Vaccines after 65 — who and what for?

Dear Dr. K: I recently heard that there are certain vaccines that are recommended for adults. I thought I got all my necessary vaccines as a kid.

Not to pick on you, but I can tell by your question you didn’t read last month’s newsletter. In that issue I discussed influenzal vaccine (flu shot) which is recommended on a yearly basis. The vaccine is given yearly because it is a different shot each year, in order to address the new viral strains that emerge.

The tetanus/diphtheria (TD) vaccine is needed every 10 years throughout life. A new spin on this recommendation is that once during adulthood the TD should include pertussis (TDap).  The “ap” stands for acellular-pertussis, which is the new, improved whooping cough vaccine. This new recommendation reflects a resurgence of whooping cough illness in adults, due to waning immunity from our childhood vaccine.

Pneumococcal vaccine (pneumonia shot) can be taken by all adults, but is felt to be essential for persons with respiratory disease (COPD and asthma), heart disease, kidney disease, liver problems, diabetes, HIV and asplenic patients (persons who have lost their spleen). If the first vaccine is given before age 65, then a second vaccine is recommended after five years. If the initial vaccine is given after age 65, then no further shot is needed.

Herpes zoster (shingles) vaccine is recommended for all adults 60 years or older. Even if a person has already had shingles, the vaccine is still recommended.

Meningococcal vaccine (meningitis) is recommended for all young adults attending college. It is also recommended for mature adults with asplenia, HIV; and those who travel to endemic areas and for military personnel.

Hepatitis A vaccine is recommended for travel exposure, gay men, people with liver disease, and people with daycare exposure.

Hepatitis B vaccine is recommended for gay men and for heterosexual people who are not in a monogamous relationship. It is also recognized for all healthcare workers and for public safety personnel and for family members of patients who have chronic hepatitis B infection.