Vaccines for
Adults
The New York Times 07/08/03
Most adults ensure that their children are vaccinated
against childhood diseases, but many neglect to get
their own immunizations. Even those who are well
informed about health do not seem to know that adults,
too, need vaccines. Nearly 50,000 adults die in America
each year from vaccine-preventable diseases. The Centers
for Disease Control and Prevention estimates that these
illnesses cost society $10 billion a year. Reaching
adults with vaccines takes creative thinking, but it can
be done, as has been shown by France and other countries
with effective adult vaccination programs.
While all children need basic immunizations, adults
have more varied needs, an obstacle to getting out the
vaccine message. People over 50 and anyone with chronic
heart, lung or kidney problems should get annual flu
vaccinations. But in 2001 only a quarter of the adults
from 18 to 64 with a specific risk of flu were
vaccinated. People 65 and older and those with special
health problems should also be vaccinated against
pneumococcal disease - the most common cause of
pneumonia, accounting for some 175,000 hospitalizations
each year. In addition, a vaccine can protect against
hepatitis B, which is transmitted through sex and shared
needles and kills 5,000 adults a year in the United
States.
Adults should also get a tetanus booster every 10
years. Certain people should be vaccinated against
hepatitis A, chickenpox, diphtheria, measles, mumps and
rubella. In the next few years vaccines are likely to
become available against the herpes virus and the human
papillomavirus - the world's most prevalent sexually
transmitted infection and the leading cause of cervical
cancer.
Children benefit from a good vaccine structure.
Pediatricians inform parents about vaccines and are
equipped to administer them. Schools and day care
centers require proof of immunization. In most cases, an
insurance company or the government pays for vaccines.
Many states have a computerized registry to track
immunizations.
Adults have none of these advantages. They tend to
see doctors only when they are sick, and those doctors
are often specialists who rarely mention vaccines.
Despite the fact that adult vaccines are extremely
cost-effective, Medicare and insurance coverage is
spotty. Adults are often unsure of which shots they have
had.
As children's vaccine coverage has improved, money
has become available in the last five years to create a
better system for adult vaccinations. But it has a long
way to go. The hepatitis B vaccine should be available
in prisons, at college health clinics and at sexually
transmitted disease clinics. All doctors' offices and
hospitals should provide information about adult
vaccines, and clinics and doctors who see patients on a
regular basis, like gynecologists, urologists and
cardiologists, should offer vaccines. State registries
for children could be expanded to allow adults to keep
track of their own immunization histories online. It is
worth investing in ways to promote a basic,
cost-effective health measure that not only helps
protect adults, but also everyone in their households.
