Adults urged to get vaccinated

A nurse displays a tetanus, diphtheria and pertussis whooping cough vaccine at a free medical and dental health clinic in Los Angeles (Copyright Reuters 2017)

Too many U.S. adults are not getting vaccinated, putting themselves and others at risk, immunization experts say.

According to the latest available data, about 44 percent of adults over age 19 had a flu shot; 20 percent had a Tdap vaccine, which protects against tetanus, diphtheria and pertussis; and 20 percent of 19-to-64-year-olds at risk of pneumonia had that vaccine (compared to 60 percent of those over 65).

Just 27 percent of those over age 60 were vaccinated against herpes zoster, which cuts the risk of shingles in half, according to new guidelines from the Advisory Committee on Immunization Practices (ACIP) published in Annals of Internal Medicine.

"Vaccinations not only protect you. They also protect those around you," ACIP liaison Dr. Sandra Fryhofer said by email, yet, "vaccination coverage rates for adults are abysmal."

Fryhofer, an Atlanta physician and adjunct associate professor at Emory University School of Medicine, also pointed to racial and ethnic disparities in vaccination rates, with whites more likely than all other groups to be vaccinated. And she noted that adults with health insurance are two to five times more likely to be appropriately vaccinated.

"It's a double whammy for those without insurance. They don't have insurance coverage if they get sick and they don't have insurance coverage to pay for vaccinations that can help them stay well," said Fryhofer, who was also a member of the working group that came up with the new guidelines.

Dr. Walter Orenstein, associate director of the Emory Vaccine Center in Atlanta, called adult vaccine uptake "disappointing" and said it is substantially below the rates achieved for most recommended vaccines for young children.

"All adults should be vaccinated against influenza annually, receive a booster of a tetanus vaccine every 10 years, two different types of pneumococcal vaccine when they turn 65, and a vaccine to prevent shingles when they reach age 60," Orenstein said by email.

If you weren't vaccinated as a child, you may need additional vaccines, added Orenstein, who was not involved in the guidelines. "All pregnant women should receive influenza vaccine, which protects them and their newborns, as well as a dose of a vaccine that protects their newborns against whooping cough," he said.

Some of the important changes made in the 2017 guidelines, according to Fryhofer and Orenstein, include the recommendation that everyone aged 6 months and older should still be vaccinated against flu, even this late in the season, but should not use the nasal vaccine, which has been found not to work very well.

Another new guidance says that young people vaccinated against human papilloma virus (HPV) before age 15 need only two vaccine doses, not three, given at least five months apart. If you're 15 or older and haven't been vaccinated before, you still need three doses.

People with liver disease should get the hepatitis B vaccine, which also protects against liver cancer. And those with HIV need two doses of a meningococcal vaccine, and doctors should use the same vaccine for all doses.

How well an individual responds to a vaccine - whether or not it works - depends on the health of their immune system, Fryhofer said. "The very young, the old, or anyone with a weakened immune system - including pregnant women - don't respond as well," she noted.

"Healthy people are more likely to make the most protective antibodies, and that's another reason why it's important for them to get vaccinated. They need to stay protected so they won't spread infection to others who are not so healthy and could die if they get sick," she added.

The Centers for Disease Control and Prevention's Vaccinations for Adults web page (http://bit.ly/2fzDu1A) can help you determine which vaccines you need, Orenstein said.