Assignment- Immunization for Adults

Immunizations1

Assignment- Immunization for Adults

Andrea Eden-Shingleton

MPH 584 Fall B- Community Health

Dr. Wheeler

November 15, 2015

According to data from the 2012 National Interview Health Survey (NHIS), too few adults are getting their recommended vaccines (CDC, 2012). The CDC (2014a) estimates that every year thousands of American adults suffer serious illness, are hospitalized, and even die due to disease for which vaccines are available. Many adults do not realize that even if you were fully vaccinated as a child, the protection from some vaccines you received can wear off (CDC, 2015). Additionally, certain jobs, lifestyles, travel, or health conditions increase the risk for other disease, requiring vaccinations (CDC, 2015).

The 2015 recommended immunizations for the adults: by age are listed in Figure 1.

Figure 1Available at

Most frequently,all adults need a yearly Flu vaccine in order to reduce flu illnesses, doctors' visits, and missed work and school, as well as prevent hospitalizations (CDC, 2015a). Less frequently, Tetanus booster (Td) is recommended every 10 yearsespecially immediate after a wound to help prevent infection (CDC, 2013). Due to a resurgence of Pertussis (Whooping Cough), the Tdap booster is recommended for adults to prevent the spread of the disease to unvaccinated young children (CDC, 2015b). At age 60, adults should receive the Shingles vaccine to prevent an acute Shingles infection and the long lasting pain called post-herpetic neuralgia (CDC, 2015c). Next, at age 65, older adults advised to receive the Pneumococcal vaccines due to increased susceptible to infections caused by Streptococcus pneumonia bacteria leading to Pneumonia (CDC, 2015d).

Vaccine recommendations for adults from the CDC are backed by a variety of organizations; Advisory Committee for Immunization Practices (ACIP), American Academy of Family Physicians, American Medical Association(AMA) and the American Public Health Association (APHA).In the past, the AMA (1981) established vaccine policies in conjunction with autonomy and informed consent. Today, to increase immunization rates, address vaccine-preventable illnesses and improve health outcomes, AMA Board Member William E. Kobler, M.D. emphasizes the importance of ensuring patients have access to the care they need when they need it, especially access to preventive care like immunizations (AMA, 2014). The shift is directly a result of research and evidence-based practices.

The most influential medical organizations recommend the CDC’s schedule for adult immunizations due to negative health outcomes if infected with these diseases. Specifically, vaccines are advised on the basis of age, health conditions, lifestyle, occupation and travel (CDC, 2014b). Addressing the current low levels of vaccination coverage among adults, the CDC (2014b) in collaboration with the National Vaccine Advisory Committee (NVAC) made a couplesuggestions to increase coverage. First, a health-care provider’s recommendation was found to be a strong predictor of patient compliance with the scheduled vaccine regimen (CDC, 2014b). Next, the proper documentation of immunizations is a challenge. The NVAC is developing an Immunization information system (vaccine registry) to ensure all the patients’ providers have access to important records (CDC, 2014b).

The CDC’s Immunization Safety Office (ISO) is vital to ensuring the quality of vaccines in the U.S. (CDC, 2015e). Federal government agencies and other stakeholders determine the best public health response to vaccine safety concerns; inform the public of the benefits and the risks (CDC, 2015e). For example, concerns about the Flu vaccine are addressed by the ISO and available to the public including these topics; the Flu Disease and How to protect against it, Flu Vaccine Side Effects, How CDC monitors Flu vaccine safety, and more resources (CDC, 2015f). Reiterating the safety of the flu vaccine, the CDC (2015f) identified the most common side effects. They are listed as mild and self-resolving like soreness at injection site, cough, fever, headache and fatigue (CDC, 2015F). Severe allergic reactions are very rare; the CDC (2015f) estimates they occur one in a million doses.

Personally, I have received all the recommended vaccination for my age, occupation and travel experience. To not have experienced any of the infectious diseases even after exposure, my bias is the promotion of vaccines to all adults. Having experienced the mild side effects of these immunizations has not deterred me from recommending them to others. I agree with the current CDC vaccination schedule for adults. Working as a health care profession, I could potentially be exposed to more infectious diseases than others and depend on my employer to mandate vaccinations. Recently, the employee health department contacted me due to the lack of proof of my Varicella immunity. Without a vaccine registry in the past, I could not give them written documentation, so I had my blood drawn to prove my immunity. The NVAC found that a doctor’s recommendation is important in helping adults maintain their immune status (CDC, 2014b). In 1995, I received the Hepatitis B vaccine series. In 2011, my primary care physician mentioned that I had not had my immune status checked recently; my testing found I was non-reactive, so I received a booster. I was grateful my doctor advocated for my health, it is especially important due to the negative health outcomes related to Hepatitis B. In fact, after a needle stick, oneof my co-workers developed Hepatitis B. He was so ill that he could not work and later received a liver transplant. Unfortunately, the transplantfailed and this 23 years old father/ husband left behind two orphans and a widow due to an occupational exposure. In my investigation of the adult immunization guidelines, I could not find any evidence to dissuade me from advocating of vaccines.

References

AMA.(1981). Opinion 8.08 - Informed Consent. Retrieved November 14, 2015, from

AMA. (2014). AMA Adopts New Policies to Improve Health of Nation at Interim Meeting.Retrieved November 14, 2015, from

CDC. (2012, February 3). Morbidity and Mortality Weekly Report: Adult Vaccination Coverage. Retrieved November 14, 2015, from

CDC. (2013).Tetanus. Retrieved on November 14, 2015, from

CDC. (2014a).Adult Vaccinations. Retrieved on November 14, 2015, from

CDC. (2014b).Advisory Committee on Immunization Practices Recommended Immunization Schedule for Adults Aged 19 Years or Older — United States, 2014. Retrieved on November 14, 2015, from

CDC. (2015a).Influenza (Flu).Retrieved on November 14, 2015, from

CDC. (2015b).Pertussis (Whooping Cough). Retrieved on November 14, 2015, from

CDC. (2015c).Shingles (Herpes Zoster) Vaccination. Retrieved on November 14, 2015, from

CDC. (2015d).Pneumococcal Vaccination. Retrieved on November 14, 2015, from

CDC. (2015e).About the Immunization Safety Office (ISO). Retrieved on November 14, 2015, from

CDC. (2015f).Influenza (Flu) Vaccine Safety.Retrieved on November 14, 2015, from