The Doctor Is In
Gail Hacker, MD
Welcome to the first edition of "The Doctor Is In."
In this column we hope to address issues of interest to you regarding your health. This entry will be dealing with immunizations (shots). Every once and awhile it is a good idea to review your immunization status to make sure you are up-to-date with current recommendations for people in your age group and risk category. The beginning of a new school year marks a good time to do this.
Tetanus/Pertussis (Lockjaw/Whooping Cough): The tetanus vaccine is usually combined with other vaccines, most commonly the diphtheria vaccine. A new vaccine has been developed to additionally provide adults with protection against pertussis (whooping cough). This is because we have been seeing many cases of pertussis in adolescents and adults, partially because some did not receive a series of childhood vaccines for various reasons, and partially because immunity may wear off. In adults, pertussis can cause a prolonged cough (up to 3 months) and occasionally lead to pneumonia. The main concern, however, is an adult can pass this infection on to infants who have not completed their initial series of vaccines. In infants, pertussis can cause severe illness, and possibly sudden death. Because of this concern, it is now recommended that all adults receive one dose of the new vaccine, Tdap, at either the time of their booster for tetanus (recommended every 10 years), or sooner if they will be in close contact with small children, as in the case of childcare workers or nursing/health care personnel.
Hepatitis B: Hepatitis is an infection of the liver. There are many types of hepatitis, but there are shots to protect only against Hepatitis A and B. Hepatitis B is transmitted between people through infected body fluids such as blood and semen. It can lead to liver failure, liver cancer and death. Because of these serious complications of chronic hepatitis infections, we recommend that all adults consider getting vaccinated against Hepatitis B, particularly people going into health care or child care, those who are currently using IV drugs, and men who have sex with men. The recommended schedule is 3 shots spaced over 6 months time. People going into health care should have a blood test 6-8 weeks after their third shot to make sure they are immune to Hepatitis B.
HPV: the human papilloma virus has been identified as the main cause of cancer of the cervix. It is transmitted through sexual contact and is extremely contagious. There are now immunizations to protect women from infection with this virus. It is best given before a woman becomes sexually active, but can be given to any woman under the age of 26. It is given as a series of 3 shots over 6 months. A later issue of the "Doctor Is In" will focus on this topic exclusively.
Influenza (flu): More people die from influenza every year than from any other vaccine-preventable disease. People at highest risk are infants and toddlers, elders, and those with heart and lung disease. Because it is extremely contagious, even if you are not in a high risk group yourself, you should consider getting vaccinated to prevent giving the infection to someone who is at higher risk. The flu shot is reformulated every year by infectious disease experts to try to target the type that will be most likely prevalent that year. Shots usually become available in the fall and need to be repeated every year because the virus changes every year.
Meningitis: The "meningitis vaccine" really only protects against one cause of bacterial meningitis, but this bacteria is very strong and extremely contagious. It primarily affects small children, adolescents, and college coeds living in dormitories. The current recommendation is that all students entering high school and all college students living in dorms receive this vaccine. It is also available to college students not living in dorms if they want to decrease their risk of contracting this deadly disease.
MMR (measles, mumps and rubella): These 3 diseases are very contagious. Measles can lead to encephalitis (infection of the brain). Mumps in adults can lead to sterility. Rubella is generally not a significant infection in adults, but can lead to severe birth defects if a pregnant woman contracts this illness. The current requirement for MMR is 2 doses of vaccine over an unspecified period of time for all people born after or during 1957.
Supporting you in good health,
Gail Hacker, MD