by JoAnn Gurenlian, RDH, MS, PhD, AAFAAOM, FADHA
August 28, 2024
Dental hygienists conduct assessments of the individuals they provide preventive and therapeutic care to at each appointment. One of these assessments includes a thorough health history. In children, this history may include a review of immunizations with recommendations to parents and caregivers for vaccinations that should be included to support the child’s health. However, as practitioners, we may be missing another cohort that could benefit from a review of immunizations and vaccination recommendations; that is, adults.
We are entering the winter months when respiratory illness, among other conditions, flare. According to the Centers for Disease Control and Prevention, respiratory illness activity is currently “high” in the United States. New Hampshire is listed as having “very high” respiratory virus activity. Other states with “high” activity include Arizona, Delaware, Georgia, Idaho, Kansas, Kentucky, Louisiana, Oklahoma, Tennessee, Texas, and Wisconsin. And 29 other states are listed as having “moderate” respiratory virus activity. COVID-19, flu, and respiratory syncytial virus (RSV) are increasing across the country with many people visiting emergency departments for care.1
Given the increasing episodes of winter illness, it is recommended that we encourage adults to update their immunizations. Many adults believe that an annual COVID and flu vaccines are sufficient immunization. However, according to an article in Medscape by Swift, the main vaccines recommended for adults include flu, COVID, RSV, shingles, pneumococcal disease, measles, mumps and rubella (MMR), and tetanus, diphtheria, and pertussis (Tdap).
There are two licensed vaccines for RSV, Arexvy and Abrysvo. A single dose of the RSV vaccine is recommended for adults aged 60 years and older. Chronic health conditions associated with a higher risk of severe RSV include cardiopulmonary disease, diabetes, kidney, liver and hematologic disorders. Other considerations include compromised immunity, older age and frailty.
Shingles has the potential complication of postherpetic neuralgia, which leads to long-term nerve pain for many individuals. The two-dose recombinant zoster vaccine (Shingrix) is recommended for individuals 50 years and older and those 19 years and older with weakened immune systems.
There are three approved pneumococcal vaccines including Vaxneuvance, Prevnar 20 and Pneumovax 23. Immunization against the Streptococcus pneumoniae pathogen for all older and at-risk adults is recommended.
It is apparent that measles, though preventable, is making a comeback. The two approved MMR vaccines are M-M-R II and PRIORIX. Another vaccine, ProQuad, adds varicella. Those born before 1957 are considered immune. However, adults lacking presumptive evidence of immunity should get at least one dose of the MMR combination vaccine. Two doses are recommended for adults entering high-risk settings for measles and mumps transmission including health care providers, students at college, and international travelers. Women who are planning to become pregnant should be vaccinated before each pregnancy.
Adults without previous Tdap vaccination should receive a single dose of Adacel or Boostrix followed by a booster every 10 years. Boostrix is advised for adults over 64 years. Pregnant women should have a single dose of Tdap during gestational weeks 27 through 36.
While vaccine hesitancy remains prevalent, it is important to remind individuals that vaccination is one of the most effective tools for preventing individuals’ illness and protecting the health of the public. Dental hygienists can serve as a valuable resource providing information about adult vaccinations and the importance of getting vaccinated to protect each person and their community.
To learn more about adult vaccinations, read the full article here.
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References:
¹Centers for Disease Control and Prevention, “Respiratory Virus Activity Levels,” Centers for Disease Control and Prevention, December 27, 2024, https://www.cdc.gov/respiratory-viruses/data/activity-levels.html.
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This article summarizes the article from MD Edge by Diana Swift, “5 Vaccinations Adults Need Beyond COVID and Flu,” June 5, 2024. (https://www.mdedge.com/internalmedicine/article/269460/vaccines/5-vaccinations-adults-need-beyond-covid-and-flu).
JoAnn Gurenlian, RDH, MS, PhD, AAFAAOM, FADHA, is the ADHA Director of Education, Research and Advocacy, professor emerita in the Department of Dental Hygiene at ISU, and former president of the American Dental Hygienists’ Association 1990-1991.