Adult immunizations
Why do adults need to be immunized?
Many of the diseases that vaccines can prevent are more dangerous to adults than to
children. Many adults think they have outgrown the need for immunizations, but they are
wrong. The most common adult vaccines are described below. Some adults will need
others because of their jobs, travel plans, or health problems. Adults should be sure to
talk with a health care provider about vaccination during regular check-ups.
Tetanus
Tetanus (also called lockjaw) kills about one of every three people who get the disease. It
is caused by bacteria that make toxin (poison) after entering the body, usually through a
cut or scrape. The cut does not have to be large or deep for someone to catch tetanus.
People immunized as children need booster shots every ten years. Sometimes a booster is
given after five years if a person suffers a deep puncture wound. Tetanus boosters are
usually combined with diphtheria vaccine and given as one shot called Td. These
vaccines are also sometimes combined with pertussis (whooping cough) vaccine as one
shot called Tdap.
Anyone who was not immunized as a child needs three shots. Then they need boosters as
described above. Many older Americans did not receive tetanus immunization as
children.
Diphtheria
The symptoms of diphtheria include fever and swelling/soreness in the throat. Diphtheria
can cause swallowing problems and suffocation. It is rare in the United States because so
many people have been vaccinated, but it is still common in other parts of the world.
Diphtheria is dangerous. One of every ten people who get the disease dies from it.
Diphtheria vaccine is usually combined with tetanus vaccine and given as one shot called
Td. People should get Td boosters every ten years.
Pertussis (whooping cough)
Pertussis is a very contagious infection of the respiratory tract that causes whooping
cough. Children in the US are vaccinated against pertussis. However, the protection from
the vaccine can wear off over time. So most adults need a booster shot to make sure they
are still protected against pertussis. The pertussis booster for adults is usually combined
with the tetanus and diphtheria vaccine as one shot called Tdap. Adults under 65 should
receive one dose of the Tdap vaccine. Adults under 65 who are in close contact with
children under 12 months old should be especially sure to receive this vaccine.
Flu (Influenza)
Flu is very contagious. It is caused by a virus. Symptoms include sudden high fever,
muscle aches, sore throat, and cough. Most people who catch it get well without any
problem. But flu sometimes leads to pneumonia which can be fatal. Immunization is very
important for people at high risk for pneumonia and other problems caused by flu. People
in the following groups should get a flu vaccine:









People 50 and over
Pregnant women
People with certain chronic medical conditions
People with weakened immune systems
Those who live in a nursing home or another long-term care facility
Health care workers
Children aged 6-59 months of age
Children 6 months to 18 years who are on aspirin therapy
Child care workers, including those caring for children less than 6 months old (these
babies are too young to be vaccinated)
People who are not at high risk but just want to avoid the flu can also talk with their
providers about getting a flu vaccine. Vaccination is available as a shot or as a mist
sprayed in the nose. The shot is made from an inactivated (killed) virus; the mist is made
from a live, weakened flu virus. The mist is given only to healthy persons between the
ages of 5 and 49. (People who are in close contact to someone with a weakened immune
system should not receive the mist vaccine.) Individuals who are under 5, over 49, and
those with certain medical problems receive the flu shot.
In some years, a shortage of flu vaccine occurs. When this happens, people who are not
in high-risk groups may be asked to wait until a certain date to receive the vaccine.
During shortages, vaccination is available to everyone after people in high-risk groups
are vaccinated.
A new flu shot is needed each year in order to be protected. The best time to get it is in
the fall, before flu season starts, but it is never too late to get it. The vaccine cannot give
you the flu.
Pneumococcal disease
Many people think of pneumococcal vaccine as a “pneumonia shot,” and it does prevent
some kinds of pneumonia. But it also prevents some forms of meningitis and infections
of the blood. People 65 and older and anyone with a chronic illness should get this
vaccine.
Most people only need one dose at age 65 or older. However, some people need a dose at
an earlier age. This includes people with diabetes, chronic lung illness (but not asthma),
chronic liver or kidney disease, sickle cell anemia, transplants, people with no spleen, or
people with weakened immune systems (that is, those who take steroids or chemotherapy,
have HIV, or have some types of cancer).
Some people need a booster shot of the pneumococcal vaccine. This includes anyone who
received the vaccine at younger than 65 years and some people with chronic medical
conditions. Ask your doctor if you need a booster shot.
Hepatitis B
Hepatitis B is a viral disease that can damage the liver. Symptoms include a flu-like
illness, extreme tiredness, and jaundice (yellowing of light skin and the whites of the
eyes). The disease can cause chronic hepatitis, which can be fatal. It is spread through
contact with infected blood or body fluids.
Children are now being immunized routinely against this disease. Certain adults should
also receive this vaccine. Three doses of the vaccine are needed for protection. The
vaccine is recommend for:
 health care workers
 people with several sexual partners
 IV drug users
 house-mates of hepatitis B carriers
 sexual partners of hepatitis B carriers
 anyone likely to have contact with infected blood or body fluids
 some people planning to travel to a country where hepatitis B is common
 patients on dialysis
Measles
The symptoms of measles include a rash, fever, sore throat, dry cough, and cold
symptoms. Measles can lead to ear infections, pneumonia, swelling of the brain, and
death. The risk of death from measles is highest among infants and adults. Many adults
born after 1956 never had measles, even though they may think they did. Many of these
adults never got a vaccine against measles, or got one before their first birthdays when
they were too young. These people are not immune to measles and should be vaccinated.
Several cases of measles were reported in the Boston area in the last few years.
Measles vaccine is usually combined with mumps and rubella in the MMR shot. Ask
your doctor if you need immunization against measles. Some adults need one shot; others
need two.
Mumps
The main symptom of mumps is swelling of the salivary (spit) glands. Mumps is more
common in children than in adults. But if adults do get it, it is more likely to cause
serious problems. These problems can include swelling and damage to the testicles,
ovaries, pancreas, thyroid, kidneys, heart, joints, or the membrane covering the brain and
spinal column (meninges).
Only one dose of vaccine is needed to prevent mumps. The shot is called MMR and
covers measles, mumps, and rubella. Ask your doctor if you need immunization against
mumps.
Rubella
The symptoms of rubella include low fever, joint pain, and a rash in some people. It is
usually a mild disease in both children and adults. But it can cause severe birth defects or
a miscarriage if a woman gets it while pregnant. The best way to prevent these problems
is to vaccinate as many people as possible.
Only one dose of vaccine is needed to prevent rubella. Vaccination is given through the
MMR shot which protects against measles, mumps, and rubella. Ask your doctor if you
need this vaccine. Women should be advised not to get pregnant for three months after
they get the vaccine. Woman who are already pregnant should not be vaccinated until
after the baby is born.
Varicella (chickenpox)
Children in the US now receive vaccination against varicella (chickenpox). However,
most adults have not received this vaccine. It is now recommended that chickenpox
vaccination be given to all adults who never had chickenpox, or those whose blood tests
show that they are not immune to the disease. The vaccine is given as 2 shots that are 4-8
weeks apart. Pregnant women should not be vaccinated until after the baby is born.
Women should not get pregnant for one month after getting this vaccine.
Travel immunizations
People who plan to travel abroad should contact a doctor or board of health at least six
weeks before leaving the country to find out if they need any shots. Travel to Canada,
Mexico, the Caribbean, Europe, or Australia does not usually require any special
immunization, but it is best to double check. Polio, rubella, measles, tetanus, diphtheria,
varicella, hepatitis A, and hepatitis B vaccines are sometimes recommended for people
going to countries where these diseases are common. Some countries will not let people
enter without proof of yellow fever vaccination. For more information, please visit
www.cdc.gov/travel.
For more information
For more information on immunizations, contact:




Your doctor, nurse, or clinic
The Beth Israel Deaconess Learning Center - (617) 667-9100
Your local board of health (listed in the telephone book under Local Government)
The Massachusetts Department of Public Health Immunization Program (617) 9836800
 The National Immunization Program at http://www.cdc.gov/nip
This material was prepared by clinicians from the department of infection control at Beth Israel Deaconess Medical Center. It is
adapted from a fact sheet made available by the Massachusetts Department of Public Health. It is produced and distributed by The
Beth Israel Deaconess Learning Center. ©2006, Beth Israel Deaconess Medical Center. All rights reserved.
MC0060 REV 09/06