Why the adults need to get immunised as well

By Lois Thornton

What do the names Jonas Salk and Edward Jenner have in common? Both were inventors of a medical intervention that would change the face of health care around the world—immunisations.

Jenner invented the smallpox vaccine in 1796. Unfortunately, small-pox vaccine was not available on a large scale until the late 1940s when prevention of the disease began in earnest.

Today, small-pox is considered to be an eradicated disease in most countries and the vaccine has been removed from immunisation schedules.

Jonas Salk developed the polio vaccine in the 1950’s, and was given hero status when his vaccine stopped the spread of the dread disease that left adults and children paralysed and incapacitated. These are just two of the success stories that have made immunisations such a powerful force for prevention of infectious diseases, and the health of populations.

Disease prevention has held a prominent place in health care delivery systems for some time and immunisation programmes have been at the top of the list of cost effective, efficient measures for the prevention of infectious diseases.

Childhood immunisation programmes have grown rapidly over the past few decades. New vaccines and vigorous information campaigns have been successful in convincing parents of the worth of immunising their children.

In Qatar, childhood immunisation coverage rates for polio, diphtheria, pertussis, tetanus, and measles are over 90%, and have been so for the past 15 years.

However, adult immunisation rates are much lower. Adults need to wake up to the fact that immunisations are not just for children. Full immunisation coverage for adults is just as important for good health of the whole family.

Hepatitis B and influenza are two cases in point. An effective vaccine for hepatitis B has been available since 1981, yet hundreds of thousands of people worldwide still die from hepatitis B infection annually.

According to the Hepatitis B Foundation, hepatitis B immunisation lasts for at least 30 years and the vaccine is safe and free of side effects.

Similarly, influenza immunisation is a high-impact preventive health strategy, having been ranked, in one study, as being as important as smoking cessation and cancer screening programmes.

Flu vaccination has been shown to significantly decrease the risk of hospitalisation and reduce both health care and loss of productivity costs related to influenza. However, rates of flu immunisation generally run far short of targets. The benefits of adult immunisation extend beyond the health of the individual, though. They also help to ensure better health for the family and the community.

While the primary goal of immunisation is to prevent infectious disease, it also contributes to decreased risk for long-term serious conditions related to the infection. Liver disease, for example, is associated with hepatitis B infection, and cervical cancer is the most serious risk related to infection with human papilloma virus (HPV).

Influenza infection carries a high risk of death and disability particularly for people over the age of 50, and for those with chronic diseases such as diabetes, and heart and lung disease. One study in Spain showed that influenza vaccine reduced the risk of winter mortality by 37%.

Immunisations contribute to quality of life and healthy, active and productive ageing.

The benefits of some adult vaccines extend to family members, as well. Adults may unwittingly pass the pertussis, or whooping cough, virus to infants in their care, for whom the disease may be fatal.  

Flu vaccine can also decrease the risk that vulnerable family members, such as the very young and the very old, will contract the disease and suffer very serious consequences.

Adult vaccines also benefit the community. It is possible that by reducing the amount of antibiotics needed to treat infectious diseases, vaccines also contribute to decreasing the diseases caused by antibiotic-resistant strains of bacteria.

As well, if large numbers of people in the community are immunised against a disease, this reduces the risk of infection for the whole community, including those who are not immunised. It is clear that the benefits of adult immunisation are great. The risks have been shown to be quite small. Unless you have an allergy to a vaccine component, side effects of most vaccines are no more than soreness and swelling at the injection site.

As an adult, the specific immunisations that you need depend on factors such as your age, lifestyle, health conditions, locations of travel and previous immunisations. The Center for Disease Control recommends that all adults who have not been previously vaccinated receive immunisation for tetanus, diphtheria, pertussis (whooping cough), and varicella (chicken pox).

Human papilloma virus (HPV) vaccine is recommended for women ages 19 to 26 and men ages 19-21. Zoster (shingles) vaccine is recommended for those over the age of 60, and pneumococcal vaccine for those over the age of 65.

Other vaccines, such as meningococcal, hepatitis A and hepatitis B may be recommended for adults with risks related to health, job, or lifestyle. Various vaccines are needed for travel to different parts of the world. A health care practitioner can advise on which vaccines are necessary for you.

Because this is the beginning of flu season, the influenza vaccine deserves special consideration. There is abundant evidence that the flu vaccine is effective in reducing hospitalisation and long term consequences from influenza, as well as decreasing related health care costs and loss of workforce productivity.

Flu vaccine must be received each year because it is formulated annually according to the virus strains that are most likely to be circulating in any given year. As well, the immunity lasts for only 8 to 10 months.

Contrary to a popular myth, the flu vaccine does not carry live virus and so it is not possible to contract the flu from the vaccine. The side effects of flu vaccine are generally mild, usually soreness at the injection site and possibly, a mild fever. The winter months could be much healthier if everyone would receive a flu vaccine.

In Qatar, adults are encouraged to complete their immunisation schedules. Call or visit a Primary Health Care centre for more information.

l The author is a Nursing Instructor at University of Calgary, Qatar. Her research interests include gerontology, dementia care and spirituality in nursing.