Your Health This Week
Shots for adults and honey for kids.
This week, Dr. Sydney Spiesel discusses the immunizations that adults need, the value of giving honey to coughing kids, and the difficulty of killing off medical recommendations that prove to be wrong or obsolete.
Problem: When parents bring their children in for shots, I often sense a touch of gratitude that their own time at the mercy of the needle has passed. Wrong. Many adults are due for shots. Their doctors often neglect this, but the recently issued U.S. Recommended Adult Immunization Schedule should remind them.
Question: Why immunize adults? The answer is simple: It's the most natural, specific, and cost-effective way of preventing illness. Vaccines take advantage of the body's ability to act as a chemical factory. Exposed to a protein from a virus or to a fragment extracted from a bacterial cell, our body recognizes the material as something resembling an invading parasite, and makes a protein molecule (an antibody) to stop the invader. Since the person who was vaccinated is prevented from getting the infection, he or she also can't pass it on, and thus helps break the chain of infection (an advantage called "herd immunity").
Recommendations: With time, sometimes the protection children receive through immunization fades and needs a boost. What are the vaccines recommended for adults?
• The newly introduced Tdap. This boosts protection against diphtheria, whooping cough, and lockjaw, a horrible illness caused by certain soil bacteria when they enter the body through a deep injury (think of stepping on a rusty nail). The vaccine should be repeated every 10 years and should also be given after an injury if it's been more than five years since your last dose.
• Two doses of chickenpox vaccine and (if you were born after 1957) at least one dose of measles, mumps, or rubella vaccine. If you are 60 years or older, the shingles vaccine is strongly recommended. None of these should be given to pregnant women or people with suppressed immune systems.
• If you are a woman under 27, three doses of the HPV vaccine against cervical cancer and genital warts.
• If you are older than 50 or live in a household with a child under 2, an annual flu shot.
• If you are traveling to a wonderful place with less than wonderful sanitation, seek out a hepatitis A shot—nothing spoils a vacation like vomiting, diarrhea, and turning yellow.
Sydney Spiesel is a pediatrician in Woodbridge, Conn., and clinical professor of pediatrics at Yale University's School of Medicine.
Photograph of honey by Photodisc.



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