Bad news in the fight against the AIDS virus: The government is halting a large U.S. study of a possible HIV vaccine because the experimental shots aren't preventing infection.

The study had enrolled about 2,500 people, mostly gay men, in 19 cities. Half received an experimental vaccine developed by the National Institutes of Health, and half received dummy shots.

A safety review this week found that slightly more volunteers who had received the vaccine later became infected with HIV. It's not clear why.

The NIH said Thursday that it is stopping vaccinations, but will continue to study the volunteers' health.

Multiple attempts at creating an AIDS vaccine have failed over the years. But researchers continue to try, pointing to modest success in a 2009 study in Thailand.

More parents of teen girls not fully vaccinated against human papillomavirus (HPV) are intending to forgo the shots altogether - a trend driven by vaccine safety concerns, new research suggests.

That's despite multiple studies showing the vaccine isn't tied to any serious side effects but does protect against the virus that causes cervical cancer and other cancers as well, researchers said.

"There were a lot of very sensationalized anecdotal reports of (girls) having bad reactions to the vaccine," said pediatrician and vaccine researcher Dr. Amanda Dempsey from the University of Colorado Denver.

"Safety concerns have always risen to the top of the pile, in terms of being one of the main reasons people don't get vaccinated, which is unfortunate because this is one of the most well-studied vaccines in terms of safety and is extremely safe," Dempsey, who wasn't involved in the new research, told Reuters Health.

The U.S. Centers for Disease Control and Prevention recommends that all kids - both boys and girls - receive three HPV shots as preteens.

Researchers led by Dr. Paul Darden from the University of Oklahoma Health Sciences Center in Oklahoma City got their data from a national immunization survey that involved phone calls to almost 100,000 parents.

They found that from 2008 to 2010, the percentage of teens who were up to date on their Tdap (tetanus, diphtheria and pertussis), MCV4 (meningococcal) and HPV vaccines all increased slightly.

Still, about three-quarters of girls ages 13 to 17 were not up to date on their HPV series in 2010. And the proportion of parents of those girls who said they didn't plan to get their daughters the rest - or any - of their HPV shots rose from 40 percent to 44 percent, the research team wrote Monday in Pediatrics.

At the same time, the proportion who cited safety concerns as their reason for abstaining from getting the HPV vaccine increased from less than five percent to 16 percent.

For all three vaccines asked about in the survey, other reasons parents gave for skipping their teenagers' shots included not thinking they were necessary, not having had a specific vaccine recommended by a doctor and, for the HPV vaccine, believing their child was not sexually active.

"These are wonderful vaccines preventing severe diseases," Darden told Reuters Health in an email. "HPV is the first vaccine that will prevent cancer, which is a tremendous health benefit."

Dempsey said past research has suggested that although more girls are being vaccinated against HPV, vaccine rates haven't increased as quickly as for other shots, such as Tdap.

Darden reports having been a consultant for Pfizer, and one of his co-authors is on a safety monitoring board for vaccine studies funded by Merck, which makes Gardasil, one of the HPV vaccines.

Parents shouldn't rely on the media or Internet to learn about vaccines, according to Dempsey, since it's hard to tell what information is legitimate.

"If they have questions or concerns, they should trust their provider to give them accurate information about the vaccine," she said.

 Related:

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• HPV vaccine may lower cancer rates
• Teens don't have to have sex to be at risk for HPV

By MIKE STOBBE
Associated Press

Researchers have discovered the first U.S. cases of whooping cough caused by a germ that may be resistant to the vaccine.

Health officials are looking into whether cases like the dozen found in Philadelphia might be one reason the nation just had its worst year for whooping cough in six decades. The new bug was previously reported in Japan, France and Finland.

"It's quite intriguing. It's the first time we've seen this here," said Dr. Tom Clark of the Centers for Disease Control and Prevention.

The U.S. cases are detailed in a brief report from the CDC and other researchers in Thursday's New England Journal of Medicine.

Whooping cough is a highly contagious disease that can strike people of any age but is most dangerous to children. It was once common, but cases in the U.S. dropped after a vaccine was introduced in the 1940s.

An increase in illnesses in recent years has been partially blamed on a version of the vaccine used since the 1990s, which doesn't last as long. Last year, the CDC received reports of 41,880 cases, according to a preliminary count. That included 18 deaths.

The new study suggests that the new whooping cough strain may be why more people have been getting sick. Experts don't think it's more deadly, but the shots may not work as well against it.

In a small, soon-to-be published study, French researchers found the vaccine seemed to lower the risk of severe disease from the new strain in infants. But it didn't prevent illness completely, said Nicole Guiso of the Pasteur Institute, one of the researchers.

The new germ was first identified in France, where more extensive testing is routinely done for whooping cough. The strain now accounts for 14 percent of cases there, Guiso said.

In the United States, doctors usually rely on a rapid test to help make a diagnosis. The extra lab work isn't done often enough to give health officials a good idea how common the new type is here, experts said.

"We definitely need some more information about this before we can draw any conclusions," the CDC's Clark said.

The U.S. cases were found in the past two years in patients at St. Christopher's Hospital for Children in Philadelphia. One of the study's researchers works for a subsidiary of Johnson & Johnson, which makes a version of the old whooping cough vaccine that is sold in other countries.

 An experimental malaria vaccine once thought promising is turning out to be a disappointment, with a new study showing it is only about 30 percent effective at protecting infants from the killer disease.

That is a significant drop from a study done last year in slightly older children, which suggested the vaccine cut the malaria risk by about half — and even that is far below the protection provided by most vaccines. The three-shot regimen reduced malaria cases by about 30 percent in infants aged 6 to 12 weeks, the target age for immunization, researchers reported Friday.

“We're all a bit frustrated that it has proven so hard to make a malaria vaccine," said Eleanor Riley of the London School of Hygiene and Tropical Medicine. She said a malaria vaccine might be useful if combined with other strategies, like bed nets.

"The question is how much money are the funders willing to keep throwing at it,” said Riley, who was involved in an earlier study of the vaccine and had hoped for better results.

Dr. Jennifer Cohn, a medical coordinator at Doctors Without Borders, described the vaccine's protection levels as "unacceptably low." She was not involved in the study.

Scientists have been working for decades to develop a malaria vaccine, a complicated endeavor since the disease is caused by five different species of parasites. There has never been an effective vaccine against a parasite. Worldwide, scientists are working on several dozen malaria vaccine candidates.

In 2006, a group of experts led by the World Health Organization said a malaria vaccine should cut the risk of severe disease and death by at least half and should protect for longer than one year. Malaria is spread by mosquitoes and kills more than 650,000 people every year, mostly young children and pregnant women in Africa. Without a vaccine, officials have focused on distributing insecticide-treated bed nets, spraying homes with pesticides and ensuring access to good medicines.

In the new study, scientists found 30 percent fewer cases of malaria among babies who got three doses of the vaccine compared to those who didn't get immunized. The research included more than 6,500 infants in Africa. Experts also found the vaccine reduced the number of cases of  severe malaria by about 26 percent for up to 14 months after the babies were immunized.

Scientists said they needed to analyze the data further to understand why the vaccine may be working differently in different regions. For example, babies born in areas with high levels of malaria might inherit some antibodies from their mothers that could interfere with the vaccine.

"Maybe we should be thinking of a first-generation vaccine that is targeted only for certain children," said Dr. Salim Abdulla of the Ifakara Health Institute in Tanzania, one of the study investigators.

Results were presented at a conference in South Africa on Friday and released online by the New England Journal of Medicine. The study is scheduled to continue until 2014 and is being paid for by GlaxoSmithKline and the PATH Malaria Vaccine Initiative.

"The results look bad now, but they will probably be worse later," said Adrian Hill of Oxford University, who is developing a competing malaria vaccine. He noted the study showed the Glaxo vaccine lost its potency after several months. Hill said the vaccine might be a hard sell, compared to other vaccines like those for meningitis and pneumococcal disease — which are both effective and cheap.

"If it turns out to have a clear 30 percent efficacy, it is probably not worth it to implement this in Africa on a large scale," said Genton Blaise, a malaria expert at the Swiss Tropical and Public Health Institute in Basel, who also sits on a WHO advisory board.

Glaxo started developing the vaccine in 1987 and has invested $300 million in it so far.

WHO said it couldn't comment on the incomplete results and would wait until the trial was finished before drawing any conclusions.

By Jennifer Nelson
MyHealthNewsDaily

Getting a flu shot this season may not only greatly lower your risk of influenza this year, it may also lower your risk of heart disease, a new review from Canada suggests.

Results show that people who received the flu vaccine were 50 percent less likely to experience a heart attack or stroke, and 40 percent less likely to die from one, compared with people in the unvaccinated control group.

The flu vaccine could be an important way to maintain heart health and ward off strokes and heart attacks, the researchers said. They presented their findings at a cardiovascular disease research meeting today (Oct. 28) in Toronto.

In the study, Dr. Jacob Udell, a cardiologist at Women's College Hospital and the University of Toronto, and colleagues looked at four previous studies involving a total of more than 3,000 people — some with previous heart disease, and some without such conditions. Participants in all the studies were randomly assigned to receive a flu vaccine, no vaccine or a placebo injection, and were tracked for the following year. The average age of the subjects was 60; most included were over 30, according to Udell.

The findings suggest that “perhaps that the flu vaccine is a heart vaccine,” Udell said.

During the year after vaccination, there were 187 cases of heart attacks or stokes, including 65 deaths.

Regardless of whether study participants had a history of heart disease, those who got the flu vaccine were less likely to have cardiovascular events, or die them from.

While the reason for the link is not exactly clear, Udell said it may be that when people develop heart disease, some factor "tips them over the edge," such as plaque clogging arteries, or lower levels of oxygen as a result of the flu.

The flu vaccine may stop this "tipping" by preventing flu, or by actually breaking up plaque in the arteries. “Either one is very provocative, and it's important to drill down and get the answer,” Udell said.

Don't believe these 6 flu vaccine myths

Dr. Sarah Samaan, a cardiologist and director of the Women’s Cardiovascular Institute at Baylor Heart Hospital in Plano, Texas, said the key to the link may be in reducing inflammation.

When someone gets the flu, blood levels of inflammatory substances rise, and inflammation of the blood vessels can trigger heart attacks.

“This happens because inflammation can make cholesterol plaques in the blood vessels unstable," Samaan explained. Unstable plaques are more likely to develop tiny cracks, which can cause blood clots to form. Such clots can block blood flow within arteries, causing a heart attack (if the blood vessel supplies the heart) or a stroke (if the artery feeds the brain), she said.

Udell cautioned that the 50 percent reduction in cardiovascular events seen in the study may be a high number, but said that even if the flu vaccine reduced the risk of a heart attack or stroke by just 10 percent, vaccination could make a major dent in saving lives.

A larger study could help firm up the numbers, he said, and he hopes to start one.

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Expert government advisers want every pregnant woman to get a whooping cough vaccination.

It's only the second time a vaccine has been recommended during pregnancy. Flu shots are also recommended for pregnant women.

The aim of the whooping cough shot is to protect newborns, who are too young to get the vaccine.

The panel's vote was a reaction to the resurgence in whooping cough. The nation is on track to have the worst year for whooping cough since the 1950s. There have been more than 32,000 cases, including 16 deaths, this year.

The Advisory Committee on Immunization Practices approved the recommendation Wednesday. Federal health officials usually adopt the panel's advice and send it to on to doctors and the public.

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Can you trust what biomedical researchers have to say about your health?

There are plenty of people out there who say no, including anti-vaccinators, mega vitamin proponents, lovers of non-Western medicine and those who see a pharmaceutical company plot behind every drug, device or genetically altered seed. Few of these skeptics have any sound evidence to offer on behalf of their distrust. Often their opposition is based more on ideology or politics than it is solid evidence for doubt.

But, that does not mean that biomedical science should ignore problems that do undermine public trust in what they have to say. One of the most important and disturbing is fraud. 

A study published Monday in the very trustworthy journal Proceedings of the National Academy of Sciences shows that fraud is a real problem in scientific publications.  This study is both a reason for concern and, ironically, a reason to trust what scientists and doctors say.

The study reviewed 2,047 retracted biomedical and life-science research articles dating back to 1973 and found that the biggest reason for their retraction wasn't honest error but fraud.  More than 40 percent of the retractions were due to the discovery of outright fraud and another 23 percent to plagiarism. The rate of retractions of published articles, while a tiny percentage of all papers published in biomedical journals — 2,000 out of tens of millions published in the past four decades -- is growing. The rate has jumped 10 fold in the past 37 years.   

It’s an unsettling trend. A teeny number of fraudulent articles can do an enormous amount of harm. Prominent cases of fraud certainly and rightly make the public wonder about the credibility of biomedical claims. Why, however, does this study and its findings have a silver lining?

Let me ask you a simple question: When is the last time you heard critics of vaccines or GMO food admit that there is fraud on their side? In my experience, the answer is never. Those who tout the benefits of chelation, megavitamins or cleansing enemas never confess to any degree of fraud among their number. Strange as it may seem, what makes mainstream biomedicine trustworthy is its willingness to admit that there are frauds and charlatans out there and that efforts need to be made to catch them.

Real trustworthy science knows that error happens, that sometimes the error is malicious, that there are bad apples out there and that you have to try and weed error out.  If you are not ready to admit these truths then you are not trustworthy at all.

That said why is fraud on the rise?  The study authors are not sure. 

I suspect the increasingly competitive nature of science, the drive to secure more grants, patents and equity by individual scientists and the huge proliferation of journals that are not doing a good job peer-reviewing articles are all to blame.  So are scientists who have agendas. 

The biggest fraud mentioned in the study is Dr. Andrew Wakefield. Wakefield is no friend of vaccination. His bogus paper reporting a link between autism and vaccines had a huge and devastating impact on the health and well-being of babies and kids all over the world. Even though it was retracted and he was discredited, many still continue to believe he was right.  

Biomedicine needs to do more to stop the growing trend of fraud.  More education of young researchers, tougher penalties for fraud, and increased resources and rewards for peer reviewing will help. The fact that biomedicine is willing to look hard and publicly at its “bad apples” shows that there is every reason to think that scientists and doctors ought to continue to be trusted.

Arthur Caplan is the head of the Division of Medical Ethics at NYU Langone Medical Center.

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By Maria Cheng
Associated Press

Results from an early test of a dengue vaccine suggest it isn't ideal, but scientists say the study is still encouraging news in the global fight against the disease known as "break-bone fever."

There is currently no treatment or vaccine for dengue, which causes symptoms including fever, severe joint pain, headache and bleeding. The mosquito-borne disease infects up to 100 million people worldwide every year, mostly in Asia, Africa and Latin America.

The research "provides the first evidence we could actually develop an effective vaccine against dengue," said Orin Levine, a professor at Johns Hopkins Bloomberg School of Public Health. He was not connected to the study, published online Tuesday by the journal Lancet.

"This is a milestone, but we're not there yet," he said.

Larger studies in about 30,000 people are now under way and should provide more information about the effectiveness of the vaccine made by Sanofi Aventis SA. Other dengue vaccines are being developed but Sanofi's is the furthest along.

The Sanofi vaccine was tested in more than 3,600 Thai children ages 4 to 11. More than 2,400 got three injections of the vaccine six months apart while about 1,200 got a rabies vaccine or a dummy shot. The study was paid for by Sanofi.

During about two years of follow-up, there were 134 dengue cases, including five severe cases. In the vaccine group, about 3 percent got dengue, compared to about 4 percent in the group that didn't get the shot. The difference wasn't big enough to suggest any benefit from getting the vaccine.

Scientists said the vaccine seemed partly effective against three of the four viruses that cause dengue and no unusual side effects were reported. The study took place during an outbreak of mostly type 2 dengue, which causes the most serious disease, but the vaccine didn't work against that kind.

"It's not exactly a slam dunk," said Scott Halstead, a senior scientific adviser for the Dengue Vaccine Initiative, who wrote an accompanying commentary. He said Sanofi might need to consider reformulating the vaccine or creating separate shots for each type of dengue.

Joachim Hombach, a dengue expert at the World Health Organization, said it was encouraging that the vaccine appeared safe. "But the public health value of this vaccine remains to be demonstrated," he said.

By MyHealthDailyNews.com

Since the vaccine against chickenpox became available in the United States, the country is seeing a lot less of the disease.

Between 2000 and 2010, the incidence of chickenpox declined nearly 80 percent, from 43 cases per 100,000 people, to nine cases per 100,000 people, according to a new report from the Centers for Disease Control and Prevention (CDC). The report included information from 31 states.

The biggest declines were seen in children ages 5 to 9, the CDC says.

In 2010, four people died from chickenpox, none of whom had been vaccinated.

The chickenpox vaccine was introduced in 1996, and for 10 years, just one dose of the vaccine was used. In 2006, children were recommended to receive two doses, one between ages 12 and 15 months, and a second between 4 and 6 years old.

The declines in chickenpox cases were greatest after the introduction of this second dose. Between 2000 and 2005, the incidence of chickenpox declined 43 percent, compared with 72 percent between 2006 and 2010.

Further declines in chickenpox are expected as more people get vaccinated with two doses, the CDC said.

To continue monitoring the impact of the two-dose chickenpox vaccine, a strengthened surveillance system and participation from all states is needed, the CDC says.

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Could it really be possible to cure AIDS?

The virus has been decimating populations since the “gay plague” first started spreading in the early 1980s. It insinuates itself into the body’s deepest recesses, hiding out to evade drugs and vaccines alike. It spreads in blood, breast milk and sperm -- making the most intimate human encounters deadly.

It has exploded across the world -- killing 25 million people, infecting a million more every year, and moving from gay and bisexual men into wives and mothers, to their children, and among drug users.

But experts think it might be possible to stop the spread and even to speak of curing the infection in those with human immunodeficiency virus (HIV), which causes AIDS. And they see a hopeful symbolism, as well, in the return of the giant international conference, held every two years, to the United States, where it hasn’t been in 22 years.

The International AIDS Society decided to bring the conference to Washington after President Barack Obama lifted a much-criticized ban on visas for HIV-infected travelers in 2009.

Starting today, 25,000 researchers, activists, patients and officials meet for the colorful conference to trade ideas, demonstrate and float policy ideas. As is always the case with AIDS meetings, protesters will gather to point to inequalities -- the lack of funding for treating women, the startlingly high rates of infection among U.S. blacks, high prices charged for AIDS drugs, discrimination against sex workers and the stigma that still surrounds the disease.

In the days before the conference, researchers and activists issued what they call the Washington, D.C. Declaration. “Through new scientific advances and societal, political and human rights gains, it is possible to turn the tide against the AIDS and begin to end the epidemic in our lifetimes,” it reads.

“It’s time to start thinking about the end of AIDS,” said Michel Sidibe, head of the United Nations AIDS agency UNAIDS.

“We do have these amazing scientific tools at hand that are really enabling us for the first time to begin thinking about a generation free from AIDS,” Dr. Ronald Valdiserri, U.S. Deputy Assistant Secretary for Health, told reporters in a conference call last week.

To ever cure HIV infection, researchers still have to figure out how to roust it from its hiding places in the body and kill it. HIV is a retrovirus, and it invades the very immune cells that the body sends to fight it off, turning them into little virus factories. Cocktails of drugs called highly active antiretroviral therapy -- HAART or ART for short -- can hijack this process in various stages and some of the drugs can even protect a person from being infected in the first place.

While HAART can keep patients healthy and can help keep them from infecting others and even protect people who aren’t yet infected, it can’t fully eradicate HIV.

But the case of Timothy Brown, once called the “Berlin patient”, shows it is in theory possible. He was infected with HIV, developed leukemia, and got his immune system replaced with a bone marrow transplant. Luckily for him, the bone marrow donor had a genetic mutation that provided resistance to HIV.

Bone marrow transplants are drastic treatments, expensive and dangerous, and no one thinks it’s possible to use them to treat HIV patients in general. But the science shows a cure is possible.

The best way to eradicate a disease is, of course, with a vaccine. Researchers wowed themselves and the world in 2009 when tests on a vaccine no one really expected to work lowered the risk of HIV infection by more than 30 percent over three years. More study published this year shows that the volunteers who were protected produced certain antibodies -- the first clue to breaking through HIV’s ever-changing disguises. They’ll present more details of what they have found at this week’s conference.

There also will be more details on studies that find treatment can be used as prevention. Taken properly, the drugs can reduce by 96 percent the chance that an infected person will infect someone else sexually. They can protect someone at high risk -- say a woman married to an infected man -- from ever becoming infected.

UNAIDS issued a report ahead of the conference that shows a 20 percent drop in death rates from HIV. Better treatment is a big part of this, according to the report. A big success has been in protecting babies -- 100,000 fewer babies got the virus at birth from their mothers or in breast milk, the report showed. Treating mother and baby with ART drugs worked.

It won’t be all good news at the conference. New details will shed light on how quickly the epidemic is moving back into the gay community, with black and Hispanic men at especially high risk and less likely than ever to have been tested or treated. A batch of reports in the Lancet medical journal this past week showed behavior may not be entirely to blame -- biology shows that men may be more susceptible to sexual transmission of the virus.

And there are two sides to the symbolism of holding the conference in Washington, D.C. Washington has one of the highest rates of HIV infection in the world -- more than 3 percent of the city’s residents over the age of 12 are infected -- about the same rate as in Congo. About 6.3 percent of black men in Washington are infected -- comparable to Uganda’s 6.5 percent rates.  About half a percent of people in North America are infected. CDC estimates 1.2 million Americans are infected, and that 20 percent of them don’t know it. 

Washington, D.C., is working hard on its epidemic, however, distributing free HIV tests widely, even offering them in supermarkets. Officials are distributing condoms, clean needles and providing health benefits to virtually all residents.

Conference organizers had hoped President Obama could travel the few blocks to the conference, but the best he offered is a video greeting. He’ll send Secretary of State Hillary Clinton and Health and Human Services Secretary Kathleen Sebelius instead.

A entire session at the conference will focus on another tough issue -- money. The global recession has hit AIDS efforts in the pocketbook.

“Regardless of where you work or live, if you are devoted to making a difference in the HIV epidemic, you are trying to do more with limited resources, “ said CDC’s chief AIDS official, Dr. Jonathan Mermin.

Related links:

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• AIDS increase in Uganda shows needs for more money

By Rachael Rettner
MyHealthNewsDaily

The vaccine against swine flu seems to offer broader protection against other flu viruses, compared with the seasonal flu vaccine, researchers say.

This vaccine, officially called the 2009 H1N1 vaccine, was administered in 2009 to protect against a new virus strain that caused a pandemic that year.

In the new study, people who received this vaccine developed antibodies against not only H1N1, but also several other flu strains, the researchers said. Such protection against multiple strains is rarely seen in people who receive the seasonal flu vaccine or are infected with seasonal flu, the researchers said.

The findings bring researchers closer to developing a universal flu vaccine — one that provides broad protection against flu viruses and lasts for years, said study researcher Rafi Ahmed, director of the Emory University's Vaccine Center. Currently, a new seasonal flu vaccine must be developed and administered every year because its protection is limited to certain strains, and wanes over time.

The study will be published this week in the journal Proceedings of the National Academy of Sciences.

Broad protection
Previously, Ahmed and colleagues found that people who became sick with the 2009 H1N1 flu virus produced antibodies against multiple flu viruses, but it was not known whether the vaccine could do this as well.

The new study involved 24 healthy adults who were immunized with the 2009 H1N1 vaccine. Seven days after they received the flu shot, the researchers analyzed their blood.

A universal vaccine for flu?
Flu viruses consist of a "head" region that changes over time and varies between strains, and a "stalk" region that remains fairly constant. Usually, antibodies against the flu bind to the head of the virus, and for this reason, the protection that seasonal flu vaccines offer is typically quite specific.

However, in the new study, participants produced some antibodies that could bind to the stalk of the flu virus — it's these antibodies that could be the basis for a universal flu vaccine, Ahmed said.

Antibodies are produced by cells called B cells. The researchers speculate that, because H1N1 was such a "new" strain of flu, it forced the body to activate a rare type of B cell, one that could produce antibodies that bind to the virus' stalk.

"The next step now is to design a vaccine to target these B cells," Ahmed said.

"The study is encouraging, that we're seeing antibodies generated against the conserved portions of the virus," said Dr. Bruce Lee, an associate professor at the University of Pittsburgh Graduate School of Public Health. "But it's just an initial step," Lee said, noting that much more work is needed before the results could be translated to a universal flu vaccine.

And while the production of antibodies against a virus suggests that people will be protected against it, it remains unclear whether they could avoid catching the disease, Lee said.

Participants had increases in antibodies against several flu strains, including H1N1, H5N1 and H3N2. Antibodies are immune system proteins that bind to harmful pathogens, such as viruses.

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By Erin Sykes
NBC News

A big reason for the alarming rise in whooping cough cases across the country is because too few adults are getting their pertussis booster shots, doctors say. But that's not the only vaccine that grown-ups are unaware they need -- nearly half of the adults in the U.S. don't know which shots the government recommends for their age group, according to a new survey by Walgreens.

For example, at least 1 million older adults a year in the U.S. get shingles, an extremely painful skin rash, yet fewer than 10 percent of people over 60 -- the recommended age for the shot -- have been vaccinated against it, research indicates.

The low vaccination rate for grown-ups is a serious problem, because more than 40,000 adults die each year from vaccine-preventable illnesses, government research shows. 

The recommended immunizations for adults (over age 18) include:

Influenza -- all adults, every year
Tetanus, diphtheria, pertussis (TdTdap) -- booster vaccine every 10 years
Zoster (Shingles) -- age 60 and over, 1 dose
Pneumonia -- over 65, 1 dose
Source: Centers for Disease Control and Prevention

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