Immunity and Adult Vaccines
Pediatric vaccine programs in the USA have been extremely successful against a wide range of contagious diseases, such as measles, rubella, tetanus, diphtheria, poliomyelitis, and smallpox. Smallpox has been completely eradicated as a result of compliance with quality vaccine programs.
However, healthy adults also require regular vaccines that play a critical role in protecting health throughout a person’s lifetime. Despite the availability of safe and effective vaccines, up to 70,000 people die annually in the US of pneumonia and influenza, a number that could be greatly reduced with adherence to the vaccine programs available.
Our immune system protects us from infections, toxins, and other foreign substances, collectively known as antigens, by producing proteins called antibodies. These antibodies attach to the antigen and facilitate their removal from the body before they can cause disease and harm. Antibodies are produced by specialized white blood cells called B lymphocytes (B Cells). After attaching to the antigen, these B Cells mature and multiply into distinct plasma cells that produce millions of specific antibodies that are released into the blood stream and attack the antigen (bacteria or virus). Some bacteria cause disease through the production of toxins. Our immune system produces antibodies that not only destroy the bacteria but neutralize the toxin. These antibodies remain in the circulation for several months, providing extended immunity against that particular antigen thus avoiding a recurrent infection. Some antigens stimulate production of antibodies that remain active for a lifetime, thus providing lifetime immunity and protection from that disease recurring.
Vaccines work by stimulating the immune system to produce antibodies without the person actually becoming ill. The earliest vaccines were composed of whole organisms that were weakened or crippled before being administered to the patient. These vaccines, on rare occasions, could cause the illness that it was attempting to prevent because the ‘bug’ would recover and multiply. Current vaccines are made from dead organisms or just parts of the organism. They can still stimulate an immune response in the recipient without the risk of the organism reviving and causing illness.
It seems that many people remain concerned about the risks of vaccines. However, the fact is, that vaccines have a very long record of being a safe and effective method of preventing disease. In most cases, the benefits of vaccination far outweigh any potential risks.
Receiving a vaccination reduces the chance of illness for family members, friends, and even an entire community’s chance of illness by decreasing the number of people who become sick and transmit the infection to other people. This process is sometimes referred to as “Heard Immunity”.
As already mentioned, an example of a very successful vaccine program involved smallpox. Before a vaccine was available, smallpox killed millions of people every year. As a result of an intensive vaccination program, smallpox has been completely eliminated throughout the world.
Contrary to what many people believe, the following conditions do not require that a person delay or avoid vaccinations: a) current or recent mild illness with or without fever; b) current or recent antibiotic therapy; c) history of previous local reaction at the site of a vaccine injection; d) a family history of adverse reactions to vaccines.
The following are recommended adult immunizations for ‘healthy’ people: a) Influenza – Annually for people 6 months and older; b) Pneumococcal – The most common bacteria that causes community acquired pneumonia. There are multiple types of pneumococcal bacteria, currently estimated to be about 90. One of the vaccines that provides protection from 13 types is called Prevnar13. The other vaccine available is Pneumovax23 which covers 23 types. These vaccines are recommended for everyone at age 65 or older. A person that is 65 or over and has never had a pneumococcal vaccine, should receive the Prevnar13 vaccine initially, followed by the Pneumovax23 one year later. Subsequently, they should get the Pneumovax23 every 5 years. People from 19-64 years old with health risk factors should not wait until 65 to be vaccinated. The risk factors of concern include diabetes; chronic heart, kidney, or liver disease; asthma or any chronic lung disease; smokers; and people without a spleen. Anyone with these conditions should receive one dose of Pneumovax23. Anyone in this age group with an immunocompromised condition should receive Prevnar13 followed 2-3 months later by the Pneumovax23. C) Shingles – Everyone 50 y/o or older should get the new shingles vaccine, Shingrix, even if they previously had Zostavax, the original vaccine. d) Tdap – Tetanus, diphtheria, acellular pertussis (whooping cough). If Tdap was not received at age 11 or older, they should get Tdap now then a Td every 10 years. It is not necessary to get a pertussis booster.
There are other vaccines to consider under certain circumstances: Hepatitis A, B, and C; meningococcus (common cause of meningitis); and human papillomavirus. You should discuss these vaccines with your personal physician to determine if they are appropriate for you. If you are planning travel abroad, discuss your destination with the Health Department to determine if there are endemic diseases in the area that you are visiting that require prophylactic medication or vaccines.
Dr. Tippett is the founder of Comprehensive Quality Healthcare Providers, a concierge internal medicine practice, located at 1210 Commerce Dr. Suite 106, Greensboro, Ga. 30642. He can be reached at 706-510-3659. Visit his webpage at www.drtippett.com