The sight of a sharp needle causes some children to burst into tears and others to make a run for the exam room door.

Adults harbor similar phobias of needles, according to David Ensz, a family practice physician at the South Sioux City Mercy Medical Clinic. Their fear of getting stuck by a 22-25 gauge needle is so great that some adults avoid vaccination altogether, putting them at risk for developing a host of illnesses.

Over the past 2-3 years, immunization schedules for adults have changed. That's why Ensz said it's important that they touch base with their doctor.

"They're all injections," he said of the common immunizations adults need. "You can't sweet talk your physician into taking a pill."

Another reason adults fail to keep up-to-date on their immunizations, Ensz said, is because they don't know that they need any. When patients visit their local clinic for a reason other than a physical, he said physicians won't always remember to check their records to see if they're due for a booster injection.

"It's always good for that patient to inquire about it and ask the physician if it's not brought up at the visit," Ensz said. "If I'm seeing somebody for high blood pressure and working with their medicine, sometimes I'm not thinking about when their last tetanus shot was."

Beyond the annual flu shot, Ensz said, adults should consider the following immunizations:

The pneumococcal vaccine to prevent blood, brain and lung infections due to the Streptococcus pneumoniae bacteria was previously only recommended for those 65 and older. Now, Ensz said, patients suffering from diabetes or emphysema and those who smoke should receive it much earlier.

A vaccine to prevent against shingles, a painful skin rash with blisters, is recommended for adults 60 and older. Shingles is caused by the Varicella Zoster virus, the same virus that causes chickenpox.

Adults, Ensz said, may need a tetanus, diphtheria and pertussis (Tdap) booster if they haven't had one recently. Receiving the booster, he said, is especially important if you care for or work around children. In addition to protecting against lockjaw, a bacterial disease that affects the nervous system, the vaccine also prevents pertussis, or whooping cough, a highly contagious bacterial infection that causes severe coughing spells that can last for months.

"Whooping cough has kind of been on the rise. The whooping cough vaccine is within the tetanus vaccine and there's a new formulation of whooping cough vaccine in that tetanus vaccine," Ensz explained.

Both women and men ages 26 and younger, Ensz said, should also consider getting vaccinated against HPV-related diseases. Certain types of human papillomavirus, a common sexually transmitted virus, are associated with cervical and throat cancers, as well as genital warts. HPV vaccines are given as a series of three shots over 6 months.

"As long as you're under the age of 26 and you haven't had it, it's worth getting," he said.

Those traveling to foreign countries, especially Sub-Saharan Africa, Ensz said, will want to be vaccinated against yellow fever, a mosquito-borne illness that causes flu-like symptoms that can lead to organ failure and eventually death.

Expect to feel a little soreness at the injection site with any immunization. Other side effects, such as a low-grade fever, Ensz said are uncommon in adults. Some clinics, he said will have cream available that numbs the skin.

"Depending on the depth of the injection, it may become more sore," he said. "If somebody's very thin, they might have more pain."

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