Influenza (Flu) Vaccine

• The single best way to prevent the flu is to get a flu vaccine each season. Flu vaccine is recommended for everyone age 6 months and older.

• While everyone should get vaccinated, certain people are at greater risk for serious complications if they get the flu: older people, young children, pregnant women, people with certain health conditions such as asthma, COPD, diabetes or heart disease, and people living in facilities like nursing homes.

• It is also important for anyone who lives with or cares for people at high risk for developing flu-related complications to get vaccinated each year.

• Flu seasons are unpredictable and can be severe. Annual flu vaccination should begin by September or as soon as vaccine is available, and continue throughout the flu season, which can last as late as May. Flu season can begin as early as October. Seasonal flu activity usually peaks in January, February or later.

• It takes about two weeks after vaccination for antibodies to develop for protection against influenza virus infection. Flu vaccines will not protect against flu-like illnesses caused by non-influenza viruses.

• Complications of flu can include bacterial pneumonia, ear infections, sinus infections, dehydration and worsening of chronic medical conditions, such as congestive heart failure, asthma or diabetes.

• A 2013 study by CDC flu experts estimated that cumulatively over six flu seasons, from 2005 to 2011, flu vaccination averted approximately 13.6 million illnesses, 5.8 million medical visits, and approximately 112,900 flu-related hospitalizations in the United States.

• The highest fraction of prevented outcomes associated with flu vaccination was observed during the 2010-2011 season, when more than 18.5 percent of potential influenza illnesses were averted by vaccination. Researchers attributed this to the increase in vaccination coverage among all age groups that occurred following the 2009 pandemic.

Tetanus and Tdap Vaccine

• Tdap vaccine is recommended for adults age 19 and older who did not get Tdap as an adolescent to protect against tetanus, diphtheria, and pertussis (whooping cough).

• Tdap vaccine is especially important for adults who will have close contact with newborn babies or infants younger than 1 year.
• Pregnant women are also recommended to get the Tdap vaccination during each pregnancy, preferably at 27 through 36 weeks, to help protect their newborns from whooping cough.
• Tdap vaccine can be safely given at any time during pregnancy, but is recommended during the third trimester to pass the most amount of protection to the baby.
• Tetanus, diphtheria and pertussis are all caused by bacteria.
• Both diphtheria and pertussis are spread from person to person.
• Tetanus enters the body through cuts, scratches or wounds/
• In 2012, more than 48,000 cases of whooping cough were reported in the U.S., a nearly 60-year high. While overall reporting of whooping cough declined during 2013, 13 states and Washington, D.C. reported an increase in cases compared with the same time during 2012.
• CDC’s current estimate is that Tdap vaccination protects about 65 out of 100 adolescents who receive it.
• Tdap is an effective vaccine, but it does not protect as well as we would like and may only protect against whooping cough for a few years.
• Adults who haven’t had a Tdap shot yet should talk to their doctor about getting it as soon as possible, no matter when they last had a tetanus (Td) booster.
• After receiving the Tdap shot, adults should continue to get a Td booster every 10 years.
• Adults need to get Tdap even if they were vaccinated as a child or have been sick with whooping cough in the past; neither provides lifelong protection.

Hepatitis A Vaccine

• Hepatitis A vaccine is recommended for adults who are working in or traveling to any area of the world outside of Canada, Western Europe and Scandinavia, Japan, New Zealand and Australia.

• Other adults who should get the vaccine include men who have sex with men, people who use illegal drugs, people who have clotting factor disorders, people with chronic liver disease, and people who might be exposed to hepatitis A on the job (such as those who work with hepatitis A virus in laboratory settings or with hepatitis A-infected primates).

• Hepatitis A is caused by a virus. It spreads primarily by oral contact with fecal matter, person to person, or by contaminated food or water.

• More than 95 percent of adults will develop immunity within one month of a single dose of hepatitis A vaccine. Nearly 100 percent will have immunity after two doses.

Hepatitis B Vaccine

• Hepatitis B vaccination is recommended for adults at high risk of infection by sexual or blood exposure to hepatitis B virus.

• People at high risk of sexual exposure include sex partners of people who are positive for Hepatitis B, people who have had more than one sex partner in the last six months, people seeking evaluation or treatment for a sexually transmitted disease, and men who have sex with men.

• People at risk of blood exposure include current or recent injection-drug users, household contacts of people who are positive for Hepatitis B, residents and staff of facilities for the developmentally disabled, people with end-stage renal disease, and some health care and public safety workers.

• Other groups at risk include international travelers to regions with high or intermediate levels of Hepatitis B infection and people with HIV infection.

• Hepatitis B is caused by a virus and is spread from person to person primarily through blood or semen.

• In healthy adults, the vaccine is 80 to 95 percent effective in preventing infection or clinical hepatitis in those who complete a hepatitis B vaccine series (usually three doses).

Herpes Zoster (Shingles) Vaccine

• Herpes zoster (shingles) vaccine is recommended for adults aged 60 years or older.

• Shingles occurs when latent varicella zoster (chickenpox) virus reactivates later in life.

• Pain from shingles lesions, called post-herpetic neuralgia, can be very severe and can last a year or more.

• 50% of people who live until age 85 will develop shingles.

• In people 60 years and older, the shingles vaccine:
•             Reduces the risk of shingles by about half (51%).
•             Reduces the risk of post-herpetic neuralgia (prolonged pain at the rash site) by 67%.
• The shingles vaccine is effective for at least six years but may last longer; research is being done in this area.

Pneumococcal Vaccine

• Pneumococcal polysaccharide vaccine is recommended for all adults age 65 and older.

• In addition, certain adults younger than 65 years should be vaccinated if they have high-risk conditions such as cardiovascular disease, pulmonary disease, diabetes, alcoholism, cirrhosis, cerebrospinal fluid leak, or a cochlear implant, or if they have a suppressed immune system.

• Adults 19 years and older should also get a pneumococcal-polysaccharide vaccine if they have asthma or smoke cigarettes.

• There were approximately 32,000 cases of invasive pneumococcal disease in 2012. Of those cases, there were about 3,300 deaths.

• The majority of cases and deaths occur among adults 50 years or older, with the highest rates among those 65 years or older. Almost everyone who gets invasive pneumococcal disease needs treatment in the hospital.

• Overall, pneumococcal polysaccharide vaccine (PPSV23) is 30 to 70 percent effective in preventing invasive pneumococcal disease, such as meningitis and bloodstream infections.

• Effectiveness is highest among otherwise healthy adults.
• Effectiveness is lowest among adults who have significant underlying illness.

• Adults with significant underlying illness (including HIV, immuno-compromising conditions, asplenia, kidney failure, end-stage renal disease, or those receiving hemodialysis) should also get the pneumococcal conjugate vaccine (PCV13), which has proven highly effective among children.

Vaccine Safety

• Vaccines are tested and monitored.

Vaccines are thoroughly tested in clinical trials with thousands of volunteers before being licensed by the Food and Drug Administration (FDA). Both the CDC and FDA continue to monitor vaccines after they are licensed.

• Vaccine side effects are usually mild and temporary.

The most common side effects are soreness, redness or swelling at the injection site. Severe side effects are very rare.

• Vaccines are one of the safest ways to protect your health.

Even people taking prescription medications can be vaccinated. However, if you are pregnant or have a weakened immune systems, talk with your health care professional before being vaccinated, as some vaccines may not be recommended for you.

Frequently Asked Questions

Why do adults need vaccines?

All adults need vaccinations to help prevent getting several serious diseases that could result in poor health, missed work, medical bills and not being able to care for family. Even if adults were vaccinated at a younger age, the immunity from those vaccines can wear off or the virus or bacteria that the vaccine protects against changes so your resistance is not as strong. And as adults get older, they may also be at risk for vaccine-preventable diseases due to their job, lifestyle, travel or chronic health condition.

Are vaccine-preventable diseases really a threat for adults?

Yes. Any of the diseases that adult vaccines protect against can be serious. And many of these diseases are common in the U.S. Every year thousands of adults in the U.S. still suffer serious health problems, are hospitalized, and even die from diseases that could be prevented by vaccines. For example, in 2012, there were approximately 32,000 cases of invasive pneumococcal disease, resulting in 3,300 deaths.

Older adults and those with chronic health conditions such as lung disease (asthma or COPD), heart disease, and diabetes are at higher risk of complications from pneumococcal bacteria, influenza and other vaccine-preventable diseases.

What vaccines do adults need? How often and when do they need them?

All adults need a flu vaccine every year. The flu vaccine is also recommended for pregnant women to decrease the risk of flu and flu-related severe illnesses in children less than 6 months old.

All adults need a tetanus vaccine every 10 years to protect against harmful bacteria in the environment that can enter through broken skin.

All adults should get a one-time dose of Tdap vaccine to protect against tetanus and diphtheria plus whooping cough. Whooping cough epidemics have increased in the U.S. in the past few years. Women are recommended to get a Tdap vaccine during every pregnancy to protect themselves and their newborn babies.

Other vaccines you need as an adult are determined by factors such as age, lifestyle, job, health condition and vaccines you’ve had in the past. They may include those that protect against shingles, pneumococcal disease, human papillomavirus (which can cause certain cancers), meningococcal disease, hepatitis A and B, chickenpox (varicella), and measles, mumps and rubella. Adults traveling outside the United States may need additional vaccines.

Ask your health care professional which vaccines are right for you.

Are these boosters or whole new vaccines you’re recommending?

Some vaccines recommended for adults can be boosters, like the Tdap vaccine, which provide a boost in immunity because the protection from the vaccines we get as children don’t last into adulthood. Other vaccines, like the zoster vaccine, protect against diseases that affect adults and aren’t recommended for children.

The pneumococcal polysaccharide vaccine is given to adults younger than 65 if they have certain conditions, and then again at age 65 years. Some people age 19 to 64 might also need a booster dose five years after their first dose. Other people may need a second kind of pneumococcal vaccine, called pneumococcal conjugate vaccine, if they have certain medical conditions such as a weakened immune system.

Like the pneumococcal vaccine, recommendations for other vaccines also may need to be tailored to each individual person and their situation. So adults should make sure to discuss vaccines with their doctor or other health care professional.

Why are we hearing about these vaccines now?

Many of the vaccines recommended for adults have been around for years, while other vaccines and vaccine recommendations are newer.

One reason we’re hearing more about Tdap vaccine is the increase in whooping cough in the last few years. More than 48,000 cases were reported in the United States in 2012. While overall reporting of whooping cough declined during 2013, 13 states and Washington, D.C. reported an increase in cases compared with the same time during 2012. We have learned that protection from the DTaP whooping cough vaccine given to children doesn’t last into adulthood. Therefore, now all adults are recommended to get one dose of Tdap whooping cough vaccine if they did not receive it as an adolescent. Women are also now recommended to get a Tdap vaccine during each pregnancy to protect their newborn, who is at high risk for developing serious complications or even dying from whooping cough.

Licensed in 2006, zoster vaccine helps protect against shingles, which a very painful disease that affects one out of three Americans. Since older adults are most likely to get shingles and have serious complications from the disease, all adults 60 years and older are recommended to get the zoster vaccine.

How can I find out which vaccines I need?

Ask your health care professional which vaccines are right for you based on your age, lifestyle, medical conditions and previous vaccinations. You can also visit www.cdc.gov/vaccines/adults for more information and find a link to an adult vaccine quiz to see which vaccines are recommended for you.

What are potential risks from adult vaccines?

Side effects from vaccines are usually minor and temporary, such as soreness at the injection site or a slight fever that goes away in a few days. Some people may have allergic reactions to certain vaccines. Serious and long-term effects are rare.

As with any medical procedure, vaccination has some risks as well as important, proven benefits. Individuals react differently to vaccines, and there is no way to absolutely predict the reaction of a specific individual to a particular vaccine.

Anyone who takes a vaccine should be fully informed about both the benefits and the risks of vaccination. Any questions or concerns should be discussed with a physician or other health care professional.

Are adult vaccines safe?

Yes! The longstanding vaccine safety system in the U.S. ensures that vaccines are as safe as possible. In fact, the United States currently has the safest, most effective vaccine supply in its history.

Safety monitoring begins with the U.S. Food and Drug Administration (FDA), which ensures the safety, and effectiveness of vaccines for the United States. Before a vaccine is approved by the FDA for use by the public, the results of studies on safety and effectiveness of the vaccine are evaluated by highly trained FDA scientists and doctors. FDA also inspects the sites where vaccines are made to make sure they follow strict manufacturing guidelines.

FDA and CDC continue to monitor vaccines after licensing to ensure continued safety of the vaccines in the U.S.

What are the ingredients in vaccines?

Vaccines contain ingredients, called antigens, which cause the body to develop immunity. Vaccines also contain very small amounts of other ingredients – all of which play necessary roles either in making the vaccine, or in ensuring that the vaccine is safe and effective, such as preventing vaccine contamination.

For more information, see www.cdc.gov/vaccines/vac-gen/additives.htm

Is it safe to get vaccines if I have certain health conditions or am taking certain prescription medications?

For people with chronic health conditions like diabetes, asthma, or heart disease, it is actually more important to be up-to-date on vaccines because they are at higher risk for complications from vaccine-preventable diseases like flu and pneumonia.

People with HIV and other immune-compromising conditions are also at higher risk for complications from disease. They are recommended to get some vaccines, but cannot safely get all vaccines, so it’s very important to check with your medical provider about which vaccines are right for you.

It is safe for people who are taking prescription medications to get vaccines. There are, however, other factors that may make it unsafe for individuals to get certain vaccines, such as allergy to a vaccine or certain vaccine ingredients. And some vaccines should not be given to people with weakened immune systems, such as people taking medication for cancer treatment or taking other medication that weakens the immune system. Talk to your health care professional to determine which vaccines are right for you.

How well do adult vaccines work?

Vaccines work with the body’s natural defenses to reduce the chances of getting certain diseases and suffering from their complications. The amount of protection from vaccination varies by vaccine and each person’s age and health. People with very weakened immune systems might not get as much protection from the vaccine as people without a weakened immune system. Making sure people around those with weakened immune systems get vaccinated is important to help protect them.

Vaccines generally work better when given to younger, healthier persons, but immunization is the best defense against many of these serious, and sometimes deadly, diseases. The greatest risk of vaccine-preventable diseases occurs among people who are not vaccinated.

Will insurance help pay for vaccines?

All Health Insurance Marketplace plans and most other private insurance plans must cover the following list of vaccines without charging a copayment or coinsurance when provided by an in-network provider:

• Hepatitis A
• Hepatitis B
• Herpes Zoster
• Human Papillomavirus
• Influenza
• Measles, Mumps, Rubella
• Meningococcal
• Pneumococcal
• Tetanus, Diphtheria, Pertussis
• Varicella

Check with your insurance provider for details of coverage. Under the Affordable Care Act, insurance plans that cover children now allow parents to add or keep adult children on their health insurance policy until they turn 26 years old.

Medicare Part B will pay for the following vaccines:

• Influenza (flu) vaccine
• Pneumococcal vaccines
• Hepatitis B vaccines for persons at increased risk of hepatitis
• Vaccines directly related to the treatment of an injury or direct exposure to a disease or condition, such as rabies and tetanus

Medicare Part D or Medicare Advantage Plan Part C that offers Medicare prescription drug coverage may also have coverage for:

• Zoster
• MMR
• Tdap

Most state Medicaid agencies cover at least some adult immunizations but may not all offer vaccines. Check with your state Medicaid agency for more information.

Where can I get vaccines?

Vaccines may be available at private doctor offices, pharmacies, workplaces, community health clinics, health departments or other community locations such as schools and religious centers. There is an online tool to help you find immunization providers near you: http://vaccine.healthmap.org. You can also contact your state or local health department to learn more about where to get vaccines in your community. If your primary health care provider does not stock all the vaccines recommended for you, ask for a referral.

Why aren’t adults getting their recommended vaccines?

Many adults do not always go for “well visits” like children do. When it has been a while since an adult has seen a health care professional, there are often competing issues to discuss. However, make sure you take the time during your visit to talk with your health care professional about vaccines you may need – it could help you prevent a serious disease!

Cost has also been an issue for some adults. However, most insurance now covers routinely recommended vaccines. Those eligible for Medicare and Medicaid also have coverage for certain vaccines. Although adults do believe immunization is important, a recent national survey showed that most adults are just not aware that they need vaccines throughout their lives to protect against diseases like shingles, pertussis, and hepatitis.

I hear that some people get the flu from the flu vaccine because the virus is injected in us. Can I get the disease that a given vaccine is supposed to prevent?

You cannot get the flu from the flu vaccine. Vaccines are very safe and healthy people receiving vaccines cannot get sick because the antigens in vaccines are either killed or greatly weakened. Vaccine antigens are not strong enough to cause disease but they are strong enough to make the immune system produce antibodies (immunity) against them so they can fight the disease in the future. Vaccination provides us with immunity without suffering from the diseases the vaccines prevent. There are some weakened vaccines that women who are pregnant or those with weakened immune systems shouldn’t get. If you are concerned, talk with your health care professional.

What’s the bottom line? What should people know about adult vaccinations?

There are many things adults do to stay healthy. We know we need to eat the right foods and exercise. We need to get our recommended cancer screenings.

Another important thing we need to do is get our recommended vaccines.

If we aren’t up-to-date on our vaccinations, we are at greater risk of getting and spreading certain vaccine-preventable diseases. It is especially important for older adults and those with health conditions such as heart disease, lung disease, and diabetes to get vaccinated because they are at higher risk for complications from diseases. CDC encourages adults to talk to their doctor or other health care professional about which vaccines they need – and get vaccinated.

Shingles

I’ve heard more about shingles in the past few years.

Since I had chickenpox, is the virus still in my body?

Anyone who has recovered from chickenpox still has the virus in their body. It stays in the body in an inactive (dormant) state, but can become active again later and cause shingles. One out of every three people will get shingles at some point in their lives. You have a greater chance of getting shingles when you’re older, which is why the vaccine is recommended for everyone 60 years and older.

Pertussis (whooping cough)

I thought whooping cough was a disease of the past.

Why do we need to get vaccinated against it now?

Whooping cough is not a disease of the past. While we no longer see the number of cases we did before whooping cough vaccines were available, it is a growing health concern. The United States experienced a nearly 60-year record high number of cases in 2012, with data showing more than 48,000 reported cases and 20 deaths. Whooping cough is most severe for babies; about half of infants younger than 1 year of age who get the disease need treatment in the hospital and 1-2 percent of infants who are hospitalized with whooping cough will die.

Why are cases of whooping cough increasing?

There are several reasons that help explain why we’re seeing more reported cases of whooping cough lately. We are more aware of whooping cough, have better tests to diagnose it, and have better systems for reporting. There is also more circulation of the bacteria, and waning immunity. When it comes to waning immunity, it seems that the acellular pertussis vaccine (DTaP) we use now may not protect for as long as the whole cell vaccine (DTP) we used to use.

Throughout the 1990s, the U.S. switched from using DTP to using DTaP for infants and children to reduce potential side effects. Therefore, we now need to have additional doses of whooping cough vaccine to increase immunity.

Why do women need to get Tdap vaccine with each pregnancy?

Whooping cough can be serious for anyone, but it is life-threatening in newborns and young babies. Most of the deaths reported in 2012 were in babies younger than 3 months of age, and about half of babies who get whooping cough need treatment in the hospital.

CDC recommends that pregnant women receive the Tdap vaccine during each pregnancy because the mother’s body creates protective antibodies and passes some of them to her baby before birth. These antibodies give babies some short-term protection against whooping cough until they can begin building their own immunity through childhood vaccinations. The amount of whooping cough antibodies a person has decreases over time. This is why women need a whooping cough vaccine during each pregnancy so high levels of protective antibodies are transferred to each baby.

Where can I get more information?

 

• Talk with your health care provider about which vaccines are right for you.
• Visit CDC’s website on adult vaccination: www.cdc.gov/vaccines/adults/index.html
• Take the CDC quiz to find out which vaccines are recommended for you: www.cdc.gov/vaccines/AdultQuiz
• Use the Healthmap Vaccine Finder to find vaccines: http://vaccine.healthmap.org/
• For more information on adult vaccines and the Affordable Care Act, visit: www.healthcare.gov/what-are-my-preventive-care-benefits/

Web Links & Resources

CDC: Adults Need Vaccines Too!

www.cdc.gov/vaccines/adults/index.html

This is CDC’s adult vaccination website, where you can find the ‘VSI’ video,

e-cards (to send to individuals or groups), podcasts, spotlight on whooping cough, vaccine schedule and quiz, recordkeeping tools, vaccine finder, international travel recommendations, and vaccine recommendations for specific groups of adults.

CDC: Easy-to-Read Adult Immunization Schedule (PDF) – English & Spanish

www.cdc.gov/vaccines/schedules/easy-to-read/adult.html

CDC: Adolescent and Adult Vaccine Quiz

Take CDC’s quiz to find out which vaccines are recommended for you:

www.cdc.gov/vaccines/AdultQuiz

CDC: VSI (Vaccine Scene Investigation) – Video

Fun and informative short video about “crimes of diseases” for older adults

(close captioned for the deaf and hearing impaired)

http://streaming.cdc.gov/vod.php?id=bc4ea520d308431381d44a5e8cbfa9af20100812135645473

CDC: Adult Vaccination – Podcasts

www.cdc.gov/vaccines/adults/resources/audio.html

CDC: Finding and Paying for Vaccines –

www.cdc.gov/vaccines/adult/find-pay-vaccines.html

Healthmap Vaccine Finder

Locate vaccines near you –http://vaccine.healthmap.org

Vaccine Information for Specific Groups

CDC: Older Adults (Age 60+)

www.cdc.gov/vaccines/adults/rec-vac/older-adults.html

CDC: Adults with Special Health Conditions

www.cdc.gov/vaccines/adults/rec-vac/health-conditions.html

CDC: Health care Workers

www.cdc.gov/vaccines/adults/rec-vac/hcw.html

CDC: Travelers

www.cdc.gov/vaccines/adults/rec-vac/travel.html

CDC: Spanish – Adult Vaccine Resources

www.cdc.gov/vaccines/adults/resources/spanish.html

CDC: Vaccines for Pregnant Women

http://www.cdc.gov/vaccines/adults/rec-vac/pregnant.html