Shots for Safety

Last Editorial Review: 3/23/2006

Shots - or immunizations - are not just for children! Adults also need to be vaccinated from time to time to protect themselves against serious infectious diseases. In fact, some shots are more important for adults than for children. Every year, thousands of older people die needlessly. The Federal Government's Centers for Disease Control and Prevention (CDC) strongly encourage older adults to be immunized against flu, pneumococcal disease, tetanus and diphtheria, and chickenpox, as well as measles, mumps, and rubella.


Flu - the short name for influenza - is a highly contagious infection that causes fever, chills, dry cough, sore throat, runny or stuffy nose, as well as headache, muscle aches, and often extreme fatigue. Flu usually is a mild disease in healthy children, young adults, and middle-aged people. However, it can be life threatening in older adults.

Flu viruses change all the time. For this reason, you need to get a flu shot every year. To give your body time to build the proper defense, it's important to get a flu shot between September and mid-November, before the flu season usually starts.

Although side effects from the flu shot are slight for most people, some soreness, redness, or swelling may occur on the arm where the shot was given. About 5 to 10 percent of people have mild side effects such as headache or low-grade fever, which last for about a day after vaccination.

The flu shot is the primary method of preventing and controlling the flu. However, four drugs have been approved to treat people who get the flu: amantadine (Symmetrel), rimantadine (Flumadine), zanamivir (Relenza), and oseltamivir (Tamiflu). When taken within 48 hours after the onset of illness, these drugs reduce the duration of fever and other symptoms. These drugs are available only by prescription.

Pneumococcal Disease

Pneumococcal disease is a serious infection. Many people are familiar with pnuemococcal pneumonia, which affects the lungs. But the bacteria that cause this form of pneumonia also can attack other parts of the body. When the same bacteria invade the lining of the brain, they cause meningitis. When they enter the bloodstream, they cause bacteremia. They also can cause middle ear and sinus infections.

The CDC recommends that people 65 and older get the pneumococcal vaccine. The shot is safe and can be given at the same time as the flu shot. Most people only need a single dose. However, the CDC advises people 65 and older to have a second dose of the pneumococcal vaccine if they received the shot more than 5 years previously and were younger than 65 when they were vaccinated the first time. No one should receive more than 2 total doses of the pneumococcal vaccine available now.

About half of the people who get the shot have minor side effects - temporary swelling, redness, and soreness at the place on the arm where the shot was given. A few people (less than 1 percent) have fever, muscle pain, or more serious swelling and pain on the arm.

Pneumococcal disease is treated with antibiotics. However, in recent years the bacteria that cause pneumococcal disease have become more and more resistant to penicillin. This is one reason why prevention and the development of newer, more effective vaccines are so important.

Tetanus and Diphtheria

Tetanus (sometimes called lockjaw) is caused by the toxin (poison) of a bacterium. The bacteria can enter the body through a tiny pinprick or scratch but prefer deep puncture wounds or cuts like those made by nails or knives. Tetanus bacteria commonly are found in soil, dust, and manure. Tetanus is not spread from person to person. Common first signs of tetanus are headache and muscle stiffness in the jaw, followed by stiffness of the neck, difficulty swallowing, muscle spasms, sweating, and fever.

Diphtheria usually affects the tonsils, throat, nose, or skin. Like tetanus, it is caused by the toxin, or poison, of a bacterium, but it can spread from an infected person to the nose or throat of others. It can lead to breathing problems, heart failure, paralysis, and sometimes death. Diphtheria may be mistaken for a severe sore throat. Other symptoms include a low-grade fever and enlarged lymph nodes in the neck. A second form of diphtheria causes sores on the skin that may be painful, red, and swollen.

Vaccination is the best way to protect yourself against tetanus and diphtheria. Most people receive their first vaccine as children in the form of a combined diphtheria-tetanus-pertussis vaccine or DTP. For adults, a combination shot, called a Td booster, protects against both tetanus and diphtheria. You need a Td shot every 10 years through-out life to protect yourself against these rare, but dangerous, illnesses. During everyday activities (such as gardening), the tetanus bacteria can enter a break in the skin and cause infection. It's particularly important to have a booster shot if you have a severe cut or puncture wound and haven't had a booster in the past 5 to 10 years.


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The Td vaccine is safe and effective. Most people have no problems with it. When side effects do occur, they usually are minor and include soreness, redness, or swelling on the arm where the shot was given.


Chickenpox - also known as varicella - is a very contagious disease that is caused by a virus. It is spread easily through the air by infected people when they sneeze or cough. The disease also spreads through contact with an infected person's chickenpox sores. People who have never had chickenpox can get infected just by being in the room with someone who has the disease.

While chickenpox is a mild disease for children, adults usually get much sicker. Early symptoms include aching, tiredness, fever, and sore throat. Then, an itchy, blister-like rash appears.

People who have had chickenpox are protected from getting it again. A vaccine is available to protect people who have not had chickenpox. Two doses of the vaccine are recommended for people 13 years of age and older. Most people who get chickenpox vaccine don't have problems with it. The most common side effects are mild and include pain and swelling on the arm where the shot was given. Fever or a mild rash may develop.

Some people who have had chickenpox may develop shingles later in life. Shingles is caused by a reactivation of the same virus that produces chickenpox.

The National Institute of Allergy and Infectious Diseases currently is testing a shingles vaccine at the National Institutes of Health in Bethesda, Maryland. The vaccine they are testing is similar to the one used to immunize against chickenpox. After the shot, some people have had some discomfort around the area of the injection. In addition, a few people have had a low-grade fever. For more information about this study, call 1-800-411-1222.

Measles, Mumps, and Rubella

Measles, mumps, and rubella were once very common diseases in the United States, but they have become rare because of the use of vaccines to prevent them. As with many other diseases, measles, mumps, and rubella generally are more severe in adults than in children. Most adults are immune to all three infections because they had them (or a vaccine) as children.

Everyone born in or after 1957 should have received at least one dose of the measles-mumps-rubella (MMR) vaccine sometime after their first birthday. Some adults - such as health care workers and people who travel out of the U.S. - may need a second dose. People born before 1957 may be vaccinated if they believe they've never had one of these diseases. There's no harm in receiving the vaccine if you already are immune to the infection.


If you are planning to travel abroad, check with your doctor or local health department about the shots that you need. Sometimes a series of shots is needed, so it's best to get them well in advance of your trip. For information about specific vaccines required by different countries, general health measures for travelers, and reported outbreaks, call the CDC information line for international travelers at 1-877-394-8747. The Web site address is

Keeping a Shot Record

It's helpful to keep a personal immunization record with the types and dates of shots you've received, as well as any side effects or problems that you had. The medical record in your doctor's office also should be kept up to date.

Widespread use of vaccines can reduce the risk of developing a number of contagious diseases that seriously affect older people. You can protect yourself against these illnesses by including vaccinations as part of your regular health care.

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SOURCE: Source: National Institute of Aging, National Institutes of Health