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July 2024

Many adults are unaware of the vaccinations they should receive in addition to keeping up to date with influenza (flu), tetanus, and, if you choose, COVID-19. This is particularly important for older adults and those with chronic illnesses such as heart disease, high blood pressure, asthma, COPD (emphysema), and diabetes, and those undergoing cancer treatment or other treatments that compromise their immune systems.

As your primary care office, Block Island Health Services (BIHS) follows the Center for Disease Control (CDC) recommendations for adult immunizations. The current adult recommendations are to receive vaccines for respiratory syncytial virus (RSV), pneumonia, measles, mumps, rubella (MMR), tetanus, diphtheria, and pertussis (Tdap). For some individuals, it may be important to receive vaccinations against hepatitis if they are at risk or proven to have low immunity.

Here is some need-to-know information about each of these vaccines to help you decide whether you should have them.

Respiratory syncytial virus vaccines: There are two licensed RSV vaccines, Arexvy and Abrysvo. This immunization is recommended for adults 60 years and older, especially those at high risk of contracting this virus, such as those with heart disease, diabetes, kidney disease, and those who are immune compromised. BIHS currently recommends that adults receive this vaccine off the island from your pharmacy as limited storage capacity keeps us from having it available on the island.

Shingles vaccination: Shingles is a painful rash that carries a potential complication of post-herpetic neuralgia, which is nerve pain that occurs in 10-18% of adults who develop shingles. Post-herpetic neuralgia especially affects those 40 years and older. The CDC recommends two doses of the recombinant zoster vaccine Shingrix for those 50 years and older. However, it is sometimes given to much younger individuals if they are at a higher risk of developing shingles. The recombinant vaccine is one where a small piece from a virus or bacterium is inserted into a cell to produce the vaccine antigen. This cell then produces a protein that is purified and used to create the vaccine given to an individual. This is called recombinant DNA technology. The Shingrix vaccine is administered in two doses given 1-2 months apart.

Pneumococcal (pneumonia) vaccines: There are three approved pneumonia vaccinations: PCV 15 (Vaxnuvance), PCV20 (Prevnar 20), and PPSV23 (Pneumovax 23). The choice of which vaccine you receive is made based on which pneumonia vaccine you may have been given in the past and your current age. The PPSV23 vaccination prevents 23 strains of pneumonia, the greatest number for all the vaccines; however, the PCV vaccinations give us longer-term immunity. BIHS staff can assess your risk of pneumonia and your current vaccine status to offer you the appropriate initial or subsequent vaccine to boost your immunity.

Measles (aka rubeola), mumps (aka parotitis), rubella (aka German measles), and varicella (aka chicken pox) vaccines: There are two approved MMR vaccines (M-M-R II and Priorix) as well as the third vaccination that includes varicella. Unfortunately, measles is making a comeback. There were 146 cases reported in 28 states in the US, 48 of those in adults, as of May 31 of this year. Most of these were linked to international travel. Certain individuals, such as those traveling internationally or working in healthcare, are recommended to be evaluated for the need for this vaccine.

Tetanus, diphtheria, and pertussis vaccine: There are two approved vaccinations, Adacel or Boostrix. This vaccination prevents tetanus and is important for its content against pertussis, which is also making a resurgence. In fact, the RI Department of Health reported a case of pertussis in a high schooler in East Greenwich on June 18, 2024. Pertussis, also known as whooping cough, can be very serious in older adults who have chronic lung diseases or who are immune compromised. Tetanus, also known as lockjaw, is a serious bacterial infection that is found in soil and can infect an open wound. BIHS always keeps this immunization so that we can booster individuals who are injured on the island and those who are due for a routine, 10-year booster.

We are all aware of the recent controversies related to vaccinations. The staff at BIHS are happy to answer your questions about vaccinations and to evaluate your individual risk of developing a vaccine-preventable disease. Staying immunized against vaccine-preventable diseases is one of the best ways we have to prevent individual illness and protect our community.

    Laurie Anderson, APRN-C, CDOE