Usually we who are older see our docs regularly, and probably get our shots. This is an essay on shots for people over age 40, who sometimes forget about these things, and often are not sick enough to see a doctor regularly.

The big ones that come to mind are the yearly flu shots, which make some people mildly ill but stops most but not all cases of flu. If you are healthy, you probably don’t need it. If you are over sixty, you should get it.

Then there is the pneumonia shot, which again stops many cases of pneumococcal pneumonia, but not all cases, and of course doesn’t stop other types of pneumonia.

Then comes the one we often miss: Tetanus. Most younger folks get it when they cut their hands or step on a nail, but often we forget Grandmom works in her garden and might not see a doctor for a minor wound is also at risk. So remember to get your tetanus booster every ten years.

End of story. Or not?

Figure 1

What is new?
Whooping cough.

Every once in awhile we see someone with a terrible cough that won’t go away. We treat with one antibiotic, and then the person isn’t better, so we treat with a different antibiotic ( or more commonly, they see our collegue and get a second antibiotic) but a month later they’re still coughing.

Well, studies now show that although most of these people just have a viral infection, some have whooping cough. The old Whooping cough (pertussis) vaccine had lots of side effects, so we didn’t use it over a certain age, but the newer (acellular pertussis) can be used in adults, and some people are advising to use the pertussis/tetanus shot when you get your every ten year tetanus booster.

Another new recommendation is MMR. Most people over 50 had measles and are immune, but if you were born after 1955 that might not be true. And the shot you were given as a child wears off. We now give two shots because they found the immunity wore off by the time the kids were in high school. So we recommend more boosters so you don’t come down with it as an adult. Also, mumps in adults is sometimes seen. Not a major disease, but it can cause encephalitis (brain infection) and in men affect their testicles and make them sterile.

Another vaccine is those for hepatitis A and B. These disease are spread via “fingers/feces/fly” and also can be sexually transmitted.
Most babies get these shots nowadays. So why give grandmom these shots?

Because some people who have had hepatitis B develop a carrier state and spread it.
I had one pastor’s wife who came down with it. We figure she caught it either from working with the kids of migrant workers, since her husband remained negative, and her son, who was a flight attendant, had received the vaccine.

Finally, what about chicken pox vaccine??

Well, you can get chicken pox several times, but it is usually mild the second or third time around. I once sent a dialysis patient with an “FUO” (fever that we couldn’t figure out what was causing it) to the local university for a workup…they sent him back immediately, because during the 300 mile flight, he broke out in chicken pox.

But there is another form of chicken pox called Shingles. (Herpes Zoster). It is not fatal, but can be very very painful. By giving a booster of chicken pox vaccine, you cut the rate of disease in half.

In summary, the good thing about vaccines is that we don’t end up with kids dying of measles, whooping cough, or tetanus (and I’ve seen kids die of all three disease working in Africa). But now we might start seeing these disease in adults.
We can cut down the rate of other illnesses like pneumonia and flu with some shots.

And rare “adult” disease like hepatitis can now be prevented.

So get your shots, and remember: it’s only a small owie, and if you don’t cry we’ll give you one of these: ———————-

Nancy Reyes is a retired physician living in the rural Philippines. Her website is Finest Kind Clinic and Fishmarket, and she writes medical essays at HeyDoc Xanga Blog

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