Other Magazines: October 2007 Archives

By Jessica Snyder Sachs, as originally published in PREVENTION

On a mid-August morning two summers ago, Debbie Twenge started coughing. Just a cold, thought the resident of Dundee, OR, now 56. But the body-racking cough got worse--much worse. Over the next 6 weeks, Twenge had to make two trips to the emergency room. One particularly frightening evening, her daughter called 911 when Twenge's throat closed up during a coughing fit. "I thought I was going to die," she recalls.

By the end of September, her doctor was suggesting tranquilizers--"as if I was just a nervous female," Twenge says with outrage. That's when her husband read about a local outbreak of whooping cough, aka pertussis. A test quickly revealed she had it, but it took 6 months for her to recover from the lingering inflammation and injury to her breathing passages.

So it was with great interest that Twenge recently learned that the CDC now recommends all adults get a booster shot to protect themselves against this "childhood" disease. Health officials estimate that the vaccine could prevent more than 8,000 adult infections and 30 to 40 deaths each year. "If I had known what pertussis was like, I would have jumped at the chance to be vaccinated," says Twenge.

Chances are, when you hit adulthood, you figured that you were pretty much done with vaccines, except for the occasional flu shot. But it's time to roll up your sleeve. Experts say the right vaccines can prevent pain and misery--and could even save your life.

Still hesitant? Worried about side effects? Don't be. Here's the lowdown on the shots you need and when--and why you want them.

Get It Now

Tdap booster: Prevents whooping cough, diphtheria, and tetanus

You probably got a pertussis shot as a child, or maybe even had a bout of whooping cough, and think you're immune. But experts now realize that neither immunization nor infection provides lifelong protection. In fact, immunity wanes within 10 years, explains Anne Schuchat, MD, director of the CDC's National Immunization Program. That's a big reason there's been a massive resurgence of pertussis over the past 20 years--more than 25,500 cases in the United States in 2005.

Protect yourself: The next time you're due for your 10-year tetanus-diphtheria shot (Td)--and yes, you should be getting a tetanus booster every decade--ask for the Tdap booster, which includes protection against pertussis. Get the shot now if you're in close contact with a baby or someone whose immune system has been weakened by age, chemotherapy, or HIV infection--they might not survive if you pass pertussis to them. (You can get a Tdap booster as soon as 2 years after a previous Td vaccine.)

MMR: Prevents mumps, measles, and rubella Just when we'd almost vanquished mumps, the viral infection is making a comeback. In a typical year, fewer than 300 Americans catch mumps, but in 2006, there were more than 5,800 cases! The reason may be found in England: Lagging childhood immunization rates there have led to a comeback of this disease, and tourists may have carried it here. In adults, mumps can be serious: 1 in 20 women develops swelling of the ovaries; 1 in 5 men, inflammation of the testes. Rarely, adult mumps can cause potentially deadly encephalitis (an infection of the brain).

If you were born between 1957 and 1967, you're particularly susceptible to catching mumps, because the version of the vaccine your pediatrician gave you wasn't effective enough to provide reliable lifelong protection.

Protect yourself: If you're not sure you had mumps or received two MMR doses after 1967, get this vaccine ASAP. (Kids need two shots 28 days apart; as an adult, you'll get only one.)

Flu Shots: Prevents influenza--and reduces risk of potentially deadly pneumonia. Late in 2003 and into 2004, doctors in the Baltimore area were helpless to save a previously healthy man in his 50s when he developed an antibiotic-resistant form of pneumonia on the heels of the flu. Three others--women in their 20s and 30s--nearly died the same way.

The bug behind those drug-resistant pneumonias is a new and nasty strain of Staphylococcus aureus, or MRSA--and researchers say flu raises the risk of catching it. There are plenty of other reasons to avoid the flu: 36,000 people die each year from flu-related complications. That's why the CDC now says that all adults should get an annual flu shot.

Protect yourself: This fall, get a flu shot or a spritz of the new nasal vaccine, FluMist (approved for adults up to age 50). It's best to get immunized in October or November, but immunization as late as January is still worthwhile--the flu often peaks as late as March.

Get It if You've Had Chickenpox

Zostavax: Prevents shingles and postherpetic neuralgia

One in four people who have had chickenpox eventually develops the blistering rash of shingles--caused when the chickenpox virus, Varicella zoster, is reactivated. Around 40% will go on to suffer what's been described as the worst kind of pain imaginable. Called postherpetic neuralgia (PHN), it is so agonizing that it's been known to lead some people to suicide.

Protect yourself: As soon as you hit 60, get a dose of Zostavax, approved by the FDA last year. Schuchat predicts that people in their 50s will eventually be urged to get the vaccine, too, if ongoing tests show that it's equally effective in their age group. You've never had chickenpox? Then definitely get the chickenpox vaccine, Varivax, as well. Adult chickenpox has a substantially higher risk of complications, such as pneumonia and potentially deadly encephalitis.

Get it if You're Dating

HPV vaccine (Gardasil): Prevents cervical cancer

The benefits of the HPV vaccine for women under 26 have been all over the news. But the headlines overlooked something important: Gardasil may also be lifesaving for older women, especially those who are divorced or in a nonmonogamous relationship. Younger women were studied first because they're more likely to be exposed to the cancer-causing human papillomavirus, but research is under way on women over age 26. The vaccine targets four of the viral strains most commonly associated with cervical cancer and genital warts and, says Schuchat, "the chance that any woman has been exposed to all four types is tiny. So the vaccine will probably benefit everyone who gets it."

Protect yourself: Consider getting the three-shot HPV series if you've been mutually monogamous--or abstinent--but are now dating again. (Think about getting a hepatitis B vaccine, too; that sexually transmitted virus sometimes causes liver cancer.) If you're over age 26, your insurance may not cover the $350 cost of the series, at least until Gardasil is approved for older women or a similar shot, called Cervarix, gets okayed (that vaccine was recently green-lighted in Australia for women up to age 45). However, one or both approvals may happen soon.

Vaccine Fears and Facts

Fear: Mercury

Fact: A few years back, researchers raised the concern that people (especially babies) might accumulate a toxic dose of mercury from thimerosal, a vaccine preservative that consists largely of the metal. To be on the safe side, thimerosal was removed from many pediatric vaccines. But since then, studies have shown that the form of mercury found in the preservative, ethyl mercury, does not build up in the body.

 Fear: Allergic reaction

 Fact: These do occur, so tell your doctor if you have an allergy to egg (flu vaccine), gelatin (MMR vaccine), or yeast (HPV and hepatitis B vaccines). If you have an unexpected reaction, the doctor will give you an antihistamine, or a shot of epinephrine if your allergy is severe. It's worth noting, though, that vaccines cause only one death or serious reaction per million shots given--and save many more lives by preventing disease.

 Fear: The flu vaccine actually causes the flu

 Fact: The flu shot contains no live virus, while FluMist contains one that has been weakened so that it's incapable of causing infection. Neither can give you the flu, says Andrew Kroger, MD, a CDC epidemiologist and vaccine information specialist. But if you were exposed to the flu right before you were immunized, the protection may come too late to keep you from getting sick.

Copyright 2007, Prevention

Science writer Jessica Snyder Sachs is the author of Good Germs, Bad Germs: Health and Survival in a Bacterial World (Hill & Wang/FSG).