While the publicity surrounding the influenza vaccine dominates airwaves and in-pharmacy advertising during flu season, adults receive relatively little information about other vaccines. Pharmacists are well positioned to advise customers on the other vaccines they need based on their age and chronic conditions.
Elderly patients with ongoing health issues may have received the pneumococcal polysaccharide vaccine, but healthy baby boomers should get it, too. The CDC recommends vaccination for all adults over age 65 years, as pneumococcal infections can easily turn deadly in older people. The CDC notes that about 20% of patients over age 65 years who develop pneumococcal bacteremia or meningitis die from the infection, as do 5% of those who get the more common pneumococcal pneumonia. Vaccination is also advised for younger adults with chronic health conditions such as asthma, heart disease, and diabetes, and those with compromised immune systems, as well as smokers.
Many adults should also receive the shingles vaccine, but this situation is more complicated. Healthy adults aged 60 years and older can receive the zoster vaccine live (Zostavax), but it is only about 50% effective. Shingrix, a recombinant zoster vaccine, is recommended by the Advisory Committee on Immunization Practices (ACIP) for all adults aged 50 years and older. Although it is 90% effective, the need for two doses, the lower age recommendation, and unprecedented adoption have boosted demand so much that the CDC projects shortages through the end of the year.
All adults should receive the tetanus/diphtheria/pertussis (Tdap) vaccine if they have not been previously immunized and then get a tetanus/diphtheria (Td) booster shot every 10 years.
Pregnant women and women trying to become pregnant need other vaccinations. Because rubella infection during pregnancy can result in miscarriage or birth defects, previously unvaccinated women should receive the measles, mumps, and rubella vaccine at least a month before they conceive to protect them during pregnancy and avoid complications. Women also need the Tdap during the third trimester of every pregnancy that will provide antibodies to protect their newborn from whooping cough during the first 2 months of life, when infants have the greatest risk of infection and complications.
Adults in their 20s might need the human papillomavirus (HPV) vaccine if they did not receive it as adolescents. The HPV vaccine protects against cancers of the cervix, anus, penis, and vulva and may reduce the risk of oropharyngeal cancer, the fastest-growing cancer among young men.
The ACIP also recommends that individuals with common chronic conditions receive additional vaccinations. Diabetic patients need the hepatitis B vaccine, as infection rates are particularly high in this population and seem to be associated with blood glucose monitoring procedures. The CDC advises that individuals with liver or kidney disease also receive the hepatitis B vaccine, and those with liver disease should get the hepatitis A vaccine as well.
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