Giving it my best shot

Dear Lucy: I’m old (over 45). Should I get revaccinated with the MMR vaccine? Will MIT Medical give it to me, or do I have to wait until I’m 50 for the shingles vaccine? —Aging Gen-Xer 

Dear Gen-Xer: Before we get to your vaccine-related questions, Lucy would like to clarify one thing: You are not old. Not even close. Lucy even has data to support this assertion. Based on a 2009 Pew Research Center survey of nearly 3,000 adults, the answer is clear: Old age begins at 68. Of course, the age of the respondent had a lot to do with how they answered this survey question. On average, adults younger than 30 think old age begins at 60, while respondents older than 65 think it begins at 74. But, markedly, just 35 percent of survey respondents 75 or older said they actually feel old. So, Gen-Xer, Lucy sincerely hopes you’re not feeling old at your age, for that would be a problem no vaccine can address.

But let’s get back to your questions about vaccines, which Lucy will be answering with help from Primary Care Provider and Nurse Practitioner Vini Anand. 

First of all, Anand notes that you’re asking about two different vaccines. First is the MMR vaccine, which confers protection from three highly communicable, viral diseases — mumps, measles, and rubella. Second is the shingles vaccine, which prevents the painful, blistering rash known as “shingles” or “herpes zoster,” which occurs when the varicella zoster virus is reactivated in an older adult who had chickenpox as a child.

Anand explains that documentation of two doses of live measles vaccine is a requirement for college students, healthcare personnel, international travelers, and people who are immigrating to the US. In addition, the CDC (Centers for Disease Control and Prevention) recommends at least one dose of live attenuated measles vaccine booster for adults born after 1957 and vaccinated prior to 1968 with either an inactivated (killed) measles vaccine, which we now know was ineffective, or with a measles vaccine of unknown type. “Individuals born before 1957 are presumed to be immune by virtue of having lived through prior measles epidemics,” Anand clarifies, “though healthcare workers born before 1957 would need to be vaccinated if a lab test does not show immunity.” On the other hand, individuals vaccinated after 1968 would have received live vaccine and all necessary boosters. “If you’re between the ages of 45 and 50, you would have been born in 1970 or later,” Anand notes, “so, you are not old, and you do not need an MMR vaccine.” 

Anand tells Lucy that the “Shingrix” vaccine is available at MIT Medical to patients older than 50. “This is the newer of two vaccines for shingles and requires two doses spaced between two and six months apart,” Anand explains. “Shingrix is preferred over the older ‘Zostavax’ vaccine, which was less than 70 percent effective initially and became even less effective over time. Because its effectiveness declined so quickly, Zostavax wasn’t offered to patients under 60. But the new vaccine maintains its effectiveness, so we’re recommending it patients once they turn 50.” 

While high demand for the new vaccine has led to nationwide shortages, as of this writing (December 2019), Nurse Practice Manager Aimee Chevalier tells Lucy that MIT Medical is well stocked and making shots available to any patient who is old enough to get one. Eligible patients can call our Adult Primary Care Service at 617-258-9355 to make an appointment with a nurse to get the shot. Of course, you’ll have to wait a bit longer, since, alas, you are still too young. —Lucy 

Back to Ask Lucy Information contained in Ask Lucy is intended solely for general educational purposes and is not intended as professional medical advice related to individual situations. Always obtain the advice of a qualified healthcare professional if you need medical diagnosis, advice, or treatment. Never disregard medical advice you have received, nor delay getting such advice, because of something you read in this column.