Adult immunisation
Adequate vaccination is just as important for adults as it is for children. It's not just travel vaccines that are relevant for adults. Some vaccines given in childhood need boosters to ensure they still offer protection. Sometimes people miss having essential vaccines in childhood and so are not protected against specific diseases.
Fortunately, boosters and catch-up vaccines are available for many vaccines normally given in childhood. Your doctor is best placed to advise you on whether you need any vaccines. The National Health and Medical Research Council makes recommendations for both child and adult immunisation which are detailed in the Australian Standard Vaccination Schedule.
Some of the diseases Australian adults should consider being vaccinated against are listed here.
Tetanus
Tetanus vaccination is included in the Australian Standard Vaccination Schedule. The primary course for children is followed with a booster at 4 years of age. A second booster at 15 to 17 years is intended to help maintain immunity into adulthood. Adults who had their primary course as an adult should have boosters 10 and 20 years after the primary course. However, the Schedule recommends that all adults should receive a booster at 50 years, unless they have already had one in the previous 10 years.
Adults receiving a wound that may become infected with tetanus, such as a gardening wound or nail puncture, should have a tetanus booster if they haven't had one within 5 years.
Diphtheria
Although diphtheria has been almost eradicated in Australia, there are still isolated cases in people who haven't been immunised, almost entirely due to imported infections, particularly from developing countries. If people don't keep up their immunity through vaccination, then we are at risk of more infections. The epidemic in the mid-1990s in the former Soviet Union, which affected more than 140,000 people and led to over 4000 deaths, was due to decreasing vaccination rates.
In Australia, diphtheria vaccination is part of the standard schedule of vaccinations given in childhood, in conjunction with tetanus and whooping cough vaccines. Booster doses are also recommended at 15 to 17 years and at 50 years of age.
Whooping cough
Although it is more often associated with children than adults, whooping cough does infect adults. And infected adults pose a serious risk to very young babies who are too young to be vaccinated or who haven't finished their vaccination course. Whooping cough (pertussis) vaccine is usually given in a combination vaccine along with diphtheria and tetanus vaccines. The Australian Standard Vaccination Schedule recommends a booster at 15 to 17 years. Adults who have missed out on vaccination should see their doctor, especially adults working with young children, those working in healthcare, or adults who are planning to become parents.
Rubella
Rubella (German measles) infection in early pregnancy (up to 10 weeks) is well-known to result in damage to the unborn baby in a high proportion of affected pregnancies. This damage can cause multiple defects including deafness, intellectual disabilities, cataracts, and heart abnormalities. This is why it is important for women to be immunised against rubella before becoming pregnant. Rubella vaccine is usually given as part of a combination vaccine called MMR, which stands for measles, mumps, and rubella. MMR is part of the Australian Standard Vaccination Schedule and is given as 2 doses in childhood. Women of child-bearing age who have missed being vaccinated or who are not immune after vaccination should be vaccinated (unless they're pregnant) and must not become pregnant for 28 days after vaccination. Men born during or after 1966 who have no record of being immunised against rubella should also be vaccinated.
Hepatitis
An ongoing hepatitis B vaccination programme for infants and adolescents is aimed at controlling hepatitis B infection in Australia. Other groups who are at increased risk of hepatitis B, such as injecting drug users, residents and staff of facilities for the intellectually disabled, and sexual contacts of people with hepatitis B, are also recommended to have hepatitis B vaccination. For adults and children who have not been vaccinated, a simple course of 2 or 3 injections will give protection for several years.
Hepatitis A infection is covered as part of the Australian Standard Vaccination Schedule for Aboriginal and Torres Strait Islander children in high-risk areas. Among other groups, it is mainly a risk for travellers. It is contracted from shellfish, water, ice or food that has become contaminated with human sewerage, or directly from an infected person. You should see your doctor at least 4 weeks before you travel to ensure your vaccination offers full protection. Combination vaccines that offer protection against hepatitis A and hepatitis B are also available.
Chickenpox (varicella)
Chickenpox is a highly infectious disease caused by the varicella-zoster virus, and is often more serious in adults than in children. Chickenpox virus can also reactivate years after the initial infection and cause shingles (herpes zoster). Chickenpox infection during pregnancy can result in abnormalities in the baby including eye problems, limb defects, and problems with the nervous system.
Chickenpox vaccination is part of the standard schedule of vaccinations given in childhood. It is also recommended for adults and adolescents aged 14 years or older who have not had chickenpox. Adolescents and adults require 2 doses of vaccine for adequate protection.
Pneumococcus and 'flu
Pneumococcal disease is a risk for the older person whose immune system may not be able to protect them. The recommendation of the Australian Standard Vaccination Schedule is that people aged over 65 should be vaccinated against pneumococcal disease and have an annual 'flu shot to protect them against influenza.
Aboriginal and Torres Strait Islander people are at greater risk of pneumococcus and ‘flu and so should start these shots at 50 years of age.
The pneumococcal and 'flu vaccines are free for all Australians over 65 years and for anyone who has a higher than average risk of infection. A booster dose of the pneumococcal vaccine is usually given 5 years after the first dose.
Human papillomavirus (HPV) infection
The human papillomaviruses are a group of viruses that can cause skin warts, genital warts and some cancers, including cervical cancer. The HPV types that can cause genital warts and cervical cancer are spread by direct, skin-to-skin contact during all types of sexual activity with someone who has the virus.
There is a vaccine available against several types of HPV that cause cervical cancer and genital warts (Gardasil), and another vaccine that can protect against 2 types of HPV that cause cervical cancer (Cervarix).
HPV vaccination is recommended for females aged 10-26 years. The vaccine, listed on the National Immunisation Program Schedule, is free for all girls aged 12 to 13 years — free vaccination is provided as part of a school-based programme. The vaccine is given as a course of 3 injections over 6 months.
Adolescent males aged 9-15 years may also be vaccinated with Gardasil, although this is not covered on the National Immunisation Program and there is a lack of evidence proving its effectiveness in males. Some women aged between 27 and 45 years may benefit from HPV vaccination with Cervarix. Check with your doctor whether vaccination is appropriate for you.
It's important to note that even women who have had a full course of HPV vaccination still need to have regular Pap smears, because HPV vaccines do not prevent all cervical cancers.
Last Reviewed: 01 August 2008
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