Got your shots yet? Maybe you’re not a fan of needles or vaccines, in which case the State does provide religious and personal conviction exemptions, pursuant to form completion. When it comes to broader public health, though, not having to deal with outbreaks of typhoid, scarlet fever, yellow fever, malaria, smallpox, cholera, diptheria, and polio like the first county ancestors did sure is nice.

Some of that is due to better sanitation practices and modern plumbing. Pest houses, be gone!

In order to avoid the need for a return to such old school defenses against dreaded pathogens like the above, however, vigilance is needed. So what’s the situation on general immunization among adults, anyway? Glad you asked.

Attendance at public school VACCINES

in Wisconsin legally requires a certain vaccination regiment, with many private schools in Pierce County at or above the public school numbers. When it comes to adults, however, it’s not so simple. You can’t exactly require vaccination to participate in civil society—or can you? Scaremongers do abound, and not all YouTube videos are of equal authority. Still, back to the original question, what are adult immunization levels at in Pierce County, for the pre-COVID era disease threats?

As it turns out, the numbers are across the board, some rather good (widespread) in protecting each other from a pathogenic nightmare, and others still quite young and in process, so far as reaching the adult population goes—not just the COVID vaccine. First up, the Tdap shot(s)!

Consisting of one or more doses over time and meant to pack a triple whammy against Tetanus (lockjaw), diptheria (a disease that can cause paralysis and heart failure), and pertussis (whooping cough), the Tdap booster shot is among those required for enrollment in state-funded public schools. Starting out at 52.37 percent in 2014, Pierce County’s adult population saw a steady increase in the percentage with Tdap protection, at 59.72 percent in 2015, then 63.4 percent in 2016, 65.81 percent in 2017, 68.04 percent in 2018, and 66.47 percent in 2019, covering ages 19 through 64 in the Western region of Wisconsin as pertaining to Pierce County. So what of the next, ‘HPV Complete,’—and what is that anyway?

HPV-Complete is administered to young adults through 26 years of age, with HPV, standing for ‘Human Pappiloma Virus,’ for which the CDC recommends that both boys and girls get vaccinated, as it can cause cancer later in life. Although the CDC does say that certain groups should NOT get the HPV vaccine (including those with an allergic reaction to any ingredient or a a previous dose, allergy to yeast, or women who are pregnant), in general terms the vaccine is recommended. So what’s the Pierce County picture for HPVComplete coverage? Starting at 18.56 percent in 2014, the percentage of adults with HPV coverage rose to 19.45 percent in 2015, 23.65 percent in 2016, 27.44 percent in 2017, 30.88 percent in 2018, and 33.77 percent in 2019. So what about the ‘Zoster’ vaccine, and again, just what IS that?

Called “Zostovax” down at fda.gov, the Zoster shot “helps to reduce the risk of getting herpes zoster (shingles) in individuals 50 years of age and older,” the Food and Drug Administration website makes known. As to adverse effects, the FDA website admits they can happen, but lists the most common side effects as being headaches and injection-site reactions. A live vaccine that “should not be given to people with a weakened immune system,” those who also shouldn’t get the shot per the FDA are pregnant women and those with an adverse reaction to any ingredient, while the Zostovax shot should not be administered to people under 50, pending further data from studies. So who does or doesn’t have the Zoster shot?

Beginning in 2014, 28.25 percent of adults in Pierce County were registered as having the complete Zoster shot regimen, while 2015 saw that number increase to 30.24, followed by 32.14 percent in 2016. In 2017, 33.08 percent were covered, while in 2018 and 2019 the numbers were 2.07 and 6.99 percent respectively. Mirrored by other Wisconsin counties, its unlikely to be a typo. So what gives? Scrolling to the bottom of the chart gives the explanation: “The Advisory Committee on Immunization Practices changed their Zoster recommendation at the end of 2017 from one Zostovax dose for individuals 60 years and older to two Shingrix doses for individual 50 years and older regardless of prior Zoster vaccine receipt. Prior to 2018, Zoster complete rate reflect individuals 60 years and older who received one Zostovax vaccine. Beginning in 2018, Zoster Complete represents individuals 50 years and older who have received two Shingrix vaccine doses” (emphasis added).

So that explains it: new and reportedly better (per outside sources) vaccine called ‘Shingrix,’ new cohort group measure, and a return back at zero statistically to retabulate who is or isn’t covered, numbers-wise.

Well at least they clarified as much. Next up, protection and a leg up immunity-wise for severe pneumonia, also known as PCV13 and PPSV23. Once contracted, severe pneumonia can be deadly in older adults. So with all the different immunity strategies, how do PSV13 and PPS V23 work exactly—put another way, are they safe? Why not try a non-government and non-manufacturer (but still reputable) website for a change?

Contained in a paper attributed to Class of 2017 Tufts University School of Medicine graduate Mila Quinn and Wayne Altman, MD and Associate Professor of Family Medicine and posted at tusk.tufts.edu in a short summary is the following Q. and A; in part: “Is PCV13 safe?

Safety of PCV7 and PCV13 have been evaluated in more than 90,000 children with no major safety problems identified. PCV13 was approved by the FDA in 2010 for infants and young children. Ongoing surveillance is conducted with the Vaccine Adverse Event Reporting System.

What is the vaccine made from?

The PCV7 vaccine is made from pieces of the coating of seven types of pneumococcal bacteria in a lab without the infectious components, so it cannot cause infection. The bacteria coating is connected to a harmless protein that alerts the immune system and helps it recognize Strep Pneumoniae. A newer vaccine introduced in 2010 adds six more types of bacteria. This vaccination is safe for people with compromised immune systems.” Clarified not to contain ‘thimerosal preservative” otherwise known as ethyl mercury, the PCV13 vaccine contains “a small amount of aluminum,” Quinn and Altman write, though less than is “found in 500 mL of infant formula.” No “associated negative health outcomes have been identified in the amounts (of aluminum) found in vaccines,” Quinn and Altman make known. With the numbers for PCV13 and PPSV23 vaccine (related to protection against severe pneumonia in older adults) being listed in the table, there’s just one more to cover: HepA UTD, or the Hepatitis A vaccine. Protecting against the Hepatitis A virus as ‘a severe liver disease’ per the CDC, this vaccine is one that is actually recommended to pregnant women, along with a host of others. So what are the numbers for adult protection against Hepatitis A or ‘inflammation (-itis) of the liver (Gr. “hepar”)?’ Beginning in 2019, the percentage of Pierce County adults with the HepA UTD vaccine registered at 11.44 percent, with no prior years to show data for, a pattern across the board. And so we come full circle, back where it all began, pre-vaccine. With the adult population a constantly changing cohort group through death and/or aging out of childhood, the fight to keep immunization levels high and public places open with safety, is a never ending battle.—or so it seems. Talk about frustrating—time to roll up that sleeve.

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