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Recommended vaccinations for adults and travelers

Main Line Health March 14, 2017 General Wellness By Matthew N. Olah, MD

Q: I’ve always kept up with my kids’ vaccinations and I get the flu vaccine every year. I’m just wondering if are there other vaccines I still need to get as an adult? Also, I’m planning to travel outside the country this year. How do I know what immunizations I will need?

These are great questions to consider in light of the fact that many American adults are under-vaccinated and there are some vaccines we receive as children that do not provide lifetime protection.

There are several vaccines you need to keep up with in your adult years, and depending on your age and health condition, as well as your job, lifestyle, and the kind of traveling you do, additional vaccinations may be recommended for you.

First and foremost, everyone six months and older should get a flu shot, with “rare exception,” according to the Centers for Disease Control (CDC). The flu, in its many strains that can change from year to year, can lead to serious complications and is a common cause of contagious disease transmission and missed work and life opportunities.

Many adults are also overdue for Td/Tdap (tetanus, diphtheria, pertussis). The CDC recommends a Td booster every 10 years and a booster for pertussis (whooping cough) if you never got vaccinated for it as a teenager. There are also vaccines that you may not have received, or which may not have existed when you were a child, such as:

  • MMR (measles, mumps, rubella)
  • HPV (human papillomavirus)
  • Varicella (chicken pox)
  • Hepatitis A and hepatitis B

Special considerations apply to pregnant women and soon-to-be pregnant women. These groups should consult with their providers before getting vaccinated for flu or other infectious diseases. There are also people who simply should not be vaccinated due to allergies such as to egg or latex, or because of a weakened immune system due to cancer, HIV/AIDS, or another chronic illness.

As your immune system ages, you become more susceptible to diseases such as shingles (herpes zoster), regardless of whether you had chicken pox when you were younger, and pneumococcal disease (pneumonia), which can cause severe respiratory illness and death. Shingles vaccination is recommended for anyone over 60 years of age and the pneumococcal vaccine is recommended if you are over 65. Pneumococcal may sometimes be recommended for people with asthma, heart disease, or diabetes, or for people who have no spleen (needed to help fight off bacteria and support the immune system), or those who have an already weakened immune system due to cancer or another chronic illness. Smokers may also be candidates for the pneumococcal vaccine.

Many insurance providers cover routine vaccination so you generally have little or no out-of-pocket expenses when you get vaccinated. Take the adolescent and adult vaccine quiz to determine which vaccines you might need and be sure to talk about your vaccination history with your primary care doctor.

If you’re planning to leave the country, it’s a good idea to see your doctor four to six weeks in advance to discuss your health and vaccine history, and determine what vaccines may be recommended for you, depending on the type of traveling you’ll be doing and where. If you’re a business person traveling to a major city, for example, you may not need the same vaccinations as a backpacker who is going on a rain forest adventure. A great way to anticipate the vaccinations you might need is by going to the travelers’ health section of the CDC website and plugging in your destination and other details to receive a customized recommendation for vaccinations and any travel precautions you should take. Keep in mind that some vaccines, such as antimalarial medications, may require multiple doses over a period of days or weeks. Be prudent and plan for this well in advance of your trip.

Ultimately, your health care provider can guide you and make detailed recommendations based on knowledge of your health history.