Fit & Proper: Do adults need vaccination?

Ahmed (name changed), a 55-year-old diabetic smoker who was being treated for a heart condition, was referred to my hospital after his chronic bronchitis worsened. After his infection settled, he underwent a baseline spirometry (lung function test) following which he was advised inhalers for his chronic obstructive pulmonary disorder as well as influenza and pneumococcal vaccinations. He took neither. A year later, he arrived at the emergency department of our hospital gasping for breath. He had been on a pilgrimage to Mecca where he had acquired a respiratory infection. He self-medicated with antibiotics and felt better, but the symptoms recurred and he went breathless on his flight home. His chest X-ray showed severe pneumonia. He was immediately administered oxygen and supportive treatment but when his condition deteriorated, he was placed on mechanical ventilator. The recovery was difficult and long.

As an adult you might think you were done with all the vaccinations as a child. There are many adults who have not even been immunised as children. If you think infections such as pneumonia, measles, and pertussis affect only children, you are mistaken. Adults are as likely as children to fall prey to diseases that immunisation can potentially prevent.

Today's ambition-driven adults live life on the edge. Stressful professions, inadequate rest, improper nutrition and unhealthy lifestyles do more harm than good to the body. The body's immunity begins to wear off around the age of 50, increasing a person's vulnerability to infections. Other accompaniments of age such as diabetes, heart, kidney and lung diseases and immuno-compromising conditions further lower the body's capacity to ward off infections.

With the possibility of travelling the globe in just one day, it's not hard to imagine how effortlessly infections travel too. Vaccination is safe and has shown to prevent about 50 per cent of deaths from pneumococcal disease, and 80 per cent of deaths from influenza-related complications in the elderly.


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Recommended for adults:

• Flu vaccine prevents influenza, which has a nasty reputation of killing healthy individuals. Single dose annual vaccination is recommended for all adults aged 19 and above.
• TDAP vaccine prevents tetanus, diphtheria and pertussis, and is recommended for all adults above 19 years who have never received it. Tetanus booster is recommended every ten years (or sooner if lacerated by an object contaminated with soil).
• Pneumonia vaccine prevents pneumococcal disease which is a fatal health threat because of the bacteria's increasing antibiotic resistance. One-shot PCV13 vaccine is recommended for adults above 50 years suffering from chronic, immuno-compromised and respiratory diseases, and generally for elders above 65 years.
• Shingles vaccine prevents shingles, a condition that gives rise to painful skin sores around a nerve, and if untreated, could prove fatal. A single shot is recommended for people above 60 years who have earlier had chickenpox.
• Hepatitis A, B vaccine is advised for adults who travel overseas.
• HPV vaccine prevents cancers of the cervix, head, neck and rectum. It is recommended for adults below 26 and women above 26 who have tested negative for the virus through a pap smear.

Ashfaq Hasan
Head of pulmonary medicine, Owaisi Hospital & Research Centre, Hyderabad