Melinda Wenner Moyer is out this week. I’m Knvul Sheikh, a reporter on the Well desk, filling in today.
After a case of polio was reported in an unvaccinated adult in New York in July, health officials scrambled to assess how long and how widely the virus had been circulating. The news also prompted many Americans — myself included — to try to find their own immunization history.
Most adults don’t have to worry: They would have been vaccinated against polio in childhood, since the vaccine has been part of immunization campaigns around the world since the 1950s and ’60s. In the United States, it is also part of mandatory vaccination requirements for children to attend public schools. Nearly all states have similar requirements for day care centers and private schools as well, though some allow exemptions. Nonetheless, periodic outbreaks of other vaccine-preventable diseases — including measles, mumps, whooping cough (also known as pertussis), hepatitis A and influenza — have caused serious illness in children and adults in the United States in recent years. So you’d be justified in trying to track down your vaccine history.
“The problem is that vaccine 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 never got immunized — or if you are vaccinated but the vaccine did not work for you (since no vaccine is 100 percent effective) — you may be susceptible to disease. This is especially true if there are others who are unvaccinated in the same geographical area, going to the same schools, socializing in the same restaurants or attending the same religious centers.
Making sure you’re vaccinated not only protects you, it also protects people in your community, Dr. Salmon said. And keeping track of when you were last vaccinated can be important for knowing when certain future vaccines or boosters are due.
Even if your medical records are in a faraway basement gathering dust, there are things you can do to piece together your vaccine history.
How to find your immunization history
Collecting and organizing this information can be a hassle. There’s no federal database of immunization records (though there are regional registries — more on that below), so it is usually up to individuals to keep track of their vaccines and make sure they are up to date.
If you’re lucky, all your vaccines from childhood will be recorded on one piece of paper: the vaccine card given to your parents at your birth or first pediatrician visit. Start by asking your parents if they still have this record, or consider digging 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 retained proof of your immunizations from your parents or your health care provider. Some employers may also ask for your vaccine records before you can start a new job, Dr. Salmon said. However, data retention policies can vary across institutions — some places may keep records for only a year or two after you leave.
If you moved to the United States from another country, you may have already collected vaccination information for your visa process. Look through the paperwork for your medical exam, which typically requires proof of certain vaccinations.
Your current primary care doctor may also have your vaccination information if you’ve been diligent about transferring old medical records whenever you switched providers, or if your provider participates in a record-sharing system like Epic Care Everywhere. Record transfers are not always perfect, so be prepared for possible gaps in your history.
By now, all 50 states, the District of Columbia and all U.S. territories have local or regional immunization registries, and health care providers are required to report vaccines for children up to 18 years old. Some states may have vaccine information going back to the 1990s, said Rebecca Coyle, executive director of the American Immunization Registry Association.
Other registries are much newer. For instance, the New York State Immunization Information System, or N.Y.S.I.I.S., was launched in 2008. Doctors and pharmacists can opt to enter immunizations adults received before 2008 if they have that information. Reporting of recent vaccines given to adults is also encouraged, though it is not required. (The exception is Covid-19 and monkeypox vaccines, which are required to be reported to the N.Y.S.I.I.S.)
It may be worth checking whether your local registry, or one where you grew up, has your vaccine history.
What to do if there’s no record of your vaccines
If you can’t find your immunization records, you can ask your doctor for a blood titer test for some diseases. The test will measure your antibody levels, and if they are positive (or above a particular known value) you have immunity to the disease, either from a previous vaccination or an infection. Negative test results (meaning no immunity) or equivocal results (meaning not enough immunity) indicate that you need to be vaccinated.
For some diseases, it simply makes more sense to catch up on your vaccinations. “That’s usually what I advise my patients to do, particularly if they’re at high risk for a certain disease,” said Dr. Jack Cappitelli, the New Jersey region chief medical officer for Summit Health, a network of clinics and urgent care centers that includes CityMD. “Even if we revaccinated somebody who was actually vaccinated 10, 20 years ago, the downside to that is almost negligible.”
What vaccines 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 the seasonal flu vaccine every year and a tetanus shot (or combined tetanus, diphtheria and pertussis vaccine) every 10 years. Adults up to 26 years old should also get the HPV vaccine, which protects against several types of human papillomaviruses that cause cervical, anal and other cancers, as well as genital warts. And of course you should have the Covid vaccine as well as the boosters you’re eligible for.
Adults over 50 should also get two shingles vaccine doses. And those over 65 should get a pneumococcal conjugate vaccine, or P.C.V., which protects against the bacteria that causes pneumonia.
A doctor may suggest some vaccines, like the hepatitis B vaccine, typically given in childhood, if you are still unvaccinated and considered part of a high-risk group. Health officials are currently urging adults in New York to get the polio vaccine if they were not immunized as children.
But because there are so many factors that can impact which vaccines you should stay up to date on, it’s best to consult a doctor about your specific circumstances. Your health, the type of job you do and whether you travel to countries where certain diseases are still prevalent will determine which vaccines you should get and when.
The best way to store records going forward
Once you’ve done all the hard work of hunting down your vaccine history, it’s important to save it in a place where it won’t get lost and make sure your doctor has access to it.
“The first thing you should do is have your provider put it into their electronic health record system,” Ms. Coyle said. That way, there will be a digital record of your vaccines that will be easier to track in the future. If your provider uses a patient portal or app, you will also be able to see the list of your vaccines there.
The next step is to ask your provider to send your vaccine information to the local or state immunization information system, Ms. Coyle said. Make sure that every time you receive a new vaccine, it is entered into the system.
“The reality is you may already have a record in an immunization registry if you received a flu vaccine or a Covid vaccine in the last couple of years,” Ms. Coyle said. “You just need to add to your information so that it is comprehensive.”
For storing paper records at home, it is a good idea to use a vinyl sleeve or a sealable plastic bag so that they don’t get damaged. You may want to keep backup copies or take a photo or scan of your immunization records and store it with other important documents.
The C.D.C. also has a handy immunization record form developed in partnership with the Immunization Action Coalition that you can print and keep updated. In the end, the best record-keeper for yourself and your family will be you.
Reconnecting With a Prickly Teen
Research suggests that adolescents generally like and admire their parents — and that they want to spend time with them, even as they are figuring out how to be more independent. Experts in adolescent development share a few simple strategies for finding connection with even the most screen-addled teenagers.
Abortion Bans Make Things More Complicated for Surrogates
In the wake of the U.S. Supreme Court’s decision to end the constitutional right to abortion, more state bans loom. This is making surrogacy agencies and surrogates — as well as the people they carry babies for — concerned that they will be forced to go to extreme lengths to access abortion or miscarriage care in the event that it’s medically necessary. The agencies are rethinking their approach, and the surrogates themselves are, too.
Read more:
The Surrogacy Industry Braces for a Post-Roe World
The Week in Well
Here are more stories you don’t want to miss:
Let’s keep the conversation going. Follow me on Twitter, or write to me at well_newsletter@nytimes.com.
Stay well!
