Friday, February 24, 2012

Health Care and Immunizations for all Ages

Immunizations have been de riguer in the US for decades, and typically that process starts with infants, progresses incrementally during childhood, and then even adults are often required to have vaccinations. Getting a shot to prevent some horrific disease has been very controversial, but evidence abounds that the preventive nature of immunizing children and adults has proven to be extremely successful over time with little down side or side effects.

For example, one disease that until recently, has been largely under control. According to the Center for Disease Control (CDC), Whooping cough — known medically as pertussis — is a highly contagious respiratory tract infection. Although it initially resembles an ordinary cold, whooping cough may eventually turn more serious, particularly in infants. Whooping cough is most contagious before the coughing starts. The best way to prevent it is through vaccinations. The childhood vaccine is called DTaP. The whooping cough booster vaccine for adolescents and adults is called Tdap. Both protect against whooping cough, tetanus, and diphtheria.

However, according to Medscape Today, this week an advisory panel to the US Centers for Disease Control and Prevention (CDC) today took the last step toward making the tetanus, diphtheria, and acellular pertussis (Tdap) vaccine a shot for Americans of all ages. The CDC Advisory Committee on Immunization Practices (ACIP) voted 14 to 1 in favor of immunizing adults aged 65 years or older with Tdap on a routine basis. Before, the ACIP had recommended such shots for seniors only if they had close contact with an infant younger than 12 months of age and had not been vaccinated with Tdap before.

According to current ACIP guidelines, individuals aged 11 through 18 years should get a single booster dose of the vaccine after receiving Tdap or diphtheria, tetanus, and whole-cell pertussis (DTP) vaccine as part of their childhood vaccination series. In addition, the ACIP recommends a single dose for adults aged 19 through 64 years who have not gotten Tdap already. With today's vote by the ACIP, the recommendation for Tdap vaccination becomes universal. The ACIP reached its decision after considering the rebound that pertussis has made in the United States during the last 30 years. The number of reported cases peaked in 2010 at 27,550, with roughly 700 involving seniors, according to the CDC. However, the disease among seniors may be underdiagnosed, as the characteristic "whoop" is often absent in adults. More info about this issue can be found at this site: http://www.medscape.com/viewarticle/759054?sssdmh=dm1.760974&src=nldne.

In light of the recent increased incidence of pertussis in the United States, in 2011, the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices approved recommendations for the use of the tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine (Tdap) for pregnant women. Furthermore, the committee updated Tdap recommendations for special situations during pregnancy and for persons in contact with infants. The revised guidelines, which are based on a review of data on Tdap safety, immunogenicity, and barriers to receipt of Tdap, are designed to facilitate the use of Tdap to reduce the burden of disease and risk of transmission to infants. There is no evidence of adverse fetal effects from the vaccination of pregnant women with an inactivated virus, bacterial vaccine, or toxoid, and these should be administered if indicated, according to the American College of Obstetricians and Gynecologists (ACOG). More details can be found online about pre-natal immunizations at their site: http://www.acog.org/.

When children advance to middle school, Tdap is now a required vaccination. According to ShotsforSchool.org, for the 2012-2013 school year, and all future school years, all students entering, advancing or transferring into 7th grade will need proof of an adolescent whooping cough booster immunization (called “Tdap”) for school in the fall. Unless they have an exemption, all students going into 7th grade must have proof of having had the Tdap booster shot. This includes current students, new students and transfer students in both public and private schools. Many students have already received the vaccine and simply need to supply proof to the school, so check with your doctor or provider.

Unimmunized children are at risk for catching pertussis, getting really sick and missing weeks of school. Besides protecting your child, you can also beat the back-to-school rush by making an appointment for your incoming 7th grader to get a Tdap booster shot now. Keep documentation of your child’s Tdap booster shot in a safe place. Your child will need proof of immunization for school. Check with your school about how and when to submit the documentation. Testing for immunity to pertussis is not reliable and will not meet the new school requirement. According to state and national recommendations, the dose of Tdap required for the school law may be given at any time after the last tetanus shot. Much more details about this concern can be found here: http://www.shotsforschool.org/parents_faq.html#requirements-and-documentation-1.

Immunizations are every bit as essential to the life of an 18- to 24-year-old, as they were back in the days of toddlerhood. Your college-aged child may not waltz out of the doctor's office with a balloon and a Sponge Bob Band-Aid, but she'll have vaccines that ward off such deadly diseases as cervical cancer and meningitis. And most of these are required by campus health services. If your child is college bound, her university is going to want to see a complete list of immunizations, dictated by state laws, which require basic immunizations against diptheria, for example, tetanus, measles, mumps and rubella. And if your child is heading overseas for study abroad or gap year programs, community service, military duty or some backpacking and hosteling action, it's even more essential to schedule a visit with the doctor, according to "Vaccines for Grown-Up Kids" on About.com Guide.

Tetanus and Whooping Cough: Tetanus or "lock jaw" is one of those old-fashioned diseases great-grandparents talk about. The violence of the muscle spams and horrifying progression of a disease that begins with a simple, infected scrape sounds like something out of a grim Grimm fairy tale. But tetanus is a global health problem that is nearly 100% preventable, thanks to a highly effective vaccine. Whooping Cough, or Pertussis is a severe coughing disease that is most severe in young children. In teenagers and young adults, the symptoms are often difficult to differentiate from other common respiratory illnesses, but can cause severe complications. In addition, teenagers and adults can serve as a source of infection in unprotected young children. The new combined Tetanus and Acellular Pertussis (Tdap) vaccine is now recommended for all adolescents age 11 to 12 with catch up till age 18 for those that have not received it yet. Once the teenager has received a Tdap vaccine they then only need a Tetanus booster every 10 years. Make sure your college-aged kid gets one.

Tdap is an immunization required by law for children and adolescents, and strongly suggested for adults of all ages. Do your best to keep your family safe from the diseases protected by this vaccination, and stay on track. Keep  your shot records in a safe, secure location with your important documents. The schools require proof, and you must provide it. Also, it's the law. The shots are not that expensive, but going without is very costly. Typically, the vaccinations are covered under your health insurance, but if you are not insured, there are plenty of local clinics who administer the immunization for little or no cost. Health care prevention of horrific diseases is your responsibility. Plus, it's the right thing to do to protect yourself and your family, not to mention the rest of society.

Until next time.

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