When I reached adulthood, I thought I was done with vaccines. Then my father was diagnosed with Chronic Obstructive Pulmonary Disease (COPD). If I caught a cold—let alone influenza—I couldn’t be around him. The idea that I could miss spending Christmas with my family because of illness made me nervous as the holidays approached.

That’s why I get a flu vaccine every year. Getting one did not completely ensure that I wouldn’t get sick with something contagious, but it increased the odds that I would be well to visit my father when I wanted to.

Even now that he’s gone, I continue to get vaccinated against influenza every year, in early fall. I know that a bout with the flu is no fun and that if I come down with it, not only will I miss work, but it also will take me a while to get back up to speed with other activities as well. A severe bout could even land me in the hospital.

The toll that vaccine-preventable illnesses can take on us—especially as we get older—is a great reason to brush up on what inoculations you might still need as an adult.

Take influenza. In 2017-18, the United States experienced an especially bad flu season.
CDC estimates that flu has resulted in between 9.2 million and 35.6 million illnesses, between 140,000 and 710,000 hospitalizations and between 12,000 and 56,000 deaths annually since 2010.

Most of these people are adults, although the recent flu season was an especially bad one for children too. But just about everyone over the age of 6 months can get the flu vaccination. Those with chronic conditions or weakened immune systems should line up for a shot if they can, because they can be more susceptible to illness.

Flu isn’t the only disease to keep at bay. About 900,000 people get pneumococcal pneumonia every year, leading to as many as 400,000 hospitalizations and 19,000 deaths. And in 2016, there were 20,900 new cases of Hepatitis B, which can lead to complications including liver cancer. West Virginia has the highest rate of Hepatitis B cases in the country. And like Hepatitis A—the disease that health officials are battling in a southern West Virginia outbreak—Hepatitis B is vaccine-preventable.

And annually, there are approximately 1 million cases of shingles, which usually manifests as a painful, blistering rash on the body and sometimes on half of the face. About 10-15 percent of people who get shingles experience postherpetic neuralgia (PHN), which is severe pain in the areas where the shingles rash occurred.

Shingles is caused by varicella zoster virus (VZV), the same virus that causes chickenpox. If you had chickenpox as a child, the virus remains dormant in your body and can emerge as a case of the shingles, often when you are older.

Luckily, there is a way to help avoid these illnesses—vaccination. Shingrix, the new shingles vaccine that has been found to be more than 90 percent effect, is currently available through Monongalia County Health Department’s Clinical Services program for those who do not have insurance or who are underinsured. Eventually, we should have doses for anyone who wants it.

Unfortunately, not all adults know about their risk for these illnesses. Or they are so busy with their jobs and their families they do not take the time to protect themselves. The number of people getting the shingles vaccine has been rising since the original vaccine, Zostavax, was introduced in 2006. But in 2016, that rate for those over the age of 60 getting the vaccine was still only 33.4 percent.
 
Certain vaccines are recommended based on a person’s age, occupation or health conditions, such as asthma, COPD, diabetes or heart disease.

Also, if you travel, you might need vaccines depending on where you plan to go. That’s where MCHD Clinical Services’ International Travel Clinic can help. County Health Officer Dr. Lee B. Smith, a frequent traveler himself, can help determine what vaccines you need—as well as provide other useful information—depending on your destination.

All adults should have their immunization needs assessed by a health provider, including expectant mothers, who can receive the flu vaccine during any trimester of pregnancy. And if you are pregnant or going to be around babies and young children, a Tdap vaccine not only offers protection against tetanus, diphtheria and pertussis, but also offers a safety net to the infants and toddlers against the latter illness, also known as whooping cough. Whooping cough is usually much more serious for babies who are too young for vaccination, and a case of it can result in hospitalization and even death.

If you are unsure which vaccinations you need, the Centers for Disease Control and Prevention offers a short quiz that will guide you. And remember, your physician or health care provider can also help you decide which inoculations you should get, as well as when.

For more information about adult and travel vaccines, or to make an appointment, call Monongalia County Health Department at 304-598-5119.

Vaccines have proven to be an invaluable weapon against several formerly common diseases. Unfortunately, babies are not born fully vaccinated, and it takes some time to get them up to speed through the recommended schedule to inoculate them against 14 diseases before they are 2 years old.

This is where the mother comes in. During a pregnancy, a woman is getting vaccinated for two—not only to keep her from getting ill but also to pass on maternal antibodies against certain diseases to her baby.

Two great examples are the vaccines to protect against influenza and pertussis, better known as whooping cough, both of which should be administered to the mother during pregnancy. A woman who is expecting is at an increased risk for complications during a bout with the flu. That’s because changes in immune, heart and lung functions make a bout with the flu more potentially dangerous. And pregnant women with the flu have a greater chance for serious problems for the developing babies, including premature labor and delivery.

Babies cannot receive their first flu shot until the age of 6 months. Therefore, it makes sense for the mother to get the vaccine during pregnancy to help protect both herself and the baby.

Ideally, making sure you are up-to-date on shots actually begins before pregnancy. For women who need live vaccines, those should be administered at least one month before getting pregnant.

The measles-mumps-rubella vaccines is a great example. Most women were vaccinated as children with the MMR vaccine, but you should confirm this with your doctor. If you need to get vaccinated for rubella, you should avoid becoming pregnant until one month after receiving the MMR vaccine and, ideally, not until your immunity is confirmed by a blood test.

The Centers for Disease Control and Prevention invites expectant and anticipated mothers to take the Adult Vaccine Quiz to find out what vaccines you may need before becoming pregnant.

Vaccines received during pregnancy should be inactivated, which means the viruses or bacteria in the vaccine are killed rather than weakened. Pregnant women can receive a flu shot made with killed virus during any trimester, so that is not a problem. Flu activity can begin as early as October and can last as late as May, and it generally takes up to two weeks for the vaccine to provide full protection against the flu.

Then there is whooping cough. Young babies are especially susceptible to a bout with this disease, often being exposed to it by adults who might not realize they have it. Babies do not begin the series of five vaccines, called DTaP, until the age of 2 months and ending between the ages of 15 to 18 months. Up to 20 babies die of whooping cough each year in the United States, and about half of the babies younger than the age of 1 who get illness require treatment in the hospital.

Not only that, but despite its name, not all babies have the hallmark cough when sick with this disease. Instead, it can cause them to stop breathing and turn blue.

The good news is that whooping cough is usually less severe in babies whose mothers got the vaccine while pregnant. Over the age of 6, the inoculation that helps protect against pertussis—as well as diphtheria and tetanus—is called the Tdap vaccine. And an expectant mother who wants to protect her child against whooping cough should get the Tdap vaccine between 27 and 36 weeks of pregnancy, each time she is having a baby.

Another strategy for keeping babies safe is for any other caregivers or household members who will be close to the infant inoculated as well. This is called “cocooning,” and while it’s a good idea, it is still important for the pregnant mother to receive the Tdap vaccine.

Then there is Hepatitis B. West Virginia currently has the highest rate of this illness in the country. Expectant mothers who have Hep B should discuss getting the vaccine with their health care provider. It could lessen your baby’s chance of getting Hep B.

So while making plans for the baby like what color to paint the nursery and reading up on childbirth, expectant mothers also should explore the vaccines they should receive during pregnancy. Talk to your ob-gyn or midwife, visit the CDC Adult Vaccine Site Maternal Vaccines: Part of a Healthy Pregnancy or call the Monongalia County Health Department at 304-598-5119 to make an appointment for vaccines.

Sure, kids hate getting shots. I remember convincing my sister to politely ask our pediatrician to forego our vaccines during one appointment. In my toddler mind, I thought that would do the trick to avoid a nurse sticking a needle into my arm. I was wrong. What I didn’t realize at the time was that a few uncomfortable moments could spare me a bout with an unpleasant illness—one that not only made me feel sick but also that my sister could catch, keeping my mother at home taking care of us.

These days, parents have an arsenal to help them combat 14 harmful and potentially deadly diseases that their kids can be exposed to at home, during a playdate with a friend, at day care or at preschool. And all before their children hit the terrible twos. Most parents agree that inoculating their offspring against diseases such as measles, chickenpox and whooping cough is the right thing to do. According to the Centers for Disease Control and Prevention, nine out of 10 people have their children vaccinated according to an immunization schedule or intend to do so.

And that is in spite of the fact that most young parents have never seen the devastating effects that measles can have on a family and the surrounding community. A measles outbreak last year in Minnesota—the state’s first case in 2018 was diagnosed last week—serve as reminders of how quickly infectious diseases can spread when they reach groups of unvaccinated people. And that’s a tragedy, because vaccines are thoroughly tested before licensing and monitored after licensing to make sure they are safe.

Unfortunately, recent measles outbreaks show that people sometimes become complacent when they forget how commonplace those diseases were before the widespread availability of vaccines. Many of them also never saw complications associated with illnesses such as measles.

Measles is highly contagious and can be dangerous, especially for babies and young children. According to the CDC, one out of four people who get measles will be hospitalized, one out of every 1,000 who get measles will develop brain swelling due to an infection called encephalitis—which may lead to brain damage—and one or two out of 1,000 people with measles will die, even with the best care.

Measles was declared eliminated in the United States in 2000. Then travelers brought it back from other countries and it was spread to communities with larger-than-normal numbers of people who did not get vaccinated, perhaps for religious, philosophical or personal reasons. The MMR vaccine—when administered according to the CDC’s immunization schedule—provides children with protection from measles, mumps and rubella.

Another disease that has made recent headlines is pertussis, better known as whooping cough. There was an outbreak as recently as 2012, according to the CDC. Pertussis can cause serious and sometimes deadly complications for babies and young children, especially those who are not fully vaccinated. Complications include:

• 1 out of 2 babies younger than the age of 1 will need hospital care
• 1 out of 4 will get pneumonia
• 1 out of 100 will experience convulsions
• 3 out of 5 will have apnea, or slowed or stopped breathing
• 1 out of 300 will have encephalopathy, or disease of the brain
• 1 out of 100 will die

The DTaP vaccine, administered at 2 months, 4 months, 6 months, 15 through 18 months and through the ages of 4 and 6, not only protects against whooping cough, but also diphtheria and tetanus. If a child falls behind schedule, he or she can get the Tdap vaccine after the age of 6.

These are just some of the common childhood illnesses that vaccines can prevent or make symptoms less severe. Vaccines are the safest and most effective way to protect children from these diseases. Parents can provide the best protection by following the recommended immunization schedule, giving children the vaccines they need when they need them.

And while Hepatitis A and Hepatitis B might never have been considered childhood illnesses, there is currently a Hep A outbreak in southern West Virginia that health officials have been battling. And Hepatitis B is on the rise, and West Virginia has the highest rate of the illness in the country.

It might seem overwhelming, but the CDC has prepared a graph and chart that details the 14 diseases prevented by vaccines before the age of 2 in an easy-to-read format. And all vaccines used in the United States require extensive safety testing before they are licensed by the U.S. Food and Drug Administration (FDA).

For more information on vaccines, contact your health care provider or the Monongalia County Health Department (MCHD) at 304-598-5119. If you are sending your children back to school, information on West Virginia school immunization requirements can be found on our website.

Backpack? Check! Books? Covered! Vaccines? It’s that time again. August means parents and their kids are focused on back-to-school.

While the implements of learning are a big part of that, so are the tools that will help keep students safe from illness while they are learning and interacting with hundreds of their peers.

August is National Immunization Awareness Month, and in the next few weeks, we will be taking a look at how people need vaccines during all stages of their lives, from infanthood to old age.

Because school will be back in session soon, though, we’re going to start with kids who are around ages 5 through early adulthood.

But first, let’s talk about the importance of vaccines. Just think, thanks to a vaccine, most Americans today do not worry about getting polio and having to live their lives in a wheelchair—or an iron lung—because of it.

Smallpox, a disease that could scar and blind its victims—if it didn’t kill them—was declared eradicated by the World Health Organization in 1980.

And illnesses such as chickenpox and measles are no longer considered rites of passage for kids but are still around and pop up in outbreaks among those who remain unvaccinated.

That’s why vaccinations are so important. Last winter saw an especially bad flu season; according to the Centers for Disease Control and Protection, 178 children died during the 2017-18 flu season from the illness.

Hepatitis A and Hepatitis B are on the rise, especially in West Virginia. Vaccines provide protection against both of those diseases. Human papillomavirus is usually harmless, but it can lead to several different types of cancer in both women and men. Meningitis, a potentially deadly disease, can often attack those in group settings, such as college dorms or sports teams. There are vaccines that can prevent certain types of both bacterial and viral meningitis.

Plus, tetanus, diphtheria and pertussis, also known as whooping cough, are still real threats that can lead to a variety of dangerous symptoms.

The CDC offers an easy-to-read guide on vaccinations that babies should receive from infanthood to the age of 6. These are the mandated vaccines that the state of West Virginia requires students to get in order to attend public school.

For children who have been vaccinated according to the current schedule, here is a list provided by the CDC of recommended vaccines for students between the ages of 7 and 18:

•    All preteens and teens need a flu vaccine every year. Some children 6 months through 8 years of age require two doses of flu vaccine. Children 6 months through 8 years getting vaccinated for the first time, and those who have only previously gotten one dose of vaccine, should get two doses of vaccine this season. The first dose should be taken as soon as the flu vaccine is available, and the second dose should be received at least 28 days after the first dose. In following years, only one dose is needed.

In addition to an annual flu vaccine, three vaccines are recommended specifically for preteens:

•    HPV vaccine protects against HPV infections that can cause cancer later in life, including cervix, for which women can be routinely screened, as well as mouth/throat, anus/rectum, penis, vagina, or vulva, for which people are not routinely screened.

•    Tdap is a booster shot to help protect preteens from whooping cough, tetanus, and diphtheria. Tdap not only protects the child from these diseases, but also keeps them from giving whooping cough to a young baby who does not have immunity yet.

•    Meningococcal conjugate vaccine protects against meningitis, and bloodstream infections (bacteremia or septicemia). These illnesses can be very serious, even fatal.

If you haven’t gotten your child vaccinated yet, there is still time. Call your health care provider. Or make an appointment at Monongalia County Health Department’s Clinical Services at 304-598-5119. We are currently holding back-to-school vaccine clinics. Call us to find out more!

Your adorable and adored tabby cat is basking in the sun on your porch. Suddenly, an aggressive raccoon staggers across the lawn and onto the porch. A tussle ensues. Fur flies and hissing permeates the air. When all is said and done, Fluffy might have a scratch or a bite. The raccoon is shot and tested for rabies, and the results are positive. What do you do?

If Fluffy is up to date on her rabies vaccine, she will be given a rabies booster and you can observe her for 45 days to make sure she is OK.

If Fluffy is not current on her rabies vaccine, health officials will recommend that your beloved pet be euthanized. If you’ve seen “Cujo,” about a lovable St. Bernard turned savage beast after he is bitten by a rabid bat, you know why.

While that might have been an exaggeration of the effects of this viral disease on an animal, it’s still a horrible way for a pet to die, with advanced symptoms that include delirium, abnormal behavior and hallucinations. Not to mention that before that happens, the pet could spread rabies to you or your family.

If you don’t have Fluffy euthanized, you will be required to keep her in strict quarantine for six months—or until she exhibits signs of rabies, at which point she would be put down—in a double cage with no human contact other than the owner. Think solitary confinement. (Or “Old Yeller”). It’s expensive, time-consuming and a really awful experience for Fluffy.

Give those choices, making sure your pets have been routinely vaccinated for rabies seems like the obvious and much easier voice. Plus, it’s the law. In West Virginia, household pets such as dogs, cats and ferrets must be vaccinated for rabies. Although not required, it is also highly recommended for other animals such as horses and cows, because all mammals can become infected and die from rabies.

Rabies has been an issue in West Virginia now for nearly 40 years, and it’s in the forefront again with recent confirmed cases of raccoons that have approached pets on private property. So far, there have been six confirmed cases of rabies in Monongalia County in 2018, in numbers collected by MCHD and the United States Department of Agriculture (USDA) Wildlife Services based in Elkins.

The disease wasn’t found much in the state until raccoons were imported from Florida for the purposes of hunting in the late 1970s. Ever since then, health officials from the USDA have struggled to keep raccoon rabies at bay with bait that is dropped from helicopters. Raccoons that eat the bait are inoculated against the disease. The next round of bait drops is scheduled to take place in a couple of weeks, although it will happen mostly west of Monongalia County.

Here at Monongalia County Health Department, we also work to prevent rabies in the community. Registered sanitarians in our Environmental Health program conduct rabies surveillance. For instance, if we get a call from someone who has been bitten by a dog or cat, the sanitarian works to evaluate the animal to determine if the person who was bitten should seek medical care to prevent infection from rabies.

Rabies is transmitted in saliva, so if you or a family member is bitten or scratched by an unknown, unvaccinated animal or one that is behaving strangely, either domestic or wild, wash the wound immediately and seek medical attention. The doctor will work in conjunction with MCHD to determine appropriate treatment.

If you have a more pressing animal situation, you can call MECCA 911. If it’s about an unknown animal on your property acting strangely, or a bat in your house, call MECCA’s non-emergency number at 304-599-6382. If you or someone in your family is bitten by a wild or unknown animal, call MECCA 911.

As MCHD’s regional epidemiologist Dr. Diane Gross has noted, animals most commonly found to be rabid in West Virginia tend to be raccoons, bats, skunks and foxes. A bat found in a room where someone has been sleeping can be especially troublesome because that can make it more difficult to determine if the person has been bitten or scratched. That is enough to transmit rabies. It’s also a good reason to examine your home for any holes or openings where wild animals can get in and repair those.

And it’s also a good reason to make sure that your pets are up to date on their rabies vaccinations. With rabies, prevention is everything, because once the disease develops, there is not a cure.