You do not need proof of innoculations to enter China, only your passport and Visa which you can obtain from a Chinese consulate or embassy in the US ( if that's where you're from.)or have a visa serivce do it for you for much more money. It is advised that you get typhoid protection in either a series of four pills or by injection. The pills give you longer lasting protection. Your doctor may recommend Hep A as well. I have never had any reactions to any of these shots or pills. Since you're going with Tauck, I would guess you are going to more mainstream cities and areas, but these precautions area good idea to have no matter where you travel.
Travel clinics are often found at hospitals affiliated with medical schools. My own internist wrote the Rx for my recent typhoid pills which I got at my local CVS, expensive and not covered by our insurance. Have you looked at the Center for Disease Control website? They have sections and advice for each country.Make sure your tetanus is up to date.If you're leaving in six weeks, get any pills or shots now. Do not drink tap water in China.

Vaccinations are not required for entry into China. However, it is wise to have some vaccinations. I'd refer you first to the cdc website: www.cdc.gov/travel

Read all of the info about recommended vaccines which include routine vaccines you should have even if you don't travel, like tetanus, appropriate boosters for "childhood" diseases like measles/mumps/rubella, flu vaccine, and vaccines like hep A (which you'd be wise to have in any case.

Print out the cdc info and take it with you to your appointment at a travel med clinic. If the clinic is advising vaccines that aren't listed, ask why, and if they don't advise vaccines that are listed ask why. The cdc guidelines are the standard of practice at travel clinics in the US.

Certainly people go to CHina and many other places without appropriate vaccines. But people ride in cars without seats belts and even if they don't get in accidents, it doesn't make it a good idea.

The side effects of the vaccines are pretty minor: sore arm, etc. The side effects of contracting any of these illnesses is certainly more problematic. The decision on vaccines should be made in consultation with your doctor. Get started now - it takes all vaccines some time to be fully effective.

www.mdtravelhealth.com China best correct info. It very much depends upon your itinerary and time of year. Biggest risk
Travelers diarrhea bring meds for this. Hepatitis Flu Pneumonia jabs are warranted in some situations. On upscale tours like tauck.com (very nice have done a couple) others like typhoid yellow fever and malaria preventives usually are NOT indicated. istm.org best site for travel clinics if needed. Public Health Clinics are a good place to find them cheaply in the US.

Happy Trails!

Do note that yellow fever is not present in Asia, it is only present in parts of Africa and South America. If someone at a travel clinic recommends the Yellow fever vaccine to you for your visit to China - leave. Typhoid, however is recommended for visits to tropical and semi-tropical areas. Not knowing your itinerary, I don't know whether it is a good idea. Diseases like Hep A and typhoid are food and water borne illnesses. You have no control over (or even knowledge of) how carefully the people who prepare your food wash their hands.

The pneumonia vaccine is only recommended for people age 65 and above in the US. And it is recommend for those people whether or not they are traveling.

I chose to get typhoid (already had Hep A from Egypt) before I went to China just incase. It was an easy series of pills and I don't remember any side effects from the pills. The only side effects I remember from the shot was a very slightly sore arm for a day or so.

Read the CDC recommendations. Are you going to be traveling again in the next few (5-10) years to anywhere that the same vaccinations are recommended? If you are, why not just get the vaccination and be done with it?

As for getting sick from the vaccinations, I don't *think* Hep A or Typhoid are live vaccinations. If they're not live you can't get sick from them (and even for the live vaccinations the risk of getting sick from it is absolutely miniscule unless you're immunosuppressed).

Vaccinations don't prevent you from getting sick from everything, they prevent you from getting that particular illness. Your friends who got sick likely just had run of the mill travelers diarrhea (ate something that just didn't sit well or slight food poisoning that led to a few bad days) or even just a cold/flu bug picked up in the airports/airplanes on the way over.

As someone pointed out above, you have no control over the people preparing your food. Why risk it?

Tetanus shots, absolutely. and the Hep shots.

I always get the full complement of shots for travel to any destination, and I used to do quite a bit of international travel. Why take a chance?

CDC website is very good. You'll need to know which are the essential shots.

Don't go to any travel clinic, find a good one.

Safe travels!

This thread is why Fodors is one of my favorite travel sites...can always count on solid, sincere and intelligent advice.

Thanks to everyone for taking your time to share your experiences...very persuasive; your advice to go ahead with the vaccinations just makes sense...as 'easytraveler' said, "why take the chance?" And 'Yes' Iowa_Redhead, we will be traveling to several countries over the next few years, so, your right - why not go ahead and get them over with.

Now, the real challenge is to get my wonderful, incredible (and determined not to) wife to get the vaccinations with me. Oh, boy, now the work begins!

Rock

<<<Now, the real challenge is to get my wonderful, incredible (and determined not to) wife to get the vaccinations with me. Oh, boy, now the work begins! >>>



If it helps, your normal doctor should be able to give you (or give you the prescription for) any of the vaccinations you might need. CDC is the go to source for travel vaccination info, your doctor will use this same info. I highly suggest reading the page on China and reading about the specific vaccinations suggested. http://wwwnc.cdc.gov/travel/destinations/china.htm

Tetanus - this one really should be up to date anyway.
Hep A - "Cases of travel-related hepatitis A can also occur in travelers to developing countries with "standard" tourist itineraries, accommodations, and food consumption behaviors." (Quote from the CDC link). Even on normal itineraries and nothing rural there's still a risk. Food handlers are your big risk here and you can't do anything to control that. No serious side effects have been reported from the vaccine.
Hep B - This one is from blood/body fluids but I think there's a combo vaccine for Hep A and Hep B so you don't have more needle pokes.
Typhoid - Think bad water/food for this one and again, it's something that you often have little control over. The vaccine is NOT 100% effective but 50-80%. This one can be given as pills (I think it was one pill every other day for 4 pills).

You could be looking at 1 shot and 1 series of 4 pills, not too scary.


Good luck with the discussion! Do try to get into your doc as soon as possible as the vaccines do need time to take effect. Thus far China has been one of my absolute favorite places in the world and I would go back in a heartbeat. Learn how to say please and thank you in Chinese, have fun bargaining and you'll have a fantastic time!

Not all cities have travel clinics, which are convenient for the most exotic immunizations such as yellow fever which an internist will not have.

Otherwise your internist/family doctor should be able to advise you what to take, eg tetanus, hepA, flu, pneumonia, depending on who you are, healthy, young or older, etc. Better to do that than trying to decipher the CDC website.

Most immunizations have effective titer rise within 2 weeks.

Using a hand sanitizer at all times, taking 1-2 Pepto-bismal pills after each meal and drinking only treated water should go a long ways to help keep you healthy.

The Hepatitis A vaccine is good even if you don't travel. It protects you from food borne hepatitis just from eating at a local restaurant or consuming contaminated fruit/produce.

Tetanus now also contains a component to protect you against Pertussis (whooping cough). You'll be given a Tdap which is "tetanus, diphtheria, and pertussis". Anyone who doesn't know how long it's been since their last tetanus shot should get it updated regardless of travel plans.

okoshi2002 brings up something else I was concerned about - what I should take and use that's 'over the counter?'

I've been told to take Pepto-Bismol in 'pill' form; Imodium, hand wipes (always wash the hands), lots of snack/energy bars, and this one surprised me..a roll of toilet paper. (say it ain't so) Seems there's a very small portion of our tour that is 'off the beaten path' and I've been told that restroom facilities in certain locations are not exactly up to western standards. This tid-bid almost almost "X'ed" the trip for my wife but she said "to heck with it, I'm going to see China."

Here's a question for you: now that you have returned home from China, and knowing what you know from your previous trip/s, if you go again, what will you be sure to take this next time that you wish you had taken previously?

All tips and advice are greatly appreciated for this '1st time' China traveler.

Tks.

We went to China in 2001 and again in Fall 2011. We saw huge changes this last trip. We were off of the beaten path and therefore still dealt with squat toilets everywhere we went. I actually encountered them in the ultra nice upscale shopping center attached to the Grand Hyatt in Beijing, The Malls at Oriental Plaza. A tip is that if you see a handicapped sign on a stall door, that one will be western style.Take Purel and a small package of kleenex with you when you go out for the day.However, if flying within China, be aware that the airport security may confiscate the Purel since it has an alcohol base..so also have wipes too.
We found western style drug stores in Beijing and Shanghai(Watson's) but I would take along cold pills, a Pepto bismal type product, handi wipes/purel, Aleve for muscle soreness,.I also pack moles skin in case of blisters. We always ate with chopsticks. Friends of ours went a tour and never saw a squat toilet, but the opposite was true for us on both of our trips.
I think it depends where a tour group is taken, how westernized the places are.
We love China, the food, history,and it's ancient culture. You'll have a great time.

I actually would suggest against taking something like Pepto on a daily basis just as a preventative. If you don't need it don't take it.

Instead of taking something like that purely as a preventative (that you might not need anyway) I would suggest taking Tums/Rolaids and immodium pills. At the first sign of a grumbly stomach I took one or two rolaids. That pretty much settled my stomach right down. If needed, follow with immodium/pepto.

Hand wipes are a wonderful thing for before/after meals and for just general. Many places you'll visit are extremely busy and just touching things is how you generally pick up things like colds. Take a handful in your day pack each day and you've got them if you want them. I wasn't even remotely religious about using them, but when I wanted one I was thrilled to have it. Also if you're visiting in the summer it's always nice to be able to wipe off a bit if you get sweaty (always a good feeling after a long flight or train ride).

Snack bars... definitely a bonus! I was often on the go in China and walked constantly. A small snack bar kept me going when I wanted to finish poking around a site before I went to find lunch/dinner or when I got tired on the Great Wall. A 3 minute break to munch a granola/snack bar, have a swig of water and I was a whole new person. Do be careful to always find a trash bin for the wrapper or keep it in your daypack until you do find a bin. Same with water bottles.

TP and bathrooms... just remember that China is an amazing place and it's totally worth it! Always carry a pack of Kleenex or a bit of TP in your daypack as most bathrooms don't stock it. They are generally 'squatty potties' but many are actually very clean. Get in the habit of always going before you leave the hotel in the morning. Also, don't wait until you're really in a hurry for one so that you can pick and choose a bit. Is it the same as western standards? Not all of them and some are honestly terrifying, but if you wanted exactly what you're used to you wouldn't be going to China. Just keep repeating "it's all part of the adventure" (say it often enough and you may even start to believe it). I promise that China is without a single doubt worth it.

Also, you're going with a tour group and the tour guide is going to point out clean bathrooms. They know that's a concern for many/most westerners and will do their best to take care of that concern.


Definitely try to learn how to use chopsticks before you go. You don't have to be great with them, but generally able to get food from the dish to your mouth 3 tries out of 5. Forks aren't always available and people were very friendly when they saw me trying to use the chopsticks. I wasn't good at it (though I got a LOT better after just a couple days), but I was making at attempt and they appreciated that. I found it hilarious that the two little sticks were so obviously smarter than I was.

If someone gives you a business card, take it with both hands and do NOT put it in a rear pocket (even in a wallet). I don't know why anyone would give you a card, but just incase. Definitely learn the words for please, thank you, yes, no, how much, etc. You don't have to be good at them but again just the attempt goes a long way.

What time of year are you going? I was there over Christmas a year ago and Beijing was very windy. Dressing in layers is the best thing you can do no matter what time of year you go.

I can't think of anything else off the top of my head but I can't imagine anyone not enjoying a visit to China. It truly was amazing.

I forgot to add duct tape! I always travel with a little bit of duct tape wrapped around a small chunk of cardboard (think credit card sized) and many people use a pen to wrap it around. It's great for fixing tears or hems that you don't have time/inclination to stitch, can be used to hold curtains shut if they don't quite meet in the middle and for 1,000 other uses including medical.

When I start to get a blister I generally put a bandaid or a chunk of kleenex/tp down to protect it and then put duct tape over it because a bandaid just gets rubbed off. In China I twisted up my ankle a bit and used a duct tape brace (simple gauze or kleenex against my skin, and then wrapped a figure 8 under my foot, in front of my ankle, around my ankle, back in front of my ankle and around). It sounds ridiculous, but it worked wonderfully! As with any brace, remember not to make it too tight.

Not all traveler's diarrhea should be treated with Imodium or similar anti-diarrheal. Depending on the organism causing the diarrhea, trying to stop the diarrhea can make the infection worse.

Talk to you doctor or travel clinic about when you should or should not use an anti-diarrheal.

Jaya is correct. Not all diarrhea is treated the same except it is always important to keep well hydrated and keep up with fluid loss- not just water but any broth, clear liquids.

Most diarrhea is self-limited meaning they usually get better without specific antibiotics.

Pepto-bismol has been recommended by CDC to PREVENT gastroenteritis. As anybody who has traveled and trekked will tell you, preventing diarrhea is always worthwhile.

Liquid hand-sanitizers eg CVS/Purell brand are ecologically better than hand wipes which add to waste/trash.

Have fun.

I agree with using Purel over handiwipes but Beijing airport security took one of ours away, held it up high for all to see, shaking her head and expressing disdain for what we had done.

I got a slew of vaccinations before I went last fall: TDP (it is the combined tetanus, diptheria, pertussis...you seldom get "just" a tetanus shot anymore), Hep A (had first for Russia, second for China), Hep B (managed to get 2 of the required 3 in before I left), did the typhoid pill series. Your personal physician may not even stock most of those (mine didn't) so a travel clinic may be your only option. These are not cheap either, so call your health insurance company to confirm. Total billed for my vaccinations was over $600. A travel clinic will also want to know your exact itinerary as they will research particular regions where you are going to see if there are any recent outbreaks they can vaccinate you against.

But more importantly, both my personal physician and the travel clinic recommended a TB test about 3 months after I return. As China is a "spitting" culture and we were walking in it and cooped up on airplanes with Chinese who may have it, they said it was good practice to get the test done at the very least, regardless of whether you get the vaccinations for anything else. Others I traveled with were told the same.

That's an interesting recommendation about TB testing.

To really know whether you have been exposed and therefore developed a positive test will require proof of a negative test before you leave.

It gets even trickier because some positive reactors may initially be negative then become positive only after a second test called an amnestic response.

I would discuss it with your doctor to see if it's indicated. There are many ramifications of taking a TB test not the least of which is what to do with the result.

We had the Hep A/B, called TwinRix, series last November before we went to China. It is a series of three shots and even on the accelerated schedule it takes 5 weeks to complete. Also did the Typhoid and DPT but not the malaria as the side effects look way scarey.

michele, there is no vaccine for malaria. If you are speaking of anti-malarial pills one takes, I can only assume that you read/heard about larium (which can have bad side effects) and not about the other options (malarone, doxycycline) which have fewer side effects. Still, if you are traveling in a high risk region, the side effects of anti-malarials are not nearly as scary as the impact of contracting malaria. Given that only small parts of CHina are malarial risk, I'm assuming your travel med doctor did not recommend that you take anti-malarials.

Kathie,
You are right. I am speaking of the anti-malarial pills. The reason I choose not to take the pills, even though they were recommended for the small area of the Yangtze River we visited, was because of my predisposition to nightmares and night terrors. A side effect of the pills was vivid nightmares which could continue for years.

After consulting with the health dept, my doctor and my pharmacist they all recommended I not take the pills and I agreed. The thought of having increased nightmares was a terrifying thought. I had to weigh the pros and cons and for me it was the better choice I believe. It's hard to know what to do sometimes. Each person has to do the research and determine what is best for their situation.

Malaria is only one of many mosquito borne illnesses, many of which have no prophylaxis. The most prudent thing to do in Asia is to do whatever is possible to avoid mosquito bites. You will still get an errant bite here and there, but most can be avoided by staying in hotels that don't have mosquitos in the rooms so you don't get bitten up while sleeping.

Certain types of mosquitos bite in the morning and other types bite in the evening. Daytime is usually the safest for not getting bitten. Loose, gauzy clothing makes it harder for them to bite through your clothing.

Bring repellant and use it generously.

Michele, my point was that only one anti-malarial, larium, causes nightmare/night terrors. Neither malarone not doxy do. I'm not second-guessing your choice not to take anti-malarials for this trip (and Jaya's advice to use repellent is good), but I hope you (and others) know that not all anti-malarials have serious side effects.

Thanks Kathie. Yes, Larium is what my doc prescribed for me. Good to know about the other ones though. It was December and snowing when we were in China and we were so covered up a mosquito would have a hard time finding any skin to bite anyways.

One of the ways to stay safe has nothing to do with vaccinations.

It's what you put in your mouth.

Think seriously about what you put in your mouth.

Brushing your teeth? Use bottled water.

Taking a shower? Don't open your mouth.

Ordering meals? never order raw salad or peeled fruit. Even fruit with skin on can be a problem. You handle the skin to peel the fruit, then pop the peeled fruit into your mouth with the same (contaminated) fingers.

That street food look or smell really tempting? Don't.

Drinking from a glass? Do you know where that glass was before it reached your table? This is why, even in the States now, some Asian restaurants serve water with a straw.

In other words, take a lot of precautions about what you put into your mouth.

The chances of you catching something via food or drink may be minimal, but again, why take the chance?

I'm going to tell this story again. I had a colleague with whom I travelled quite a bit in Asia. You think he would have known better, but, in Korea, where they like raw beef (sort of like carpaccio), he ate some at a banquet. Thereafter, he had severe intestinal problems for the rest of his life. Not even the medications in the US, when he came home, could help him.

So, please, be careful what you put into your mouth. Nothing raw, untreated, or uncooked.

Have a great trip! I hope i haven't scared you too much!

Or just stay at home - its much safer!!!

<<<crellston on Apr 10, 12 at 1:15pm
Or just stay at home - its much safer!!!>>>

Ick! Boo! Hiss!



China is safe, but do take reasonable precautions. easytraveler mentioned using bottled water to brush your teeth... I always tried to forget and have learned to put a wash cloth (or something) over the tap so that I stop before I just go for the water on autopilot.

lol -the data on accidents in the home should be enough to make anyone want to go on vacation!

The hotels we stayed in and cruise ship supplied bottled water daily. I kept these bottles on the bathroom counter so I would always see them and not accidentally forget.

If you read the CDC they are recomending that adults have an up dated Polio shot. There is an outbreak in China. Not a bad idea in general, as alot of our childhood inoculations are past their sell by date.

My husband and I have traveled to China 4 times and never had any vaccinations and/or medical issues during or after a trip. Common sense is the biggest factor.

On an organized tour, you will be in mainly areas frequented by tourists.

Go and have fun!

Our MD said these shots/pills are a good precaution to have in any event, no matter where you are in the world, due to possible food contamination.

As a physician an frequent traveler, here is my 2 cents.
First, get whatever vaccines that you should have for your age anyway.
Next, get the vaccines advised by the CDC for the specific cities you are visiting. Most likely with a Tauk tour, there won't be any that you should not have had anyway. ALso, it's unlikely that they will recommend malaria meds and since they do have side effects, don't take them unnecessarily.
Only drink bottled water or other bottled drinks, drinks made with boiled water (coffee, tea) or alcoholic beverages.
As for food, Tauk will likely only take you to tried and true restaurants - if their clientele were getting sick all the time, they would not stay in business. So, if your guide says it is OK, trust him/her and have a good time enjoying local cuisine - that is one of the main reasons for traveling. However, when wandering around on your own, I'd follow the usual advice not to eat raw vegetables or unpeeled fruit.
The most common illness that I have seen on guided tours are colds and these sometimes lead to bronchitis or pneumonia as travelers' immune systems are stressed because of jet lag, sleep deprivation, etc. Colds are spread by touch - so wash hands, wash hands, use hand sanitizer, etc. If possible, don't touch the railings on busses, staircases, etc. - though do so if needed, as a fall and fracture in China may be a lot worse than a cold.
Above all, don't let your fears get in the way of your enjoyment.

Great advice for you here, RockStone! Bottled water for everything is a must, as is (sadly) avoiding street food. And you just never know when or where you'll encounter a squat toilet - just think of it as the cultural difference it is.

You asked what else to bring, and I agree with what's been listed already. In addition to toilet paper, pepto tablets, immodium and hand sanitizer, I brought an asthma inhaler - I have very mild, exercise-induced asthma here, but I was concerned about the effect of living in Beijing's air pollution for a month.

As for hand sanitizer, I found a lavender-scented one at Whole Foods. I put the full-size bottle in my checked luggage and the tiny travel-size one in my carryon, with no problems going through airport security. I bought the lavender scent for its calming properties (not knowing if I'd need a little aromatherapy support in crowds!), but it also came in handy when I wanted relief from occasional pungent scents around me!

China is an amazing place to experience firsthand. As 'fb' said, "Above all, don't let your fears get in the way of your enjoyment." !!!

Re: eating fruit. I found it weird in our group, three people ate fruit off a street cart. A very well-traveled husband and wife ate it with absolutely no issue. A woman who was traveling out of the US for the first time became very, very ill for a few days. As we all ate together all three daily meals other than that, the fruit was the only thing different, but how it affected one and not the other two? Do you build an immunity with frequent travel, I wonder?

Also, I got a measles mumps rubella shot, only because Boston (where I live/work) was having an outbreak last year at the time and there was a period in the mid-60s to mid 70s where the vaccinations were found to have lasted as long, and that's when I got mine as a child. Just something else to know.

We were told it was OK to eat fruit with hatd shell like melons. Otherwise, fruit had to be peeled.