August: National Immunization Awareness Month

Hepatitis A

Hepatitis A is a virus that causes infection and inflammation of the liver. Patients with hepatitis A will typically have fever, aches, nausea, abdominal pain, and jaundice (which means that the skin and the whites of the eyes can turn yellow). Although there is no treatment, the illness generally resolves on its own after several weeks.

Hepatitis A is acquired by ingesting contaminated food or water. Hepatitis A exists in the United States, but is much more common in Third World countries. Any woman who travels to areas of the world where Hepatitis A is common, women who are exposed to Hepatitis A, and women who seek protection from this virus should be vaccinated. The vaccine is given as two doses, the second of which is given six to twelve months after the first. The vaccine is generally well tolerated, but soreness at the injection site and low-grade fever may develop.

Hepatitis B

Hepatitis B is another virus that causes infection and inflammation of the liver.  Patients have similar symptoms as patients with Hepatitis A. However, whereas Hepatitis A almost always resolves spontaneously, some patients with Hepatitis B can develop a chronic or ongoing infection that can cause continued liver damage. Hepatitis B is acquired via sexual contact or exposure to blood or bodily fluids of someone with the disease.

The Hepatitis B vaccine is now generally given to all children in this country and should be given to women who are at risk of Hepatitis B due to potential sexual exposure, blood exposure (eg., health care workers), or women who are seeking protection from Hepatitis B. The vaccine is given as three doses; the second dose is given one month after the first, and the last (third) dose is given six months after the first. The vaccine is generally well tolerated, but local pain and redness, as well as low-grade fever, may occur.

RELATED: Hepatitis C—Causes, Transmission, Treatment, Vaccines


Zoster (also known as “shingles”) is caused by the same virus that causes chickenpox. It occurs when the chickenpox virus reactivates, or “wakes up,” after spending years in a dormant or quiet state. Shingles causes a rash that can occur anywhere on the body, but this rash affects only one side of the body (left or right). Because both skin and nerves are infected, patients experience some pain, which can be quite severe. Unfortunately, pain can persist even after the rash of shingles has resolved.  Shingles is more common in older individuals.  Indeed, the varicella vaccine was originally approved for patients 60 years of age or older who had had chickenpox, but the vaccine can now be given to patients who are 50 years of age or older who had had chickenpox. The vaccine cuts the risk of getting shingles by about half, but lowers the risk of the pain that can follow an infection by about two-thirds.

The vaccine is administered as a one-time dose, but, since it is a live vaccine, it cannot be given to patients with a weakened immune system (such as patients with cancer or patients who take drugs that weaken the immune system). Redness, pain, tenderness, and warmth at the site of injection are common, but more severe reactions can occur. [For Dr. Kendler’s more extensive, article on the shingles vaccine, see “Should I Get the Shingles Vaccine?” ]

Pneumococcal Vaccine

Streptococcus pneumoniae is the name of a bacterium that is the most common cause of bacterial pneumonia, a lung infection. Patients with pneumonia may complain of fever, cough, chest pain, or shortness of breath. The same bacterium can also cause other infections, including sinus infections, ear infections, and meningitis. All women who are 65 years of age or older should receive a single dose of the pneumococcal vaccine. Women with other medical conditions, including diabetes, lung disease, and heart disease should receive the vaccine prior to age 65.

The vaccine commonly causes pain, redness, and swelling at the site, but other side effects, including fever, may occur.

These are the basics about vaccinations that all adults should understand in order to have an informed conversation with a primary health care provider.

My hope is that you are now better informed and can have a educated discussion with your doctor about vaccination for influenza, diphtheria/tetanus/pertussis, varicella, viral hepatitis, shingles, and pneumonia.  Although side effects are always a concern, please realize that most of these vaccines are very well tolerated and the benefit outweighs the small risk involved. Remember that prevention is better than cure! Stay healthy.


Join the conversation

This site uses Akismet to reduce spam. Learn how your comment data is processed.

  • Andrea August 9, 2016 at 8:56 am

    Thanks Dr Kendler for a very informative article. It’s also important to have anyone who works/lives in your home ( nannies housekeepers) given the influenza vaccine as well.