Adults skipping vaccinations, boosters

January 25, 2008 7:28:15 AM PST
Vaccines aren't just for kids, but too few grown-ups are rolling up their sleeves, say disappointed federal health officials.

The numbers of newly vaccinated are surprisingly low, considering how much public attention a trio of new shots - which protect against shingles, whooping cough and cervical cancer - received in recent years.

Yet many seem to have missed, or forgotten, the news: A survey by the National Foundation for Infectious Diseases found that aside from the flu, most adults have trouble even naming diseases that they could prevent with a simple inoculation.

"We really need to get beyond the mentality that vaccines are for kids. Vaccines are for everybody," said Dr. Anne Schuchat of the Centers for Disease Control and Prevention, who called the new data sobering. "We obviously have a lot more work to do."

The new CDC report found:

-Only about 2 percent of Americans ages 60 and older received a vaccine against shingles in its first year of sales.

There are more than 1 million new cases a year of shingles, an excruciating rite of aging that causes a blistering skin rash. Up to 200,000 of them develop a complication, severe nerve pain that can last for months or even years. Anyone who ever had chickenpox is at risk, especially once they hit their 60s, because the chickenpox virus hibernates for decades in nerve cells until erupting again.

"Many people describe the shingles pain as the worst pain they've ever endured," said Dr. Michael Oxman of the University of California, San Diego.

The shingles vaccine, Merck & Co.'s Zostavax, isn't perfect, but it cuts in half the risk of shingles - and those who still get it have a much milder case.

-About 2 percent of adults ages 18 to 64 got a booster shot against whooping cough in the two years since it hit the market. The cough so strong it can break a rib is making a big comeback, because the vaccine given to babies and toddlers starts wearing off by adolescence. Older patients usually recover, but whooping cough can cause weeks of misery. Worse, those people can easily spread the illness to not-yet-vaccinated infants, who can die from the bacterial infection, also called pertussis.

The pertussis booster was added to another long-recommended shot, a booster against tetanus and diphtheria that adults should get every 10 years. The new triple combo is called "Tdap." Sanofi-Aventis's Adacel brand is for ages 11 to 64. There also is a version for 10- to 18-year-olds, GlaxoSmithKline's Boostrix.

-About 10 percent of women ages 18 to 26 have received at least one dose of a three-shot series that protects against the human papillomavirus, or HPV, that causes cervical cancer.

There are more than 100 different types of HPV, the most prevalent sexually transmitted infection. Usually, the body gets rid of HPV without symptoms. But certain high-risk strains can persist and cause genital warts or cervical cancer.

The vaccine, Merck's Gardasil, protects against four of those high-risk types. That's not complete protection - so even the vaccinated still need regular Pap smears - but those strains are responsible for about 72 percent of cervical cancer and 90 percent of genital warts, said Dr. Stanley Gall of the American College of Obstetricians and Gynecologists.

Stay tuned: The government is considering whether even more women should get the vaccine - those up to age 45 who aren't yet infected, Gall said. And studies are under way to see if it works in men.

Price may play a role in these low vaccination rates. The shingles shot costs around $150, and the three-shot HPV vaccine about $300, and insurance coverage varies. There's no national program to guarantee access for adults who can't afford vaccines as there is for child vaccines.

But adults aren't taking full advantage of some cheap old standby vaccines, either. Among people 65 or older, a high-risk age, CDC found only 69 percent get an annual flu shot; just 66 percent have had a one-time pneumonia vaccine; and 44 percent had received a tetanus shot in the past 10 years.

It's not too late for a flu shot this year - and Oxman urged getting some of the other adult shots in the same doctor visit.


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