It’s not only in childhood that you need immunisation to protect you from severe and potentially fatal illnesses.

By Glynis Horning

23 January 2023

Covid-19 brought home the need for vaccines throughout life. “They are not only necessary for children, but also, and sometimes more so, for adults,’ says Dr Albie de Frey, medical doctor and CEO at Travel Doctor Corporate in Johannesburg.

Some vaccines only become necessary later in life, such as the vaccine against shingles, but some of those you received in childhood wear off over the years and require boosters. In addition, your age, lifestyle, health conditions, work or travel can all expose you to diseases for which there are vaccines. “Unfortunately, outdated and short-sighted laws make it impossible to ‘advertise’ vaccines, leading to gross ignorance among the general population,” says De Frey.

Ask your health provider, pharmacy clinic nurse or a travel doctor which would benefit you, and get your shots.

Seasonal flu: Every year you can have a shot against the most prevalent flu strains expected that season. It’s particularly important to have this if you’re over 60, have underlying health conditions, are pregnant, or live or work in crowded conditions. “Influenza viruses thrive in the tropics year-round,” says Dr De Frey. “A holiday or work assignment in the tropics warrants a flu vaccine.”

Tetanus (lockjaw), diphtheria, pertussis (whooping cough) and polio vaccine: All children should receive DTap vaccine in infancy in various formulations, and a booster (Tdap) at the age of 12. After that, because of waning immunity, we should all receive a Tdap booster every 10 years, says Dr De Frey. “If you can’t remember when you last had one, the time is now.” All pregnant women must have a Tdap booster at 27-36 weeks to protect themselves and their new-born babies. “Tetanus spores occur in soil worldwide, so every time you have a skin-breaking injury you should get a tetanus, or even better, Tdap booster, if you’ve not had one in the last five years,” he says. “Grandparents should not meet their grandchildren unless they’ve had a Tdap booster, to ensure they don’t infect the new-born with whooping cough or diphtheria.”

HPV vaccine: This protects against types of human papillomaviruses that cause cervical, anal, penile and vaginal cancers, and genital warts. “The virus also plays an important role in the development of head and neck cancer, especially in men,” says Dr de Frey. The vaccine is now given to girls aged 9 to 12 at government schools as part of the government vaccination programme. “Women and men up to the age of 45 should seriously consider having an HPV vaccine to reduce their risk of developing warts and cancer.”

Hepatitis B vaccine: All South Africans born after 1994 should have had a hepatitis B vaccine course to protect them against liver cirrhosis and liver cancer in later life, says Dr De Frey. “If you were born before 1994, or did not receive at least three hepatitis B vaccines, you should get vaccinated, as about 40% of South Africans have been infected with this virus and some are carriers that can infect others.” Hepatitis B is transmitted through sex, sharing needles and syringes, tattoos and infected blood transfusions.

Pneumococcal conjugate vaccine: This protects against serious pneumococcal disease (infection by Streptococcus pneumoniae bacteria). “All adults over the age of 65 are at risk of pneumococcal disease – lung, brain and blood infection,” says Dr De Frey. “They and children and younger adults with certain medical conditions, including chronic heart, lung, kidney or liver disease, diabetes, or illnesses or medication that weaken the immune system, such as HIV, certain cancers, and ‘biologicals’ used to treat conditions like rheumatoid arthritis, are at risk and should be vaccinated.” Speak to a well-informed health-care provider.

MMR (measles, mumps and rubella): Measles vaccine is part of the government immunisation programme for children. “Measles is highly contagious and kills thousands of children globally every year, and it can cause debilitating disease and death in adults as well,” says De Frey. “South Africa is currently experiencing a measles outbreak due to inadequate vaccine coverage in children in the wake of the Covid-19 pandemic and general failure of the health system.” Mumps and rubella vaccine is not part of the government child vaccination programme, but the vaccine is available in the private sector. “Mumps causes serious illness in adults and infertility in young men, and rubella is the cause of congenital malformations in the babies of infected pregnant women,” he says. “If for some reason you didn’t have shots for these in childhood or don’t know if you did, you should get vaccinated to protect your fertility and possible future babies.”

Varicella (chickenpox) vaccines: Chickenpox is a very common childhood disease. It may leave scars, but also gives life-long immunity to those who have had it, at the cost of being at risk of developing shingles in later life. “Chickenpox is a serious disease in adults, who may develop lung or brain infections from it, causing disability and death,” says Dr De Frey. If you didn’t have chickenpox as a child, you should seriously consider getting vaccinated.

Shingles vaccine: Everyone who ever had chickenpox is at risk of developing shingles, says Dr De Frey. “This vaccine gives protection against shingles and its complications and is recommended for adults aged 50 or older and all younger immune-compromised adults. “An important sub-group is people who have cancer or have had an organ (liver, kidney, lung etc) transplant. They can’t receive the commonly available live vaccine, they need to get a specially imported recombinant vaccine, Shingrix®.”

Covid-19: It’s never too late to be vaccinated against Covid-19, says Dr De Frey. “And even if you have been vaccinated, you should remain up to date with the latest available vaccine, or perhaps another available vaccine, as there is sadly little indication that we will soon be having updated Covid vaccine in this country. Ample research has shown that natural and vaccine-induced immunity wanes over time, and with the advent of new strains, especially in the older age group and the immune-compromised.”

If you are travelling: Wherever you are going in the world, check with your travel health provider which vaccines you may need – not only for trips into so-called developing countries, says Dr De Frey. “Cowpox originated in Africa but made headlines at mass gatherings in Europe and North America. Cowpox illustrates nicely that what you need depends not only on where you are going, but what you will be doing there. Travellers with health concerns and older travellers may have specific needs, but younger travellers may be more adventurous and get exposed to another spectrum of vaccine-preventable diseases.” Plan to have vaccinations four to six weeks before you depart, he urges, to give your system time to build up optimal immunity, especially if the vaccines need multiple doses.

For more on information visit your Clicks clinic (https://clicks.co.za/clinicBooking), and contact the travel doctor (https://traveldoctor.co.za/).