introduction

Vaccinations are now part of the medical routine and have led to diseases in the western world, such as smallpox, poliomyelitis or mumps, being known only from stories or books, but hardly ever occurring.

In general, a primary vaccination should be completed as a child.
However, some vaccines such as tetanus or diphtheria require a booster every 10 years.
Other vaccines, such as the flu vaccine, are only recommended at a certain age and are therefore part of the adult vaccination plan.

If no vaccination against meningitis has taken place in childhood, this can be made up in adulthood.

Which vaccinations should an adult have?

There are some standard vaccinations in Germany that you should have got as a grownup regardless of lifestyle (travel, possibly medical profession, etc.).
These include vaccinations against tetanus, diphtheria, whooping cough, poliomyelitis (after vaccination in childhood usually lifelong immunity, in the absence of vaccination in childhood, the poliomyelitis virus is also infectious and dangerous for adults), measles, mumps (if you are born after 1970 ) and rubella.

  • Vaccination against diphtheria
  • Vaccine against polio
  • Vaccination against whooping cough
  • Vaccination against measles

In addition to these vaccinations, there are a variety of other vaccines that are recommended only for people at special risk.
These include cholera, yellow fever, meningococci and Japanese encephalitis when traveling to the appropriate areas of infection (more information on which pathogens can be found in which countries can be found on the Foreign Office page).

Due to the often fatal course of disease people over 60 years should be vaccinated against influenza and pneumococci.
People living in the southern half of Germany or in TBE risk areas should be vaccinated against tick-borne tick-borne encephalitis ( TBE ).
Girls from 9 to 12 years or adult HPV-negative women should also be vaccinated against human papillomavirus ( HPV ), which can cause cervical cancer.

  • Inoculation against meningitis
  • flu shot
  • Vaccination against pneumonia
  • Vaccination against cervical cancer

What are the common side effects after vaccination in adults?

Just like all other medicines, vaccines have side effects in addition to the desired effect.
The individual vaccination decision should be made by weighing the risks of the disease with those after the vaccination. This is also the procedure used by the Standing Vaccination Commission (STIKO) in choosing their vaccination recommendations.
The frequency of side effects is differentiated between very common (10%), common (1-9%), occasional (0.1-0.9%), rare (0.01-0.09%) and very rare ( less than 0.01%).
Basically, one differentiates between two types of vaccines. The live vaccines such as against measles, mumps, rubella or yellow fever, which arise from modified pathogens, often trigger greatly attenuated symptoms of the disease and also generally lead to a stronger immune response of the body.
The advantage with live vaccines is that hardly any excipients need to be used to enhance the vaccination reaction.
In addition, live vaccines need less or no refreshments.

This contrasts with the dead vaccines such as rabies, meningococci or poliomyelitis in which only virus particles are administered.
Dead vaccines often cause fewer side effects and a weaker vaccine response, but they often need to be administered repeatedly according to a specific scheme and do not guarantee lifelong immunity.

The usual degree of side effects from the Paul Ehrlich Institute include redness, local swelling, or pain at the injection site.
These symptoms are common and usually should regress after a few days.
In addition, it can often lead to fever below 39.5 ° C, feeling unwell, nausea and headache.
Rarely there are joint problems or seizures, very rarely neuropathies.

The common symptoms are not classified as dangerous and are rather evidence of vaccine-activated immune defense.

How long do the side effects after vaccination last?

How long the side effects of vaccination take depends on many factors. Among other things, this depends on the vaccine. For example, flu vaccines have a slightly longer duration of side effects than a TBE vaccine. Furthermore, the duration also depends strongly on the immune system of the vaccinated person. Some side effects also last longer than others. For example, the typical muscle aches after vaccination are longer lasting than mild fever.
So it can be said that, depending on the vaccine, the side effects can last anywhere from a few hours to five days. If the side effects have not disappeared after five days, a consultation with a doctor is recommended.

When can I do sports again after a vaccination?

Against a slight physical stress after the vaccination, for example, a walk or light house and garden work, is usually not objectionable. However, strenuous activities should wait at least until the next day, because sport can increase temporary vaccination reactions such as redness, swelling and pain.
If in doubt, wait until they have disappeared. Even before surgery, no vaccination should be done. Depending on the type of vaccine, there should be two weeks between vaccination and surgery

Pain after a vaccination

In vaccinations, especially dead vaccines, adjuvants, so-called adjuvants (lat. Adiuvare = help) are added to the virus particles, which are contained in the sprayed solution and support by the stimulation of local immune cells, the effectiveness of the vaccine.
An example would be aluminum, which is added at a dose of 0.125-0.82 milligrams to the dead vaccines.
By comparison, most European untreated foods contain less than 5 milligrams of aluminum per kilogram of food, according to a 2008 opinion from the European Food Safety Authority. For non-European products such as fish from Asia or other European products such as baked goods, various types of tea and vegetables or spices, the aluminum content may well exceed 5 milligrams per kilogram of food.
The risk-free intake of aluminum per day classified by the Food Safety Authority is about one milligram per kilogram of body weight.
However, these adjuvants often cause the classic local pain at the site of injection or on the injected arm.
This is done by stimulating local immune cells such as the Langerhans cells located in the skin, which in turn release inflammatory substances called cytokines. Among other things, these cytokines cause an increase in temperature and swelling at the injection site.

The intensity of the side effects is individual and varies from vaccine to vaccine.
For example, the polio vaccine is significantly better tolerated than the tetanus vaccine.

In most people, the side effects sound after 1-3 days, if after a long time no improvement can be seen, it is advisable to visit his family doctor.

Fever after vaccination

In contrast to the pain and swelling, fever is triggered after vaccinations by the vaccine itself.
This increase in temperature represents a physiological, ie natural reaction of the body to the pathogen particles, the so-called antigens (antibody-generating (pathological cell constituents)).

These antigens must be taken up by local immune cells, the so-called dendritic cells, and after migration into the lymph nodes there be presented to the locally resident lymphocytes.

After so-called antigen presentation, activated B lymphocytes develop into B memory cells. These memory cells can form specific antibodies directed against the vaccinated antigen as soon as the body comes into contact with the pathogen.
This ensures immunity.

In order to facilitate the immigration into the lymph nodes of the dendritic cells, inflammatory factors are formed which can increase the body core temperature.

If the fever does not go down after a few days or reaches temperatures above 39 ° C, a doctor should be consulted.

List of different vaccinations

Tetanus vaccination

The tetanus vaccination is done with a dead vaccine, so that the body itself does not have to form antibodies, but gets them injected directly.
As a result, antibodies against the tetanus toxin can be administered without major side effects during vaccination. However, this leads to the degradation of the antibodies after some time, so that a regular refresh of the vaccine protection at intervals of 10 years is necessary.
Tetanus leads to the clinical picture of tetanus and can be fatal.
The toxin-forming bacteria are in the soil and can get into the wound and the body through minor injuries and contact with soil. For this reason, this vaccination is absolutely necessary and must be renewed regularly.

Diphtheria immunization

Like the tetanus vaccine, the vaccine against diphtheria is a dead vaccine, which means that the body itself does not have to form antibodies.
So the Diphtherie vaccination is again every 10 years necessary.
Diphtheria is a very dangerous disease caused by Corynebacterium diphtheriae. It is transmitted by droplet infection from person to person and usually affects first the throat and throat area. In addition to sore throats, redness and deposits, the lymph nodes and the entire pharynx can swell massively, so that suffocation attacks can occur.
In addition, other organs such as kidneys, heart or liver may be affected. It can cause circulatory failure, myocarditis and severe kidney damage.
Even though the disease is very rare in Germany, contagion from constant travel can occur at any time. Because the treatment of diphtheria is very difficult, every adult should be re-vaccinated every 10 years. The diphtheria vaccine can be given together with the tetanus vaccine as a combination vaccine, so that only one injection is necessary.

Influenza vaccine (influenza)

The virus flu is a worldwide disease that leads to a new flu epidemic every autumn.
Since the flu virus changes slightly from year to year due to mutations, the vaccine from the previous year does not protect against a disease caused by the current virus!
For this reason, the vaccine is redeveloped and administered every autumn.
The flu itself is a very serious illness, especially of the upper respiratory tract, which is transmitted by droplet infection, which is accompanied by a high fever, a bad general condition, coughing, severe body aches and a massive malaise.
It can not be compared to a cold or a flu infection. Although healthy and immune-dense people may be severely weakened and ill for some time due to the flu, there are seldom major complications.
Complications include bacterial superinfections, cardiovascular failure or myocarditis.
Particularly at risk are older people and people with risk factors, such as a chronic disease (eg diabetics, asthmatics, heart disease). But pregnant women, or people with immunocompromised cancer are at high risk.
For this reason, the annual vaccination is recommended to all persons over the age of 60 years and to all chronically ill patients.
Pregnant women and people working in close contact with patients, such as nurses, doctors, etc. should also be vaccinated on a regular basis.

Pneumococcal vaccine

Pneumococci are bacteria that are transmitted from person to person during coughing or by handshake via droplet infection.
They are the cause of severe pneumonia, sepsis or meningitis.
In immunocompetent individuals, the bacteria usually cause only minor infections or no disease.
Infants and children, as well as the elderly or the chronically ill, however, can not properly ward off the bacteria, which then lead to the most serious infections, some of which are fatal if the treatment is not done fast enough.
For this reason, the pneumococcal vaccine has been included in the vaccination standard in children a few years ago. Today, children are no longer vaccinated with the 6-fold vaccine against polio, hepatitis B, tetanus, diphtheria, whooping cough and Haemophilus influenzae, but also receive the pneumococcal vaccine.
However, this was only introduced a few years ago, so that almost all adults today have not received this vaccine. For this reason, the vaccination is recommended once from the age of 60, as well as all endangered or non-immunocompetent persons.

  • Vaccination against pneumonia
  • Pneumonia in old age

Whooping cough vaccination

Whooping cough is caused by the causative agent Bordetella pertussis and is accompanied by flu-like symptoms and agonizing coughing attacks that can last for weeks.
Whooping cough occurs worldwide and can take a heavy course especially in infants and the elderly as well as immunocompromised, which requires inpatient treatment and some ventilation.
Although most children are vaccinated by the primary immunization, however, there are many adults who have not received this vaccine as a child. Since the whooping cough is transmitted by droplet infection, and is often not recognized in lighter gradients, those affected are not treated and can then infect immunodeficiencies or infants. The danger is particularly high, because the people are contagious for up to 5 weeks, without even necessarily show symptoms. For this reason, whooping cough vaccination is recommended as a one-time vaccination for adults if they have not yet received immunization.

Poliomyelitis vaccination

Polio is transmitted by polioviruses, which attack the nervous system.
In over 95% of cases, the disease is overcome without consequential damage. In about 4%, however, polio is in a chronic paralysis stage and attacks the nerve cells.
In most cases, the leg muscles are affected. Rarer but also arm, chest or eye muscles.
In every 200th case, these paralysis symptoms are irreversible; some patients have to be ventilated all their lives because the respiratory muscles are affected by the virus.
The disease is transmitted by smear infection and affects not only children, but in many cases adults. Although most countries are now polio-free, there are isolated cases of polio outbreaks that lead to further spread if people are not vaccinated.
As recent statistics show that especially adults today are not sufficiently vaccinated, the vaccine is recommended to anyone who has not been vaccinated. It consists of a primary vaccination in childhood and a booster dose in adulthood. Since the vaccine is the only possible therapy or prophylaxis, each adult should receive the booster.

TBE vaccination

The tick-borne encephalitis, or TBE, is transmitted by ticks, which are only found in certain regions of Germany and, as the name implies, may be accompanied by inflammation of the brain ( encephalitis ) and the meninges ( meningitis ).

The highest density of FSME risk areas can be found in the southern half of Germany.
For example, people living in a high-risk area should always consider vaccination against FMSE.
A more urgent recommendation for vaccination is directed at people who have much contact with grasses or meadows, such as hikers, forest joggers or people with dogs.
It usually takes 3 injections to ensure a 99% immunization, which then lasts for 3 years.
The disease is severe in adults in 50% of the cases, which means that it comes to encephalitis and not only to meningitis ( meningitis ).
In children, on the other hand, only 25% of cases take a serious course.
Because of this, the risk of neurological sequelae is increased in adults.

  • Inoculation against meningitis
  • Meningitis
  • TBE

Chickenpox vaccine

Since most children in Germany come into contact with or are vaccinated with the chickenpox, the varicella-zoster virus, only about 5 out of 100 adults are not immune to chickenpox.

This is a good thing, especially in adults, the disease is often not as mild as in children. So they get a stronger rash and complain a stronger feeling of illness.

In addition, the risk of chickenpox-induced pneumonia, known as varicella pneumonia, is increased in adults.

These pneumonia occur in one out of 400 adults and are almost always life threatening. Even with hospitalization and treatment, artificial respiration can not be avoided.

In addition, the risk of involvement of the central nervous system in adults is increased. Another particularly endangered group are unimmune women, who come into contact with the varicella-zoster virus during pregnancy and have an even higher risk of pneumonia.

Hepatitis vaccination

Basically, there are different subtypes of hepatitis. There are hepatitis A, B, C, D, E and F. Can be vaccinated against hepatitis A and B.

The hepatitis A vaccine is recommended only for certain risk groups.
For example, people receiving medical care (hospitals, psychiatry, etc.), as well as people with frequently changing sexual partners and people who depend on regular blood transfusions (such as people with hemophilia ), should have their vaccinations. In addition, the recommendation also applies to personnel in food preparation, wastewater treatment and travelers in infection risk areas such as Africa or Asia.

Since the hepatitis B vaccine is included in the standard vaccine schedule of every infant, the number of adults without hepatitis B vaccine is steadily decreasing.
For adults who have not yet received immunization, similar recommendations apply as for the hepatitis A vaccine.
Here, too, only adults with an increased risk of infection, such as dialysis patients, high-risk staff or patients with contact with hepatitis B sufferers should be vaccinated.

  • Vaccination against hepatitis A
  • Vaccination against hepatitis B

Summary

Basically all adults are advised to have the tetanus and diphtheria vaccine refreshed every 10 years.
If adequate vaccination against whooping cough or polio is missing, it is possible to administer these vaccinations as a 3-fold or 4-fold combination vaccine.
In addition, all adults born after 1970 are recommended to use measles vaccine if there is insufficient or assured protection.
Furthermore, the STIKO recommends the annual influenza vaccine and the one-off pneumococcal vaccine for all persons over the age of 60, as well as those chronically ill or those working with sick people.


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