New: Gardasil vaccine against cervical cancer and vulvar and vaginal cancer and related diseases is available at our clinic. read more...

  Every adult has a reason to ask about immunization. Immunizations or vaccinations that you received as a child may need a booster. Your occupation, lifestyle, or medical condition may put you at greater risk of infections. You may be travelling to other countries and need protection from diseases not normally seen in Canada. There are many good reasons to get more information on the most effective means of preventing disease. Common questions will be answered below. If you need more information, ask your doctor, local public health office or pharmacist, or contact the references listed at the end of this document.  

 

  1. Why do adults need immunizations?

Vaccines are not just for children. Many parents are careful about protecting their children with vaccines but forget about protecting themselves. Adults continue to need immunizations for several reasons:

• Some vaccines do not provide lifelong protection.

In order to be protected against tetanus and diphtheria, all adults need a booster shot every 10 years. All adults should get the influenza vaccine each year, especially those with high risk conditions, the elderly and health care workers. Experience in other countries has shown that if large numbers of people do not keep their immunizations up-to-date, serious outbreaks of disease can occur. For example, in Russia there were 5,000 deaths due to diphtheria in 1994 after the organized immunization system broke down.

• Some adults did not get all the vaccines recommended in childhood.

People who have lived in another country as a child may not have received all the immunizations that are recommended in Canada. There may be other reasons for a person not receiving all of the routine vaccines for children – for example, leaving school before graduation. Some diseases, such as measles, that were once common are now rare because most children are immunized. However, it is still important for everyone to be protected against these diseases. If an outbreak of measles occurs in a community, adults who did not receive all their shots as children may be at high risk for serious disease. As another example, pregnant women who are not protected against rubella (German measles) may become infected and pass the infection on to their baby, causing serious birth defects. Other adults who are not protected against rubella can spread the disease to unprotected pregnant women.

• New vaccines have become available in recent years.

Vaccines which protect against hepatitis A (a liver disease) and varicella (chickenpox) are among several new vaccines now available for adults. It is important to talk to your doctor about whether you need any of the new vaccines. For example, if you never had chickenpox as a child, it may be especially important for you to get the chickenpox vaccine if you are a health care worker, if you routinely work with small children, or if you are likely to become pregnant in the future. The chickenpox vaccine is recommended for anyone who is not already immune to the disease.

• Adults may need vaccines when they travel to other countries.

Most Canadians are not protected against diseases that do not exist in Canada – such as yellow fever, typhoid fever, and Japanese encephalitis. Other diseases such as hepatitis A and hepatitis B are more common in other countries than they are in Canada. Before you travel to other parts of the world, you should find out what diseases may be a risk for you. The vaccines you need will depend on where you are travelling and what you plan to do there. For example, some tropical diseases may be a risk in rural areas of a country but not in a city. To get current information on which vaccines are required or recommended for travel, contact a travel health clinic or your local public health office. You can also find out more from your doctor and from the Public Health Agency of Canada (www.TravelHealth.gc.ca). You can obtain the vaccines you need from a travel health clinic.

• Some jobs or lifestyles put people at risk for specific diseases that can be prevented by vaccines.

Health care workers, emergency responders, laboratory workers and students training for these jobs are at risk of exposure to communicable diseases because of their contact with people or specimens from people who may carry disease. These workers and students also have a responsibility to protect themselves against communicable disease because they could pass it on during their work to sick or injured people who are at risk of serious complications from disease. All of these workers and students should be immunized against diphtheria, tetanus, measles, mumps, pertussis, polio, rubella, hepatitis B, influenza, and chickenpox (if they do not already have immunity). Other vaccines may also be recommended for laboratory workers, health care workers or for other occupations. People who live or work in residential institutions should also be immunized against diphtheria, tetanus, measles, polio, rubella, hepatitis B, and influenza. People who use street drugs and people with multiple sexual partners have a lifestyle that puts them at risk for certain diseases. Anyone who works with people with these lifestyle or environmental risks can help prevent disease by encouraging these people to get the vaccines they may need.

back to top

2. Which immunizations do adults generally need?

Diphtheria and tetanus:

Adults need a tetanus-diphtheria booster shot every 10 years. The vaccines against diphtheria and tetanus are combined into one shot. Tetanus (lockjaw) is caused by a germ that lives in soil and causes painful tightening of the muscles, permanent damage, and death in about 3 out of 10 cases. Every adult needs to be vaccinated against tetanus because there is no protection from “herd immunity” with this disease. Diphtheria is a contagious disease that causes a thick coating at the back of the throat, and can lead to breathing problems, heart failure and nerve damage. Immunization has greatly decreased this disease but remains essential to keep diphtheria under control. Serious outbreaks of diphtheria have occurred in countries where immunization programs lapsed or were interrupted.

Pertussis (whooping cough):

Immunity to whooping cough is not lifelong, either following natural infection or following immunization in childhood. This means that adults can develop whooping cough (a prolonged illness with persistent cough and respiratory distress) if exposed to the disease. This may happen at an age when adults are new parents or new grandparents. They can then transmit whooping cough to babies who are too young to be fully immunized. Whooping cough can be a life-threatening illness for young infants. A single dose of pertussis vaccine (in Canada this is combined with the tetanus and diphtheria booster) can prevent illness in adults and therefore protect young infants.

Measles:

Any adult in Canada born in 1970 or later who has not already had measles disease or a measles vaccine should get a measles shot. The measles virus is very contagious. It usually causes a rash and fever but can also lead to pneumonia or a serious brain infection (encephalitis). Usually just one shot is needed to protect adults against measles. This is given as a combined measles, mumps, and rubella (MMR) vaccine.

Rubella (German measles):

Rubella is rarely a serious disease for adults but it causes birth defects if a woman gets rubella in early pregnancy. There is a high chance her baby will be born with blindness, deafness, heart disease, or intellectual disability. All women of child-bearing age and all health care workers should get the rubella vaccine, unless they are immune. One dose is needed and is usually combined with measles and mumps vaccine (MMR).

Influenza:

The flu is a serious respiratory disease, especially for older adults and anyone with certain medical conditions that may leave them vulnerable to complications from flu. The flu should not be confused with the “common cold” which is a less serious disease and for which there is no vaccine. Flu kills thousands of adults every year in Canada. All adults should receive influenza vaccine each year, especially those over the age of 65, and those less than 65 years of age who have underlying medical conditions. Adults who want to reduce their chance of catching the flu, or of passing it on to others, can benefit from the flu vaccine. A new shot is needed each year, and it is best to get it between October and mid-November.

Varicella (chickenpox):
Any adult who has never had chickenpox should consider getting this vaccine. Complications from chickenpox are more common and often more serious when adults get the disease, compared to children. Some children as well as adults die from chickenpox every year in Canada. Besides protecting themselves, chickenpox vaccine is also recommended for adults who could transmit the disease to vulnerable people. Adults who should particularly consider chickenpox vaccine include:
• Women of child-bearing age (getting chickenpox during pregnancy can pose a risk to the mother and baby)
• People who live with someone with a damaged or depressed immune system
• Day care workers and teachers of young children
• Health care workers
• New immigrants from tropical climates where chickenpox is much less common compared to Canada.

Pneumococcal disease:

This is a group of bacterial infections that infect the lungs (pneumonia), the blood (bacteremia), and the covering of the brain (meningitis). Antibiotic drugs used to be effective against treating these infections, but the germs have become more resistant to these drugs, making treatment more difficult. This makes vaccination even more important to prevent this disease. The vaccine, called PPV (pneumococcal polysaccharide vaccine), protects against 23 types of pneumococcal bacteria. All adults over 65 and anyone with a medical condition that increases their risk of serious infection should get PPV. Usually just one dose is needed; for some people a one-time booster shot after 5 years is recommended as well. Ask your doctor or public health nurse to find out if you need a PPV booster.

back to top

z

4. How often should my immunizations be reviewed?

Adults should talk to their doctor or nurse about whether they need certain vaccines. Important times to review your vaccines are:
• When you see a new doctor
• If you are thinking of having children
• If you work with young children
• If you are beginning work in health care or emergency response
• If you develop a chronic disease
• If you are having sexual contact with multiple partners
• If you use intravenous drugs
• Before you travel to an area that has diseases different than those where you usually live
• If you are 65 or older
• At least every 10 years.

back to top

5. Why should I get the influenza vaccine when I am young and healthy?

The flu (influenza) is not just a bad cold. It is much worse. Flu causes fever, headaches, general body aches, and weakness, along with stuffy nose, sore throat, and cough. People with flu usually feel quite sick for 5 to 10 days, but the cough and weakness may last up to 6 weeks. Influenza is very contagious and can be transmitted easily to people at high risk of complications. Influenza is caused by a virus; antibiotics are not effective in treating the flu. The flu vaccine is recommended for nearly everyone, even healthy adults. Among elderly people and people with chronic diseases, the flu vaccine can prevent complications that might otherwise kill them. Serious complications include pneumonia, kidney failure, and heart failure. Between 500 and 1,500 people in Canada die from influenza every year. For younger healthy people, the flu vaccine is important for several reasons: to prevent transmitting the flu to someone who is at high risk for complications; to prevent transmitting the flu to your household and workplace; to avoid lost time from work; and to prevent the personal distress and disruption of having the flu. A new flu shot is required each year because there are several types of influenza virus and the viruses mutate or change over time. A new vaccine is developed each year to protect people against the flu virus that is most likely to cause disease in Canada for the coming winter.

Back to top

6.What are the potential risks of vaccines?

As with any medicine, there are very small risks that problems could occur for someone getting a vaccine. For all of the vaccines discussed, your chance of being harmed by the infection is far greater than any chance of being harmed by the vaccine. Vaccines are among the safest medical interventions, and they are subjected to vigorous safety and quality control standards. The vaccines recommended for adults will protect you against serious diseases that have not disappeared from the world. If people stop using these vaccines, the diseases will almost certainly become common again, causing many illnesses and deaths. These vaccines are extremely safe and highly effective. If you have any questions or concerns about vaccines, check with your doctor or public health office.