Measles
is an extremely infectious viral illness most
commonly associated with childhood. It is so infectious
that a non-immune person has a greater than 90%
chance of catching this disease if they are exposed
to the virus. Prior to 1963 there were approximately
3-4 million cases, with greater than 500 deaths,
every year in the United States and more than
90% of college age Americans had had the illness.
Like
many childhood illnesses, it is more severe in
adults and is occasionally responsible for serious
long-term health problems. Pneumonia, ear infections,
encephalitis (an infection surrounding the brain),
and seizures may all occur. Between 1 and 2 out
of every 1000 patients die from this illness.
Mumps is also a viral illness associated with
childhood. Prior to the development of a vaccine
in 1967, there were over 200,000 cases per year
in the United States. With the vaccine these numbers
have dropped to around 650 cases per year.
Mumps,
particularly in adulthood, is a serious illness.
In addition to just making you feel lousy, mumps
may affect the brain (meningitis and encephalitis),
and, in men, the testes. Approximately 1 in 20,000
patients go deaf, and as many as 3 in 10,000 actually
dies. In men, up to half will develop testicular
inflammation that often leads to small testes
and rare sterility.
A note on Rubella (German Measles)
Rubella
is another viral illness most closely associated
with childhood, although it affects all age groups.
Prior to the development of a vaccine in 1969
there were around 58,000 cases every year in the
United States. It is a less severe illness than
either measles or mumps but may be rarely fatal.
Adult women frequently develop painful joints
that usually subside in around one month.
The
major health issue with rubella is in regards
to birth defects. Early in a pregnancy this is
a disastrous disease, leading to fetal death,
premature delivery, and an array of congenital
defects. It is for this reason that health professionals
are particularly concerned about rubella.
The
MMR (Measles, Mumps, and Rubella) Vaccine
Measles,
mumps, and rubella immunizations are usually combined
into one shot - the MMR.Each may also be given
separately.
Cost
of the MMR
The
cost for the MMR is $45 per injection.
Chickenpox
(Varicella)
A
note on Chickenpox (Varicella)
Chickenpox
is a highly contagious viral illness most commonly
associated with childhood. In the early 1990's
there were approximately 4 million cases every
year in the United States. Although it is a relatively
mild disease in healthy children, it is more severe
in adults. Despite the fact that adults account
for only 5% of the cases, 55% of the deaths are
in this group. Approximately 10,000 people are
hospitalized due to complications every year (skin
infections and pneumonia), and around 100 die.
Pregnant women need to be particularly cautious,
as chickenpox is associated with fetal abnormalities.
Once a person has had the illness, they are protected
for life, although the virus may reactivate and
cause shingles at a later date. Testing is a more
accurate way of determining immunity than history
alone. Studies have shown that as many as 70%-90%
of adults without reliable histories of chickenpox
were actually immune.
The
Chickenpox (Varicella) Vaccine
The
chickenpox vaccine consists of a live attenuated
virus that is given to adults on two occasions
4-8 weeks apart. This is a safe vaccine.
Cost
of the Chickenpox (Varicella) Vaccine
The
cost for the chickenpox vaccine is $80 per injection,
with a total of two injections. The blood test
to check for immunity is $25.
Hepatitis
B
Hepatitis
is any infection or inflammation of the liver,
and the hepatitis B virus is an important cause
of hepatitis. Hepatitis B strikes 150,000 - 200,000
people in the United States each year. Of these,
approximately 1% will die, and 10% will become
chronic carriers who are capable of passing the
disease to others and frequently develop long
term liver problems such as cirrhosis and cancer.
The
Hepatitis B Vaccine
The
hepatitis B vaccine is one of the safest vaccines
ever developed. It is not a live virus, so there
is no chance of contracting hepatitis or any other
disease from the shot. While it is now routinely
given to all infants in the U.S., it was not yet
invented when today's college students were born.
The
vaccine is a series of 3 shots, most commonly
given over a period of six months. It is extremely
well tolerated, with side effects consisting of
the possibility of some mild arm soreness and
fatigue, headache, or fever.
Cost
of the Hepatitis B Vaccine
The
cost for the hepatitis B vaccine is $65 per injection.
Since a series of three shots over six months
is required, the total cost would be $195.
Meningococcal
Meningitis
Meningitis
is a serious infection of the lining surrounding
the brain. Meningococcal meningitis is a specific
type of meningitis that strikes both children
and adults. Despite treatment with antibiotics,
it still kills as many as 13% of those infected,
and often leaves others with permanent disability.
Meningococcal meningitis is different from the
meningitis in infants for which vaccination is
routinely given.
The
meningococcal meningitis vaccine is an extremely
safe vaccine. It does not have any live bacteria
in it, and cannot cause the disease. It is effective
against 4 of the 5 subtypes of meningococcal meningitis.
It is a one-time injection, and the effects last
for 4-5 years. Adverse reactions are very uncommon
with this vaccine. Localized redness at the injection
site lasting one or two days may occur. Even rarer
is the possibility of an allergic reaction.
Cost
of Meningococcal Meningitis
The
cost of the Meningococcal Meningitis Vaccine is
$90.
Tetanus
and Diphtheria (Td) Booster
Tetanus
(also known as "lockjaw") is a serious
illness caused by bacteria that live in soil,
dust, and the intestines of many animals. The
bacteria enter humans through cuts and scratches.
Tetanus is a serious illness that kills approximately
30% of those it infects. Prior to the discovery
of a vaccine in the 1940's, there were 500-600
cases per year. With the use of routine vaccination,
this number dropped to 27 in 1996.
Diphtheria
is an illness that is also caused by a bacterium.
It attacks susceptible individuals by breathing
contaminated air. The severity of the illness
it causes ranges from extremely mild to deadly
(overall 5%-20% of patients die).
In
the United States, almost all infants are immunized
against Diphtheria, Tetanus, and Pertussis (the
DTP vaccine). Most adults become familiar with
the need for booster shots when they have an injury
and are given a "tetanus shot" (Td -
which includes tetanus and diphtheria). This booster,
for most people, should be given every 10 years.
The
Tetanus and Diphtheria (Td) Booster
Tetanus
and Diphtheria are usually combined into one vaccination
and should be given every 10 years. Most adults
receive their boosters when they have an injury
(e.g. laceration) and see a doctor.
The
vaccine is a very safe vaccination. It does not
contain any live bacteria, and cannot cause disease.
Side effects are usually mild and easily controlled.
The most common adverse reactions are local pain,
redness, and/or swelling at the injection site.
This is self-limited and requires no treatment.
Occasionally, a small nodule may be felt for several
weeks.
Rarely,
a more severe local reaction may occur. This is
called an Arthus-like reaction and can cause painful
swelling from the shoulder to the elbow. This
is more common in those who have received numerous
previous tetanus/diphtheria shots.
The
cost of the Tetanus and Diphtheria (Td) Booster
is $25.
Tuberculosis
(TB) Skin Test (PPD, Mantoux)
Worldwide,
tuberculosis (TB) is the most common infectious
disease. It is estimated that approximately 1/3
of the entire world's population is infected with
the bacterium that causes TB. In the United States
this number is much lower, but those who live
in close quarters, inner cities, or work in health
care settings are at higher risk.
The
TB test is NOT a vaccine. It does not protect
against TB. It is only designed to identify those
individuals who carry the bacterium.
The
Tuberculosis (TB) Skin Test (PPD, Mantoux)
The
tuberculosis (TB) skin test (also known as a PPD
or Mantoux) is NOT a vaccine. There is no vaccine
for TB in use in the US. The TB test is only designed
to help unmask those who have been infected with
TB (most of whom are not sick and have no symptoms).
The
only significant adverse reaction to this test
is an abnormally large swelling in the forearm
that may occur in those who have positive tests.
This reaction is rare, and is usually treatable
with cortisone type creams. On very rare occasions
the reaction may lead to some of the skin dying
and peeling off.
The
cost of the Tuberculosis (TB) Skin Test (PPD,
Mantoux) skin test is $25.
Hepatitis
A
Hepatitis
A is an infection of the liver that is caused
by a virus (the hepatitis A virus). This is a
different disease than hepatitis B (see above).
Hepatitis
A is spread through contaminated food and water.
There is an average of 27,000 cases annually in
the United States, not uncommonly clustered in
epidemics. This disease is much more common in
many parts of the world, and is a particular concern
for travelers to developing nations.
Hepatitis
A strikes with a sudden onset of fever, fatigue,
loss of appetite, nausea, abdominal discomfort,
dark urine and jaundice (yellowing of the skin
and eyes). It usually makes the poor victim quite
ill, and kills approximately 3 out every 1000
it attacks.
Unlike
hepatitis B, hepatitis A does not cause any chronic
or long term problems.
The
Hepatitis A Vaccine
The
hepatitis A vaccine contains an inactivated whole
virus. This means it is not capable of actually
causing the disease. It is an extremely effective
vaccine, with a greater than 95% protection rate.
It is a series of two injections given 6-12 months
apart. It is also an extremely safe vaccine. Pain,
redness, or swelling at the injection site occurs
in 20%-50% of recipients. These symptoms are generally
mild and self-limited. Fewer than 10% of injections
may result in mild systemic complaints (e.g. fatigue,
low-grade fever). Severe systemic side-effects
have not been reported.
The
cost of the Hepatitis A Vaccine is $75 per injection.
It is a two-dose immunization, so total cost is
$150.
Influenza
(Flu)
Influenza
(the "flu") is a highly contagious,
airborne illness that strikes in the fall and
winter. It is extremely common illness, but also
runs a very variable pattern. There is an unpredictable
pattern of epidemics making some years much worse
than others.
For
most healthy adults influenza is an annoyance,
but not dangerous. It strikes suddenly and severely.
Fever to above 102 is common, as is severe body
ache, headache, dry cough, sweats and chills.
For some it is more serious, and deaths related
to the flu are still quite commonly seen in the
elderly and the infirm.
The
virus that causes influenza varies every year.
There are three major types of the influenza virus
(A, B, and C) and numerous subtypes. Every year
a new vaccine is developed that incorporates those
strains felt to be most prevalent in the coming
year.
The
Influenza (Flu) Vaccine
The
influenza (flu) vaccine is composed of three subtypes
of inactivated flu viruses. Each year the components
change, so the vaccination needs to be repeated
every year. There is no live virus in the vaccine,
and it is NOT capable of causing the flu.
The
vaccine takes around two weeks to become effective,
so it is usually given prior to the flu season
in October-November, though it may also be given
later in the year. The vaccine is approximately
90% effective in protecting young, healthy people
against the strains it contains. Occasionally,
a strain of flu different from what the vaccine
contains circulates in the community, and the
vaccine would offer little protection. The vaccine
is well tolerated. Local reactions consisting
of soreness, redness, and swelling occur in 15%-20%
of recipients, and almost always subsides in 1-2
days.
Please
call our office at 908-226-0600 for further information.
|
