Adult immunization needs to move up the health check list

Check-list for a healthy life: Quit smoking. Don't drink too much. Exercise regularly.

Oops! You forgot something – up-to-date immunizations.

Adult Canadians are not being immunized routinely for life-saving, vaccine-preventable diseases, according to Dr. Vivien Brown, an adjunct associate professor of McMaster University's Michael G. DeGroote School of Medicine who lectures extensively to doctors and other health care professionals across Canada.

The family physician said a national survey in 2006 found less than 47 per cent of adults were properly immunized for tetanus, with an "abysmal" 39 per cent of adults over 65 receiving the pneumococcal vaccine which protects against serious infections in the lungs, blood and brain.

"Although immunization might not prevent clinical illness in adults, it is clear it leads to decreased severity of illness and fewer deaths," Brown said. Her study appears in the December issue of the journal Canadian Family Physician.

Brown said physicians have the responsibility to educate and inform patients so that they can make good decisions on their own. However, doctors often do not have the time to run through a comprehensive preventive care checklist with each patient as they manage acute and chronic conditions. Prevention alone is estimated at taking up more than seven hours a day, she said.

But, Brown says, both doctors and patients can do a better job. "If we start to evaluate health by including immune status, we will be in a position to make better decisions, to order appropriate tests, and to have more complete preventive assessments."

She suggests a starting point in physicians' day-to-day practice is to "move immunization up from the bottom of the heap."

Patients also carry some responsibility, Brown said. "Patients also need to be aware of keeping track of their history of immunization. For example, when did they last have a tetanus shot…often given at a walk-in clinic or in the emergency department after trauma, and the doctor may not be aware of this situation. Patients tend to know their drugs and drug allergies and they need to be responsible about immunization records as well."