lab evidence of immunity or disease history, documented history of disease.

Meningococcal vaccine: This vaccine will protect against bacterial meningitis, or inflammation of the brain and spinal cord’s protective lining. This infection can be deadly; therefore, any individuals with immune deficiencies, as well as those living in close quarters (college freshmen living in dormitories, military members) should receive this vaccine.

Hepatitis A: This vaccine protects against infectious inflammation of the liver, yellowing of the skin and eyes. It is given as a series of two injections. Those recommended for hepatitis A vaccine include: clotting disorders, chronic liver disease, high risk of exposure (men who have sex with men, traveling to countries with high incidence of hepatitis A, IV drug users).

Hepatitis B: This vaccine protects against chronic liver disease, which can be severe. Those recommended for Hepatitis B vaccination include healthcare workers, sanitation workers, individuals with HIV, individuals with diabetes, living or working in correctional facilities, traveling to countries with high incidence of hepatitis B infection.

*Vaccination recommendations for pregnant patients vary from the general population; if you are pregnant or planning to become pregnant, your OB/GYN provider can discuss which vaccines are best for you.

*Traveling to foreign countries may also require you to have additional vaccinations, which vary from country to country. You can check the CDC website, as well as your local public health department/travel clinic, to ensure you’re appropriately vaccinated before traveling.