December 2007
Adult vaccination: The shots you need
The 10 vaccines listed below protect against some of the most common and serious ailments that afflict Americans, including
the flu, which sends more than 200,000 people to the hospital each year and kills more than 35,000. Some of the other diseases
aren't likely to kill you, but can be extremely painful and flare up with no warning. And when the usual childhood diseases
occur in adults, the effects can be devastating. Though many people fail to get an annual flu shot, a vaccine against the
disease has been available for more than 60 years. Other vaccines, including one against shingles and another that helps to
protect against cervical cancer, came out fairly recently. All the vaccines listed below are generally very safe and effective,
though many adults aren't aware that they need them, aren't being reminded by their doctors, or are skeptical about their
safety and effectiveness. But even if you are healthy and willing to forgo a shot and risk getting sick, vaccinating yourself
protects vulnerable family members, friends, and coworkers from catching diseases that could be potentially deadly to them.
This chart will tell you which adult vaccines to consider, based on your personal situation. In addition to the few vaccine-related complications listed below, any vaccine can cause temporary, minor reactions such as a mild fever or soreness or swelling at the injection site. And any vaccine (or one of its inactive ingredients) can, in rare cases, cause an immediate, serious allergic reaction known as anaphylaxis. If you've had such a reaction, avoid the vaccine unless your doctor determines that the shot's benefit for you outweighs its risk.
In general, the more serious the problem, the less common it is.
Inhaled vaccine not approved for children under age 2 or adults over age 49, pregnant women, and people with weakened immunity.
This chart will tell you which adult vaccines to consider, based on your personal situation. In addition to the few vaccine-related complications listed below, any vaccine can cause temporary, minor reactions such as a mild fever or soreness or swelling at the injection site. And any vaccine (or one of its inactive ingredients) can, in rare cases, cause an immediate, serious allergic reaction known as anaphylaxis. If you've had such a reaction, avoid the vaccine unless your doctor determines that the shot's benefit for you outweighs its risk.
| The vaccine and dosing schedule | Who needs it? | Severe consequences of natural disease |
Moderate or severe vaccine side effects (%) | Vaccine efficacy (%) |
| Chicken pox (varicella) Two doses at least 4 weeks apart. |
Anyone who hasn't had chicken pox. (Immunity can be checked with a blood test, if necessary.) | Infected lesions, pneumonia, encephalitis, meningitis, and death | Appear rare |
|
| Hepatitis A Two doses at least 6 months apart. |
|
Impaired liver function, death | Appear rare | 94 to 100 effective |
| Hepatitis B Two doses 1 month apart, followed by a booster dose at least 6 months later. |
|
Impaired liver function, cirrhosis or cancer of the liver, death | Rare | 80 to 100 percent effective |
| Herpes zoster (shingles) Once. |
Everyone 60 and older with a history of chicken pox | Skin lesions, debilitating pain; most serious in the very old and people with suppressed immunity | Appear rare (based on limited data since this is a new vaccine) |
|
| Human papillomavirus (HPV) Two injections 8 weeks apart, with a booster at least 6 months later. |
|
Genital warts, cervical cancer | Appear rare (based on limited data since this is a new vaccine) | 95 to 100 percent effective (against four strains of HPV responsible for about 70 percent of cervical cancers and 90 percent of genital warts) |
| Influenza (flu) Once a year for injected (inactivated) vaccine or nasal spray (live vaccine). Optimal time for vaccination is late October to early December, but it still can offer some protection if received after
that. |
|
Pneumonia (especially in older or chronically ill people), inflammation of the heart muscle, death. | Injection: Rare Nasal spray: Nasal congestion 20 to 75 percent, headache 2 to 46 percent, vomiting 3 to 13 percent |
|
| Measles, mumps, rubella Two doses at least 4 weeks apart. |
Adults born after 1957 who were never immunized or infected. (Adults born earlier are generally immune. Immunity can be checked with a blood test, if necessary.) | Measles: Pneumonia, encephalitis, death Mumps: Meningitis, inflamed testicles or ovaries, deafness Rubella: Encephalitis, internal bleeding, eye damage, deafness, heart defects and retardation in children born to infected mothers |
Fever 5 to 15 percent, joint pain in women 25 percent, rash 5 percent, others appear rare | Measles: 99 percent effective Mumps: 90 to 97 percent effective Rubella: 95 percent effective |
| Meningococcal disease (meningitis) Once. (Booster shot after 5 years for some high-risk people.) |
|
Bloodstream infections, pneumonia, hearing loss, neurologic damage, loss of limb, death | Rare | 98 percent effective |
| Pneumococcal disease (pneumonia) Once. (Booster shot after 5 years for people who got first shot before age 65 or are at very high risk.) |
|
Pneumonia, most serious in elderly and chronically ill; death | Rare | 60 to 70 percent effective |
| Tetanus, diphtheria, pertussis Once for pertussis and 3 to 4 doses over one year, plus a booster every 10 years, for tetanus and diphtheria. |
|
Tetanus: Lockjaw, convulsions, pneumonia, death Diphtheria: Paralysis, heart failure, coma, death Pertussis: Severe coughing, impaired breathing, pneumonia, death |
Rare | Tetanus: 99 percent effective Diphtheria: 95 percent effective Pertussis: 80 to 85 percent effective |
In general, the more serious the problem, the less common it is. Inhaled vaccine not approved for children under age 2 or adults over age 49, pregnant women, and people with weakened immunity.
