Melinda Wenner Moyer is out this week. I’m Knvul Sheikh, a reporter at the well desk filling in today.
After a case of polio in an unvaccinated adult was reported in New York in July, health officials struggled to assess how long and how widely the virus had circulated. The news also prompted many Americans – myself included – to try to find their own vaccination history.
Most adults need not worry: they would have been vaccinated against polio in childhood, as the vaccine has been part of immunization campaigns around the world since the 1950s and 1960s. In the United States, it is also part of the mandatory immunization requirements for children to attend public schools. Almost all states have similar requirements for day care centers and private schools as well, although some allow exceptions. Still, periodic outbreaks of other vaccine-preventable diseases — including measles, mumps, whooping cough (aka whooping cough), hepatitis A, and influenza — have resulted in serious illness among children and adults in the United States in recent years. So you would be entitled to try to track down your vaccination history.
“The problem is that immunization coverage can be high at the state or national level but very low at the local level,” said Dan Salmon, director of the Institute for Vaccine Safety at the Johns Hopkins Bloomberg School of Public Health. If you are immunocompromised or have never been vaccinated—or if you have been vaccinated but the vaccine hasn’t worked for you (since no vaccine is 100 percent effective)—you may be susceptible to disease. This is especially true when there are others who are unvaccinated in the same geographic area, attend the same schools, meet at the same restaurants, or attend the same religious centers.
Making sure you’re vaccinated not only protects you but also the people in your community, said Dr. salmon. And keeping track of when you were last vaccinated can be important in knowing when certain future vaccines or booster shots are due.
Even if your medical records are gathering dust in a distant basement, there are things you can do to piece your vaccination history together.
How to find out your vaccination history
Gathering and organizing this information can be tedious. There is no federal database of vaccination records (although there are regional registries – more on that below), so it’s usually up to the individual to keep track of their vaccines and make sure they’re up to date.
If you’re lucky, all your childhood vaccinations will be recorded on a piece of paper: the vaccination card that your parents receive when you are born or when you visit the pediatrician for the first time. Start by asking your parents if they still have these records, or consider searching through baby books or other documents from your childhood.
Another source to check is an old school or college. Your school may have requested and kept immunization records from your parents or healthcare provider. Some employers may also ask for your vaccination records before you can start a new job, said Dr. salmon. However, data retention policies may vary from institution to institution – some locations may only keep records for a year or two after you leave.
If you moved to the United States from another country, you may already have immunization information collected for your visa process. Review paperwork for your medical exam, which usually requires proof of certain vaccinations.
Your current GP may also have your vaccination information if you have carefully transferred old medical records each time you switch providers or if your provider participates in a data sharing system such as Epic Care Everywhere. Record transfers aren’t always perfect, so be prepared for possible gaps in your history.
All 50 states, the District of Columbia, and all U.S. territories now have local or regional immunization registries, and healthcare providers are required to report vaccines for children 18 and younger. Some states may have vaccine information dating back to the 1990s, said Rebecca Coyle, executive director of the American Immunization Registry Association.
Other registers are much newer. For example, the New York State Immunization Information System (NYSIIS) was introduced in 2008. Doctors and pharmacists may choose to enter adult vaccinations received before 2008 if they have this information. Reporting of vaccines recently administered to adults is also recommended, although not required. (The exception is Covid-19 and monkeypox vaccines, which must be reported to NYSIIS)
It may be worth checking to see if your local registry, or one where you grew up, has your vaccination history.
What to do if there are no records of your vaccines
If you can’t find your vaccination records, you can ask your doctor for a blood test for some diseases. The test measures your antibody levels, and if they’re positive (or above a certain known level) then you’re immune to the disease, either through a previous vaccination or infection. Negative test results (meaning no immunity) or ambiguous results (meaning insufficient immunity) indicate that you need to be vaccinated.
For some diseases, it simply makes more sense to catch up on vaccinations. “That’s what I usually advise my patients to do, especially if they’re at high risk for a particular disease,” said Dr. Jack Cappitelli, New Jersey-area chief physician for Summit Health, a network of clinics and emergency centers that includes CityMD. “Even if we re-vaccinate someone who was actually vaccinated 10, 20 years ago, the downside of that is almost negligible.”
What vaccinations do you need to keep up with?
The Centers for Disease Control and Prevention recommends that all adults get a handful of vaccines. You should get seasonal flu shots every year and tetanus shots (or a combined tetanus, diphtheria, and pertussis vaccine) every 10 years. Adults up to age 26 should also get the HPV vaccine, which protects against several types of human papillomavirus, which cause cervical, anal and other cancers, and genital warts. And of course you should have the Covid vaccine and booster shots you are entitled to.
Adults over 50 should also get two doses of the shingles vaccine. And those over 65 should get a pneumococcal conjugate vaccine, or PCV, which protects against the bacteria that causes pneumonia.
A doctor may suggest some vaccines, like the hepatitis B vaccine, which is usually given in childhood when you are unvaccinated and considered part of a high-risk group. Health officials are currently encouraging adults in New York to get vaccinated against polio if they weren’t vaccinated as children.
However, because there are so many factors that can affect which vaccines you should keep on track with, it’s best to consult a doctor about your specific circumstances. Your health, the nature of your work and whether you travel to countries where certain diseases are still prevalent will determine which vaccinations you should receive and when.
The best way to save recordings in future
After you’ve done all the hard work of tracking down your vaccination history, it’s important to save it in a place where it won’t be lost and make sure your doctor can access it.
“The first thing you should do is have your provider put it in their electronic health record system,” Ms Coyle said. This creates a digital record of your vaccinations that can be better tracked in the future. If your provider uses a patient portal or app, you can also see the list of your vaccines there.
The next step is to ask your provider to send your vaccination information to the local or state immunization information system, Ms Coyle said. Make sure every time you receive a new vaccine it is entered into the system.
“The reality is that if you have had a flu vaccine or a Covid vaccine in the past few years, you may already have an entry on a vaccination registry,” Ms Coyle said. “You just have to supplement your information to make it comprehensive.”
When storing paper records at home, it’s a good idea to use a vinyl sleeve or a sealable plastic bag to avoid damaging them. You may want to keep backup copies or take a photo or scan of your vaccination records and keep them with other important documents.
The CDC also has a handy immunization record form, developed in partnership with the Immunization Action Coalition, that you can print out and keep up to date. In the end, you are the best record holder for you and your family.
Reconnecting with a prickly teenager
Research suggests that teens generally like and admire their parents — and want to spend time with them even as they discover ways to become more independent. Teen development experts share some simple strategies for connecting with even the most screen-crazed teens.
Abortion bans complicate things for surrogates
More federal bans are looming after the US Supreme Court’s decision to end the constitutional right to abortion. This makes surrogacy agencies and surrogate mothers — and the people they carry babies for — concerned that they will be forced to go to extreme lengths to access abortion or miscarriage if medically necessary. Agencies are rethinking their approach, and so are surrogates themselves.
The surrogacy industry is gearing up for a post-deer world
The week in the well
Here are more stories not to be missed: