1. Adults Need Vaccines, Too! Why We Need to Set the Standard to Educate Ourselves About & Encourage Vaccination in Our Communities

2. What Do Vaccines Do? Protect you from diseases, many of them infectious Protect anyone you come in contact with who cannot be vaccinated – Very young infants – People with medical conditions When vaccines work in our communities, what happens? – Do we appreciate prevention? 2

3. ACTRESS ANGELINA JOLIE - CHICKENPOX NATIONAL HOCKEY LEAGUE - MUMPS DISNEYLAND- MEASLES Vaccine Preventable Diseases In The News: A Reminder That Diseases Can Strike If We Don’t Vaccinate 3

4. Adults Need Vaccines…Really? Healthy adults largely unaware they should be seeking vaccination Think vaccines are for kids, old people, or those with poor health Haven’t heard about other vaccine-preventable diseases (whooping cough, shingles, HPV, etc.) that affect adults Not getting recommendations for vaccination from their healthcare professionals Adult vaccination services beyond influenza/pneumococcal may not be offered by all healthcare providers The role of pharmacies in adult vaccination expanding (beyond flu) Vaccinations are increasingly offered at work sites and for travel abroad Sources: 1) Vaccines and Adults: Al Lifetime of Health; Vaccine Education Center, CHOP & AMA, Fall 2013. 2) Adult Vaccination Saves Lives; NFID, March 2012. 4

5. Yes, Adults Need Vaccines Adults do need vaccines to protect against a number of common and serious diseases Protection from some childhood vaccines may not last There may be other diseases that adults are at risk for due to age, occupation, lifestyle, heath conditions, or travel IT IS IN OUR BEST INTEREST – AS ADULTS – TO TAKE CHARGE OF OUR OWN PREVENTIVE HEALTH CARE BY LEARNING ABOUT RECOMMENDED VACCINES, SEEKING THEM OUT & ENCOURAGING OTHERS TO GET IMMUNIZED! 5

6. Adult Vaccine Personal Stories Provide your own personal story or example of a person with a vaccine preventable illness or who benefited from vaccination. [Personal stories are important to put a face on why vaccines are important. You can insert your own example here or see other examples in the appendix at the end of this slide set.] 6

7. Adult Vaccines Flu (Influenza) Td/Tdap (Tetanus, Diphtheria, Pertussis) Shingles (Zoster) Pneumococcal Meningococcal MMR (Measles, Mumps, Rubella) HPV (Human Papillomavirus) Chickenpox (Varicella) Hepatitis A Hepatitis B 7

8. All adults need: – Influenza (flu) vaccine every year – Td or Tdap vaccine: Every adult should get the Tdap vaccine once, a Td (tetanus, diphtheria) booster shot every 10 years, and women should get the Tdap vaccine each time they are pregnant – Zoster vaccine at age 60 – One or two pneumococcal vaccines at age 65 Other vaccines you may need as an adult are determined by factors such as: – Health conditions (e.g., diabetes, heart disease) – Job (e.g., if you are a healthcare worker) – International travel – Vaccines you have received or maybe did not get as a child Adult Vaccines 8

9. 1.Disease knows no age: Vaccines are recommended for adults starting at 19 years old Young and healthy people can get sick, too 2.Many adults may no longer be protected by vaccines received in childhood or weren’t fully immunized as a child Booster doses for some vaccines (e.g., whooping cough) are recommended to remain protected Why Adults Need Vaccines, Too Source: Adapted from National Foundation for Infectious Diseases (NFID)’s 10 Reasons To be Vaccinated (http://www.adultvaccination.org/10-reasons-to-be-vaccinated)http://www.adultvaccination.org/10-reasons-to-be-vaccinated 9

10. 3.Getting immunized protects not just you, but other vulnerable people in your community, such as: Babies too young to get vaccinated Older grandparents/family members Co-workers who can spread germs to others 4.Some “newer” vaccines are just for adults and teens Shingles (a.k.a. “zoster”) is a good example of a painful disease with possible life-long after-affects one can avoid by getting vaccinated Human Papillomavirus (HPV) vaccine (depending on type) can prevent cervical cancer in young women and genital warts/anal cancer in both sexes Why Adults Need Vaccines, Too 10

11. 5.Adults are, in general, too busy to spend time being sick (responsibilities, activities, travel, etc.) 6.Many adults with health conditions are highly vulnerable to vaccine-preventable diseases (VPDs) Pregnant women Those with asthma, heart/lung disease or diabetes Those with HIV/weakened immune system or liver disease Why Adults Need Vaccines, Too Source: Adapted from National Foundation for Infectious Diseases (NFID)’s 10 Reasons To be Vaccinated (http://www.adultvaccination.org/10-reasons-to-be-vaccinated)http://www.adultvaccination.org/10-reasons-to-be-vaccinated 11

12. 7.We are living longer than ever before: 1 in 5 Americans will be 65 years of age by 2030 As we age, our immune systems weaken, making us even more vulnerable to infection Older adults are at higher risk for contracting and developing serious complications due to influenza, invasive pneumococcal disease, and shingles 8.Vaccine-preventable diseases are expensive Being sick with the flu can last up to 15 days and cause adults to miss an average of six work days Adults who get hepatitis A lose an average of one month of work Why Adults Need Vaccines, Too Source: Adapted from National Foundation for Infectious Diseases (NFID)’s 10 Reasons To be Vaccinated (http://www.adultvaccination.org/10-reasons-to-be-vaccinated)http://www.adultvaccination.org/10-reasons-to-be-vaccinated 12

13. 9. Vaccines are recommended by the nation’s top doctors Vaccines are safe, but vaccine preventable diseases kill tens of thousands US adults each year Most adult vaccines are covered by private insurance and those 65 years of age or older are eligible for Medicaid. Adults without health insurance can visit www.HealthCare.gov or contact their local health department for information about vaccine coveragewww.HealthCare.gov 10. Like diet and exercise, vaccines are an important part of staying healthy Vaccines play a vital role in helping the immune system and keeping adults healthy, just like eating wholesome foods and exercising regularly Why Adults Need Vaccines, Too Source: Adapted from National Foundation for Infectious Diseases (NFID)’s 10 Reasons To be Vaccinated (http://www.adultvaccination.org/10-reasons-to-be-vaccinated)http://www.adultvaccination.org/10-reasons-to-be-vaccinated 13

14. 1.CDC. Estimates of deaths associated with seasonal influenza – United States, 1976-2007. MMWR. 2010;59(33):1057-1062. 2.CDC. Notifiable Diseases and Mortality Tables. MMWR 2015. 63(53): ND-733 – ND-746. 3.CDC. Active Bacterial Core Surveillance. http://www.cdc.gov/abcs/reports- findings/survreports/spneu10.pdf. Some Sobering Facts… From 3,000 - 49,000 deaths & more then 200,000 hospitalizations per year 1 >28,000 cases per year in 2013 and 2014 Infants exposed to infected adults are at greatest risk of death Nearly 40,000 cases of invasive pneumococcal disease resulting in 4,000 deaths in 2010 3 14

15. More Sobering Facts… Every year, 1 million people experience this painful condition 1 The rate of Shingles disease increases with age; many people can develop a painful after-shingles condition called postherpetic neuralgia, or “PHN”, where pain can last for months. Caused by a virus that attacks the liver, causing lifelong infection, cirrhosis (scarring) of the liver, liver cancer, liver failure, and death 2 There are about 35,000 cases, 90% among adults 1.CDC. Viral Hepatitis Surveillance United States, 2010. National Center for HIV/AIDS, Viral Hepatitis, STD& TB Prevention/Division of Viral Hepatitis. 2.CDC. Prevention of Herpes Zoster. MMWR 2008. 57(RR-5): 1-30. 15

16. Adult vaccine rates in diverse racial and ethnic communities continue to be lower, for example – Tetanus, Diphtheria, Pertussis (Tdap) for adults 19 or older African American: 12.6%; Hispanic/Latino: 10.2%; Asians: 15.5%; Whites: 19.7% – Shingles (Herpes Zoster) for adults 60 or older African Americans: 10.7%; Hispanic/Latino: 9.5%; Whites: 27.4% – Human Papillomavirus (HPV) for women 19 – 26 years African Americans: 30.6%; Hispanic/Latino: 30.3%; Asians: 19.8%; Whites: 41.7% More Sobering Facts… Source: Vaccine Coverage Rates Among Adults: MMWR: 2015, Vol. 64/No. 4, pp. 95-102 16

17. What Are Immunization Standards? Immunization standards were developed to guide healthcare providers in improving vaccination rates Vaccines are recommended by nation’s top medical experts – Standards are based on extensive review of disease patterns, who is at risk, how vaccines work and for how long, etc. Standards outline the healthcare provider’s role in counseling patients on recommended vaccines – If your healthcare provider isn’t talking to you about vaccines, then ask them! Bottom line: It is very important to get vaccines as recommended to get the maximum benefit! 17

18. What can we - as a community - do to encourage adults to get immunized? Create an environment that encourages other adults to: – Set an example for others by educating themselves about recommended vaccines – Ask healthcare providers or pharmacists about what vaccines are needed Be persistent in seeking vaccination as not all healthcare providers offer vaccination – Remind family, loved ones, and co-workers about the importance of being up-to-date on vaccines that adults need Setting Our Own “Standards” 18

19. If At First You Don’t Succeed While primary providers may or may not offer immunizations, as adults, we should set the standard for ourselves and our communities! What can we do? – Take the CDC Quiz, use it to ask your HCP about getting vaccinated: http://www2a.cdc.gov/nip/adultimmsched/ – If your regular HCP does not offer vaccination, ask him/her for a referral – Or, speak to your local pharmacist or health department 19

20. Physicians’ offices Pharmacies Clinics/Other Workplace (if offered) Public Health Department(s) Health Map: http://vaccine.healthmap.orghttp://vaccine.healthmap.org Where Can Adults Get Recommended Vaccines? 20

21. The following sample list of websites are a good place to start: Centers for Disease Control and Prevention (CDC) http://www.cdc.gov/vaccines/adults/index.html http://www.cdc.gov/vaccines/adults/find-pay-vaccines.html#pay-vaccines http://www2a.cdc.gov/nip/adultimmsched/ American College of Obstetricians & Gynecologists (ACOG) http://www.immunizationforwomen.org/ Immunization Action Coalition (IAC)/Vaccine Information You Need http://www.immunize.org/ www.vaccineinformation.org National Foundation for Infectious Diseases (NFID) http://www.adultvaccination.org/ Getting More Information… 21

22. Appendix Extra slides – may be useful for some audiences 22

23. PERSONAL STORIES OF VACCINE PREVENTABLE DISEASES – DO YOU HAVE ONE? 23

24. Meet Christian Olson: Instructional Designer & Father of Four “What the Pneumonia Vaccine Gave Me” Feels “lucky to be alive” – was extremely vulnerable to pneumonia – Suffered through pneumonia multiple times as a child due to underdeveloped lungs resulting from premature birth Physician recommended pneumococcal vaccine to prevent the onset of pneumonia Thanks to vaccination, only developed pneumonia 3-4 times instead of 30+ times over the last 15 years For Christian’s full story, visit: http://www.voicesforvaccines.org/what-the-pneumonia-vaccine-gave-me/ http://www.voicesforvaccines.org/what-the-pneumonia-vaccine-gave-me/ “I’ve heard people say the pneumococcal vaccine is unnecessary, even wasteful. I can only shake my head. There’s nothing wasteful or unnecessary about giving a child—or anyone else—a chance to live a happy, healthy life.” 24

25. Meet Linda Ohri: Associate Professor, Pharmacy “Practicing What You Preach” Linda has a close friend who is 86 years young, and a dynamic testament on how to grow older gracefully Unfortunately, Linda discovered she wasn’t practicing what she preached in her personal relationships When Linda’s 86-year friend developed pneumococcal pneumonia, she realized she hadn’t asked her about getting immunized! See more at: http://www.nfid.org/real-stories-real- people/linda-pneumococcal.html#sthash.fqmJhIIQ.dpuf “When my friend developed pneumonia, I realized I had never talked to her about the benefits and safety of the pneumococcal polysaccharide vaccine (PPV23)! “ 25

26. Meet Joan: Special Education Teacher “The Pain of Shingles” Joan developed severe pain in her back and the doctors could not initially figure out what was wrong then the rash started several days later. She had contracted shingles, but not the traditional rash that is common to many at disease onset. – In some cases, rash happens after the pain The pain was so severe it kept her awake at night. Joan says that she would have sought vaccination if she had known it was recommended. For Joan’s full story, visit: http://www.nfid.org/real-stories-real-people/joan-shingles.html “If I had known that a vaccine is recommended for everyone my age, I would have gotten it. Believe me, if you could understand the pain of shingles, you’d get the vaccine, too.” 26

27. Jacob Ryan Schmidt: A competitive martial arts expert “A Son’s Life Cut Short by Influenza” Jacob was strong as a bull and enjoying life. In 2010, at the age of 27, he succumbed to complications from H1N1 influenza. His lungs collapsed; he developed an infection. His organs were shutting down. After about five weeks of influenza ravaging his body, Jacob died. For Jacob’s full story, visit: http://www.nfid.org/real-stories-real-people/jacob-influenza.html#sthash.qbrBJ6AE.dpuf “Jacob was not someone you’d expect to fall ill to influenza. He was healthy and athletic, and built like a freight train.” 27

28. Meet Dr. William Cochran: A Pediatric Gastroenterologist “A Doctor’s Personal Experience with Whooping Cough” Dr. Cochrane came down with a severe cough where he could not catch his breath and would even pass out. He coughed so long and hard that he cracked several ribs. He learned that he had pertussis or “whooping cough” It took him three months to recover. For Dr. Cochrane’s full story, visit: http://www.nfid.org/real-stories-real-people/cochran-pertussis.html “Anyone – doctor, parent, grandparent, caregiver, who comes into contact with infants should be sure they are up to date on their immunizations to spare those too young to be protected through vaccination.” 28