Can Adults Catch Childhood Illnesses?

Turns out, not all childhood vaccines are created equal.

Most people assume that after getting vaccinated for a disease as a child, they will have lifelong immunity. So recent outbreaks of measles among children and adults in Brooklyn, N.Y., and in the United Kingdom have some people worried their protection has waned. Turns out, not all childhood vaccines are created equal. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, a division of the National Institutes of Health, explains the concerns.

Catch as Catch Can

Catching a disease provides one major benefit: immunity for life. Protection for diseases obtained from vaccinations—especially measles, mumps, rubella, pertussis and polio—may not last forever, Dr. Fauci says. There is a low likelihood adults will be infected because these diseases occur so infrequently in the U.S. But as childhood vaccination rates have declined in some communities on concerns about possible adverse effects from the vaccines, this can affect adults, too. "When we see a mini-outbreak of measles, it may include some adults whose immunity is not optimal but who would never have gotten measles from these children had those children been vaccinated to begin with," Dr. Fauci says.

Age Does Matter

Adults born before 1957 were likely exposed to epidemics of measles and are generally considered to be immune to the disease. Anyone born in that year or later may no longer carry antibodies even if they were vaccinated. Still, measles remains very rare and the Centers for Disease Control and Prevention doesn't recommend scheduled boosters for everyone. In general, health-care workers, college students and some people with chronic illnesses should get boosters. "The CDC very clearly states that adult immunization is determined by age, health and lifestyle. Even if you were born on or after 1957, measles hasn't gotten to the point where all adults should be revaccinated against it," he says.

A Pandemic in the Wings

The bigger threat is pertussis, or whooping cough. Outbreaks of this upper respiratory infection are on the rise: 41,000 cases were reported to the CDC across 49 states in 2012. Most of the 18 deaths were of infants, though "the disease can be deadly to anyone," says Dr. Fauci.

Pertussis was nearly eradicated in the 1970s in the U.S. until a commonly used vaccine was phased out because it caused fevers. Research shows that its replacement, called acellular pertussis, offers weaker immunity than the original, Dr. Fauci says.

Pertussis vaccine conveniently comes with boosters for tetanus (immunity of which wanes after about 10 years) and diphtheria. The CDC recommends all adults get a one-time, follow-up DTaP (diphtheria, tetanus and pertussis) shot.

Shots for Later in Life

Another common childhood disease, chickenpox, makes adults susceptible to catching shingles. For healthy adults, the CDC recommends a single dose of the Zoster vaccine against shingles for those over 60. It also recommends immunizations against pneumococcus (a major cause of bacterial pneumonia and meningitis) for those over 65. If your immune system is compromised, you need to also get the hepatitis B vaccine. In 2010, about 38,000 new cases of hepB were reported, according to the CDC.

Nothing Is Forever

"All vaccine protection doesn't last forever, since humans are so variable," Dr. Fauci says. "But you shouldn't be worried about every single childhood illness." Get the DTaP one time, get your annual flu shot, he says, and be sure your doctor is following the CDC guidelines for your age, health and lifestyle: "Then consider yourself covered."

By: Heidi Mitchell, Wall Street Journal
Reviewed / Posted by: Scott W Yates, MD, MBA, MS, FACP

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