Adult Vaccines

Routine Vaccines for Adults 2022

Amidst all the attention on the Covid Vaccines, we should not lose sight of the importance of other important vaccines.  In this blog, we will focus on the current recommendations for adult vaccinations for those ages 18 and older.  During childhood, there are many other vaccinations and if they have not been completed, it may be important to let your physician know about this.  The following recommendations are based on healthy individuals who are not immunocompromised, pregnant, nor have end-stage kidney/liver disease. 

Influenza Vaccine - The ACIP recommends influenza vaccine annually  for all adults. There are a wide range of manufacturers for this vaccine. It helps to protect against the influenza virus.  With the exception of the nasal spray vaccine, all influenza vaccines contain inactive forms of the virus.  This means you cannot get  influenza from the vaccine, as many people falsely believe.  The vaccine may give you some mild symptoms that mimic the flu.  This is your immune system responding to the vaccine and building immunity.  While the flu vaccine aims to prevent hospitalization and severe illness from influenza, it does not protect against the common cold either.  Patients commonly report that even after they have received the influenza vaccine, they got the “flu”. The explanation in these cases is that those patients incidentally contracted a cold virus and felt it was influenza.  On average, the influenza virus is about 50% effective from year to year.  It is recommended to get it around October in anticipation of the upcoming flu season. 

Tetanus Vaccine - Most patients think of this when they get a wound and are then given a Tetanus vaccine while at an urgent care center or the Emergency Room.  The tetanus vaccine helps protect against a bacteria called “clostridium tetanai” which can cause lockjaw.  Your primary care physician may give you a Tdap vaccine at your routine wellness check. This has the advantage of having the Pertussis Vaccine , which protects against the “whooping cough”.  All pregnant women are recommended to get this vaccination during their third trimester to better protect their  baby from “whooping cough”.  The ACIP recommends that all adults receive a Tdap vaccine at least once in adulthood and a tetanus booster vaccine every ten years. The booster vaccine can be the Td or Tdap vaccine. If you get a wound, the tetanus vaccine is not required should you have had it within five years of the injury.  

Shingles Vaccine (Shingrix) - The ACIP recommends  the two shot series of Shingrix for all adults aged 50 and older.  The shingles vaccine is intended to help protect against the reactivation of the chicken pox virus that is dormant.  The reactivation of the chickenpox virus can cause a painful burning rash that originates from the nerve involved. Some patients go on to develop postherpetic neuralgia where they will continue to suffer from chronic burning pain for months.  

Pneumonia Vaccine (Older Vaccine: Pneumovax23 & PCV 13) (Newer Versions: PCV 15 & PCV 20).  The pneumonia vaccine is intended to help prevent a specific type of bacteria called streptococcus pneumonia. It does not prevent pneumonia in general.  This was recently updated and the current recommendation is to obtain the PCV20 as a one time dose or the PCV15 followed by Pneumovax23 one year later.  .  The ACIP recommends  routine administration of this vaccine for healthy individuals ages 65 and older.  For certain populations, i.e. COPD, Chronic Kidney Disease or immunocompromised states, it is recommended to get it prior to age 65.  This is a one time shot for healthy individuals ages 65 and older. It is not every five years which is a common misconception. The exception to that is for those patients for which have a severe immunocompromised state, have had a splenectomy or condition causing “functional asplenia”. 

Hepatitis A Vaccine -While this is not a routine recommendation, it is highly recommended if d you travel to any third world countries with a high prevalence of Hepatitis A. The virus is contracted by the ‘fecal oral route”.  That means it is through contaminated foods from lack of sanitation. It is a two shot series at least 6 months apart. 

Hepatitis B Vaccine - this is a 3 shot series that is universally recommended to all adults who have not been previously vaccinated. Hepatitis B is transmitted sexually or via blood products. Ie. transfusion, or IV drug use or sexual contact. 

Human Papillomavirus (HPV) Vaccine  - If not previously vaccinated during adolescence, then a 2 or 3 shot series is universally recommended for those aged 18-26.  Certain strains of the HPV virus may cause cervical cancer in women and have also been noted to cause throat cancer in men at a later age. 

Measles, Mumps, Rubella Vaccine - most adults have been vaccinated for this 2 shot series.  If that is the case, they do not need a booster series as an adult.  For those born in 1957 or later, it is recommended to get a 1 or 2 shot series if you did not receive it already. 

Varicella Vaccine - This is a 2 shot series indicated for those born in 1980 or later.  Most adults have been vaccinated for this 2 shot series or have had chickenpox as a child. If that is the case, they do not need a booster series as an adult.  

Ryan Adami, DO

April 15, 2022

Curious as to which supplements work? Worried about safety concerns.  This is an extremely common question we get.  It turns out that there isn’t much literature from traditional medical textbooks or traditional peer reviewed medical journals in terms of general guidelines.  There is very little training in either medical school or residency as well.    People are constantly bombarded with marketing claims that certain supplements cure such and such disease.  You will then often hear the quick disclaimer “These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.“    FDA Link.  This statement is used by many companies who sell supplements to mitigate any legal recourse against them.   So despite the claim that it can take care of your insomnia or heartburn, they contradict that statement with the legal disclaimer. 

     It is important that when choosing a supplement, that it is either USP or NSF certified. You may see the USP certification on the supplement.  NSF or the National Sports Foundation, is a nonprofit organization that certifies supplement manufacturers to ensure quality controls. Unfortunately, there is no oversight on supplement manufacturer quality and there have been numerous lawsuits that have done an analysis on many supplements at your most common retail stores showing impurities or not even containing the ingredients it claims to contain.  This can lead to medical problems including liver injury. Hepatology Journal: Liver injury from herbal and dietary supplements.  You can also download the NSF app and click on product type to look for certified supplement manufacturers.  

Does this mean not to take supplements then?  No, there are many cases in which supplements can show benefits. When trying to verify claims made about a supplement, it is extremely important to ensure that multiple studies have been conducted for the condition you are seeking treatment.  In other words, you may have 5 studies showing benefit of supplement X to treat a particular symptom, but there may also have been 10 studies showing no effect.  It is very easy to only show the 5 studies that showed benefit from the company trying to sell.  So do your proper homework.  In addition, it is preferable to find studies with larger numbers of patients and studies that are randomized, controlled and double blinded.  Observational studies are helpful, but can be extremely misleading.  You can easily search for studies using Pubmed.  It is a free resource for anyone interested in researching any study. 

By: Ryan Adami, DO

December 7, 2021