Immunization is a key component of primary health care.
It is considered a human right and one of the best health investments money can buy.
That’s why there is a mandatory vaccination schedule for infants from birth.
But what about adults?
Do they also need extra vaccines other than those received at childhood?
Immunizations are not just for children. Adults may be at risk for vaccine-preventable disease due to age, health conditions or jobs.
That’s why it is important to know which vaccines are needed accordingly.
According to Age
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Any adult >60 years old → Seasonal influenza vaccine is recommended as people in this age category are more prone to complications from disease
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Any adult >65 years old → Pneumococcal vaccination is recommended as pneumococcal disease is a significant cause of morbidity and mortality in older adults. Both the incidence of pneumococcal disease and the mortality rate increase after age 50 and more sharply after age 65
There are two types of pneumococcal vaccines:
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Pneumococcal polysaccharide vaccine PPSV23
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Pneumococcal conjugate vaccines (PCV)
So, which one to administer?
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For immunocompetent individuals → PCV20 → If PCV20 is unavailable, PCV15 followed by PPSV23 one year later is an alternative
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For immunocompromised individuals →Either PCV20 alone or PCV20 followed by PPSV23 ≥8 weeks later or PCV15 followed by PPSV23 one year later
According to Comorbidities or Health Condition
Pneumococcal and seasonal influenza vaccination are recommended in any adult with the following conditions:
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Chronic heart disease (excluding HTN)
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Chronic lung disease (including asthma and COPD)
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Chronic liver disease
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Diabetes Mellitus
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Sickle cell disease or other hemoglobinopathies
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Current cigarette smoking
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Increased risk of meningitis (Cochlear implant, CSF leakage)
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Immunocompromising conditions and other conditions associated with altered immunocompetence (Active malignancy, inherited or acquired immunodeficiency, functional or anatomic asplenia, solid organ transplantation)
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History of invasive pneumococcal disease
Approach for administration of pneumococcal vaccine:
Either PCV20 alone or PCV20 followed by PPSV23 ≥8 weeks later or PCV15 followed by PPSV23 one year later
According to Job
Healthcare workers (HCWs) are at risk for exposure to serious, and sometimes deadly, diseases.
Healthcare workers include physicians, nurses, emergency medical personnel, dental professionals and students, medical and nursing students, laboratory technicians, pharmacists, hospital volunteers, and administrative staff.
Important vaccines for healthcare workers include Hepatitis B, Seasonal influenza, Varicella (chickenpox) if no previous infection, Meningococcal (specially for Microbiologists who are routinely exposed to Neisseria meningitidis)
References:
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Vaccine information for adults, CDC (accessed on 26/10/2022)
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Daniel M Musher, MDMaria C Rodriguez-Barradas, MD. Pneumococcal vaccination in adults. UpToDate (accessed on 26/10/2022)
