GRANGEVILLE -- Idaho County Free Press community editor Lorie Palmer had some questions on adult vaccinations, and Syringa Hospital’s Dr. Kelby Wilson recently took time to answer them:
Lorie: I had read some and heard on the news about adults who received measles (MMR) vaccinations 1963-1967 need to be revaccinated? Is this the case? (Those dates may not be completely accurate).
Dr. Wilson: From 1963-1967 there was an inactivated (killed) measles vaccine available that was not effective; therefore current ACIP (Advisory Committee on Immunization Practices, a committee of the CDC) recommendations are for individuals vaccinated prior to 1968 with either the inactivated measles vaccine or a measles vaccine of unknown type to be revaccinated with at least one dose of a live attenuated measles vaccine.
L: I guess my question is, who needs to be revaccinated or get boosters?
Dr. W: Current ACIP recommendations are for all adults “born during or after 1957 who do not have evidence of immunity against measles should get at least one dose of MMR vaccine.” The reason those individuals born before 1957 are excluded is that they are presumed to have been infected naturally with measles, mumps, and rubella and to have protection from that natural infection.
Further, certain adults without evidence of immunity are recommended to receive 2 doses based on risk factors; this includes those who are: postsecondary students, international travelers, healthcare personnel and household member/close contacts of immunocompromised persons.
L: Are there additional vaccines that adults need to think about?
Dr. W: The ACIP makes recommendation for adult vaccination based on age and prior immunization history.
Let’s tackle the basic recommendations by vaccine; with the understanding that everyone has unique individual circumstances and should discuss vaccination with their health care provider.
Current adult immunization recommendations from the ACIP:
1. Influenza: A single dose of the influenza vaccine is recommended annually for all adults.
2. Tetanus: A tetanus booster is recommended every 10 years; and at least once as an adult that booster should be the Tdap vaccine that also provides vaccination for diphtheria and pertussis.
3. MMR: See above.
4. Varicella: For those born in 1980 or later, two doses of Varicella vaccine are recommended unless previously vaccinated, or there is verification of a history of varicella or herpes zoster infection or laboratory evidence of immunity or disease.
5. Zoster: Those 50 years or older, two doses of recombinant Zoster vaccine (Shingrix) given 2-6 months apart.
6. HPV (Human papillomavirus): Females through age 26 and males through age 21; depending on age of first dose requires either a two-dose or three-dose series. Can be given up to age 45 years with shared decision making with your clinician.
7. Pneumococcal (pneumonia): Those age 65 years or older should receive one dose of PCV13, if not previously given followed by 1 dose of PPSV23 at least one year after PCV13, and at least five years after last dose of PPSV23. Those ages 19-64 with chronic medical conditions such as diabetes, alcoholism, cigarette smoking or chronic heart, lung or liver disease should receive one dose of PPSV 23. Those 19 years or older with immunocompromising conditions should discuss with their health care provider.
Certain adults will also have indications for vaccination against Hepatitis A, Hepatitis B, Meningococcal ACWY, Meningococcal B, and Haemophilus influenza type b. (Source: cdc.gov/vaccines)
L: Since most of us of a certain age do not have immunization records handy, is it safe and necessary to be revaccinated?
Dr. W: The above recommendations apply if you don’t have evidence of immunity. If you have specific questions about your unique situation, visit the CDC website for current guidelines at cdc.gov/vaccines and discuss further with your personal health care provider.
L: Beyond the typical infant and childhood vaccinations, are there vaccinations that parents need to remember for their high school and college aged children?
Dr. W: At ages 11-12 four different vaccinations are recommended unless there is a contraindication: Tdap, HPV, Meningococcal ACWY and annual influenza. Annual influenza vaccination is recommended throughout the teen years. The second and final dose of Meningoccal ACWY is recommended at age 16. Meningococcal B vaccination is recommended for teens who have an immune disorder known as complement deficiency, are taking a complement inhibitor or have a damaged or removed spleen.