WHAT IS A VACCINE?

What is a vaccine and why should I get a vaccination?

A vaccine confers immunity to a virus by signaling your immune system to prepare to fend off that virus.  Vaccines are made from a dead virus, a weakened version of the virus (live virus) or sometimes just a piece of the virus.  This essentially makes your immune system think that you are infected with the virus.  Your immune system then produces antibodies to destroy the virus.  Your body then continues to make antibodies to the virus, which will prevent the actual virus from being able to infect you.

The United States requires that children receive vaccines for various viruses before they are admitted to public schools.  Additionally, many colleges require proof of immunization against many viruses in order to attend classes.  However, persons born outside of the United States may not have received some of these immunizations.  Additionally, some immunizations, such as for Hepatitis, are relatively new.  This means that while children are immune, adults haven’t received the vaccine and are vulnerable to infection.

Are vaccinations covered by my insurance?

 Unfortunately, many insurance plans do not cover vaccinations for adults.  I recommend that you call your insurance carrier and ask if immunizations against certain diseases are covered.

 Even if immunizations are not covered, I recommend that all of my patients be checked for immunity to various diseases and, if not immune, be immunized.  The out-of-pocket expense is small compared to the suffering of contracting certain diseases.  I can administer an immunization in my office.

What vaccinations do you recommend?

 I recommend testing for immunity to and, if necessary, receiving an immunization against the diseases described below.

Chicken Pox is a disease that most people in the United States catch as children.  It is very contagious but does not usually cause a serious illness in children.  Once someone has contracted chicken pox, they are immune from further infection.  Some states require that children show proof of immunity to chicken pox, either by natural infection or by vaccine, before admission to public school.

 There are a few adults that did not contract chicken pox when they were children.  Chicken Pox can be quite serious in adults however, leading to pneumonia and even death.  As I mentioned earlier, chicken pox is very contagious and quite common in children.  If you or any of your friends has children, you will probably be exposed.  If you had chicken pox as a child then it really doesn’t matter since you can’t catch it again.  If you have any doubt that you caught chicken pox as a child, I recommend that you be tested for immunity.  If not immune, I recommend that you make an appointment to receive the vaccine.  You really do not want to catch this as an adult.

Hepatitis A is a viral infection of the liver and is usually contracted by eating feces-contaminated food or coming into contact with raw sewage (also called fecal-oral transfer).  This can also be caught by eating raw or undercooked food (like raw oysters) There is only a small risk of this type of infection in the United States, but it is quite common in underdeveloped countries.  Hepatitis A usually goes away in a few months, but sometime complications develop that can result in severe liver damage or death.  If you plan to travel outside the United States, or if you have friends that do, I recommend that you receive this vaccine.

Hepatitis B is a serious sexually transmitted disease of the liver caused by the Hepatitis B virus.  Hepatitis B is transmitted by the exchange of blood or other bodily fluids and usually goes away in 2-6 months, but in many cases develops into Chronic Hepatitis B, a life-long infection.  Chronic Hepatitis B can result in cirrhosis of the liver, liver failure and liver cancer.  Immunization is required for children in the United States, however this policy began in 1992.  Most adults are still vulnerable to the disease.

Hepatitis B is the only sexually transmitted disease preventable by vaccine.  I recommend that all of my patients check with their insurance carrier to verify coverage for this vaccine.  Even if your insurance does not cover it, I recommend that my patients receive this vaccine.  I especially recommend that my single, sexually active patients be immunized against Hepatitis B.

 Influenza, also called the Flu, is a respiratory illness caused by the influenza virus.  Symptoms include fever, chills, body aches, coughing, weakness and sneezing.  Yes, the description is similar to that of a simple cold.  Well, the Flu is no simple cold.  Though the virus usually clears up in about a week, it will likely be your most miserable week of the year.  You will probably also miss a few days of work or school.  Persons over 65 years of age are at risk of developing complications such as pneumonia if they contract the Flu.  Persons with certain chronic illnesses or compromised immune systems are also at risk of developing complications.

The influenza virus readily mutates into new strains, so every year a new vaccine is developed and administered.  The current year’s vaccine is usually available in September, and I recommend that all of my patients receive the vaccine.

Pneumonia is a serious infection of the lungs.  There are several causes of pneumonia, including various viruses, bacteria and (rarely) other organisms.  The most common form of bacterial pneumonia is caused by the pneumococcal bacteria.

Pneumonia frequently follows another illness, such as a cold or the flu, which provides an opportunity for the bacteria or virus to infect the lungs.  While most young and middle-aged adults recover from pneumonia when treated, young children, the elderly, and people with compromised immune systems can have additional complications.  In these people, the bacteria can spread into the bloodstream causing sepsis (blood poisoning).

Pneumonia caused by the pneumococcal bacteria can be prevented by taking a vaccine.  This vaccine will not protect you from pneumonia caused by other bacteria or viruses.  I recommend that my patients that are at least 65 years old and those with diabetes or compromised immune systems take this vaccine.

Rubella, also called German Measles, is usually a short, mild illness characterized by red bumps on various parts of the body.  This disease is usually not serious.  However, if a pregnant woman contracts the illness, her child may be born deformed.  I recommend that all of my patients, especially women of childbearing age, verify that they were immunized against Rubella as a child and, if not, that they arrange to be immunized.

Tetanus, also known as Lockjaw, is a nerve ailment caused by a toxin secreted by the bacteria Clostridium tetani.  This bacteria is very common and is found in dirt and dust throughout the world.  The toxin, tetanospasmin, has been called one of the most potent microbial poisons known.  Tetanospasmin damages nerves, causing spasms in the muscles.  The most notable of these spasms occurs in the jaw and facial muscles, giving tetanus it’s fearsome nickname “lockjaw.”  Eventually, spasms occur in the muscles surrounding the lungs and the patient cannot breath.  Tetanus has a high fatality rate.

Tetanus is contracted by a deep and/or dirty cut, or the infamous puncture wound by a “rusty nail.”  Fortunately, tetanus can be prevented.  First, wash all cuts thoroughly with soap and water.  Second, make sure your tetanus vaccine is current.

 In the United States, children are immunized against tetanus.  Afterward, a tetanus booster shot is recommended at least every 10 years.  However, if you have a very deep and dirty cut, you should get a tetanus booster shot unless you have had one within the last 5 years.

 The vaccines mentioned above are only for illnesses that I feel my patients are at the highest risk of contracting.  There are many additional vaccines that I didn’t mention, many for illnesses that are rare in the United States but very common in other parts of the world.  If you are planning on traveling outside the United States, please arrange an appointment with me so that we can discuss and plan for you to receive the proper immunizations.

Alice V. Coghill, M.D.

June, 2004