Shots aren't just kid stuff but are vital for adults

By Korky Vann
Special to The Hartford Courant

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For many seniors, doctor visits, medications and treatments are all parts of aging.

But vaccinations, they assume, are not. Studies show that most older Americans believe shots are kid stuff, more important for their grandchildren than for themselves. This is a misconception that could be fatal.

Each year in the United States, nearly 40,000 adults die from vaccine-preventable diseases or their complications. The American Society of Internal Medicine says adults are about 100 times more likely to die from vaccine-preventable diseases than children, yet few older folks think to keep a record of immunizations or to check with their physicians to be sure they are up to date.

While children have a standard vaccination schedule well known to pediatricians and parents, there is no comparable fixed schedule for adults, says Dr. John Shanley, an infectious-disease specialist at the University of Connecticut Health Center in Farmington.

"Adult immunization was a neglected area of medical management," says Shanley, who helped organize an adult immunization clinic at the health center. "It's just not as ingrained for adults as it is for children. But over the past few years, there's been a tremendous push to educate both the public and physicians on the importance of immunizations for all ages."

The federal Centers for Disease Control and Prevention and the American College of Physicians recommend the following immunizations for adults:

• Flu. The influenza vaccine is 70 percent to 90 percent effective in preventing the flu. Influenza vaccine can prevent as much as 50 percent to 60 percent of hospitalizations and 80 percent of deaths from influenza-related complications among the elderly. Adults over 50 (especially those over 65) should get a flu shot each year.

• Pneumonia. This vaccine is about 60 percent effective in preventing pneumococcal infections. Adults, especially those over 65, should get a shot every five years.

• Tetanus. Many people know they need a tetanus shot if they step on a rusty nail, but few realize the disease can be contracted other ways. Puncture wounds of any type can be infected with tetanus. Adults should get a booster every 10 years.

• Diphtheria. Immunization against this bacterial infection usually is given in combination with the tetanus-pertussis vaccine. Adults who have been vaccinated should get a booster every 10 years.

• Hepatitis. There is a safe and effective vaccine for Hepatitis A and B infectious liver diseases. Hepatitis A can be spread by infected individuals or by drinking water or eating shellfish contaminated with the virus.

"If you like shellfish, I would encourage you to get a Hepatitis A immunization. If you are an older adult traveling abroad, you should get a Hepatitis A vaccine," says Shanley.

Adults often believe that the vaccines they received as children will protect them for the rest of their lives. But some adults were never inoculated as children; those who were might have received older, less effective vaccines and even among those who were properly vaccinated, immunity can fade.

Statistics highlight the need to be vigilant about immunizations later in life. Despite effective vaccines, flu and pneumonia remain the fifth-leading cause of death among the elderly. In a typical flu season, the disease causes about 200,000 hospitalizations and takes 20,000 lives. In a bad year, it can take as many as 40,000 lives, and 90 percent of these deaths are among people 65 and older.

Forty to 50 cases of tetanus occur each year in the United States, resulting in an average of five deaths annually. Most deaths occur in people 50 years or older. Yet as many as half of Americans over 50 are inadequately immunized against tetanus.

Almost all reported cases of tetanus occurred in people who either have never been vaccinated or who were vaccinated but have not had a booster shot in the past 10 years. And one out of every 10 people who gets diphtheria will die from it.

"The elderly are more susceptible to risk factors for complications," says Shanley. "There is excess mortality among older adults who contract some of these diseases."