Routine immunization for adults

Article Abstract:

Routine use of six vaccines, namely those for tetanus-diphtheria, influenza, pneumococcus, hepatitis B, measles, and rubella is recommended for adults living in the United States. Following a primary series of immunization, everyone should also receive a tetanus-diphtheria booster injection every 10 years. At least 50 percent of adults are known to be susceptible to diphtheria, and in recent years, most cases of tetanus have occurred in those over age 50. Everyone over age 65, as well as anyone with chronic and immunosuppression diseases should be vaccinated against influenza annually. Household members and those caring for high-risk patients should also receive flu shots. A single injection of pneumococcal vaccine is recommended for those over age 65 and those with chronic diseases, alcoholism, and other conditions that predispose to pneumococcal pneumonia, particularly asplenism (absence of the spleen) and sickle cell anemia. Revaccination is recommended for high risk patients who received the earlier vaccine and should be considered for anyone who received the more recently developed and more potent vaccine six or more years ago. Hepatitis vaccine is recommended for high-risk persons, including health care workers. Pregnant women should be screened for hepatitis B antigen (HBsAg) to prevent severe disease in the mother and chronic infection in the fetus. For improved efficacy, this vaccine should be given in the deltoid (shoulder muscle) rather than the buttock. Those born before 1956 are probably immune to measles; young adults who received only one dose of measles vaccine after their first birthday should be revaccinated before going to college, entering a health care profession or traveling to a foreign country. Anyone who has not been vaccinated should receive two doses at least one month apart. Rubella vaccine is recommended for previously unimmunized women of childbearing age and susceptible healthcare givers who have direct contact with pregnant women. Inadvertently giving vaccine during pregnancy does not cause congenital rubella syndrome. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Pneumococcal vaccine, Pneumococcal vaccines, Influenza, Hepatitis B, DPT vaccine, Diphtheria-tetanus-pertussis vaccines

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Measles revaccination

Article Abstract:

There were 7,000 cases of measles reported to the United States Centers for Disease Control in the first six months of 1989, mainly in children and college students, who had been previously vaccinated against the disease. This sharp increase in the incidence of measles has prompted practitioners to request additional vaccinations against measles for their patients. Measles is a mild disease in healthy, well-nourished young children, but may become a serious respiratory infection in infants, malnourished children, children with weakened natural defense mechanisms or immune systems, and adults. Otitis media, or inflammation of the middle ear, and pneumonia are common complications; encephalitis, inflammation of the brain, may occur in one of every 1,000 measles patients. Recent outbreaks of measles have occurred mostly in children more than ten years of age. A new modified measles vaccine is associated with a lower incidence of rash and fever, but may need to be given a second time in two to ten percent of people vaccinated in order to be effective. People born before 1956 are considered to be naturally immune to measles because they had the disease. Children vaccinated at less than 15 months of age are at higher risk of developing measles. Children vaccinated between 1978 and 1980 also appear to have a higher incidence of the measles, because a new stabilizer, a substance that prevents breakdown of the vaccine, was only added in 1979. Revaccination against measles does not appear to be harmful, except in pregnancy. The measles vaccine is available alone or in a combined form which also protects against the mumps and rubella. The combination vaccine is more costly. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Demographic aspects, Vaccination

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Measles revaccination - an additional note

Article Abstract:

A recent Medical Letter article about additional vaccinations against measles indicated that there was no reason, other than expense, not to use the combined measles-mumps-rubella vaccine. However, a reader wrote to describe his experience with the combined vaccine in a group of adults. A number of persons receiving the combined vaccine developed arthritic reactions, characterized by inflammation of the joints, which persisted for weeks. Arthritis and arthralgia, or pain in the joint, are known adverse effects of the rubella vaccine, and occur most frequently in adults with an incidence of 12 to 20 percent, less often in children with an incidence of up to three percent, and with intermediate incidence in adolescents. The measles vaccine is available as a single vaccine. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Vaccines

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