By Eric Johnson, MS, FNP-BC

We are all well aware of the myriad of immunizations required and obtained during childhood, but after the high school years, our awareness of immunizations seems to fall off the radar.

While not many, there are several immunizations that are beneficial in adulthood. Here are four I think are most worth your consideration:

1. The first and probably most familiar is immunization against tetanus. Tetanus is an almost always fatal disease caused by an infection with a bacteria clostridium tetani.

These bacteria are found in soil, dust and manure and usually enters the body through a cut or puncture wound. Tetanus is not passed from one person to another. It is a rare disease in the United States because of fairly high immunization rate, but is a totally preventable illness.

Tetanus immunization is generally given in combination with a diphtheria and pertussis immunization. The first adult tetanus shot is given at age 11 or 12 as a TDaP (tetanus, diphtheria and pertussis). Subsequent immunizations are given as a Td (tetanus and diphtheria) at 10 year intervals or sometimes sooner in the case of very dirty wounds. The one potential exception to this is that grandparents may be asked to get a TDaP before visiting their newborn grandchildren.

Additionally, TDaP is recommended for all pregnancies between weeks 27-38. This provides passive immunity to the newborn, most importantly for pertussis (Whooping Cough).

2. The second most common immunization if the Flu shot.

This immunization protects against influenza, a respiratory illness that circulates every winter. The current recommendation is that every person greater than 6 months of age receive an annual influenza vaccine.

The reason for annual vaccination is that the influenza strains change from year to year and each year’s vaccine is designed to match a particular year’s circulating strains. The vaccine is a killed virus and cannot give you the Flu.

While many people claim to get the Flu after getting their shot, it is likely another flu-like virus or they were exposed to the Flu before the vaccine could take effect.

The effectiveness of the influenza vaccine varies from year to year, but averages about 60%. Still, 60% is better than nothing.

3. Shingles vaccine. Shingles is the chicken pox you had as a child coming back for a visit. This is a painful rash consisting of fluid filled blisters over an area of redness in the region of a single nerve coming off the spine. It is always one sided and does not cross the midline.

If not treated with appropriate medication it can leave behind sever nerve pain called herpetic neuropathy.

The best prevention for this is to get a shingles vaccine at age 60. While shingles can occur earlier than 60, most insurances will not pay for the vaccine before age 60. Many medical offices do not carry this vaccine, but it can be obtained at most major pharmacies.

As of this writing a new shingles vaccine has become available. Shingrix is the brand name of this vaccine. Shingrix has been approved by the FDA and the American Committee on Immunization Practices (ACIP), but has yet to be approved by the CDC director. Because Shingrix is significantly more effective than the older vaccine, persons who have received the older vaccine should also receive the two dose series of Shingrix.

Shingrix is a two shot series with the second vaccine two months after the first. At this time Medicare and other insurance coverage is unclear. Please consult with your health care provider and insurance company before receiving Shingrix.

4. Finally the pneumonia vaccines. There are two and are started at age 65, or sooner for persons with certain medical conditions.

Both vaccines protect against strains of streptococcus pneumonia. The first of these vaccines to be given is Prevnar 13 at age 65, or later in life if you received a pneumococcal 23 earlier in life.

The second vaccine in this series is Pneumovax or pneumococcal 23. Traditionally this was the only pneumonia vaccine and was give at age 65. Now this is the second and given one year after the Prevnar 13.

Currently all of these vaccines are covered by Affordable Care Act insurances and Medicare, always check with your insurance company before committing to the vaccine.

As with all things medical, there may be exceptions and special circumstances for certain individuals. Please, discuss vaccines and all medical concerns with your primary care provider.