Vaccines are often considered as protective measures exclusively for children. It is less widely known that vaccines against infections affecting adults are also available. These vaccines are recommended, but not mandatory.
Vaccines against influenza
Flu spreads as an epidemic and might cause severe disease. As the virus is highly variable, it is necessary to administer flu shots annually. Vaccines help to prevent severe, life-threatening forms of the disease and decreases the death toll caused by the influenza virus.
Flu vaccines are highly recommended for:
- people belonging to one of the risk groups;
- for people posing a threat on risk groups by transmitting the infection;
- for stock farmers, workers and people involved in animal (swine, poultry, horse) transport in order to decrease the possibility of mixing the genomic data of animal and human influenza viruses).
Risk groups include people:
- over the age of 60, regardless of their health condition;
- with asthma and chronic respiratory disease;
- with limited respiratory function due to morbid obesity or other disease;
- with cardiovascular diseases (except treated hypertension) ;
- with congenital or acquired (due to disease or treatment) immunodeficiency (including HIV positive people or people with malignant disease);
- with chronic liver and kidney disease;
- with metabolic disease (e.g., diabetes) ;
- with chronic circulatory and respiratory illnesses;
- staying transiently at rehabilitation or nursing homes;
- who live in assisted living facilities or require long-term nursing care in health care facilities;
- pregnant women;
- women who time their pregnancy to the period of flu epidemic;
- children and adolescents under long-term salicylate treatment.
Flu shots are highly recommended for employees of health care or social care facilities as well, since they can transmit the disease to the risk populations staying or living in these institutions.
Types of flu vaccines
The vaccine contains two viruses (influenza A and B type) which are determined each year by the World Health Organization (WHO) depending on the epidemiological situation. Booster vaccination is recommended annually.
Three types of flu vaccines can be differentiated based on their technology:
- inactivated vaccines contain full virus (3Fluart);
- vaccines containing split viruses („split”, Fluarix, Vaxigrip, IDFlu);
- surface vaccines („surface”, Agrippal).
Flu vaccines show a 70-90% efficacy among healthy adults above the age of 65.
Vaccination against Pneumococcal infection
The indication area of Pneumococcal vaccines is the same as in the case of influenza vaccines. More than 90 types of pneumococci are known, and vaccines provide protection against types of 23 and 13 which cause the most severe diseases.
Vaccines are recommended for the elderly (above the age of 60) and for people in the risk populations (people who had splenectomy, who are immunocompromised, people with chronic circulatory or respiratory illnesses, smoking individuals and people with kidney disease), where pneumococcal infections might have a more severe course.
For patients who are severely immunocompromised and people at very old age, the vaccine’s efficacy is lower.
Types of pneumococcal vaccines
The 23-valent vaccine (Pneumovax 23) protects against severe infections that affect the whole body (sepsis, meningitis). A novel vaccine (Prevenar 13) which offers greater protection can be administered regardless of the age. For people of different risk populations, this 13-valent vaccine is recommended, of which protection can be supplemented with the 23-valent pneumococcal vaccine later (at least 2 months have to pass after the administration of the 13-valent vaccine).
Vaccines against hepatitis
Vaccine against hepatitis type A contains the inactivated virus. The protection develops 10-14 days after the administration of the first vaccine. In order to develop permanent protection, administration of a second vaccine is necessary – this is scheduled 6-60 months after the first vaccine, depending on the vaccine type.
Vaccination against hepatitis A is recommended in the following risk groups:
- employees who are at greater risk of infection;
- people with liver disease;
- homosexuals;
- intravenous drug users;
- people traveling to endemic regions.
Actived vaccines are also available against hepatitis type A virus (Havrix, Avaxim).
Vaccines against hepatitis type B (Engerix B, HB VacPro) contain viral surface proteins. A vaccination series of 3 vaccines provide longterm protection. There is a combined vaccine against both hepatitis A and B types (Twinrix).
Vaccines against hepatitis type B are recommended in the following risk groups:
- employees at greater risk of infection (especially healthcare workers) ;
- intravenous drug users;
- homosexuals;
- patients with liver disease;
- patients receiving blood products regularly;
- people who are in close contact with infected individuals;
- people traveling to and staying for a longer period in endemic regions.
Vaccines against tick-borne encephalitis
The vaccines contain inactivated virus (FSME-Immun, Encepur). A vaccination series of 3 vaccines and later booster vaccines provide adequate protection.
Vaccination is recommended for hikers and workers at forests and farmers.
Vaccination against meningococcal infection
The infectious disease affects infants, children and young adults aged 12-26, therefore vaccination is recommended for these agegroups in most European countries. In Europe, mainly the type B and C meningococcal infections are responsible for the fast-course, severe disease. Different vaccines (Menveo, Nimenrix, Menjugate, NeisVac, Bexsero, Trumenba) provide protection against different types of meningococci.
Depending on geographical location, several types of meningococci may cause epidemics, and this fact must be considered, and the proper type of vaccine must be chosen before traveling abroad. Above the age of 5, one vaccine provides adequate protection which lasts 3-5 years. For those who had been vaccinated a long time ago or who are at greater risk of getting infected because of their illnesses (asplenia) or traveling, booster vaccine is recommended.
Vaccines against HPV infection
This is the second available “anti-cancer” vaccine. The human papillomavirus group involves more than 150 genetic types of viruses. The virus gets into the body through skin and mucosal microlesions and causes lesions. One third of the HPVs can be accountable for cervical, uterine, vaginal and rectal cancers and genital warts.
The most common malignant types are the type 16, 18, 31, 33, 45, 52 and 58, while type 6 and 11 are less malignant. In Europe, the annual prevalence of HPV-related cervical cancers is 34.000 with 13.000 deaths, while in Hungary, the annual prevalence is 1.070 (according to epidemiological data collected in 2018). The appalling high number registered in Hungary is due to inadequate screening programs. In Hungary, instead of the necessary 2.5 million women, only 600.000 women are screened for cervical cancer annually.
Human papillomavirus (HPV) vaccine types
Three types of vaccines are available against 2, 4 and 9 different HPV types:
- Cervarix: protects against type 16 and 18,
- Silgard: protects against type 6, 11, 16 and 18 (since 2018, it has been replaced with the 9-valent vaccine),
- Gardasil 9: protects against type 6, 11, 16, 18, 31, 33, 45, 52 and 58.
All three vaccines provides protection against type 16 and 18 which are accountable for cervical, vaginal, penile, rectal and vocal chord cancer in 70% of the cases. Type 6 and 11 are the ones which cause most frequently (90%) genital warts (condylomas). The vaccine containing the types of 31, 33, 45, 52 and 58 protects against 88% of malignant types. All three vaccines contain purified proteins of the virus; therefore, they do not cause disease.
Vaccines do not treat the already developed disease. Depending on lifestyle, and the number of sexual partners, vaccination is recommended in older age groups as well. HPV positive women can also be vaccinated, since the vaccines protect against more types of HPV. Vaccination for men is also recommended, primarily with the 9-valent vaccine.
Important to note: vaccination does not substitute regular gynecological screening tests!
Vaccination for adults against childhood diseases
In Hungary, vaccines administered at the recommended time provide protection against vaccine preventable infections in childhood. Vaccines have been used for decades against certain diseases – diphtheria, pertussis (whooping cough), poliomyelitis (infantile paralysis), tetanus (lockjaw). In certain cases, these childhood vaccines can be administered for adults as well.
Vaccines against diphtheria, pertussis and tetanus
Revaccination for adults is recommended in every 10-year. Recently, more and more publications have reported an increasing number of infants with whooping cough among the unvaccinated children in western countries.
The disease usually presents as one of the parents’ prolonged, atypical bronchitis with coughing and further investigations identify it as atypical pertussis. Therefore, it cannot be excluded that the childhood vaccine-caused immunity against pertussis needs to be reinforced by a booster vaccine.
For this, the newly developed, so-called “acellular” (a vaccine that does not contain cells) pertussis vaccines can be a great option (Boostrix, Boostrix Polio).
Vaccination against measles, mumps, rubella and varicella
For young adults, MMR vaccines against measles, mumps and rubella might be indicated, if childhood immunization is not verified or immunity must be verified for staying in a foreign country, for example:
- settlement in the United States,
- traveling to endemic regions.
For women who are planning to start a family, certain vaccinations might be indicated before getting pregnant or after giving birth, if:
- they were not immunized in childhood,
- their immunity status is uncertain,
- they had not been though chicken pox in childhood.
There is evidence showing that complications of infections in adulthood are more frequent and more severe compared to those in childhood, especially dangerous one is the varicella zoster virus (VZV)-caused pneumonia.
Vaccination if the elderly might be necessary due to their immune system’s decreased capacity, when immunity gained from previous vaccinations or infections wear off. Furthermore, more pathogens have been associated with infections affecting the elderly. Since mostly older patients develop respiratory infections, therefore protection against respiratory pathogens are of utmost importance (e.g., pneumococci, influenza virus).
Recommended vaccines’ administration schedule
The first step of applying for the vaccination is contacting your GP who will inform you about the vaccination (how many vaccines and their scheduling) and prescribes the vaccine for you.
With the prescription, you will be able to purchase the vaccine in any pharmacies. After the purchase, the GP will administer the vaccine and they will also provide you the necessary documents that verifies the vaccination.
