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Adolescent Vaccination with Td & Hepatitis A Vaccination for Chronic Liver Disease & Travellers

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Introduction

Vaccines are usually recommended to children to protect them from the common childhood illnesses. However, as we grow and reach adolescence and adulthood, we completely overlook the importance of vaccines and vaccination as they prevent and control the outbreak of infectious diseases including measles, tetanus, hepatitis B, hepatitis A, and chickenpox.

Vaccines consist of either inactivated or weakened forms of germs such as viruses or bacteria. These formulations are designed not to cause the disease but rather to stimulate the immune system. By getting vaccinated, individuals prompt their immune systems to produce antibodies against these germs, thereby safeguarding their bodies from potential infections. The advantages of vaccination extend beyond personal protection; vaccinated adults also play a crucial role in preventing the spread of diseases to their families. Through vaccination, they contribute to the establishment of herd immunity or community immunity. This collective immunity shields individuals who cannot receive vaccinations due to age, allergies, or underlying health conditions, offering broader protection to the community as a whole.

Adolescent and Adult Vaccination

Children around the age of 7 to 18 years require several vaccines to avoid serious health issues such as brain damage, blindness, deafness, muscle paralysis, infertility, and certain cancers.

The vaccines are recommended at specific age groups for two main reasons, this is the period in which the child needs the most protection and the vaccines respond best to the immune system at this age.

Vaccines Recommended for Adolescents and Adults

The most important vaccines recommended to adolescents and adults are as follows:

  • Td vaccine: This vaccine helps to prevent tetanus and diphtheria and is administered to children of 7 years and older, adolescents, and adults who are unvaccinated. This vaccine can be given as a booster dose every 10 years or 5 years to people with severe burns or wounds. Instead of Td another vaccine, Tdap can be used which also gives protection against whooping cough along with tetanus and diphtheria.
  • Hepatitis B: This vaccine protects you from several liver diseases like acute self-limiting hepatitis, acute fulminant hepatitis, and chronic hepatitis B viral infection (HBV). Three doses of this vaccine are required to acquire complete protection. For adolescents between the ages of 11-15 years, two doses of hepatitis vaccine are recommended and for adolescents of 18 years and above two doses of HepB or a combination of HepA and HepB are administered for full protection.
  • Hepatitis A: This vaccine protects you from liver infection caused by hepatitis A virus (HAV). Two doses of it are generally recommended for adolescents and adults who are not previously vaccinated.
  • Meningococcal Conjugate (MenACWY): This vaccine protects you from meningitis, which is a bacterial infection caused by meningococcal bacteria. The common strains of this bacteria are A, B, C, W, & Y. The MenACWY conjugate is given in two doses, the first dose at the age of 11-12 years followed by a booster dose at the age of 16 years. If the first dose of vaccine is administered at the ages of 13 – 15 years, then the booster dose is followed at 16-18 years of age.
  • Human papillomavirus (HPV) Vaccine: This vaccine protects you from six types of cancers (cervical, penile, anal, mouth and throat cancer, and genital warts) caused by human papillomavirus. Vaccinating at an early age of 9-12 years with 2 doses of vaccines helps in building strong immunity against the virus. However, if vaccination occurs after the age of 15, three doses of the vaccine are required to achieve the desired level of immunity.
  • Influenza (flu) vaccine: This flu vaccine protects you from influenza and a yearly shot of this vaccine is recommended for adolescents. In general flu vaccine is given above the age of 6 months followed each year to protect from three strains of the influenza viruses.

Vaccine for adults with Chronic Liver Disease and infection

Chronic liver disease or cirrhosis is characterized by the gradual replacement of healthy liver tissue with scar tissue, typically occurring due to prolonged damage to the liver over time. The common causes of cirrhosis are infections caused by hepatitis viruses, alcohol abuse, and nonalcoholic fatty liver disease caused by conditions such as obesity, high cholesterol, excess triglycerides, and high blood pressure.

Vaccines that can be administered to adults with chronic liver disease and chronic hepatitis B or C infections are as follows:

  • Tetanus, diphtheria, pertussis (Tdap, Td): One dose of Tdap is administered for adults who haven’t received any Tdap or Td vaccine in their lifetime. It is followed by a booster dose of either Tdap or Td every 10 years.
  • Hepatitis A (HepA) Vaccine: Two doses of HepA vaccine are administered at least 6 months apart to protect from serious complications caused by hepatitis A for those suffering from liver disease.
  • Hepatitis B (HepB) Vaccine: Two or three doses of HepB vaccine are administered to protect from hepatitis C and other liver diseases. It is not given to those who already are infected with hepatitis B infection.
  • Human papillomavirus (HPV) Vaccine: Two or three doses of HPV vaccine are administered depending on the age at which the first dose is given. In general, this vaccine is given to adults who are 26 years and younger. Adults of age between 27 to 45 years may also get vaccinated against HPV after talking to their healthcare provider.
  • Influenza (flu) Vaccine: A yearly shot of flu vaccine is administered to all adults to get protection against respiratory illness caused by the influenza virus.
  • Pneumococcal (PCV15, PCV20, PPSV23) Vaccine: One or two doses of either PCV20 alone or PCV15 are administered to adults with chronic liver disease followed by PPSV23 after a year. Other doses of the vaccine are recommended by a healthcare provider to those who have previously received either PCV13 and/or PPSV23.
  • Zoster (Shingles) Vaccine: This vaccine protects you from shingles, which is a condition causing painful rash and sometimes may lead to chronic pain, and loss of hearing and vision. It is given in 2 doses 6 to 12 months apart to adults of 60 years and older.

Other adult vaccinations

Apart from the above-mentioned vaccines some other vaccines are also recommended for adults with chronic liver disease and infections. They are as follows.

  • Hib (Haemophilus influenzae type b): Adults with a high risk of infections can get vaccinated with the Hib vaccine to protect against pneumonia, bacterial meningitis, and other infections caused by Hib bacteria.
  • Measles, mumps, rubella (MMR) Vaccine: All adults up to 65 years of age can be vaccinated with at least one dose of MMR vaccine. Pregnant women and immune-compromised adults are exempted from getting this vaccine.
  • Monkeypox (Mpox) Vaccine: Two doses of the mpox vaccine are given to adults who are at risk of unknown exposure to the mpox virus.
  • Respiratory Syncytial Virus (RSV) Vaccine:  The RSV Vaccine is given to adults above 60 years of age after consulting their healthcare provider to protect against lower respiratory tract diseases caused by the RSV virus.
  • Varicella (Chickenpox) Vaccine: Two doses of varicella vaccine are given to adults who never had chickenpox, never got vaccinated, or were vaccinated but got only one dose of the vaccine. Pregnant women and immune-compromised adults are exempted from getting this vaccine.

Travel Vaccines

Some other vaccines are administered to adults and children when they have a plan of international travel apart from the above-mentioned vaccines. These vaccines are recommended based on the destination, duration, activities planned while travelling, and your health condition. They are as follows.

  • Japanese Encephalitis (JE) Vaccine: JE is a viral disease that causes inflammation of the brain and is noticed commonly in Asian countries. Two doses of this vaccine are administered one month apart for adults travelling to Asia to protect from JE disease.
  • Polio Vaccine: Polio is a contagious disease caused by the polio virus which infects the spinal cord causing paralysis to parts of the body. One to three doses of polio vaccine are administered with the second dose 1 or 2 months apart and the third dose 6 to 12 months apart after the second dose.
  • Rabies Vaccine: TheRabies vaccine gives protection against rabies caused by a virus spread from animal bites. Three doses of the vaccine are administered with the second dose being given after 7 days of the first dose and the third dose after 21 or 28 days after the first dose.
  • Yellow Fever Vaccine: The yellow fever vaccine protects you from the yellow fever caused by a virus. One dose of the vaccine is administered followed by a booster dose every 10 years to the people travelling and continue to live in African and South American countries.

It is recommended to get all your travel vaccinations at least a month before your travel so that your body builds the immunity required, but also check for any adverse reactions that are caused by the vaccine. This process not only helps you avoid getting sick but also prevents the spread of the disease.

Conclusion

Vaccination is an essential way to prevent the spread of the disease to self and others, as it is better to prevent a disease than to get treatment for it. It is considered safe, and effective as the vaccines are tested and they are the easiest means to keep you and your family healthy. The recommended vaccination schedule helps to balance the exposure and effectiveness of the vaccine administered.

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