Recent measles outbreaks, which have disproportionately impacted New Yorkers, feel like an unforced error. Although the measles/mumps/rubella (MMR) vaccine has been available for more than 50 years, the highly contagious illness has landed dozens in the emergency room. Time and science has proven that vaccines are safe and effective, but there are still many misconceptions.
While most of the measles cases in the current outbreak in New York City are among children who were never vaccinated, 10 percent of confirmed measles patients are among those who had previously received a dose of the MMR vaccine, according to the New York City Department of Health and Mental Hygiene. Because the immunity conferred by the vaccine can wear off over time, this has prompted adults to seek another round of vaccinations that were previously completed in childhood. Erick A. Eiting, MD, MPH, MMM, Associate Professor, Emergency Medicine, Icahn School of Medicine at Mount Sinai, explains why some adults need “booster” vaccinations and which shots you may want to discuss with your primary care physician.
What is a “booster” and why might I need one for a childhood vaccination?
Booster shots are additional doses of a vaccine that was previously administered. Adults may need to “boost” their immune system so that they are adequately protected from an illness. The need for a booster shot depends on the person and the vaccine. Certain vaccines may be needed before international travel or after reaching a particular age. People who work in health care may need booster shots because they are exposed to certain diseases more frequently and need the extra protection.
Do I need a booster shot for measles?
If you have proof of immunity to measles, you don’t need a booster. Proof of immunity includes one of the following:
- Written documentation of two doses of the vaccine during childhood
- Lab tests that show enough measles antibodies in your blood
- Lab tests confirming an actual measles infection
- Being born before 1957
If none of the above applies, talk to your doctor about getting an additional dose of the vaccine. People with higher risk of getting measles (health care workers, for example) should get two doses.
What other booster shots may be needed as an adult?
In addition to MMR, you may need an additional vaccination for hepatitis A, typically a food-borne illness, and hepatitis B, transmitted through infected body fluids. Both illnesses can cause severe liver damage. Health care workers are usually required to get the hepatitis B vaccine, and the hepatitis A vaccine is often encouraged before international travel.
Booster shots are also required for the tetanus/diphtheria/pertussis (Tdap) vaccine. This combination vaccine protects against tetanus, diphtheria, and pertussis (whooping cough). It needs to be updated every 10 years, although health care workers may be required to do so more frequently, and you will receive a booster if you get a cut that lands you in the emergency room.
Which other illnesses should I be vaccinated against?
In addition to your annual influenza vaccine—which should be received by healthy people starting at six months—speak to your primary care physician about the following:
- Shingles. Adults over the age of 50 who have previously had the chickenpox should be vaccinated against this painful rash. Shingles comes from the same virus as the chickenpox and can flare up when the immune system is weakened, including during times of increased stress, following physical trauma, and while fighting a disease like cancer or HIV.
- Pneumococcal diseases. Smokers over the age of 19 and adults over 65 should be vaccinated against this set of conditions. The vaccination protects against pneumonia (infection of the lungs), meningitis (infection of the tissue covering the brain and spinal cord), and bacteremia (infection of the bloodstream).
- Human papilloma virus (HPV). First introduced in 2006, this vaccine protects against HPV 16 and 18—the strains most associated with cervical cancer. Previously, the vaccine was only approved for those up to 26; however, the U.S. Food and Drug Administration recently approved the vaccination for people up to age 45.
Erick A. Eiting, MD, MPH, MMM
Associate Professor, Emergency Medicine, Icahn School of Medicine at Mount Sinai
Dr. Eiting is a tireless advocate for vulnerable patient populations. He has focused efforts on improving access to care for incarcerated patients using innovative care models and medical technology. In previous roles, he has used telemedicine to expand access to specialty care as well as to help triage patients with same day needs.
For your safety, and those around you, talk to your primary care physician to make sure all of your vaccinations are up to date. You can also visit a Mount Sinai Urgent Care facility to receive many vaccinations. Availability may vary, so please call ahead. Our urgent care facilities are open 365 days a year for walk-ins and we accept most forms of insurance.