Adult Canadians may not have had all the vaccinations needed to provide maximum protection against infectious diseases. Are you one of them?
The prevention of infection by immunization is both easily achieved and effective, but, while most of us recognize the importance of vaccinating children, we may not be so conscientious about ensuring our adulthood vaccinations are up-to-date.
Adult require immunizations to address weakened immunity against vaccine-preventable diseases, and to ensure that immunity against diseases more common in adults is acquired.
Up-to-date immunization of adults prevents the spread of infection and is important if the adult comes into contact with young children or babies and others at increased risk of vaccine-preventable diseases.
Health Canada advises that some vaccines are needed by all adults and other vaccines may be necessary due to the specific risk/s resulting from occupation, travel, underlying illness, lifestyle or age.
In recent years, new vaccines have become available for adults. These include vaccines for herpes zoster (shingles) and human papillomavirus (a sexually transmitted virus that causes genital warts and certain cancers). However, the number of Canadians who avail themselves of these vaccines remains low. This means that many adults remain unnecessarily vulnerable to vaccine-preventable diseases.
There are many reasons why adults fail to get the vaccinations that they need. These include not liking injections, assuming injections are just for children, lack of awareness that certain diseases can be vaccinated against, and simply forgetting follow-ups such as those required for hepatitis prevention.
What vaccinations are needed?
Health Canada lists the following vaccine-preventable diseases that all Canadian adults without contraindications should avail themselves of. (Please check with your doctor or other healthcare professional if you are unsure of what vaccinations you should have in order to provide yourself with maximum protection.)
Diphtheria, tetanus
All Canadian adults should be immunized against diphtheria and tetanus. Booster doses of diphtheria and tetanus toxoid-containing vaccine are recommended every 10 years.
Herpes zoster (shingles)
Herpes zoster vaccine is routinely recommended by Health Canada for adults 60 years of age and older. However, those wishing to avail themselves of earlier protection may obtain the vaccine from age 50 on. Adults of 50 years and older who have not had chicken pox should receive two doses of varicella (chickenpox) vaccine rather than herpes zoster (shingles) vaccine.
Human papillomavirus
Human papillomavirus (HPV) vaccine is recommended for women up to and including 26 years of age and may be given to those 27 years of age or older who are at ongoing risk of exposure. (The minimum age for this vaccine is 9.)
Vaccination is also recommended for men up to and including 26 years of age and may be given to men 27 years of age and older who are at ongoing risk of exposure.
Influenza (flu)
Seasonal influenza vaccine is recommended annually for all adults. An annual seasonal influenza vaccination is strongly encouraged for adults 65 years of age and older, and adults of all ages in specific risk situations. These include healthy adults in close contact with children under the age of 5, and/or other high‑risk individuals. Measles, mumps, rubella Adults who may be susceptible to one or more of these viruses are advised to be vaccinated with combined measles-mumps-rubella vaccine (MMR). One dose is recommended for most susceptible adults born in or after 1970. Those who are at the greatest risk of measles or mumps exposure (travellers to destinations outside of North America, health care workers, students in post-secondary educational settings, and military personnel) should receive two doses, at least four weeks apart. Adults born before 1970 have usually acquired natural immunity to measles and mumps, through having contracted these diseases, and do not need vaccine unless they are non-immune military personnel or health care workers, non-immune travellers, or non-immune students. Adults who are susceptible to rubella (German measles), regardless of age, should be vaccinated.
Meningococcal diseases
These include meningitis and septicemia. Healthy adults up to and including 24 years of age should receive meningococcal conjugate vaccine if not received in adolescence. Adults with specific risk conditions (such as laboratory workers and the military, or those who are travelling where meningococcal vaccine is recommended or required, including sub-Saharan African and pilgrims to the Hajj in Mecca, Saudi Arabia) should also be vaccinated and receive booster doses as recommended by Health Canada.
Pneumococcal disease
This is an infection caused by the Streptococcus pneumonia bacterium, resulting in pneumonia, infection of the blood or bacterial meningitis. A single dose of pneumococcal vaccine
(Pneu-P-23) is recommended for adults 65 years of age and older, particularly those in long-term care homes, and for younger adults with specific risk factors as outlined by Health Canada. (These include those with HIV and those on immunosuppressive therapies.) One lifetime re-immunization with Pneu-P-23 vaccine is advisable for those at highest risk.
Pertussis (whooping cough)
All adults of 18 years of age and older should receive one dose of pertussis vaccine (Tdap) if not previously received during adulthood. Adults who have not previously received Tdap vaccine in adulthood, and who anticipate having regular contact with an infant, should avail themselves of Tdap vaccine (ideally administered at least two weeks before contact with the infant).
Polio
Most adults in Canada have received polio vaccine as a child. Those who haven’t should be immunized with IPV—a vaccine containing unactivated polio virus. A single lifetime booster dose of polio vaccine is recommended for adults previously immunized, who have increased risk of exposure according to Health Canada guidelines.
Travellers’ vaccinations
If you are travelling outside of the country, you may require vaccines to prevent diseases prevalent in the countries where you travel. These include, but are not limited to, hepatitis A and B, yellow fever, cholera, and typhoid fever.
Hepatitis A and B are easy to contract in many parts of the world. Hepatitis A—a serious liver disease that is usually contracted by ingesting food or drinks that have been contaminated with human waste—is the most common vaccine-preventable disease in travellers. Those travelling to Mexico, South or Latin America, the Caribbean, Africa, South East Asia, China and the Middle East are at greatest risk for contracting hepatitis A. Hepatitis B is a type of hepatitis commonly contracted through exposure to the body fluids of an infected person, and is less common. Vaccines against hepatitis A and B are usually given together in a vaccine product called Twinrix®, available from the London Drugs pharmacy. This vaccine can be injected by your doctor (or other primary health professional) or by one of our Travel Medicine Pharmacists or other certified injection pharmacist. Please check with the pharmacy, when picking up Twinrix®.
For more information on adult vaccination recommendations, please visit Health Canada’s Canadian Immunization Guide at: www.phac-aspc.gc.ca/publicat/cig-gci/p03-02-eng.php#table-1.
