Wednesday, July 18, 2012

Stick me with WHAT?!?!

So adult immunizations-who knew? Well, apparently not me. Or at least not enough. Sure I have kept my Tetanus shot up because I have been known to get hurt. And lockjaw? Yeah, not my thing.  Well at TAM2012 I met some people from the health activism group, "Hug Me , I'm Vaccinated" and was enlightened even further.  I have always been a proponent of childhood vaccines. The evidence is such that it cannot be denied. Well, it can, but not with any sensical basis. And since this post is about ADULT vaccines, I won't be having that discussion.


So what vaccines are recommended for adults? And why?


Diptheria
is a serious bacterial infection usually affecting the mucous membranes of your nose and throat. Diphtheria typically causes a sore throat, fever, swollen glands and weakness. But the hallmark sign is a sheet of thick, gray material covering the back of your throat. This material can block your windpipe so that you have to struggle for breath.1  


Can I just say...YUCK!!!  


Pertussis
is a highly contagious respiratory tract infection. In many people, it's marked by a severe hacking cough followed by a high-pitched intake of breath that sounds like "whoop." 1


Now this may not seem like a very big deal-nasty cough, antibiotics, all good. With Pertussis the biggest danger is not to yourself as an adult (unless you have a compromised immune system or are elderly), but to the children you may come in contact with-infants are extremely susceptible to whooping cough and have a severe reaction which can end in death. Since 2004, a mean of 3,055 infant pertussis cases with more than 19 deaths has been reported each year through the National Notifiable Diseases Surveillance System. 2  And while 19 is a small number in the grand scheme of things, when you compare it to none for a disease that has a reliable vaccine it is a mountain of dead babies-especially to the parents who lost those babies.



Tetanus
is a serious bacterial disease that affects your nervous system, leading to painful muscle contractions, particularly of your jaw and neck muscles. Tetanus can interfere with your ability to breathe and, ultimately, threaten your life. Tetanus is commonly known as "lockjaw."1


So no food, no beer, and the worst case of muscle cramps ever??  Oh, lest we forget, you could SUFFOCATE too. Yep-count me out thanks!


So those three up there can be taken care of in one fell swoop with the Tdap vaccine. There are some other ones that are available and are recommended by the Center for Disease Control


Influenza 
Or Flu is a contagious respiratory illness caused by influenza viruses. It can cause mild to severe illness, and at times can lead to death. Some people, such as older people, young children, and people with certain health conditions, are at high risk for serious flu complications.3


My past view on this has been that this is an unnecessary vaccine. That it only vaccinates for a couple versions and there are so many it is better to just fight it out if you happen to catch it. After doing some research I have been enlightened substantially. One in 10 Americans gets the flu each year. While 90% of deaths are in the elderly, many deaths and hospitalizations occur in otherwise healthy children and adults. And even a "mild" case of the flu will make you miserable for a week.4  And a week is much longer than the reaction you may get from the vaccine. According to the CDC, up to 20% of Americans get the flu each year. More than 200,000 people in the U.S. are hospitalized each year, and about 3,000 to 49,000 deaths are flu-related4 


As far as the reaction from the vaccine, it has been thought to be as bad as the flu, that you will get a bad reaction and "probably" won't even get the flu and even that everyone gets a reaction.  These ideas are suppositions from people based on fear. Fear of needles, fear of disease and in some cases spread by conspiracy theorists who like to believe the government and drug companies are out to get us. In reality, the vaccine is not the horrible danger many people (formerly myself included) think it is-just the opposite. According to the World Health Organization the most effective way to prevent the disease or severe outcomes from the illness is vaccination. Safe and effective vaccines have been available and used for more than 60 years. Among healthy adults, influenza vaccines can prevent 70% to 90% of influenza-specific illness. Among the elderly, the vaccine reduces severe illnesses and complications by up to 60%, and deaths by 80%.5  And while I can only make an educated guess on this, it seems to me that the WHO has better things to concentrate on than "how the U.S. government might be trying to screw its own citizens"!


Varicella
(chickenpox) is a highly contagious disease that is very uncomfortable and sometimes serious6


I am going to let this one speak for itself-check out this link: http://www.cdc.gov/vaccines/vpd-vac/varicella/unprotected-story.htm


MMR
Measles is a respiratory disease caused by a virus. The disease of measles and the virus that causes it share the same name. The disease is also called rubeola. Measles virus normally grows in the cells that line the back of the throat and lungs.7


Expectations (prognosis)

Those who do not have complications such as pneumonia do very well.

Complications

Complications of measles infection may include:

  • Bronchitis
  • Encephalitis (about 1 out of 1,000 measles cases)
  • Ear infection (otitis media)
  • Pneumonia 8




Mumps is an infection caused by a virus. It is sometimes called infectious parotitis, and it primary affects the salivary glands. Mumps is mostly a mild childhood disease. It most often affects children between 5 and 9 years old. But the mumps virus can infect adults as well. When it does, complications are more likely to be serious. Mumps virus is present throughout the world. It is spread by airborne droplets released when an infected person sneezes or coughs and by direct contact with an infected person. 9


Rubella  commonly known as German measles or 3-day measles — is an infection that primarily affects the skin and lymph nodes. It is caused by the rubella virus (not the same virus that causes measles), which is usually transmitted by droplets from the nose or throat that others breathe in. It can also pass through a pregnant woman's bloodstream to infect her unborn child.
It's a generally mild disease in children; the primary medical danger of rubella is the infection of pregnant women because it can cause congenital rubella syndrome in developing babies.10
As you read through the descriptions for the above three, it may strike you that in each description it is noted that these are "mild childhood diseases". Measles, mumps and rubella (MMR) are three very dangerous infectious diseases which cause severe morbidity, disability and death in low‐income countries.11   Also as with many diseases, the susceptibility for a more serious illness increases greatly as seen above with measles.


Now a typical response might be "but we are not in a low-income country". Below you will find an explanation on "herd immunity" and an example of a pathogen path, explaining how you are at risk even though your residence isn't in a third world nation.


HPV
Genital Human Papilloma Virus is the most common sexually transmitted virus in the United States. More than half of sexually active men and women are infected with HPV at some time in their lives. About 20 million Americans are currently infected, and about 6 million more get infected each year. HPV is usually spread through sexual contact.12



Most HPV infections don’t cause any symptoms, and go away on their own. But HPV can cause cervical cancer in women. Cervical cancer is the 2nd leading cause of cancer deaths among women around the world. In the United States, about 12,000 women get cervical cancer every year and about 4,000 are expected to die from it. HPV is also associated with several less common cancers, such as vaginal and vulvar cancers in women, and anal and oropharyngeal (back of the throat, including base of tongue and tonsils) cancers in both men and women. HPV can also cause genital warts and warts in the throat. 12





There are a few other recommended as adults, however they have high-risk factors which indicate who should get them. You can find the current guidelines at http://www.immunize.org/catg.d/p2011.pdf I strongly recommend doing your own research through the websites listed below to see if they apply to you.


This is a pretty neat little video outlining adult vaccine necessity: http://www.cdc.gov/CDCTV/VSI_Vaccination/index.html


So now that I have outlined some of the most important general vaccines (again PLEASE check out the guidelines to see which others fit your own personal situation) you may still wonder why as an adult you need them. Some of these we received as children going through school vaccines. Some are for relatively minor diseases, or so it may seem. Or diseases that are much more prevalent in other countries-places that you or I may never even go.


As far as vaccines we have had as children, the immunity has a end life. We need to "reboot" our immune system to account for loss of immunity or even adaptations in the disease. For example, the flu vaccine that was given out last year may not cover the same strain of flu that is projected to be the most prevalent this year. The Center for Disease Control (CDC) does an extensive amount of tracking to determine which are the top 3 strains for that year so as to develop the vaccine with the most efficacy, or chance of being efficient.  And the 30-40 years that may have elapsed between now and your last Pertussis vaccine, well that is a long time for your immune system to store that antibody information. Especially considering how hard it has worked trying to keep you healthy over those years.


"Herd immunity" is another concept I mentioned above. This is the idea that if one person is not vaccinated, but everyone that comes in contact with that person has been, who is going to infect the non-vaccinated party? So in cases where someone cannot get vaccinated due to age or health, you play a vital role in helping to keep that person safe. Because that disease that was just going to be a minor inconvenience to you could be the death of them!


To address the idea of prevalence in low-income countries, we are going to take a little trip. First we will make the assumption that the parties involved have not gotten an MMR booster as an adult. So I am going to TAM in Las Vegas (Woo Hoo!) In between conferences I sit down at a good ol' slot machine and try to get rich! Well, that doesn't work-but I do get something. o_O You see, this particular slot machine had a visitor right before me. This gentleman had flown in from Germany yesterday. He was feeling pretty lucky, because only a week ago he had a fever, bad cough, swollen lymph nodes and rash. So he got all better just in time for his trip.  Now previous to his American vacation, he was travelling from Sweden for work. He took a train, and sat next to a very fetching young Swedish beauty. They talked at length about the amazing trip she had just taken to Samabula in Fiji. 


So now fast forward to the end of TAM, and my journey home. (yes, sad I know) I am quite excited as I just received news that my favorite cousin is expecting! So as soon as I can manage I go to visit, and share the great experiences I had in Las Vegas. Unfortunately there is something else I share, because 4 days after my visit I come down with a rash, fever, swollen lymph nodes and cough. Now being unaware of the danger of Rubella (come on, I was vaccinated as a child!) I figure I have a nasty cold or flu and just suck it up. However this "cold" turns into a lifetime of sorrow.


You see, being the loving cousin, so thrilled to know a new babe is joining our family, I exposed my cousin and her unborn child to German Measles (Rubella). And here is what we are now dealing with instead of the joys of pregnancy and anticipation of birth:
 Up to 90 percent of infants born to mothers who had rubella during the first 11 weeks of pregnancy develop congenital rubella syndrome. This can cause one or more problems, including:

  • Growth retardation
  • Cataracts
  • Deafness
  • Congenital heart defects
  • Defects in other organs
  • Mental retardation
Can you imagine having to live with this, and the poor child who is most likely going to suffer with the results-if they even live? Just because you didn't want to get a shot??

Thank you for reading, I hope you learned something. Now please excuse me, I have to go call my Doc and schedule an appointment. ;-)


Sources
1 http://www.mayoclinic.com

2 http://www.cdc.gov/flu/about/disease/index.htm


3 http://www.cdc.gov/flu/about/disease/index.htm


http://www.webmd.com/vaccines/news/20101007/why-some-will-get-flu-vaccine-and-why-some-wont 

5http://www.who.int/mediacentre/factsheets/fs211/en/index.html

http://www.cdc.gov/vaccines/vpd-vac/varicella/default.htm


http://www.cdc.gov/measles/about/overview.html

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002536/

http://www.who.int/immunization_monitoring/diseases/mumps/en/


10 http://kidshealth.org/parent/infections/skin/german_measles.html


11 http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0012766/


12 http://www.immunize.org/vis/vis-hpv-gardasil.pdf

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