By John Morlino, DO
It may seem counterproductive to inject disease into the body to protect yourself from contracting that disease. However, routine immunizations are an important step in remaining healthy for both children and adults. Vaccines produce antibodies within the body, and these “agents of immunity” attack and kill the specific virus or bacteria from which the vaccine was prepared. Unfortunately, not all diseases can be fought with a vaccine. For example, there are immunizations for hepatitis A and hepatitis B, but not hepatitis C. Polio can be prevented with a vaccine, but no vaccine exists to prevent malaria or HIV infection.
Generally speaking, vaccines we receive as children protect us in adulthood. However, not all adults received the required vaccinations as children. Many received partial immunizations, and many received no vaccinations at all. Also, the development of vaccines has progressed since most of us were children. Newer vaccines, such as herpes zoster, which prevents chicken pox or shingles, and human papilloma virus, which prevents genital warts and related cervical cancer, were not available until recently. Some vaccinations given during childhood, such as pertussis, which prevents whooping cough, and tetanus, which prevents lockjaw, may lose their effectiveness over time and no longer protect us. In many cases booster shots are recommended
Reasons for Not Getting Vaccinated
So why hasn’t everyone been vaccinated? For a variety of reasons, not everyone receives the recommended vaccinations. Some may be recent immigrants, and vaccination programs were not available in their home countries; some have cultural or religious objections to vaccinations. Recently there has been some controversy about a link between vaccinations and diseases such as autism. While these studies have been thoroughly discredited, they have caused a lot of fear of confusion for parents, many of whom have chosen not to have their children vaccinated. The result is a resurgence of childhood illnesses that we have not seen in such numbers since the introduction of vaccination programs.
The vaccine most commonly given in our offices is a combination of Tetanus, Diphtheria and Pertussis, called the TDaP vaccine. We’ll provide a brief review of these illnesses and the recommendations for vaccinations against these diseases.
Tetanus is an illness caused by the toxin released by the bacteria Clostridium tetani, the spores of which are widely found in contaminated dirt. They enter the body through a cut or open wound on the skin, and the bacteria multiply and produce the toxin, which causes stiffness and spasms of muscles, most commonly of the facial muscles, which causes “lockjaw” and prevents patients from being able to open their mouths and swallow. Although rare in the United States, tetanus can be fatal in 10 to 20 percent of cases. Treatment includes alleviating the symptoms and supportive treatment and tetanus immune globulin, which works by providing antibodies against the toxin that produces the symptoms. However, prevention is the best medicine. If you think you have an infected would, it should be evaluated by your doctor.
Diphtheria is caused by the toxin-producing bacteria Corynebacterium diphtherium. Symptoms of respiratory diphtheria include a sore throat with a low-grade fever and a grayish film on the tonsils, pharynx or nose. Swelling of the neck is common in patients with a severe form of the disease. Skin-based or cutaneous diphtheria appears as infected skin lesions that don’t have a particularly remarkable appearance. Diphtheria is transmitted through cough secretions or direct contact with lesions. The disease is still extremely rare in the United States. Even with treatment, respiratory cases can be fatal in 5 to 10 percent of cases. Treatment includes antibiotics and diphtheria anti-toxin.
Pertussis is caused by the bacteria Bordetella pertussis. The bacteria cause respiratory illness by releasing toxins which paralyze the fine hairs of the respiratory tract, called cilia, causing inflammation and difficulty breathing. Since the 1980s, there has been an increase, especially in 10 to 19 year olds and infants younger than 6 months old. In 2010, 27,550 cases were reported to the Centers for Disease Control and Prevention. The illness develops in three stages. The first stage usually lasts 7 to 10 days, and includes runny nose, low-grade fever and mild cough. The second stage usually lasts 1 to 6 weeks, includes bursts of rapid coughs, especially at night, followed by a high-pitched “whoop.” Other symptoms include vomiting and thick mucus which is difficult to bring up. The last stage usually lasts 7 to 10 days, with the cough gradually disappearing in 2 to 3 weeks. Pertussis is transmitted through coughing. The disease can be very serious and life-threatening, especially for young children or patients with other medical problems. Treatment includes antibiotics and alleviating the symptoms. Because the disease is becoming more common and is life-threatening, it is recommended that pertussis be included in the vaccines given in the majority of teens and adults requiring a booster.
The Advisory Committee on Immunization Practices (ACIP) recommends the TDaP vaccine for adolescents aged 11 to 18, boosters for those aged 18 to 64, and any adults in contact with infants 12 months of age or younger. Additionally, ACIP recently recommended that women’s health care providers begin a TDaP vaccination program for women who have not previously received the vaccine. For pregnant women, health care providers should administer TDaP during the third trimester or late second trimester (after 20 weeks gestation). If not administered during pregnancy, TDaP should be administered immediately postpartum.
eMedical Urgent Care provides routine vaccination, including those discussed above. Call our office for more information, or stop in.
John V. Morlino, D.O., has been with eMedical Urgent Care since 1984. He received his medical degree from Philadelphia College of Osteopathic Medicine. He holds a bachelor’s degree in physics from Georgian Court University and a paralegal diploma from Monmouth University.