Q: I’m not sure if I should get a shingles vaccination because I’ve had shingles once already. It was incredibly painful, lasting for weeks after the lesions went away. I’m only 55. Isn’t the shingles vaccine only for people over 60? And, what about other vaccinations for adults?
A: The shingles vaccination guidelines have changed. Immunization recommendations by the Center for Disease Control (CDC) are updated on a regular basis, and the shingles vaccination is one example. I am addressing the 2018 (healthy) Adult Immunization Schedule only.
Regarding shingles (herpes zoster), the CDC now recommends 2 doses of the recombinant zoster vaccine (RZV, or Shingrix) 2-6 months apart if you are 50 yrs. old or older, even if you have already had shingles.
Vaccinations themselves are also updated and improved, so you should receive these two vaccines even if you had the old live zoster vaccine (ZVL, or Zostavax), but you should wait at least two months after you received ZVL. For people 60 yrs. old or more, either ZVL or RZV are acceptable vaccination options, but RZV is preferable.
Varicella is a vaccination for chicken pox. If you have never had chicken pox or shingles, and have never been vaccinated for varicella before, it is recommended that you receive 2 doses of varicella vaccine (VAR) 4 to 8 weeks apart. If you were born in the USA before 1980, you are likely to be immune.
In the case of the “tetanus shot,” adults should receive one Tdap (tetanus, diptheria, and acellular pertussis) shot that also covers for whooping cough, regardless of when their last Td (tetanus and diptheria) shot was. Then go back to receiving a Td every ten years.
The MMR (measles, mumps, rubella) shot used to be given only to children as part of their vaccinations. Now MMR boosters are also recommended for adults, one or two depending on their risk of contracting one of these diseases. Risks include being born after 1957, having no laboratory evidence of immunity, or having no documentation of prior immunizations. Rubella infection can be particularly dangerous during pregnancy, so women who are of childbearing age should talk to their doctors about whether or not they are already immune or should be vaccinated before attempting to get pregnant. Pregnant women cannot be vaccinated until after delivery.
The flu shot (influenza) should be given every year. Influenza can be a deadly disease and may be preventable. The vaccines against influenza are not 100% effective, but most people who get the flu after vaccination have milder symptoms. Depending on your age, vaccination with either inactivated influenza virus (IIVs) or recombinant influenza vaccine (RIV4) should be given this year.
Human papillomavirus (HPV) vaccines should be given to females from age 9-26 years old and to males 9-21 (or 26 per clinical decision). Two to three doses should be given. This vaccine may prevent cervical cancer.
Pneumonia vaccines should be given to healthy adults 65 yrs. and older (sooner if medical indications like asthma, diabetes, heart disease, etc.). One dose of pneumococcal conjugate vaccine (PCV13) should be followed by pneumococcal polysaccharide vaccine (PPSV23) at least one year later. Boosters may be required if vaccinated before age 65.
Hepatitis A and B vaccines may be given if you are identified as at risk by your doctor. Meningitis vaccines are given to college students living in dormitories, military soldiers and high-risk individuals including travelers.
Ask your doctor if you have any contraindications to vaccination. A history of allergic reactions, egg allergies, HIV, immunocompromise, some chronic diseases, or current illness or pregnancy are examples of contraindications.
There are tests available to see if you are already immune to many of these infections, but the tests are not usually necessary to administer the vaccines.