Routine vaccination is not just for kids | Expert Opinion
Routine vaccination is also an important part of adult care but sometimes ends up at the back of the priority list relative to acute concerns and chronic disease management.
At a recent gathering, a friend mentioned that her young adult daughter, who lives with her, recently became ill with pertussis, also known as whooping cough.
She seemed confused when I asked if either of them had received a Tdap booster, which protects against tetanus, diphtheria, and acellular pertussis.
“What is that?” she asked. “Besides COVID, I didn’t think adults needed vaccines anymore.”
Vaccination has long been a staple of pediatric practice, something we expect to come up at most every visit. Routine vaccination is also an important part of adult care, but sometimes ends up a low priority, relative to acute concerns and chronic disease management. This is one of the reasons to try and fit in a wellness visit with your clinician every year, to be sure you are up-to-date on prevention.
Adults should receive a Tdap vaccine booster every 10 years, and women should receive one dose with each pregnancy. Although the vaccines were part of your childhood immunization series, immunity to tetanus, diphtheria, and pertussis wanes over time.
Other important vaccines for adults:
The pneumococcal vaccine is recommended for adults 65 and older, and those 19 to 64 with chronic respiratory disease, certain other chronic diseases, or immunocompromising conditions.
The shingles vaccine is recommended for adults ages 50 and over. Shingles is a very painful skin rash caused by reactivation of varicella — the virus that causes chicken pox. Worse yet, older adults are at higher risk for developing chronic, unrelenting pain because of shingles. Those who received the older version of the shingles vaccine (Zostavax) prior to 2020 should still get the newer version (Shingrix), which has much-improved efficacy.
The influenza vaccine — though overshadowed by COVID in recent years — is highly recommended for all adults every fall, especially those over age 65 or with any chronic illness.
Hepatitis A, hepatitis B, meningococcal, and human papilloma virus (HPV) are other infections for which adult vaccinations are available in certain special situations, which your clinician can review with you at your wellness visit.
Recently, the FDA approved a new vaccine against respiratory syncytial virus (RSV), which can cause severe lower respiratory tract disease especially in older people and those with weakened immune systems. This new vaccine addition may significantly reduce winter respiratory disease risk and burden for vulnerable adults.
There is often a lot to cover at primary care visits in a limited time, so plan ahead and request a vaccine update in advance of your visit date. Many practices are doing outreach and may be able to arrange special nurse visits for vaccines, so it doesn’t cut into appointment time you need to discuss other issues with your doctor.
Routine vaccination is one of the most effective and time-tested preventive measures in medicine — and it is not just for kids.
Jeffrey Millstein is an internist and regional medical director for Penn Primary Care.