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Health report: Grown-ups need vaccinations as well

Many adults don’t realize vaccines can wear off

POSTED: February 6, 2008 5:04 a.m.

A recent national report says many adults aren't getting the immunizations they need. The Hall County Health Department provides these vaccines, including, left to right, shingles; pneumonia; tetanus, diphtheria and pertussis; measles, mumps and rubella; meningitis; and in the syringe; hepatitis A and B.

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When you were a kid, you dreaded going to the doctor because you were afraid you’d have to get a shot. Now, you don’t have to worry about that anymore.

But medical experts say maybe you should.

"People don’t realize that vaccines are something they need throughout their life," said Ben Sloat, adult immunization coordinator for the Georgia Department of Human Resources.

According to a report released last week by the National Foundation for Infectious Diseases, many adults could benefit from protection from a variety of diseases, but they aren’t getting vaccinated.

"It’s definitely a concern," said Dr. Christy Wagner, a family practice physician at the Neighborhood Healthcare Center on Thompson Bridge Road. "There are very serious consequences for some of these diseases, particularly if you’re in a high-risk category."

There are several reasons an adult might need vaccinations. Some may have never received their full series of immunizations during childhood. Those who did get shots decades ago may need boosters now, because immunity can fade over time. Also, there are some vaccines that are particularly targeted to older adults, such as those for shingles and pneumonia.

With Georgia’s large immigrant population, Sloat said there could be a significant number of adults who’ve never been immunized.

"The school vaccination program has been around since the 1960s," he said. "But if someone grew up outside Georgia or outside of the country, they may not have received all of their shots."

Wagner said doctors don’t always know which shots their patients have had or what they might need, often because they don’t ask. But Wagner said doctors need to pursue the issue more aggressively. There’s also a lack of follow-up, Wagner said.

Even when doctors do recommend vaccinations, Wagner said they often meet with resistance from patients.

"There’s a lot of fear," she said. "A lot of adults remember having bad reactions to vaccinations when they were children."

But these days, most vaccines are made from "killed," not live, viruses and bacteria. So while the patient may have a localized reaction such as bruising at the injection site, the shot cannot give them the disease it’s supposed to be protecting against.

Sometimes patients need to be convinced why a shot is advisable. One argument, Wagner said, is that even if the person isn’t interested in protecting their own health, "these vaccines are important for protecting those around you, especially if you live with someone who has a suppressed immune system."

A disease that only produces a day or two of mild illness in a healthy adult could be fatal if it’s passed on to a family member who has cancer or HIV, she said.

Wagner particularly tries to persuade patients to get the Dtap, which she said is usually covered by insurance.

"You need a tetanus booster every 10 years, and this vaccine also protects you and your family against pertussis," she said.

Pertussis, or whooping cough, has made a comeback in recent years. The illness can last for weeks and produces a cough so violent it can crack a rib, cause vomiting or leave the patient gasping for breath.

For patients older than 60, Wagner strongly recommends immunizations for influenza, pneumonia and shingles.

Shingles is caused by the same virus that causes chicken pox. After someone has had chicken pox, the virus can stay dormant in the body for decades, then suddenly re-emerge as shingles. It usually starts as a rash on one side of the body, then progresses to excruciating pain that can last for months.

But Wagner said many patients don’t know the disease is preventable. "(The vaccine) is fairly new, and a lot of patients just don’t realize it’s there," she said.

Another new, and somewhat controversial, vaccine is the one for human papillomavirus (HPV). It can help prevent both genital warts and cervical cancer, but it’s most effective if the woman has not yet contracted HPV, a sexually transmitted disease. It’s recommended for girls and women ages 11 to 26.

But the HPV vaccine has to be administered in three separate doses, and it’s pricey. Dave Palmer, spokesman for District 2 Public Health in Gainesville, said the three-shot series costs $450 at the Hall County Health Department.

"The HPV and shingles vaccines are so expensive we don’t keep them on site, so people have to make an appointment ahead of time and we order the shots for them," he said.

Prices vary among individual health departments, but in Hall the shingles vaccine costs $170. The three-shot hepatitis B vaccine, which does not have to be pre-ordered, costs $177 for the series.

Some vaccines are much more affordable. The tetanus and MMR shots each cost $14 at the Hall health department. Flu shots are $25; pneumonia $35.

There is a federal Vaccines for Children program that pays for shots for low-income kids. But no such program exists for adults.

Lack of insurance is a major reason people don’t get immunized, Palmer said. But they should consider it an investment in their health.

"Prevention is definitely better than treatment," he said.


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