Immunizations

Public Health Fact Sheet
Adult Immunization

Massachusetts Department of Public Health, 305 South Street, Jamaica Plain, MA 02130
Why do adults need to be immunized?

Many infections preventable with vaccines are more dangerous in adults than in children. Many adults think they are too old for immunization, but they are wrong. Adults should ask their doctor or nurse about tetanus-diphtheria vaccine (Td), pneumococcal vaccine, and annual flu shots, especially at visits on or around the 50th and 65th birthdays. Some adults will need other vaccines because of their jobs, travel plans or health problems.

Tetanus and Diphtheria

Tetanus (lockjaw) kills 1 of every 3 people who get it. Germs that make tetanus toxin (poison) cause tetanus after entering the body, usually through a cut or scrape. The cut does not have to show any sign of infection and does not have to be large or deep to lead to tetanus.

Diphtheria is dangerous; 1 of every 10 people who get it dies from it. The signs of diphtheria include fever and sore throat with swelling, causing swallowing problems and suffocation. It is rare in the U. S. becuse so many people have been vaccinated, but it is still common in other parts of the world.

Tetanus-Diphtheria Vaccine (Td) - Tetanus and diphtheria vaccines are usually given as one shot called Td. Anyone who has never had a Td should start with a series of 3 shots. Everyone needs a booster shot every 10 years. A booster may be given sooner if a person gets certain kinds of wounds.

Flu (Influenza)

Flu is a very contagious disease caused by influenza viruses. Signs include sudden high fever, muscle ache, sore throat and cough. Most people who catch it will get well within a week, but flu sometimes leads to pneumonia, which can be fatal. People at high risk for pneumonia should get a flu shot every year. They include anyone 50 years old or older, residents of long-term care facilitites, people of any age who have chronic medical problems (heart or lung disease, asthma, diabetes, etc.), pregnant women, and people whose immune systems have been weakened (by cancer, AIDS, or other cause). People who work or live with a high-risk person should also get a flu shot so they don't spread the flu. People who just want to avoid the flu can also get the shot. A new flu shot is needed each year. The best time to get it is in the fall, but it's not too later to get it later, even after December.

Pneumococcal Disease

Pneumococcal disease is a disease that is caused by bacteria (germs) that can infect the lungs (pneumonia), the blood (bacteremia), and the membrane that covers the brain (meningitis). People 65 years old and older, people of any age with certain medical conditions, and people with weakened immune systems should get pneumococcal vaccine. Most people only need one dose, which can safely be given at the same time as a flu shot or at any other time during the year. Some people may need a booster shot, so ask you doctor or nurse.

Hepatitis B

Hepatitis B is a disease caused by a virus that can damage the liver. Symptoms include flu-like illness, extreme tiredness and jaundice (yellowing of light skin and the whites of the eyes), but often the disease occurs without noticeable symptoms. This virus can cause chronic hepatitis, which can be fatal.  Health care workers, people with multiple sex partners, IV drug users, sexual partners and household members of hepatitis B carriers, and anyone else likely to have contact with infected blood or body fluids should get the vaccine. People who visit countries where hepatitis B is common should also get the vaccine.  Three doses are needed to protect against hepatitis B.

Measles, Mumps, and Rubella

Measles is caused by a virus and its signs include rash, fever, sore throat, dry cough, and runny nose. Ear infections, pneumonia, swelling of the brain, and death can all result from measles. The risk of death from measles is highest among infants and adults. Many adults born after 1956 never had measles (but may think they did) and never got the vaccine.

Mumps is caused by a virus and its signs include swelling of the salivary (spit) glands. Mumps is more common in children than in adults, but it is more likely to cause serious problems in adults. Thes problems can include swelling of and damage to the testicles, ovaries, pancreas, thyroid, kidneys, heart, joints, or the thin membrane that covers the brain and spinal cord.

Rubella is caused by a virus and its signs include low fever, joint pain, and rash in some people. Rubella is usually a mild disease in both children and adults, but it can cause severe birth defects or miscarriage if a woman gets rubella while pregnant.

Measles, Mumps and Rubella Vaccine (MMR) - Measles, mumps and rubella vaccines are usually combined in one shot called MMR. People born after 1956 need 2 shots of MMR, especially if they are health care workers, people traveling overseas, college students or persons living in institutional settings, such as group homes. These people are at higher risk of catching and spreading measles. Adults born in the U.S. before 1957 are usually considered immune, but they should get one dose of MMR if they are women who could become pregnant, health care workers, or college students. Women who are already pregnant should not be vaccinated until after the baby is born. One dose of MMR is also recommended for adults born outside of the U.S., regardless of year of birth.

Varicella (Chickenpox)

Chickenpox is caused by a virus. The symptoms include fever, cough, and rash that may become blisters that crust over. Adults, pregnant women, and people with weak immune systems have more severe symptoms and are at higher risk for complications such as pneumonia and infections of the brain, kidneys and liver. Adults who have not had chickenpox, expecially child care and health care workers, and people living with people with weak immune systems, should be vaccinated. People 13 years old or older need 2 doses of varicella vaccine.

Travel Vaccinations

There are a number of vaccines that are not routine for adults, but are recommended for travel to certain areas.  These include hepatitis A, typhoid, yellow fever and Japanese encephalitis vaccines. To find out if you need shots for travel, contact a doctor, board of health, or the CDC Travel Information website, or call 1-877-394-8747, at least 6 weeks before leaving the country.

Where can you get more information?

Your doctor, nurse or clinic or your local board of health (listed in the phone book under local government).

The Massachusetts Department of Public Health Immunization Program (617) 983-6800 or toll-free at 1-888-658-2850, or at a MDPH Regional Office below, or on the MDPH Website

MDPH Regional Offices:

*Boston providers and residents may also call the Boston Public Health Commission at (617) 534-5611.

CDC National Immunization Information Hotline:

English: 1-800-232-2522 or Spanish: 1-800-232-0233 (Mon - Fri, 8am - 1pm)
TTY: 1-800-243-7889 (Mon - Fri, 10am - 10pm)
June  2002