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General · 3rd December 2015
Pat Peterson
Vaccination in adulthood is done for a variety of reasons. Some are boosters for given vaccines for ongoing immunization. Others are offered seasonally such as for flu. Some vaccines are offered only to seniors as immunity wanes as one ages and some seniors become more at risk for certain infections and/or viruses.

Tetanus/diphtheria (Td) is a vaccine needed by all. Children receive Td throughout their school years, with the last update given in high school. Adults need a booster every 10 years. It is important for islanders to update their Td, as tetanus is a bacterium that lives in the soil and is more prominent in farms that have animals. As most islanders have gardens and/or animals, this puts us at risk. Tetanus is acquired when the skin barrier is disrupted due to a cut or wound. Diptheria is a respiratory infection that was common but is rarely seen now days due to vaccination.

Influenza or flu vaccine is recommended on a yearly basis for all individuals but is particularly important for the very young and the very old as well as those with chronic health issues such as COPD, heart failure, or asthma. These individuals are at higher risk of complications if they do get the flu. While the flu vaccine affords protection, it is still possible to get the flu. For those who do get the flu, it is recommended that you take antiviral medication, which helps lessen the severity, duration and length of time one is contagious. Antivirals such as oseltamivir and zanamivir can be prescribed as early as 12-24 hours after coming down with the flu.

Pneumovax is as vaccine covered under MSP given to adults over the age of 65, those without a spleen, or any adult with chronic disease at diagnosis. It affords protection against 23 varieties of the pneumococcal bacteria. It is a one-time vaccine with a booster that is offered in special circumstances. Prevnar 13 is a new vaccine for pneumococcal disease that is now given to children as part of their initial booster series. It protects (as the name suggest) against 13 varies. While pneumovax is given to prevent invasive disease, prevnar 13 works to protect against pneumococcal pneumonia. At this time it is not offered to adults under MSP but can be obtained through the public health for approximately $100.00. It is hoped that it will be offered to all older adults within the next few years. If one chooses to do both vaccinations, it is recommended that you receive the prevnar 13 first, followed by the pneumovax six mos. later.

Zostavax is the vaccine offered for protection against shingles. Shingles is the reactivation of the varicella virus or chicken pox in adults. It causes painful skin lesions. This is not covered under MSP. It costs approximately $200.00. At this time, the vaccine is only about 50% effective in preventing the occurrence of shingles. However, for those who do get shingles, vaccination can shortens the length and severity of infection. It can also help to prevent post-herpetic neuralgia, which is nerve pain that lasts long after the rash has disappeared.

Hepatitis is a virus that causes inflammation and in some cases damage to the liver. There are three main types of hepatitis: Hep. A, B and C. Hep. A is the least serious of the three, contracted from consumption of water/food infected with the virus or through close contact with an infected individual. Although some individuals become quite ill, most recover and are then immune from further infection. Hep. B is contracted through contact with blood or body fluids of an infected individual. Of those who contract hep. B, 95% will clear the virus within 6 months of infection. These individuals will then be immune to further infection. The other 5% do not clear the virus, have chronic infection and can pass this along to others. Unfortunately these 5% do not always show symptoms right away and are thus contagious. Hepatitis C is contracted ONLY through contact with infected blood and body fluids. Although some people can clear the virus, 95% are unable and become chronically infected. Of those infected, most develop liver disease and are at risk of liver failure. They are also capable of passing the virus to others. At this time there is no vaccine to protect against hep. C. It is recognized that all adults born before 1970 are at risk for Hepatitis C and it is strongly recommended that these individuals get one time testing to determine if they carry the hepatitis C virus.

Both Hep. A and B can be prevented through vaccination. For hep. B, immunization is now offered through the initial series for infants and this covers young adults who accessed the program from 1990 onward. If you do not fall into this category, both hep. A and B immunizations are not covered under MSP and must be paid for out of pocket. One can get vaccinated for Hep. A, Hep. B or both at the same time with a product called Twinnrix. Hep. A. vaccination is two part, given once, then a booster at six mos. Hep. B is a three-part vaccine given once, with a booster at three mos. and again at six mos. Twinrix is similar with three doses. Both Hep. B and Twinnrix can be given on an accelerated schedule with three doses given within one month but it then requires a booster at one year to afford longer protection. Vaccination for both A and B require a prescription from a health care practitioner. The cost is around $100.00 for Hep A, $210. for Hep B. There are few contraindications for getting immunized with either vaccine. It is recommended that any adult who is travelling to a country where hepatitis is endemic, or to a 3rd world country get vaccinated against both Hep. A and B.

For those infected with Hep. C, there are now new treatments that are very effective in clearing the virus. These are non-interferon based, often single or double oral regimes taken by the individual for up to 3 mos. There are few side effects and the efficacy is up to 97-98%. If you have been infected with Hep. C and have chosen not to do the old therapy, contact your health practitioner NOW to be assessed for the new treatment.