In his monthly column, Dr. Kent Herbert answers your questions related to health care matters. Simply submit your question to marylou@newfalconherald.com. It’s your chance to ask the doc.QUESTION: I received a letter in the mail that says that my child needs a Tdap vaccine for school. What is this?ANSWER: Tdap is a new immunization which became available in 2005. It is similar to the standard tetanus shot, but adds protection for other diseases. It contains vaccines to tetanus, diptheria and pertussis.Tetanus, or lockjaw, is a severe infection that is usually transmitted through contaminated wounds and causes a locking up of all of the muscles of the body. It is rare but very serious, causing death in two out of every 10 people. Some people wait until they cut themselves or step on a nail to get a tetanus shot, but it is far better to receive the vaccine beforehand, and a routine tetanus immunization lasts seven years.Diptheria is a severe infection of the throat and upper respiratory system. Because it is given as a childhood immunization and is included with the standard tetanus shot, diptheria is largely eradicated. However, it still exists and has a death rate of approximately 20 percent in people under age 5 or over 40 years of age and is thought to have the potential for a comeback. For example, in the former Soviet Union in 1991, there were 2,000 cases of diptheria. After the breakup of the Soviet Union, immunization rates dropped dramatically, and in 1998 there were 200,000 cases. Pertussis, or whooping cough, is an upper respiratory infection that causes severe coughing spells, vomiting and sometimes pneumonia. Pertussis is actually fairly common, with approximately 25,000 cases in the United States each year. Of these cases, approximately 15,000 are in adolescents and young adults, because children are typically immunized regularly before age 5. As with many vaccines, the protection these childhood immunizations provide decreases with age, and a booster is needed.The idea behind the Tdap vaccine is to give a booster for tetanus, diptheria and pertussis at approximately age 11 to 12, when the immunity from the childhood series wanes. It is required by most school districts, including Falcon District 49, for students starting grades six and 10 in the 2007-2008 school year. Because it includes tetanus, people who have received the standard tetanus shot within the last two years do not need to get it, but it needs to be done two years after the tetanus shot. According to the Centers for Disease Control, it is also recommended for adults who may be due for a tetanus shot and those at risk for pertussis, such as health care workers or those who work with the public. The vaccine is considered safe by the Center for Disease Control, and no serious reactions have been reported among adolescents.Several other new vaccines are available as well. Gardasil is a new vaccine for human papilloma virus. HPV is the virus that causes abnormal pap smears and cervical cancer, as well as genital warts. There are many different types of HPV, but several are identified as high-risk types, which mean they have a great potential to cause cervical cancer. Research has shown that the vast majority of women who get cervical cancer or dysplasia (pre-cancer) have one of these high-risk types. Gardasil is designed to prevent these types, but because HPV is sexually transmitted, it must be given before a girl becomes sexually active. For this reason, the CDC recommends routine immunization for girls age 11 to 12, and as young as age 9. It can be given up to age 26 to girls who have not yet been infected (tests are available to determine this). Gardasil is given as a three-shot series over six months.For senior citizens, there is a new immunization for shingles that is now available. Shingles is a painful condition that causes a blistering rash over a nerve. Shingles is common, affecting approximately 1 million people in the United States each year. It is caused by the virus that causes chicken pox and typically occurs in people over age 60. In approximately 20 percent of people who get it, shingles can cause a long term, very painful condition called post-herpetic neuralgia. To prevent this, a single dose of the shingles vaccine is given to people over age 60. Unfortunately, most insurance carriers, including Medicare, do not cover this vaccine.Like all vaccines and medications, people need to evaluate the risks and benefits and decide what’s right for them or their child. All of the vaccines currently recommended by the CDC have been researched extensively and are considered safe. Like any medicine, there are well-documents risks, but there are also substantial risks from the diseases that the vaccines are designed to prevent. Ask your doctor for more specific information regarding these and other vaccines and whether they’re right for you or your child.Kent S. Herbert, M.D.Board-Certified Family PhysicianFalcon Family Medicine7641 McLaughlin Rd.Falcon, CO 80831(719) 494-2006(719) 494-8448 faxwww.FalconFamilyMedicine.com
