A few years ago, a friend of mine — a healthy woman in her 40s — came down with whooping cough. She coughed for three months straight (whooping cough, or pertussis, is sometimes called the “100 day cough”). She would hack so hard she would throw up or pass out. It sounded so awful that I quickly made an appointment at my doctor’s office to get the pertussis vaccine booster, which Health Canada recommends every adult get once.
Why vaccinations for adults are important
As adults, vaccines tend to slide off the to-do list, or we may not even know which ones we’re supposed to get. Before my friend got sick, I had no idea that there even was an adult booster shot for pertussis. “We have good systems in place for children, so parents are aware of the regular [vaccination] schedules, but we forget that vaccinations are important for adults too,” says Dr. Shelly McNeil, an infectious disease specialist in Halifax and chair of Immunize Canada. She adds that while family doctors and other health professionals may remind you about the flu shot, they often don’t address other vaccines with their adult patients, despite the fact that prolonged illness in adulthood can be catastrophic, leading to major family stress, loss of income, or long-term health complications.
Some vaccines, like the flu shot, are available at no cost. Others, like vaccines for hepatitis or shingles, may be covered by private insurance, or else you have to pay for them yourself. Funding may also depend on the province or territory you live in, so check with your health care provider.
Adult vaccines doctors recommend
Health Canada recommends the following for all healthy adults:
Herpes zoster (shingles)
Dose: 2-dose vaccine at age 50 or older
Who needs it: Anyone who’s ever had chicken pox or shingles, even if you had the vaccine previously. There’s now a new vaccine, Shingrix, that’s more than 90% effective in preventing shingles, a viral infection that causes a painful rash, says Dr. McNeil. “That’s the most frequent vaccine I get asked about by the public,” she says.
Human papillomavirus (HPV)
Dose: 3 doses over six months, between age 9-45
Who needs it: All sexually-active women. You’re likely aware of the school-aged program of HPV vaccinations, aimed at kids before they become sexually active, but the National Advisory Committee on Immunization, which advises the Public Health Agency of Canada, now also recommends the use of HPV vaccine for anyone between the ages of 26 and 45 as prevention of vulvar, vaginal, anal cancers and their precursors.
Even if you’ve only had one sexual partner, you could still be at risk. “Patients in seemingly monogamous relationships are often not aware that their partner may have another partner at some point during their relationship,” says Dr. Nancy Durand, an OB/GYN in Toronto. “Many often find this out the hard way when they are diagnosed with an HPV-related illness.” Dr. McNeil also points out that if your long-term relationship has ended, you might consider getting the vaccine: “There’s another blip of people at risk: middle-aged adults who are leaving one relationship and entering into other new relationships.”
Pertussis (whooping cough)
Dose: One booster shot as an adult and during third trimester of every pregnancy
Who needs it: All adults, especially those who are in contact with babies under one year of age. In Canada the booster for pertussis is also part of diphtheria-tetanus (Tdab) booster.
Diphtheria and tetanus
Dose: One booster every 10 years
Who needs it: You may need it if you are exposed to certain bacteria in dirt that can enter the body through a cut or scrape and cause tetanus, or if you travel to areas where diphtheria is more common (including many countries in Asia, the South Pacific and eastern Europe, and the Dominican Republic). These two vaccines become less effective over time, so you need a booster periodically, and they are generally given together with whooping cough.
Dose: One every year, in the form of a shot or nasal mist
Who needs it: All adults. You want to help protect yourself and those around you from influenza, which is very contagious and can lead to serious complications for certain groups in the population that are immune-compromised.
Dose: One-time inoculation
Who needs it: Any healthy adult 65 and over
Other vaccines you may need
You can also consider other vaccines, depending on your circumstances.
Dose: One to two shots, depending on the brand
You may need it if: You live with someone with hepatitis A, or you travel to regions where Hepatitis A is common, including Central and South America, Africa and Asia.
Dose: One to two shots, depending on the brand
You may need it if: Your job in health care, public safety or corrections has a higher risk of contact with bodily fluids, or you live with someone with Hepatitis B.
Measles, mumps and rubella (German measles)
Dose: One booster shot
You may need it if: You haven’t already had the vaccine or the diseases in childhood. While kids now get two doses of the vaccine, Canadian children used to only get one. Toronto Public Health says for full protection, people born between 1970 and 1992 should get a booster shot of the MMR vaccine if you have not had one. Certain groups may need a second booster.
Dose: One shot at age 24 or younger
You may need it if: You are living in crowded housing, like a university residence, where the infection can spread rapidly.
Varicella (chicken pox)
Dose: One dose
You may need it if: You haven’t ever had the disease or the vaccine, typically given in childhood.
If you’re travelling, check with a travel health clinic or online at travel.gc.ca to see if vaccinations are recommended or required. For example, you might need to get immunized against yellow fever before going to Ecuador or Panama.
Keeping track of vaccines
You can download a free app called CANImmunize to keep a digital record of your vaccinations, or ask your doctor or public health office for a paper booklet. Not sure of what immunizations you’ve already had? Check with your doctor or the public health office in the area you lived as a kid.