Vaccine Clinic

Tetanus (Td):

If you want to know more about (Td) Click here for further Vaccine Information Statement (VIS).

The tetanus (Td) vaccine protects against tetanus and diphtheria. Tetanus causes serious painful muscle spasms of all muscles and can lead to “lock jaw” where the patient cannot open his or her mouth or swallow. Diphtheria is a thick coating in the nose, throat or airway and can lead to breathing problems, heart failure, paralysis or death. Everyone should have a Tetanus shot once every 10 years, more often if they have a deep cut or puncture wound. It is recommended that people who are sick or pregnant or have had an allergic reaction to the tetanus or diphtheria vaccination in the past do not get the vaccine, but they should check with their doctor.

Tdap vaccine:

If you want to know more about (Tdap) Click here for further Vaccine Information Statement (VIS).

The Tdap vaccine protects against diphtheria, tetanus, and pertussis (whooping cough). All of these are serious, potentially deadly illnesses caused by bacteria.

For information on these diseases and their treatment, see the specific article:

• Tetanus
• Diphtheria
• Pertussis

See also

• Diphtheria immunization
• DTaP immunization
• Pertussis vaccine
• Tetanus vaccine

Alternative Names

Tdap immunization Information:

Tdap is not the same as DTaP. They both protect against the same diseases, but are given at different times. For information on DTaP, see: DTaP immunization.Adults ages 19 – 64 should receive one dose of Tdap as a substitute for the Td vaccine.

If you previously had a Td vaccine in the last 10 years, ask your doctor if you also need the Tdap vaccine to protect you against whooping cough. Because this vaccine protects against pertussis, the following people should make sure they are up-to-date with their Tdap immunization:

• Adults who are in contact with infants under 12 months (Tdap can be given as early as 2 years after you receive Td vaccine)
• New mothers who have never received Tdap (during pregnancy, Td is usually preferred over Tdap)
• Health care workers who are in direct contact with patients (once every 2 years)

Children and adults who have had a severe cut or burn may need Tdap to protect against tetanus infection.

Risks and Side Effects:

Tdap may cause the following mild side effects, which usually last only a few days:

• Body aches
• Chills
• Fever
• Headache
• Nausea, vomiting, diarrhea
• Rash
• Redness or swelling at the injection site
• Soreness at the injection site

Considerations:

You should not get the Tdap vaccine if you:

• Have had a life-threatening allergic reaction to the vaccine
• Have a severe allergy to any ingredient in the vaccine
• Went into a coma or had a seizure within 7 days after receiving the DTaP vaccine

Talk to your health care provider before getting the Tdap vaccine if you or your child:

• Have epilepsy or another nervous system problem
• Had severe swelling or pain after receiving any vaccination containing tetanus, diphtheria, or pertussis
• Have had Guillain Barre syndrome
• Have a severe allergy to latex

If you or your child has a moderate or severe illness, you can delay Tdap vaccination until the illness is gone. People with a mild illness can usually still receive the vaccination.

If you cannot take the pertussis vaccine (for example, because of an allergic reaction), you will receive a vaccine against diphtheria and tetanus (DT for children and Td for adults).

Call your Health Care Provider if:

• You are not sure whether your child should get this vaccine
• You or your child develops severe symptoms after a vaccination, such as difficulty breathing, wheezing, hives, weakness, or dizziness
• You have questions or concerns about Tdap.

Hepatitis B:

If you want to know more about Hepatitis B Click here for further Vaccine Information Statement (VIS).

The Hepatitis B vaccine comes in a series of three injections. Hepatitis B is a virus that can cause a short term illness and the symptoms are loss of appetite, diarrhea or vomiting, yellow skin or eyes, fatigue, muscle or joint aches. It can also cause long term or chronic illness that leads to liver damage, liver cancer or death.

Everyone under the age of 18 or adults over the age of 18 who are at risk including health care workers, health care providers, public safety workers, including police & firemen, people who inject illegal drugs, people who have had more than one sex partner in more than 6 months, people who have sexual contact with infected people, and hemodialysis patients should get vaccinated. People who have had an allergic reaction to baker’s yeast (the kind used for making bread) or people who have had an allergic reaction to the hepatitis B vaccine in the past should not the vaccine.

HEPATITIS A & B COMBINATION (TWINRIX):

If you want to know more about Hepatitis A & B Combination (TWINRIX) Click here for further Vaccine Information Statement (VIS).

Disease Risk & Transmission:

Hepatitis A (HAV):

Hepatitis A (HAV) is a highly contagious liver disease with the common mode of transmission being person to person. Hepatitis A is found in the stool of infected persons and infection may be spread by contaminated water or food, by infected food handlers, after breakdown in sanitary conditions, or after floods or natural disasters, by ingestion of raw or uncooked shellfish from contaminated water, or by needle transmission (sharing needles, blood transfusions from infected persons), in daycare centers, during anal intercourse and during travel to countries in the world with poor hygienic conditions. A person who has Hepatitis A can easily spread on to others within the same household or dormitory. Symptoms include mild, flu-like symptoms, jaundice, decreased appetite, nausea and stomach pains, and diarrhea.

Hepatitis B (HBV):

Hepatitis B (HBV) is an infection of the liver caused by the Hepatitis B virus. Hepatitis B is spread through contact with the blood of an infected person. Between 6-10 of every 100 young adults who have Hepatitis B become chronic carriers (have Hepatitis B in their blood for 6 or more months) and may be able to spread the infection to others for a long time. Hepatitis B is highly infective if there is contact with infected blood or serum through puncture wounds, splashes into the mucous membranes, contamination of open wounds, and injecting illegal drugs. It can be transmitted sexually, during birth and by sharing personal items such as razors and toothbrushes with an infected person. Symptoms include loss of appetite, tiredness, diarrhea & vomiting, pain in muscles and joints, dark urine & skin rashes. The serious complications of HBV are chronic cirrhosis and liver cancer.

Twinrix:

Twinrix is a combination of Hepatitis A & B vaccine. Twinrix is a safe and effective alternative for adult travelers who need vaccination against HAV and HBV, as long as two doses can be given before departure. If there is only time for one dose, vaccination against Hepatitis A would be best handled by a dose of regular Hepatitis A vaccine. Effectiveness of the combination of HAV/HBV is very high and is comparable to the effectiveness of the separate HBV and HAV vaccines. One month after receiving the third and final dose of the vaccine, immunity was seen in 99.9% of people receiving the vaccine and immunity to HBV was seen in 98.5% of the people receiving the vaccine. Twinrix is administered in the upper arm. It is given in a three shot series given over six months. The second shot should be received one month after the first shot. The third shot should be received five months after the second shot.

Who Should Get The Combination HAV/HBV Vaccine (TWINRIX):

The combination HAV/HBV (TWINRIX) vaccine should only be given to people who are over 18 years of age and older. Since Hepatitis B vaccine is recommended for all students entering the University of Virginia, the combination vaccine (TWINRIX) would also provide immunity if you should you decide to travel during your college years. If you have already had one dose of Hepatitis B vaccine, you must continue with the single doses of HBV since you would already have missed 1/3 of the dose of Hepatitis A that is included in the TWINRIX vaccine. Other candidates for the combination HAV/HBV vaccine are:

• Travelers to areas of high intermediate prevalence of both Hepatitis A & B who have risk factors for acquiring hepatitis B.
• Health care workers and those individuals who might render medical assistance to others.
• Users of injectable drugs
• Patients who frequently receive blood products such as hemophiliacs.
• Household contacts of patients with acute or relapsing hepatitis A & B who are at risk of acquiring these infections.

How Can I Learn More?

• Ask your doctor or nurse to give you a copy of the vaccine package insert.
• Visit the National Immunization Program web site
• Centers for Disease control of Viral Hepatitis

Pneumonia (Pneumococcal Vaccine):

If you want to know more about Pneumonia Click here for further Vaccine Information Statement (VIS).

Pneumonia is an infection of the lungs which can lead to a blood infection or even meningitis. One out of every 20 people who get pneumonia die. Most healthy adults who get the vaccine develop protection within 2-3 weeks. All adults over 65 or anyone over two years of age who has chronic health problems or conditions that lower the body’s resistance to infections should get vaccinated. Usually only one dose is needed. A second dose is recommended for people age 65 and older who got their first dose below age 65 and 5 years have past since that dose.

Meningitis (Meningococcal Vaccine):

If you want to know more about Meningitis (Meningococcal) Vaccines Click here for further Vaccine Information Statement (VIS).

What is meningococcal disease?

Meningococcal disease is a serious bacterial illness. It is a leading cause of bacterial meningitis in children 2 through 18 years old in the United States. Meningitis is an infection of the covering of the brain and the spinal cord.

Meningococcal disease also causes blood infections.

About 1,000 – 1,200 people get meningococcal disease each year in the U.S. Even when they are treated with antibiotics, 10-15% of these people die. Of those who live, another 11%-19% lose their arms or legs, have problems with their nervous systems, become deaf or mentally retarded, or suffer seizures or strokes.

Anyone can get meningococcal disease. But it is most common in infants less than one year of age and people 16-21 years. Children with certain medical conditions, such as lack of a spleen, have an increased risk of getting meningococcal disease. College freshmen living in dorms are also at increased risk.

Meningococcal infections can be treated with drugs such as penicillin. Still, many people who get the disease die from it, and many others are affected for life. This is why preventing the disease through use of meningococcal vaccine is important for people at highest risk.

There are two kinds of meningococcal vaccine in the U.S.:

• Meningococcal conjugate vaccine (MCV4) is the preferred vaccine for people 55 years of age and younger.
• Meningococcal polysaccharide vaccine (MPSV4) has been available since the 1970s. It is the only meningococcal vaccine licensed for people older than 55.

Both vaccines can prevent 4 types of meningococcal disease, including 2 of the 3 types most common in the United States and a type that causes epidemics in Africa. There are other types of meningococcal disease; the vaccines do not protect against these.

Who should get meningococcal vaccine and when?

Routine vaccination:

Two doses of MCV4 are recommended for adolescents 11 through 18 years of age: the first dose at 11 or 12 years of age, with a booster dose at age 16.

Adolescents in this age group with HIV infection should get three doses: 2 doses 2 months apart at 11 or 12 years, plus a booster at age 16.

If the first dose (or series) is given between 13 and 15 years of age, the booster should be given between 16 and 18. If the first dose (or series) is given after the 16th birthday, a booster is not needed.

Other people at increased risk

• College freshmen living in dormitories.
• Laboratory personnel who are routinely exposed to meningococcal bacteria.
• U.S. military recruits.
• Anyone traveling to, or living in, a part of the world where meningococcal disease is common, such as parts of Africa.
• Anyone who has a damaged spleen, or whose spleen has been removed.
• Anyone who has persistent complement component deficiency (an immune system disorder).
• People who might have been exposed to meningitis during an outbreak.

Children between 9 and 23 months of age, and anyone else with certain medical conditions need 2 doses for adequate protection. Ask your doctor about the number and timing of doses, and the need for booster doses.

MCV4 is the preferred vaccine for people in these groups who are 9 months through 55 years of age. MPSV4 can be used for adults older than 55.

Some people should not get meningococcal vaccine or should wait.

• Anyone who has ever had a severe (life-threatening) allergic reaction to a previous dose of MCV4 or MPSV4 vaccine should not get another dose of either vaccine.
• Anyone who has a severe (life threatening) allergy to any vaccine component should not get the vaccine. Tell your doctor if you have any severe allergies.
• Anyone who is moderately or severely ill at the time the shot is scheduled should probably wait until they recover. Ask your doctor. People with a mild illness can usually get the vaccine.
• Meningococcal vaccines may be given to pregnant women. MCV4 is a fairly new vaccine and has not been studied in pregnant women as much as MPSV4 has. It should be used only if clearly needed. The manufacturers of MCV4 maintain pregnancy registries for women who are vaccinated while pregnant.

Except for children with sickle cell disease or without a working spleen, meningococcal vaccines may be given at the same time as other vaccines.

What are the risks from meningococcal vaccines?

Mild problems

As many as half the people who get meningococcal vaccines have mild side effects, such as redness or pain where the shot was given.

If these problems occur, they usually last for 1 or 2 days. They are more common after MCV4 than after MPSV4.

A small percentage of people who receive the vaccine develop a mild fever.

Severe problems

Serious allergic reactions, within a few minutes to a few hours of the shot, are very rare.

How can I learn more?

• Ask your doctor.
• Contact your local or state health department.
• Contact the Centers for Disease Control and Prevention (CDC):
  • Call 1-800-232-4636 (1-800-CDC-INFO)
  • Visit CDC’s vaccines website
• Ask your doctor.

MMR:

If you want to know more about MMR Click here for further Vaccine Information Statement (VIS).

Why get vaccinated?

Measles, mumps, and rubella are serious diseases.

Measles:

• Measles virus causes rash, cough, runny nose, eye irritation, and fever.
• It can lead to ear infection, pneumonia, seizures (jerking and staring), brain damage, and death.

Mumps:

• Mumps virus causes fever, headache, and swollen glands.
• It can lead to deafness, meningitis (infection of the brain and spinal cord covering), painful swelling of the testicles or ovaries, and, rarely, death.

Rubella (German Measles):

• Rubella virus causes rash, mild fever, and arthritis (mostly in women).
• If a woman gets rubella while she is pregnant, she could have a miscarriage or her baby could be born with serious birth defects.

You or your child could catch these diseases by being around someone who has them. They spread from person to person through the air.

Who should get MMR vaccine and when?

Children should get 2 doses of MMR vaccine:

• The first at 12-15 months of age and the second at 4-6 years of age.

These are the recommended ages. But children can get the second dose at any age, as long as it is at least 28 days after the first dose.

Some adults should also get MMR vaccine:

• Generally, anyone 18 years of age or older who was born after 1956 should get at least one dose of MMR vaccine, unless they can show that they have had either the vaccines or the diseases. Ask your provider for more information. MMR vaccine may be given at the same time as other vaccines.

Yellow Fever:

If you want to know more about Yellow Fever Click here for further Vaccine Information Statement (VIS).

Yellow fever is a serious disease caused by the yellow fever virus. It is spread through the bite of an infected mosquito and cannot be spread directly from person to person. It is found in certain parts of Africa and South America. Yellow fever can cause:

• fever and flu-like illness.
• jaundice (yellow skin or eyes).
• liver, kidney, respiratory and other organ system failure.
• vomiting blood.
• death.

People with yellow fever disease usually have to be hospitalized.

Flu Vaccine:

If you want to know more about Flu Click here for further Vaccine Information Statement (VIS).

Flu is a contagious disease that spreads from an infected person to the nose or throat of others. Symptoms of the flu are fever, cough, sore throat, headache, chills, muscle aches and fatigue. In some instances, it can lead to pneumonia. People who should get the shot include all children, 6 months to 5 years, adults 50 years and older, pregnant women, and anyone with chronic health problems or weakened immune systems. It is also recommended for health care providers or caregivers of any of the above. People who are sick, have had a life threatening allergic reaction, or anyone with Guillain-Barre Syndrome should not get a flu vaccine.