Your vaccine cover may be waning or there may be new options you have missed
Vaccination saves lives, prevents damaging illness and can eradicate diseases altogether [eg smallpox]. It really is the cleverest aspect of our medical progress and is now being used as a regular part of some cancer treatments, too.
Immunity can fall with age or long duration since the vaccination – thus, you need to review:
- what is available,
- what you have had off the list
- what you need to update.
And: 'teach ….your children well' [CSN from Déjà vu, released 1970]. Please ensure your children and grandchildren get their vaccines too! There are some that are specifically important for teenagers.
Conspiracy theory nonsense
Everything 'bad' you have heard about vaccination is social-media-based conspiracy/ fake news [think 'the aliens killed Jack Kennedy' etc].
Sadly this unscientific nonsense arouses fear and concern and causes vaccination hesitancy. Mothers who delay or avoid vaccinating children against measles, mumps and rubella, diphtheria or whooping cough, put their children's lives or wellbeing at risk, with good intentions but foolishly. For example measles kills and brain damages children, and where vaccination take up is low, the disease rates are now rising, globally. in 2019, prior to the COVID-19 pandemic, there were around 808 confirmed cases of measles, and 5 deaths all of which could have been avoided.
The reality
All vaccines are manufactured under strict regulations, are specifically and individually licensed and the results/ complications carefully recorded. Medical science defines who is at risk of complication and how to balance risk benefit, which vaccine is best for which age group etc. Data for Covid vaccines safety is available for over 90 million doses. All vaccines may cause minor problems such as short term temperature, a sore arm of a mild skin rash but the 4 -5 serious problems that rarely occur with vaccines are at rates in the range of 0.5 to 3 per million [1]. The lives saved or problems avoided far outweigh this for the individual and the community.
The Basics
1. Influenza and Covid every year may both reduce the risk of infection but more importantly make any illness less severe/ less life threatening. Essential for anyone 60+ or at high risk.
2. Have you been vaccinated [ever] for measles, mumps, and rubella (MMR); and tetanus, diphtheria, and -whooping cough [TDaP]. If not then resolve that now.
3. If you are on steroids or immune compromised or 80+ you should ask your family doctor about a booster program for MMR and TDaP . It is possible to check your antibody titre ie your level of immunity. There have recently been more cases of adult whooping cough in the UK.
4. Whooping cough vaccine is given to pregnant women in each pregnancy in the UK to protect their newborns.
5. In the US, Tdap vaccination is recommended for all adults [grandparents] likely to be in contact with babies <6 months of age. The babies will not have full immunity at that point and the effects of childhood vaccination will have worn off in grandparents and many parents, too. The US recommend revaccination every 10 years over 65.
Tetanus
In most circumstances, a total of 5 doses of vaccine at the appropriate intervals are considered to give satisfactory long-term protection – routine boosters every 10 years are no longer recommended in the UK.
Hepatitis A & B
If you never had Hepatitis A or B and you travel it is a must. Protection lasts 5 years for Hepatitis B and 25 years for Hepatitis A. Anyone immunocompromised, on steroids or with multiple sexual partners, a drug habit or MSM's are at higher risk
Shingles [Herpes Zoster]
Shingles has the potential complication of postherpetic neuralgia, which leads to long-term nerve pain in 10%-18% of patients over age 40.
Any one with immune compromise has a higher risk of getting shingles and its complications, including neurological problems and skin and eye infections You need: two doses of the recombinant zoster vaccine (Shingrix) given 6-12 months apart. In the US this is for anyone 50+. In the UK NICE recommends 65+ years and older. Any adults with weakened immune systems due to disease or medical treatments should get two doses of the recombinant vaccine, as they have increased risk of severe complications of infection.
Respiratory Syncitial Virus [RSV]
Thijs is most important in infants but affects vulnerable older adults too. The UK and US offer a single shot to 75+ [UK] and 60+ [USA].
Pneumococcal infection
The pneumococcus bacterium causes pneumonia, meningitis and septicaemia. There are several Pneumococcal Vaccines. In the US the long term protection that comes from use of PCV20 (Prevnar20) is preferred. In the UK the wider protection but shorter duration PPSV23 (Pneumovax23) is used over age 65, usually just once. If your vaccine was 5 years ago and you are vulnerable a second dose is advisable.
Other information that may be important for family members
Teenagers: There are several vaccines that teenagers need including HPV and Meningococcal vaccine. Human Papilloma Virus [HPV] causes cervical, oropharyngeal, penile and anal cancer. It is spsread due to sexual activity from person to person and to the relevant site depending on the nature of sexual activity and use of toys. The highest protection is for vaccination before infection ie before any sexual activity [pre-teens, both sexes]. However if this has been missed, later vaccination in mid or late teens is still valuable. Indeed, anyone below 50 who hasn't had it and is not in a stable monogamous relationship should consider vaccination as there are no complications and it may have benefit.
Gay family members: in particular, MSM have additional health risks and there is guidance here - https://www.cdc.gov/std/treatment-guidelines/msm.htm.
Summary
Review your vaccination list: top up and complete your protection.
1. Covid 19 vaccines and adverse events. Vaccine Volume 42, Issue 9, 2 April 2024, Pages 2200-2211
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