National Immunization Awareness Month is celebrated every August to raise awareness about the importance of vaccinations in protecting personal and public health. While childhood vaccinations have played a significant role in reducing the prevalence of many illnesses, adults must also remain vigilant in maintaining their immunity against various pathogens. Vaccinating adults not only shields us from severe diseases but also curtails the transmission of infections within the community, ultimately protecting vulnerable populations.
The COVID-19 pandemic brought the importance of vaccinations to the forefront of public health. The development of safe and effective COVID-19 vaccines was a monumental achievement that allowed for the rapid response to the global crisis. Vaccination against COVID-19 has proven to be pivotal in reducing severe illness, hospitalizations, and deaths. By achieving high vaccination rates, societies can approach herd immunity, which is essential in controlling the spread of the virus and minimizing the emergence of new variants. At this time all adults should have received at least one bivalent booster vaccine in addition to their primary series and former monovalent boosters.
We anticipate a new COVID booster vaccine will be available in the fall. The FDA’s Vaccines and Related Biological Products Advisory Committee (VRBPAC) met on June 15th, 2023, to discuss the 2023-2024 formulation of the COVID-19 vaccines for use in the U.S. The committee unanimously voted that the vaccine composition be updated to a monovalent COVID-19 vaccine with an XBB-lineage of the Omicron variant. Following discussion of the evidence, the committee expressed a preference for XBB.1.5 and have advised manufacturers who will be updating their COVID-19 vaccines that they should develop vaccines with this monovalent XBB.1.5 composition. We will keep our patients informed as more information becomes available regarding exact time frames of release and availability.
Influenza, commonly known as the flu, is a seasonal respiratory infection caused by influenza viruses. While the flu can affect individuals of all ages, it poses a more significant threat to older adults, young children, pregnant women, and those with certain medical conditions. Annual influenza vaccinations are recommended for all adults, as the virus undergoes frequent changes, necessitating updated vaccines to match circulating strains. While you still can catch the flu after having been recently immunized with this year’s strain, vaccination significantly reduces the risk of severe complications, hospitalizations, and deaths associated with the flu. We recommend this annually and will have it available in the office this fall.
Tdap (Tetanus, Diphtheria, Pertussis)
The Tdap vaccine protects against three serious bacterial infections: tetanus, diphtheria, and pertussis (whooping cough). Tetanus, caused by the bacterium Clostridium tetani, enters the body through open wounds and can lead to severe muscle spasms and respiratory failure. Diphtheria is a highly contagious bacterial infection that primarily affects the throat and can lead to breathing difficulties and heart failure. Pertussis, or whooping cough, is characterized by severe coughing fits and can be particularly dangerous for infants. The Tdap vaccine provides protection against these diseases and should be updated every ten years to ensure ongoing immunity.
In addition, pregnant women should receive it during each pregnancy to protect newborns, and should consider having other adults spending significant time around the newborn do the same.
MMR (Measles, Mumps, Rubella)
The MMR vaccine is a combination vaccine that protects against measles, mumps, and rubella. These highly contagious viral infections can lead to serious complications, particularly in children or adults who have not been vaccinated or have not acquired natural immunity. Measles can cause severe respiratory issues and even brain inflammation. Mumps can lead to painful swelling of the salivary glands, and in some cases, it can affect the testes, ovaries, or pancreas. Rubella is especially dangerous for pregnant women, as it can cause congenital disabilities in their babies. Ensuring adults are up to date with their MMR vaccinations can prevent outbreaks and protect vulnerable populations. Small communities throughout the US with lower measles immunization rates continue to have small outbreaks, resulting in some deaths. Prior to widespread immunization, three in 1,000 unimmunized children who contracted measles died, with up to 500 US deaths a year from measles. Now it is completely preventable; if everyone is vaccinated, no children will die.
Shingles (Herpes Zoster)
Shingles is caused by the reactivation of the varicella-zoster virus, the same virus responsible for chickenpox. After recovering from chickenpox, the virus remains dormant in nerve cells and can resurface later in life, causing a painful rash and nerve-related complications. The shingles vaccine is recommended for adults over the age of 50 to reduce the risk of shingles and its associated complications, such as post-herpetic neuralgia.
HPV (Human Papillomavirus)
HPV is the most common sexually transmitted infection globally, and its consequences can be severe, leading to cervical, anal, oropharyngeal, and other cancers. More than 90 percent of sexually active men and 80 percent of sexually active women will be infected with HPV in their lifetime. Around 50 percent of HPV infections involve certain high-risk types of HPV, which can cause cancer. While most infections clear on their own, some can persist and become cancerous. The HPV vaccine is recommended for young adults up to age 26 and is particularly effective when administered before sexual activity begins. Vaccination not only protects the recipient but also contributes to herd immunity, reducing the overall prevalence of HPV in the community. We recommend all patients, even after age 26, consider HPV vaccination if they have not already had it and plan to become sexually active with new partners, as preventing transmission of new high-risk strains can still decrease risk of HPV-associated cancer after age 26.
Pneumococcal infections, caused by Streptococcus pneumoniae bacteria, can lead to serious illnesses, including pneumonia, meningitis, and bloodstream infections. Adults over the age of 65, individuals with certain chronic medical conditions, and immunocompromised individuals should receive the pneumococcal vaccine to reduce the risk of severe infections and associated morbidity and mortality. A new and improved pneumococcal vaccine, called PCV20 or “Prevnar 20,” is now available as a one-time vaccine for healthy people over age 65.
Hepatitis A and B
Hepatitis A and B are viral infections that affect the liver. Hepatitis A is primarily transmitted through contaminated food and water, while hepatitis B is transmitted through contact with infected bodily fluids, such as blood or semen. Both forms of hepatitis can cause acute and chronic liver disease, leading to long-term health issues. Vaccination against hepatitis A and B is essential for adults at higher risk due to travel, occupation, or specific medical conditions. Most adults have achieved full and lasting immunity from childhood hepatitis A and B vaccines, but if you are unsure, please speak with us, particularly before international travel.
Meningococcal disease is a severe bacterial infection that can cause meningitis (inflammation of the membranes surrounding the brain and spinal cord) and septicemia (blood poisoning). Adolescents and young adults, particularly those living in close quarters, such as college students in dormitories, are at higher risk for this disease. Vaccination against meningococcal disease can prevent outbreaks and protect individuals from life-threatening complications. These vaccines are generally recommended prior to college dormitory life or other communal living environments, though we also consider immunization prior to travel to high-risk areas internationally (e.g. the “meningitis belt” of Africa).
National Immunization Awareness Month serves as a reminder of the indispensable role adult vaccinations play in maintaining public health. Vaccinations against COVID-19, influenza, Tdap, MMR, shingles, HPV, pneumococcal infections, hepatitis A and B, and meningococcal disease are vital for preventing severe illnesses, reducing the burden on healthcare systems, and protecting vulnerable populations. By staying up-to-date with recommended vaccinations, adults can contribute to a healthier and safer future for all. As we observe this awareness month, let us unite in promoting vaccination as a powerful tool in the fight against infectious diseases.
Jennifer Abrams, MD, August, 2023