Most childcare providers are aware of the various immunizations children need to protect their health. But are you aware of immunizations that are recommended for adults?

Most children receive a series of three doses of either the Td (tetanus and diphtheria only) vaccine or the newer Tdap (tetanus and diphtheria and acellular pertussis) vaccine during childhood. The Centers for Disease Control and Prevention (CDC) now recommends that all adults receive a single booster dose of the Tdap followed by a Td booster every 10 years thereafter.

Adults’ and adolescents’ immunity to pertussis has been found to decrease over time, leaving them vulnerable to getting and spreading this disease. Pertussis (whooping cough) is a very contagious respiratory tract infection that can cause mild coughing or a more serious illness with prolonged coughing spasms that can result in rib fractures and pneumonia in adults.

In infants, pertussis is a serious disease causing coughing spells that last for weeks, possible pneumonia, brain damage, or even death. It is especially important for adults who care for infants under the age of 12 months to be immunized with the Tdap vaccine because infants have not yet received all of their immunizations.

Complications from measles include ear infections, diarrhea, and pneumonia. Mumps causes fever, headache, and swollen glands and can lead to deafness, meningitis, and painful swelling of the testicles, ovaries, or breasts. Since December 2005, there have been outbreaks of mumps in several Midwest states.

Rubella (German measles) is usually a mild disease causing fever and a rash in children and adults. The most serious complication from rubella affects pregnant women and their unborn babies. Women who become infected with rubella in the first trimester of pregnancy have an 85 percent chance of having an infant born with birth defects such as heart problems, cataracts, mental retardation, and deafness.

All childcare providers should be immune to measles, mumps, and rubella. Most people born before 1957 can be considered immune to these three diseases because of the extremely high probability that they were exposed to these diseases in childhood, before vaccines were available.

Anyone born after 1956 also should be immune either because they were previously exposed to measles or mumps, or because they received at least one dose of vaccine for these diseases and for rubella on or after their first birthday. Only a record of immunization is considered adequate evidence of immunity against rubella because a history of having had the disease is often unreliable. There is also a blood test that can detect immunity to rubella.

Chicken pox (varicella) is a highly contagious disease caused by the varicella zoster virus. It is usually a mild disease, but complications can include bacterial infections of the skin, bones, lungs, joints, and blood. Pneumonia and brain infections can also occur. Shingles, a painful inflammation of the nerves, is a reactivation of the same virus as chicken pox. People who have had chicken pox in the past can get shingles.

Adults have a greater risk of suffering severe illness and/or complications from chicken pox than children. Childcare providers are more likely to be exposed to chickenpox than most other adults, though the risk is significantly lower than it once was because of the vaccination coverage of the population.

Anyone over the age of 13 who has not had the disease and has not been vaccinated should consider getting two doses of the varicella vaccine.

Hepatitis viruses attack and harm the liver. Hepatitis A (HAV) is spread by close personal contact with someone who is infected with this virus or by eating food or drinking water contaminated with HAV. Hepatitis B and C are spread by contact with an infected person’s blood or body fluids and can result in lifelong liver problems and can cause premature death.
Vaccines are now available to protect against Hepatitis A and B, but not for Hepatitis C. The HAV vaccine is not routinely recommended for adults unless they have certain health problems or other risk factors. The HAB vaccine is highly recommended for childcare providers. Hepatitis B vaccine is given in a series of three doses; after the initial series, booster shots are not necessary.

Influenza causes fever, chills, headache, muscle ache, sore throat, cough, and cold symptoms. It can lead to pneumonia and other severe illnesses and even death in vulnerable populations, which include young children, older adults, and those with chronic illness or weakened immune systems. Immunization against influenza can help protect both you and the children in your program.

Immunization against influenza requires annual vaccination. A new flu vaccine shot is developed each year to protect against the current year’s strain of influenza. It is now recommended that all children between the ages of 6 months and 4 years-11 months be vaccinated annually.

Infants under the age of 6 months cannot receive the vaccine. Because of this, it is especially important that parents and other caregivers who come in contact with children under 6 months be vaccinated against influenza, both for their own protection and the protection of these vulnerable infants.

Dianne Burdette, RN, BSN, CPN, Childcare Health Consultant, The Children’s Home Society of New Jersey

Contact your local health department for information on immunization schedules and clinics.

Take the adult immunization quiz available at www2.cdc.gov/nip/adultImmSched/ and find out what vaccinations are recommended for you. You can print the results of the quiz and take it to your next visit with your health care provider.

Immunization Action Coalition, www.immunize.org

Keep Kids Healthy, www.keepkidshealthy.com/welcome/immunizations/adult_immunizations.html

The National Immunization Program’s Vaccine Information Statements, www.cdc.gov/nip/default.htm

The National Immunization Program’s Adult Immunization Schedule (in English & Spanish), www.cdc.gov/nip/recs/adult-schedule.htm