Looking to hold down your health care costs? Vaccines are a cost-effective way to reduce health risks, but they are often overlooked by adults.
Many family doctors don’t routinely check adults’ immunization history and urge them to get recommended shots, said Dr. William Schaffner, head of preventive medicine at Vanderbilt University School of Medicine and a spokesman for the Infectious Diseases Society of America. The cost can also be a deterrent.
Unlike vaccines for infants and children, most adult vaccines generally aren’t stocked by primary care doctors. The exceptions are influenza and pneumonia shots, which usually are covered under preventive care. For other shots, patients often must pay out of pocket until they meet a health plan’s deductible, or pay upfront and seek reimbursement, Schaffner said.
Medical experts recommend an annual flu shot and a tetanus-diphtheria booster every 10 years for everyone over 18. Many people know that, but still don’t get those shots.
There are eight other vaccines recommended for many adults, depending on age, sex, current health and whether they had or were vaccinated against certain diseases as a child. A couple came on the market in the last several years, and pneumococcal vaccine Prevnar 13, a new rival to Pneumovax, is expected to get approval for adults shortly.
Here’s a chance to get up to speed. Then see your doctor to discuss whether you should get them, particularly if you are pregnant or have chronic health problems.
If your doctor cannot provide vaccines you want, ask for a referral. Or, contact your local health department or a hospital, travel vaccine clinic or pharmacy chain, as some pharmacists now administer vaccines. Walgreens, for example, now advertises it administers shingles shots.
Here’s what’s recommended by the federal government, along with private-sector prices, per dose, listed by the Centers for Disease Control and Prevention:
Recommended for most people
— Influenza, $8-$20. Can trigger dangerous pneumonia. One dose a year now recommended for all adults. Besides injections, a nasal spray vaccine (Flu Mist) is available for healthy adults, except pregnant women.
— Tetanus/diphtheria/whooping cough (pertussis), $38. Generally, one dose every 10 years; when vaccine status is unknown, as soon as possible for women who have just given birth and anyone caring for patients or infants.
Recommended for certain ages/conditions/situations
— Chicken pox (varicella), $84. Two doses from age 19 up, or a booster shot if you’ve had one shot. Generally not needed if you were infected with chickenpox as a child.
— Hepatitis A, $63.10. Liver infection caused by contact with contaminated food, water, stool or blood. Two doses from age 19 up, mainly for: injection-drug users, men who have sex with men, patients with chronic liver disease or taking clotting-factor medicines, those traveling to or working in countries where hepatitis A is common.
— Hepatitis B, $53. Liver infection spread mainly by sex with an infected person and sharing of contaminated implements (drug, tattoo or acupuncture needles; toothbrushes, razors, nail clippers). Three doses from age 19 up, mainly for men having sex with men and people with sexually transmitted diseases, multiple sexual partners, kidney or liver disease.
— Hepatitis A and B combination, $90.
— Human papilloma virus, $129-$130. Spread by sexual contact, it can cause vaginal, anal and mouth cancers and genital warts. Three shots needed over six months. Best before initial sexual activity. Gardasil is approved for females and males aged 9-26; Cervarix for females age 10-25.
— Measles/mumps/rubella(German measles), $50. One or two shots from 19 through 49, then a booster, for anyone born after 1956, unless they have lab tests showing immunity from prior infection or vaccination. Second dose is needed after four weeks if exposed to a measles or mumps outbreak. Rubella protection is particularly needed before pregnancy.
— Meningococcal disease, $106. Causes bacterial meningitis and bloodstream infections, which are uncommon but can Kill or disable quickly. Two-dose series recommended mainly for new college students, military recruits, people without a healthy spleen.
— Pneumococcal disease, $44-$49. Causes painful ear and sinus infections, pneumonia, bacterial meningitis and blood stream infections. One dose from age 65 up if immunity isn’t certain, or one or two doses from age 19 through 64, then a booster dose. Mainly for smokers, nursing home residents, people with lung or heart disease, diabetes, HIV and other immune conditions, liver diseases, alcoholism, or damaged or removed spleen.
— Shingles (herpes zoster), $154-$162. One dose from age 60 up to prevent shingles, a painful, blistering skin rash caused by the chicken pox virus.
It’s difficult to quantify how much money one might save by getting vaccines, particularly since they aren’t effective in every patient, but some of these infections can bring very high medical expenses and leave people too sick to work.
For example, treatment for a yearlong outbreak of shingles pain easily exceeds $5,000, and serious complications requiring hospitalization can add another $20,000. Removal of precancerous lesions that might be prevented by the HPV shot can run well over $700, and treatment would cost far more if cancer developed.
The U.S. Centers for Disease Control and Prevention recently called new vaccines one of the top public health achievements of the last decade. It cited record lows in the number of reported cases of hepatitis A, hepatitis B and chicken pox, along with the introduction of multiple-strain pneumococcal vaccines.
CDC schedule with detailed recommendations for who should get vaccines: http://www.cdc.gov/vaccines/recs/schedules/downloads/adult/adult-schedule-bw.pdf
CDC quiz to determine which vaccines you need: http://www2a.cdc.gov/nip/adultImmSched