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American College of Physicians advises public to get seasonal flu vaccine

Adults also should ask their internist about other immunizations they might need

The following statement is attributable to Molly Cooke, MD, FACP, president of the American College of Physicians:

PHILADELPHIA, October 3, 2013 -- With flu season approaching, now is a perfect time for all adults, especially people with chronic conditions and the elderly, to get a flu shot and take that opportunity to talk with their doctor about other immunizations, also called vaccinations, they might need.

Widespread immunization is one of the great public health achievements of the last 100 years, eradicating or significantly reducing the incidence of many life-threatening diseases such as measles, polio, and chickenpox, and enabling people to live longer and healthier.

Yet immunization rates remain startlingly low for adults in the U.S., resulting in unnecessarily high rates of dangerous, preventable illnesses like flu, pneumonia, and whooping cough that jeopardize the health and wellness of our nation. Hundreds of thousands of adults in the United States get sick, miss work, or die every year because of vaccine-preventable diseases or their complications.

ACP endorses the Advisory Committee on Immunization Practices (ACIP) Adult Immunization Schedule and offers the following immunization resources:

ACP recommends that all health care providers (HCPs) be immunized against influenza, diphtheria, pertussis (whooping cough), and other diseases according to the ACIP Adult Immunization Schedule. ACP’s policy exempts HCPs for medical reasons or a religious objection to immunization.

Below is information about a few immunizations that adults and their physicians should make sure are up to date. Keeping up with immunizations is a safe, effective, easy way for adults to protect themselves, their families and friends, and their communities from life-threatening diseases. If you can’t get a flu shot or other immunizations for medical reasons, talk to your doctor about other ways of protecting yourself.

Flu / Influenza

Every adult should get a flu vaccination every year, especially seniors and those with chronic conditions. This contagious respiratory illness can cause mild to severe illness or death. More than 200,000 people in the U.S. are hospitalized each year from flu-related illness. Older adults, specifically those 65 years of age and older, typically account for 60 percent of these flu-related hospitalizations each year and about 90 percent of flu-related deaths.

Only 38.8 percent of adults 18 years old and older were immunized during the 2011-12 flu season, A recent study conducted by researchers from Vanderbilt University Medical Center in collaboration with CDC found that flu vaccination reduced the risk of flu-related hospitalization by 71.4 percent among adults of all ages and by 76.8 percent in study participants 50 years of age and older during the 2011-12 flu season.

Mild egg allergy is no longer a contraindication but patients with an egg allergy should get the inactivated flu vaccine, and if you have an immune system disorder or are pregnant, talk with your doctor.

Diphtheria, Tetanus, and Pertussis

Many patients are surprised when I propose giving them the one-shot vaccination for diphtheria, tetanus, and pertussis. “I am sure that I have had the tetanus shot,” they say, and they are right. Universal vaccination of school children has made both diphtheria (a dangerous upper respiratory tract infection) and tetanus (“lockjaw”) vanishingly rare. However, pertussis is a growing problem among adults because the immunity for it is not as durable as it is for diphtheria and tetanus.

According to the latest data from the National Health Information Survey in 2011, only about 13 percent of adults reported getting a Tdap vaccination. While pertussis is not the lethal condition in adults that it can be in little children and does not typically produce the characteristic “whoop,” it is a miserable illness. In some parts of the world, whooping cough’s informal name is “100-days cough.” I have seen robust people completely exhausted by the relentless wracking cough; it is not uncommon that patients with pertussis vomit from the cough and some actually break ribs.

While pertussis typically affects infants and young children and can be fatal -- especially in babies under the age of 1 -- they usually are infected by older siblings, parents, or caregivers who might not even realize they have the disease. Beyond immunizing children, the surest way to protect them is for adults to get vaccinated, especially pregnant women, anyone in contact with infants, and health care professionals.

Pneumococcal Disease

The major types of pneumococcal disease are pneumonia, bacteremia (blood infection), and meningitis (infection of the covering of the brain and spinal cord). Annually, about 900,000 Americans get pneumonia, the most common form of pneumococcal disease in adults, and 45,000 to 65,000 die from it.

If you have chronic health conditions, ask your doctor if you need to get vaccinated. Everyone over 65 should have received this vaccine once. Some patients will need more than one shot depending on underlying conditions. According to the National Health Information Survey, only 20 percent of adults aged 19-64 years at high risk for pneumococcal disease received the vaccine.

About the American College of Physicians

The American College of Physicians (www.acponline.org) is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 137,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on Twitter and Facebook .

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