Immunizations

What immunizations should adults have after age 30? Just wondering. I had a tetanus shot in my arm about two years ago. Are there any others that an adult male should inquire about in order to keep current? Does anyone have any idea about this?

It really depends on where you travel, if you travel, more than anything. If you visit a Travel Clinic prior to a visit to an exotic location they will provide the most current vaccinations for the areas which you plan to travel. Even if you are traveling to common destinations, the TwinRix vaccine for Hepatitis A/B is a good precaution since those diseases are often water-borne and may be present in something simple like ice cubes.

Indeed, not much if any. Some vaccines such as the Hep A/B TwinRix state that they are to be administered in the deltoid muscle (upper arm) and specifically not to be injected into the gluteal muscles as it may result in a suboptimal response. Sorry, but you will likely roll up your sleeve and not drop your pants.

Every 10 years you need your DPT/Typhid.

Just got my updated immunizations (am 29)

Because GA didnt have any record of any immunizations, they gave me a dose of MMR.

They also gave me the hepatitis a&b combo and the TDaP. I also got a pneumonia vaccination because i am predisposed to pneumonia. the other shot i get on a yearly basis is the flu vaccine. after i finish with the followup doses of the MMR and the Hepatitis one... all i'll need is a tetanus every 10 years and then continue with the flu. The pneumonia one is good for 5 years.

DrJ58, you are correct when you state that a lot of vaccines have spacific instructions to be given in the deltoid muscle because giving them in another location my cause suboptimal results.

However, with this being said, the reason for these instructions isn't because of the muscle structure or location, it's actually in relation to the needle length. Let me try to explain better....

THere have been numerous studies done that prove through x-ray's and other various scans that people in countries such as the USA and Canada keep getting fatter. I can't remember off hand what the exact numbers are, but it was something crazy like almost 70 percent of IM injections given with an average IM needle in women, and like 40 percent in men, is NOT long enough to reach into the muscle due to the amount of fat.

I believe they were using a one inch needle as their primary length, but again, I am not totally sure on that. So it isn't that the vaccines have to go into the arm per se, it's that the vaccine has to get into the muscle to be distributed effectively, and for the medication to be able to reach it's optimum potential. A lot of vaccines that are injected into adipose tissue (fat) often are absorbed too slow, not at all, or break down too quickly to be distributed correctly.

Which, to be truthful, this issues as far as the drug companies are concerned, isn't about your health, it's about someone getting vaccinated, and vaccinated incorrectly, then ending up getting whatever they thought they were immunized against and then sueing the drug company. So by them printing instructions on the correct location to give the IM injection, they are in a sense, protecting them from a potential law suit.

However, if you are ever faced with getting vaccines, just be up front and honest with them. Tell them where you want them, and tell them to use at least a one and a half inch needle.

Great response Mashie. I learn something new every day, usually on this site! As for myself, I got an updated TDaP vaccine in December 2010 because adult pertussis is a real problem here, and I was expecting a new grand baby in March. I've had all the required standard vaccinations including pneumonia and I get the flu vaccine every year right around my birthday in October.

As I get farther into the evaluation process for renal transplant, I'm sure they'll come up with some vaccination requirements before my immune system gets wiped out by immunosuppressive drugs post-surgery. I know that for about a year after surgery, I'll have to wear a mask around anyone that's had a vaccine, like the grandchildren. Not a fashion statement, but a small price to pay for safety.

I went to the health department. Ours offers some free vaccines, plus all my vaccinations are covered by my insurance. My regular doctors office doesn't offer vaccinations and neither does my obgyn's office. They both suggested I go to the health department.

In the arm. all 4 injections went in the arm. 2 in each arm. I joked about getting them in the butt, but no dice.

You should of just dropped your pants, and bent over the desk and demanded you get them in your fanny, just like Hawkeye in M*A*S*H did when he had to get immunized against the flu. Margaret had the syringe loaded, up in the air and ready to go. She told him to roll up his sleve and he said "no". His reply to her as he got up off the desk, turned around, unfastened his belt and lowered his pants a little was, "I want mine in my tushy, the fleshy part, you know, the back of my front."

That still has to be one of my, if not the hottest lines I have ever heard. Even after 30 plus years, watching and hearing him say that is one of my greatest turn on's of all time. Hehehe. Try it next time, and then let me know how it goes. Hehehe.

That would be my ultimate technique, Mashie, but it has yet to be necessary to go quite that far. Sometimes I just drop my trousers, pull down my pants and bend over before the injection site is discussed with the result that the nurse takes the hint gives it to me in the bottom without comment. Normally, however, it suffices for me just to convince the nurse that I know I can have the shots in my arms but really prefer them back there. On rare occasions, I really have to insist.

Next monday I have an appointment at a local travel clinic for a few travel immunizations. Hope I'll be able to persuade them to give them in my butt, instead of my arm.. will let you know afterwards ;-)

Surely u just have the ones u need updating...if you even bother alot of people dont.

mine get updated when needed by occupational health for free.... dont need reminding and they just send me a text 😃 otherwise i would totally forget.

Here in the Netherlands, immunizations are basically only done for children until the age of 9. After that, it's only tetanus in case of certain injuries / animal bites, and for travel.

I can agree what Mashie said. When I got my Tetanus renewal, the doctor changed the needle before I got it in my butt.

P0polarstern, I'd really like to have (at least) the tetanus vaccine in my butt - did you tell the doc that you want it in your butt or was it his intended destination anyway?

I know one doctor in frankfurt who gives vaccines in the butt. Do not know any doctors in bavaria, unfortunately

The UK guidance for nurses and doctors is that vaccinations should go in the deltoid. There are a lot of trials that have shown it gives the best result. It's partly because, as Mashie wrote that people are getting larger, and you can't guarantee the vaccine is in the muscle where it needs to be. There is also thought to be a potential problem with live vaccines being given close to the sciatic nerve. I suppose a screaming needle phobia might get you a jab in the bottom, but you will probably find it difficult to get what you want.

Last vaccination I got in the butt was in 1998. From then all vaccinations have been administered in the arm. This is because the risk is too high that the serum will be injected into the fat instead of the muscle. Although I am on the opinion that with a longer needle this should not be a problem. Unfortunately I don't know any doctor nearby who is giving vaccinations in the butt any more. :-(

Tetanus is a big one that needs to be updated every 10 years, or every 5 years if you sustain any type of pucture injury. This information is only what I have been told.

Getting back to the orginal question; this is something that needs to be adderssed when you see your doctor. The shots you need will depend on your medical history and in some cases your lifestyle.

I prefer to use the term "vaccination." Whether you actually become "immunized" is questionable with some vaccines, making blood titer testing necessary, especially for things like Hep B vaccine.

As far as tetanus is concerned, the concern for contracting the illness are greatly overstated.

Clostridium tetani lives in the soil under anaerobic conditions--air kills the bacteria. You aren't going to contract tetanus stepping on a nail in your basement of cutting yourself with a knife.

Everyone should get their tetanus vaccination updated every 10 years. They also recommend that you get the diphtheria vaccination too these days (the newer tetanus vaccines have this as part of them). The only other ones that you should get regularly would be your flu vaccine every year. Everything else is dependent on if you are travelling. If you are older or have a chronic disease (eg. diabetes, asthma) they recommend you get a pneumonia vaccine.

A little off topic here but might be interesting to someone, maybe, lol. I have worked at my current place about a year and a half. Our employer highly recommends that the employees have a titer drawn for Hep B to make sure your levels are okay in case we get exposed. Now, I have been a nurse for over 10 years now and I have seen a few people in my time who have needed to get the vaccination again because their titer came back and they were too low to be considered "immunized", but in the facility I am currently working it I have noticed it happens a lot, or way more than I would have assumed to be average. And last week I believe I found out the reason.

There is this one nurse there who's been a nurse for just over a year. She is my very own personal bully. Still can't figure out exactly why she finds me so threatening to her, or what she has to be jealous of over me, but for one reason or another, she openly admits to hating my guts and is doing everything in her power to get me fired, but that's another topic for when I need to rant and bitch.

Anyway, she love to give shots as do most "new" or rather new nurses do because it's still "cool" and in some cases yes, I will admit, it makes us feel like we have the power or are in charge for a bit, sort of like an adrenalin rush. I get that, most nurses get over those feelings after a year or so and then there are others like me who will never get over it because I just like to do them, it's not about the control factor, I just enjoy giving and getting them. I'm evil like that I guess. lol.

Now another story about this same nurse who bullies the ever living shit out of me as often as she can, grrrr. One day she was the charge nurse, which puts her in charge of the entire facility (scary I know right, well it only gets worse, just wait) So this little girl, all of 18 years old and maybe 100 pounds soaking wet comes running out of the kitchen crying holding her arm. I am the first nurse she sees so she comes to me. She has a major burn from the top of her hand almost all around and top of her forearm. I get her seated and take a quick look, she's crying and in a lot of pain, I've been there and burn are very painful. In minutes she had first, second and third degree burns on her arm and hand. The skin went fron black and charred, huge liquid filled blisters the size of 50 cent pieces, nickles and pennies were everyplace. A lot of her skin had already peeled away or peeled back, it was bad, probably the worst burn I have ever seen in my nursing career. She told me she burnt it on bacon grease. So I had another kitchen worker take her back into the kitchen, and I know this is going to be the worst pain of your life, but it has to happen the way I tell you. I told the other kitchen worker to turn on cold water, not cold, but pretty cold, stick her hand and arm under the water then very gently wash off all the grease of with Dawn dish soap until she does't feel any more grease then just keep holding it there until I get back. So I ran to the back hall where the "charge nurse" was, she asked me why I was running, I told her. So I get in the back hall treatment cart because I know a resident has a large tub of it so I grabbed the tub of Silvadine, some tape, some non-adhesive sterile dressings and some cling which is a rolled up somewhat thin usually sterile dressing and a med cup to put some of the Silvadine in to so I wasn't contaminating the entire jar. Long story short here, the other nurse grabs the petroleum jelly and heads up to dress this poor girls arm. I dressed the girls arm and did so correctly. I had to almost verbally beat down the other nurse because she was the "head nurse" and the kitchen worker should have come to her first, not me first of all, and secondly, according to her training, Vaseline was the best thing to put on a burn because it keeps it moist so it won't scar. Well, I ignored her, went about my business, loaded her arm with silvadine cream, then dressed the wound and sent her to the ER. The ER said that I did the exact correct thing and had there been Vaseline on that burn they would have had to scrape that all off and start new, and they would have then redressed it with exactly what I had done. I asked that nurse what kind of hill-bunk nursing school she went to because putting Vaseline on a burn would only make it worse and scar. I still don't think she believes I did the right thing because she talked to the DON about writing me up for insubordination. Needless to say the DON had a little talk with that nurse, I didn't get written up and she was given a book on how to care for burns. Had she actually did as she had wanted to that kitchen workers arm would have scared, infection could have set in and it would have been a real mess.

So this same nurse was giving instructions to another brand new nurse who had to give a Hep B shot to one of our employees. After all was done, the newbie came to be and asked me what size needle I use to give a Hep B shot, I told her I always use an inch and a half, why was she asking? She said because that same nurse told her to use a 5/8th needle, which is what she did use on this 6 foot 4 inch 240 pound guy. The newbie told me that she was taught that it had to go into the muscle and she was thinking the 5/8th probably didn't hit the muscle. I told her she was exactly correct, there was no way it hit the muscle and he would have to be given another injection with the right sized needle.

So then it dawned on me, How many others has this other nurse given Hep B shots to with a 5/8th needle? And after doing some digging I found that most of our employees had been given them by her, which would make sense as to why their titers were coming back too low and they were having to get re-stuck. The vac was not being given in the muscle in the first place which was basically rendering it useless. So Monday I guess I am going to have to go and have a talk with the DON about that and see if maybe either she or I can give a little talk about needle length at our next in service. So basically all of the Hep B shots she's given over the last year or so have not done anyone any good, and it's no wonder these people's titers are low showing that they have to get them over again. But remember now, she thinks she's God's gift to nursing. hummmm.

She just totally annoys the living daylights out of me on a daily basis, lol.

Mashie

Hmmm, I wonder if that explains what happened to me. About 20 years ago, when I first moved to SC, I was working in the administrative office of the largest long-term care facility in the state. Because I was exposed to residents and they were exposed to me, I had to get the Hep B vaccination. Okay, fine. I went through the series of three and I always assumed that I was okey-dokey.

Fast forward 20 years and I'm going through evaluation for kidney transplant. My blood is tested for everything known to man and surprise - I have NO immunity to Hep B. One transplant facility didn't say a thing about it, the other refuses to list me until I have immunity. But I was also told not to worry, that I'd be given the vaccine when I started dialysis. Oh, yay, just another thing to look forward to, living off a machine AND a vaccination!

As for your problem-child nurse Mashie, what ever happened to the respect given to seniority? If she were a vet tech working for me, we would have had a little come-to-Jesus moment out in the parking lot. I guarandarntee that I would have come out on top. Grit your teeth and bear it, she'll get her due.

You don't mention where she gave those shots, Mashie, but no points for guessing where you would give them!

Lol, one guess jabbotuk, she gave it to him in his arm. I jokingly told him that I don't believe in giving any IM injections in the arm and that actually according to proper guidelines, most if ot all IM's should be given in the backside. The only reason the Hep B vac's and a lot of the other vac's recommend the preferred site as being the deltoids, is because they have to get into a muscle to be effective.

However, depending on the situation and who my patient is, they will almost always get their IM's in their backside. I told the guy that needed to be revacinated that if I give it I would be putting it in his fanny fanny, he just laughed and said, "that's fine, he doesn't care as long as he gets it right." After that conversation and he started to walk away I made a comment half under my breath and said something like, "I am the shot queen, I play with them for fun, I know exactly how to make them not hurt at all, and I also know how to make them hurt so good." He kept walking, I returned to my work, but about 30 minutes later he returned to me and said, "I heard every word you said, I had a feeling you might be a bit kinky in that department, yes, we will need to chat privately about this topic and hopefully a few others later off the clock. You game?" And I said yep. Then he said, "it takes one to know one, and I just had a feeling.' and I said, "yeah, me too." And that was the end of that conversation. When and if anything else comes from that conversation I will be sure to let you know. I can't and won't play for reasons most of you by now are aware of, but even if I could, I don't want to play with anyone but my precious Doc. He is a very happily married man and makes that very clear to the others at work who hit on him all the time, so I am just guessing he wants some guidance.

As far as my patients go jabbotuk, they are never given a choice as to w here their IM shorts are given, and I am here to tell you, it's never in their arms. And no, I don't give them in their tush because I happen to be a kinky nurse, I give them in their bottoms because technically, it's the proper site to give them in, and is what's best for them.

Mashie

Of course, Mashie, I believe that you insist on giving injections in the bottom for profession reasons rather than personal gratification, but it is a happy coincidence, isn't it?!

Nick

In the UK there are no routine vaccinations recommended for adults, except for people in 'at risk' groups such as those with certain health problems or healthcare workers. These include flu, pneumoccocal (PPV), hepatitis B, TB and chickenpox. Even in at risk groups TB is not usually offered to people over 35 and it's not part of the childhood vaccination schedule except in high-risk populations either.

For anyone over 10 who has missed certain vaccinations the recommended catch-ups are diptheria/tetanus/polio (3 doses 10 years apart), MMR (2 doses 1 month apart), meningitis C for under 25s and HPV for girls aged 12-18. You may well get a tetanus booster at the hospital if you're injured as most people I know can't remember even the year of their last tetanus jab but other than that it's only travel vaccinations you have to worry about.

http://www.nhs.uk/Planners/vaccinations/Pages/Landing.aspx

http://www.cks.nhs.uk/immunizations_childhood/management/scenario_children_over_10_years_of_age/missed_doses

One month ago I took my tetanus shot.

Go to any travel clinic and tell them you plan to visit my country. They'll gleefully go totally beserk, recommending almost every vaccination ever invented! Including rabies!

Unfortunately we dont have travel clinics here - or none that I know of.

Only the government run Yellow Fever vaccination clinics for travellers to Africa and other countries where the yellow fever vaccination is a mandatory requirement.