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Adult Vaccines for Shingles, Pneumonia and TDAP

Are you properly vaccinated? Having the right vaccines is as important for adults as it is for children. This is especially true for people who are over age 65 and for pregnant women.  

But who should get which vaccines?  

To learn more about vaccinations for adults, tune into SMG radio for an interview with Dr. Sweetie Mehra, who will discuss the important of getting immunized for shingles and pneumonia and also getting the single vaccine that protects against three illnesses in one shot: tetanus, diphtheria, and pertussis.
Adult Vaccines for Shingles, Pneumonia and TDAP
Featured Speaker:
Sweetie Mehra, MD
Sweeti Mehra, MD, specializes in internal medicine. She focuses on educating patients about disease prevention and the importance of screenings.  Dr. Mehra has been a faculty member at Columbia College of Physicians and Surgeons and Mount Sinai Icahn School of Medicine.

Learn more about Sweeti Mehra, MD
Transcription:
Adult Vaccines for Shingles, Pneumonia and TDAP

Melanie Cole (Host):  Having the right vaccine is as important for adults as it is for children.  This is especially true for people who are over 65 or for pregnant women or immunocompromised people.  My guest today is Dr. Sweeti Mehra.  She specializes in internal medicine at Summit Medical Group.  Welcome to the show, Dr. Mehra.  Let’s start with a talk about pneumonia vaccine because we’ve talked about flu vaccine before, too, and it can turn into pneumonia.  Tell us about pneumonia, the disease itself. What is this vaccine doing?

Dr. Sweeti Mehra (Guest):  Pneumonia is a disease that has a big group of causes.  The pneumonia vaccine, unfortunately, only covers the one that we worry about the most which is the streptococcal pneumonia bacteriaIt causes the most severe form of pneumonia, especially in our patients over the age of 65 and even in our young infants.  So, the pneumonia vaccine is very important.  There are two types now.  One is called Prevnar 13 and the traditional one we’ve had for many years is Pneumococcal 23.   

Melanie:  Tell us who should receive this and how often they need this vaccine.

Dr. Mehra:  Prevnar 13 is the newer one.  It is recommended for adults over the age of 65.  It can be given to patients from the age of 19-64 if they are immunocompromised or for some reason, they don’t have their spleen.  It is a one-time vaccine.  Currently, the recommendation is to do it just once.  Maybe down the road they might recommend to give a booster of it but at this time it’s a one-time vaccine.  The Pneumococcal 23 is also recommended for those who are over age 65. However, there’s a broader group of patients from the age of 19-64 that we might also want to vaccinate.  Those include diabetics, anyone with heart or lung disease, renal disease, liver disease like cirrhosis.  Again, we have immunocompromised patients who many have cancer, HIV, smokers and alcoholics. 

Melanie:   Is this only a one shot deal or is there a booster that goes with it?  Is it two or just one?

Dr. Mehra:  With Pneumococcal 23, there can be a booster.  So, if you are a patient who falls in the age of 19-64 and you had to get it early because you fell in one of the high risk groups, then you can get a booster over the age of 65 as long as there’s been a 5 year gap between the previous vaccines.

Melanie:   So, pneumonia can really send people to the hospitals.  Are there any symptoms of this disease that you want the listeners to be aware of?

Dr. Mehra:  Fever and cough are the two main symptoms of pneumonia.  If you are having persistent fever and cough, particularly over three days, you should see your doctor and get evaluated to see if pneumonia is a possibility, especially if you’re falling into the high risk groups – if you have lung disease, asthma, emphysema or you’re a diabetic. You really should definitely see your doctor to get evaluated for the possibility of pneumonia.

Melanie:   Moving on to the shingles vaccine, the Zoster.  Tell us a little bit about shingles.  It’s a pretty nasty disease and tell us what the vaccine can do for us.

Dr. Mehra:  Shingles is a disease which many people don’t realize that the chicken pox virus stays in our system when we were mostly exposed as children.  It never leaves our body.  It stays dormant.  Unfortunately, there are times when our immunity might decrease, for example, when you’re sick with another illness.  As you get older, your immunity can decrease or even when you’re stressed the virus can then reactivate and cause disease.  It’s not as bad as the chicken pox but it is just as painful.  The shingles vaccine is a live injectable vaccine which is attempting to boost your immune system to not cure you of the disease but to decrease the reactivation of the virus and particularly the neurologic pain that can happen with shingles called “post-herpetic neuralgia”.  This is a one-time vaccine so, unfortunately, the recommendation is to get it at once. 

Melanie:  If you have never had the chicken pox and the virus is not lying dormant in your body can you get shingles?

Dr. Mehra:  Basically, the recommendation is for people over the age of 50 to get the vaccine.  You don’t even need to document whether or not you’ve had the chicken pox disease or not.  The feeling is that most of us have been exposed so the virus is most likely dormant in our system and that getting the vaccine is going to just boost your immunity to keep that virus dormant.

Melanie:   What about the symptoms of shingles? How would you know if this is something because that people say that it comes out from stress. There’s a lot of reasons that people talk about shingles. Dr. Mehra, speak about the symptoms a little bit.

Dr. Mehra:  Pain is the biggest one.  This is one disease where can pain can occur in an area and it can precede the rash.  The rash is very similar to the chicken pox rash that we see in children.  If you have an area where you’re having an irritation, tingling, pain and then a rash develops, that most likely can be shingles and you should go to your doctor to get evaluated.

Melanie:   What can they do for it?

Dr. Mehra:  At the time, there isn’t anything they can do but if they go to their doctor, their doctor can decide to give them a medication if they presented the office within 72 hours of symptoms.  It’s a medicine called Valtrex.  Valtrex doesn’t cure the disease. It can decrease the duration of symptoms.  So, the doctor can definitely decide to start treatment with the medication.

Melanie:   We hear about giving our children the Tdap vaccine.  What is that and do we need it as adults?

Dr. Mehra:  Tdap is a vaccine that protects against three different bacterial infections.  “T” stands for tetanus.  “D” stands for diphtheria and the “P” stands for pertussis.   This is an extremely successful vaccine.  In the past, there were many cases of tetani, diphtheria and pertussis.  This vaccine has definitely decreased it.  We are very easy to give it to children and as adults we question it and we shouldn’t.  It is a really important vaccine that adults should get.  This vaccine needs to be given between the ages of 19-64 if you’ve never received the Tdap in your pediatric lifetime.  It should be given as a one-time booster.  Subsequently, once you get the Tdap booster, your doctor can give you the tetanus/diphtheria part every 10 years.  It’s really the pertussis part of the vaccine that we need to give a one-time booster between the ages of 19-64.  Now, it’s even been opened up to those greater than 65, particularly if they’re taking care of infants under the age of 12 months.

Melanie:   I think adults are hesitant because we used to hear about the tetanus shot and it being such a huge needle.  It’s not the same anymore, is it?

Dr. Mehra:  No.  It’s not a huge needle.  It’s a very similar needle we use when we give the flu vaccine, pneumonia vaccine. So, no. It’s a similar way to administer it to other vaccines where it’s just given in the muscle of the arm.  It’s a 1, 2, 3 shot.  Nothing to worry about.

Melanie:   When there’s outbreaks of pertussis, what would be the symptoms of those?

Dr. Mehra:  Pertussis used to be given the name “whooping cough” because cough is really the big symptom of pertussis.  It happens in waves.  Medically, we call it the bark-like cough because it does sound like someone is barking when you are coughing.  It’s such an uncontrollable cough and it happens in waves.  It can happen even in the middle of the night where you just wake up.  For pertussis, I would tell the listeners to think of a really bad cough and to talk to your doctor if you think you’re having it especially if you cough and then vomit.  That’s something to think about.

Melanie:   In just the last few minutes, Dr. Mehra, and its great information, wrap it up for us.  Your best advice for adult vaccinations and why they should come to Summit Medical Group for their care.

Dr. Mehra:  Like we take children to get routine immunizations, adults need to think about their immunizations, too.  They need to go to their doctor.  At Summit Medical Group, the doctors can talk to them about their age-appropriate vaccines and they should think about looking at cdc.gov to talk to your doctor and start the conversation.  Adult vaccinations are so important.  Things like tetanus, shingles, pneumonia, flu vaccines--these are such important things.  As adults, we can prevent disease, too.  Getting these vaccines we would actually keep our family, co-workers—everybody--pretty safe if we decide to get them ourselves.

Melanie:  Thank you so much, Dr. Mehra.  You’re listening to SMG Radio.  For more information, you can go to SummitMedicalGroup.com.  That’s SummitMedicalGroup.com.  This is Melanie Cole.  Thanks so much for listening.