Even Grown-Ups Need Shots

When I ask my adult patients if their immunizations are up to date, the response I'll often get is, "What, me? Now? I thought vaccines were for kids."

Kids do need vaccines, of course. And most of the protection we get in childhood will last us for many years. But adults also need vaccines—to boost that initial immunization or to take advantage of newly developed protection.

Yet many adults tend to neglect this important area of preventive medicine. The rates of adult immunizations pale in comparison to the rates for kids. According to a recent survey by the Centers for Disease Control and Prevention (CDC), barely 2% of adult Americans under 64 have been vaccinated against tetanus, diphtheria, and pertussis. The new vaccine against shingles has been administered to fewer than 2% of adults over 60. And only 10% of women aged 18 to 26 have received the recommended vaccines against HPV, a virus that causes cervical cancer.

Why do adults lag so far behind children? The main reason is that adults simply visit the doctor less often than children. There also is a powerful financial disincentive for adult vaccinations: Not all insurance companies will pay for them.

But it's a mistake to let the matter slide. Just because you made it through childhood, you don't want to risk getting diseases for which you can easily find protection. Vaccinations are one of the simplest and least costly ways to stay well. Here's what I recommend to my adult patients.

The Shingles Vaccine

The vaccine for herpes zoster, better known as shingles, has been on the market only since 2006. It is intended for adults 60 and up who have had chicken pox. That disease can reactivate later in life as shingles, with the hallmark painful rash. For many, it also has a nasty aftereffect—severe pain that can last for months. One expert estimates that, if used as recommended, the vaccine could eliminate some 280,000 cases of shingles a year.

Pneumonia Vaccine

This vaccine guards against 23 of the most common strains of bacterial pneumonia, which is responsible for 40,000 deaths a year in the U.S. The pneumococcal polysaccharide vaccine (PPV) also protects against some bacterial infections of the blood. It is given as a one-time shot for all adults 65 or older and for younger people with lowered immunity.

Tetanus Booster

A tetanus shot prevents "lockjaw" or muscle paralysis, which can lead to death. Booster shots are needed every 10 years—don't wait until there's the threat of infection from an open puncture wound. (That's when adults usually get the shot.) In 2005, a combination booster, called Tdap, was introduced. In addition to tetanus, it contains low concentrations of diphtheria and whooping cough vaccines. Whooping cough was added because of a surge in cases in recent years and the realization that if the vaccine is given in childhood, its effectiveness may wear off. Giving the vaccine to adults and adolescents provides "a double benefit," says Dr. Jeanne Santoli, deputy director of immunization services at the CDC, because adults who care for or live with young children are the number-one source of infections for kids.