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Adult Vaccinations
Are you up to date?
Vaccination is an effective way to reduce illness. By getting vaccinated, you are not just protecting yourself from becoming sick. You are also less likely to pass the illness on to others. You shield your family, friends, co-workers and anyone else with whom you have close contact. For this reason, vaccination programs work best when many people take part. It is easier and costs less to prevent disease than to treat it. By being vaccinated, you help reduce illness and lower health care costs for your community.
Preventing illness through vaccination is a lifelong process. It does not stop at childhood. All adults should make sure their vaccinations are up to date.
How do vaccines work?
Vaccines train your immune (defence) system to fight off certain bacteria and viruses faster than normal. This is called developing immunity. After vaccination, you may feel tired or have a higher temperature as your body builds immunity. These side effects are normal and should go away within a few days. Although vaccines are quite safe and cannot cause the disease they protect against, allergic reactions can occur. This is rare. Most vaccines are given as injections, which may cause a sore spot at the injection site. Some vaccines may be taken by mouth or even inhaled through the nose.
I was vaccinated as a child. Why do it again?
Some vaccines need more than one dose to develop immunity. As time passes, immunity may decrease and a repeat dose, called a booster, may be needed. As well, new versions may have come out since you last had a vaccination. The Canadian National Advisory Committee on Immunization has made new recommendations on the use of some vaccines. To protect yourself and those around you, be sure to get the right ones.
Many vaccines are available. Some protect against one specific disease. Others combine vaccines to protect against several diseases at the same time. In Canada, certain vaccinations are considered routine, meaning all adults should receive them. Other vaccinations are recommended for those at higher risk of infection.
Your vaccination needs may differ from those of others. Talk to your doctor, public health nurse or pharmacist to see which vaccines can benefit you. Check your vaccination record with your family doctor or public health center to see if it is up to date. Remember, vaccines work best at preventing disease when many people are vaccinated. If your record is unclear, your doctor can advise about re-vaccination. The following vaccinations are routine and recommended in Canada.
Routine vaccinations
Tetanus, Diphtheria and Pertussis
All adults should be immunized against the bacteria that cause tetanus, diphtheria and pertussis. Tetanus is an infection of the nervous system that causes mild to severe muscle spasms. Diphtheria infects the upper respiratory tract, commonly resulting in fever, sore throat and swollen lymph nodes. Pertussis, also known as whooping cough, is another infection of the respiratory tract that can result in a long-lasting cough. Combination vaccines against these diseases are available. The combined tetanus, diphtheria and pertussis vaccine, called Tdap, should be given once in the adult lifetime. Additionally, all adults should get a booster of the combined tetanus and diphtheria vaccine, called Td, once every ten years.
Measles, Mumps and Rubella
All adults should be immunized against the viruses that cause measles, mumps and rubella. Measles infect the respiratory system and can cause a rash on the head and body. Mumps affect the salivary glands, pancreas and occasionally, the testicles. It can also cause inflammation of the brain. Rubella is an infection with flu-like symptoms that can result in a rash on the face and body. It can be especially harmful to the developing baby of a pregnant woman who is not immune to rubella. A combination vaccine against all three viruses, called MMR, is available. All adults who have not been vaccinated before or do not have immunity against these diseases should receive it.
Varicella
The varicella-zoster virus causes the illness commonly known as chickenpox. This infection causes an itchy rash and blisters on the face and body. If you have had chickenpox in the past, you are considered immune. However, exposure to the virus does not always result in illness, but immunity can still develop. Adults who have not had chickenpox, especially if they did not grow up in Canada, should check their immunity status with their doctor. Those who are not immune should receive the varicella vaccine.
Recommended vaccinations
Influenza
Influenza, more commonly known as ‘the flu’, is one of the most common diseases vaccination can prevent. Different strains or variations of the influenza virus circulate each year. Each fall season, a new vaccine is used to protect against the most common strains, based on recommendations by the World Health Organization. Influenza vaccination is available as an injection for all ages and as a nasal spray for those aged two to 59. It is recommended for all adults, especially those at high risk of complications from influenza. High-risk adult groups include those who:
- are over age 65
- live in nursing homes or other long-term care facilities
- are pregnant
- have chronic medical conditions like heart or lung disorders, kidney disease, diabetes and other metabolic diseases
- have cancer or impaired immune system function
- have anemia or hemoglobinopathy (a problem with the hemoglobin that carries oxygen in the blood
- are very obese (BMI greater than 40)
- are aboriginal.
Pneumococcal infection
Streptococcus pneumoniae is a bacterium that can cause severe illness like pneumonia, meningitis or bacterial infection of the blood. Pneumococcal vaccine against Streptococcus pneumoniae is recommended for those who:
- have impaired immune function
- do not have spleens or functioning spleens
- have chronic medical conditions like heart or lung disorders, kidney disease, diabetes and other metabolic diseases
- smoke
- are over age 65.
Shingles
As well as chickenpox, the varicella-zoster virus can cause an illness called herpes zoster, or shingles. This results in a painful, blistering skin rash. Adults aged 60 years or over who have previously had chickenpox should get the shingles vaccine.
Human papillomavirus
Human papillomavirus (HPV) can cause cancer of the cervix, or anal and genital warts. The two different vaccines available against HPV are HPV2 and HPV4. HPV2 protects against HPV types that cause cancer of the cervix. It is recommended for women aged ten to 25. HPV4 protects against the viruses that cause cancer of the cervix, as well as anal and genital warts. It is recommended for women aged nine to 45. HPV4 vaccine can also be given to men age nine to 26 to prevent anal and genital warts.
Hepatitis A and B
Hepatitis A virus (HAV) can cause infection to the liver. It is transmitted by oral ingestion or through direct contact with infected people. Hepatitis A vaccine is recommended for those who:
- engage in sexual behaviours involving anal contact
- have household contact with infected individuals
- live in correctional facilities or facilities for developmentally challenged people
- live in rural or remote areas with poor sanitation or poor supplies of clean drinking water
- use illicit drugs
- have chronic liver disease
- are travelling to areas where HAV is frequently transmitted.
Hepatitis B virus (HBV) can also infect the liver. It is transmitted through direct contact with infected fluids. Hepatitis B vaccine is recommended for those who:
- work in health care or emergency services and may be exposed to blood or blood products
- have household or sexual contact with infected individuals
- are men having sexual contact with men
- have unprotected sex or other risky sexual practices
- have a history of sexually transmitted infections
- inject drugs
- are staff or residents of correctional facilities or facilities for developmentally challenged people
- have hemophilia or need frequent blood products or transfusions
- go through hemodialysis
- have chronic liver disease
- are travelling to areas where HBV is frequently transmitted.
For adults who need vaccination against both HAV and HBV, a combined vaccine is available.
Routine Vaccinations for Adults |
|
Vaccine |
Dosing schedule |
Tetanus and diphtheria (Td) |
3 doses at 0, 1 and 6 months, then 1 dose every 10 years |
Tetanus, diphtheria and pertussis (Tdap) |
1 dose (replacing Td) |
Measles, mumps, rubella |
2 doses at least 1 month apart |
Varicella |
2 doses at least 1 month apart2 doses at least 1 month apart |
Recommended Vaccines for Adults |
|
Vaccine |
Dosing schedule |
Influenza |
1 dose every year |
Pneumococcal |
1 dose; some individuals may need second dose after 5 years |
Shingles |
1 dose |
Human papillomavirus |
3 doses at 0, 1 and 6 months (for HPV2), |
Hepatitis A |
2 doses at 0 and 6 months |
Hepatitis B |
3 doses at 0, 1 and 6 months |
Hepatitis A and B combined vaccine |
3 doses at 0, 1 and 6 months, |
Meningococcal |
1 dose, then 1 dose every 5 years if needed |
Recommended Vaccines for Adult Travellers |
|
Vaccine |
Dosing schedule |
Cholera |
2 doses 1 week apart, starting at least 2 weeks before travel |
Japanese encephalitis |
3 doses at 0, 7 and 30 days |
Poliomyelitis |
1 dose |
Rabies pre-exposure |
3 doses at 0, 7 and 21 days |
Tick-borne encephalitis |
3 doses at 0, 1 to 3 months and 9 to 12 months, then 1 dose every 3 to 5 years if needed |
Typhoid |
1 dose (injection) or 3 to 4 oral doses |
Yellow fever |
1 dose, then 1 dose every 10 years if needed |
Meningococcal disease
Neisseria meningitidis is a bacterium that can cause severe illness like meningitis or widespread infection of the blood and other organs. Meningococcal vaccine against Neisseria meningitidis is recommended for those who:
- are young adults
- are military recruits
- do not have a spleen or have a poorly functioning spleen
- have complement, properdin or factor D deficiency (where the body will have trouble defending itself against Neisseria meningitidis)
- are travelling to areas where Neisseria meningitidis is frequently transmitted.
Adults at high risk of continued exposure can be re-vaccinated every five years.
Vaccinations for travellers
When travelling to other countries, you may be exposed to some vaccine-preventable diseases you would never encounter at home. Get vaccinated before you travel to reduce your risk of becoming ill. You will also be less likely to carry disease back home. The vaccinations you need depend where you are going and what you are doing. Check with a travel health practitioner or travel clinic for more details. (See article on page 18.) Vaccinations are available to protect against the following regional diseases:
- cholera
- Japanese encephalitis
- poliomyelitis
- rabies (pre-exposure)
- tick-borne encephalitis
- typhoid
- yellow fever
FAMILY HEALTH is written with the assistance of |
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FAMILY HEALTH is written with the assistance of |
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