Do I Need shots?
Aug 4th, 2003, 12:05 PM
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Do I Need shots?
We are going to Asia - Hong Kong, Bali, Thailand and Cambodia for 45 days in September and by reading some posts on this site I got really worried about shots and medicines I should take with me. Does anyone has special recomendations on these topics? I prefer to be on the safe side and don't take any chances. Thanks.
Aug 4th, 2003, 01:01 PM
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Do your research at the cdc website, www.cdc.gov/travel and check each of the locations you are visiting. Once you've done your research, go to a travel clinic or a tropical medicine specialist for your immunizations and medications.
There are several kinds of immunizations you'll need.
First, make sure that all of your routine vaccinations are up-to-date. This includes diptheria/tetanus, polio, MMR (measles, mumps rubella), and Hep A (and perhaps Hep B). These are immunizations you should have even if you are staying at home.
Next there are a number of traveler's immunizations, which includes typhoid, and may include others depending on your destinations and activities (these include Japanese Enchelipalitis, Mengiococcal Meninigitis, Rabies, etc.)
From what you've told us of your itinerary, it looks like the only place you'll need anti-malarials will be Cambodia. The cdc website is also very helpful in sorting out the issues around the various anti-malarials.
A travel medicine specialist can also help you sort out what kinds of over-the-counter medications to take along, and may prescribe a broad spectrum antibiotic in case you become very ill.
There are several kinds of immunizations you'll need.
First, make sure that all of your routine vaccinations are up-to-date. This includes diptheria/tetanus, polio, MMR (measles, mumps rubella), and Hep A (and perhaps Hep B). These are immunizations you should have even if you are staying at home.
Next there are a number of traveler's immunizations, which includes typhoid, and may include others depending on your destinations and activities (these include Japanese Enchelipalitis, Mengiococcal Meninigitis, Rabies, etc.)
From what you've told us of your itinerary, it looks like the only place you'll need anti-malarials will be Cambodia. The cdc website is also very helpful in sorting out the issues around the various anti-malarials.
A travel medicine specialist can also help you sort out what kinds of over-the-counter medications to take along, and may prescribe a broad spectrum antibiotic in case you become very ill.
Aug 4th, 2003, 01:49 PM
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Dani01 -
Kathie's points are all correct, but don't be surprised when you find out what these will cost you.
Some innocs must be obtained from a travel clinic or tropical desease physician, however, Tetanus, MMR, Polio, Hep A (they now have a combined A/B) you should be able to get from your regular physician, but if you are on an HMO plan, don't let the doctor put down anything about "travel" (HMOs are notorius for not paying), rather preventive update of innoculations.
The others will cost a pretty penny, so don't go running to your bed with the vapors. Realize that you will eventually need most of these, so start getting what you need immediately now and every year thereafter get those left - the $$$ hit won't be so bad.
And don't forget to ask for Cipro - it's best used for Travelers Runs, but the "bacterial" type, not just normal stomach grippers - they're expensive, so don't use unelss you must.
Also, most of the above innoc are good for 10 years, but check on each.
Kathie's points are all correct, but don't be surprised when you find out what these will cost you.
Some innocs must be obtained from a travel clinic or tropical desease physician, however, Tetanus, MMR, Polio, Hep A (they now have a combined A/B) you should be able to get from your regular physician, but if you are on an HMO plan, don't let the doctor put down anything about "travel" (HMOs are notorius for not paying), rather preventive update of innoculations.
The others will cost a pretty penny, so don't go running to your bed with the vapors. Realize that you will eventually need most of these, so start getting what you need immediately now and every year thereafter get those left - the $$$ hit won't be so bad.
And don't forget to ask for Cipro - it's best used for Travelers Runs, but the "bacterial" type, not just normal stomach grippers - they're expensive, so don't use unelss you must.
Also, most of the above innoc are good for 10 years, but check on each.
Aug 4th, 2003, 07:30 PM
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Dan:
As per Kathie's posting, check with CDC but I was in Hong Kong (April '02) and Bali-Thailand-Singapore-Japan-Korea (Feb/Mar '01) and didn't need anything.
Rest of Indonesia needed shots (Bali was listed as an exception), I wasn't in Cambodia so no comment there and SARS may have added some requirements overall (to make sure everything else is current &/or to eliminate some 'options').
Z
As per Kathie's posting, check with CDC but I was in Hong Kong (April '02) and Bali-Thailand-Singapore-Japan-Korea (Feb/Mar '01) and didn't need anything.
Rest of Indonesia needed shots (Bali was listed as an exception), I wasn't in Cambodia so no comment there and SARS may have added some requirements overall (to make sure everything else is current &/or to eliminate some 'options').
Z
Aug 5th, 2003, 05:23 AM
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I've been to Hong Kong and Thailand 5 times and have yet to get any shots! If you happen to get some sort of "bug" you can buy tetracycalene (sp) or penicilin at any drug store w/out prescription. I've never needed any of these, knock on wood, and I plan to continue to travel to Asia as often as I can. Just don't drink the water out of the tap and watch the street food, altho I've not gotten sick from it.
Aug 5th, 2003, 05:42 AM
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Just because people have gone places without shots doesn't mean it's smart to do so. And note that no shots are required. (The only exception is yellow fever, IF you are coming from a yellow fever area - parts of South America and Africa.)
Also note that SARS (for which there is no vaccination) has had no impact on what innoculations are recommended.
Also note that simpson's advice of not to worry because you can buy antibiotics without a precription is ill-informed. The innoculations you should have protect you from diseases that are not treated with antibiotics. His advice to observe food and water precautions is good.
Things like Hep A and typhiod are spread through contaminated food and water. Just observing routine food and water precautions won't be enough to protect you.
Also note that SARS (for which there is no vaccination) has had no impact on what innoculations are recommended.
Also note that simpson's advice of not to worry because you can buy antibiotics without a precription is ill-informed. The innoculations you should have protect you from diseases that are not treated with antibiotics. His advice to observe food and water precautions is good.
Things like Hep A and typhiod are spread through contaminated food and water. Just observing routine food and water precautions won't be enough to protect you.
Aug 5th, 2003, 01:53 PM
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It just makes sense once you start traveling outside your comfort area that you update innoculations.
Tetanus, Hep A, Polio and needed back at home as anyplace else. And the reason these are innoculations is because normal antibiotics, don't work.
It's just as easy to come in contact with a dirty nail in any western country; or kitchen help to forget to wash their hands when preparing your food -
So it's better "to be safe, than sorry" and as mentioned previously, they last for 10 years.
Tetanus, Hep A, Polio and needed back at home as anyplace else. And the reason these are innoculations is because normal antibiotics, don't work.
It's just as easy to come in contact with a dirty nail in any western country; or kitchen help to forget to wash their hands when preparing your food -
So it's better "to be safe, than sorry" and as mentioned previously, they last for 10 years.
Aug 6th, 2003, 01:12 PM
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Dani, you also need some advice on anti-malarial medication, depending on where you are going in Thailand and Cambodia. You may decide not to take anything, but it should be an informed decision. (If Malarone is an option, we've found it to have the least side effects.)
And please don't take this the wrong way, but if, as you say, "I prefer to be on the safe side" then you should be seeking trained medical advice (preferably from a travel doctor or service) and not asking the question on a travel forum where the credentials of the posters (myself included!) are unknown to you.
And please don't take this the wrong way, but if, as you say, "I prefer to be on the safe side" then you should be seeking trained medical advice (preferably from a travel doctor or service) and not asking the question on a travel forum where the credentials of the posters (myself included!) are unknown to you.
Aug 6th, 2003, 04:20 PM
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Marilyn -
You are absolutely correct that a traveler should contact a Travel Clinic or specialist in Tropical Diseases.
However, when one does this with no previous experience or having inquired of other travelers, you can be shocked when you're advised what innoc, meds you need and the cost. The prices charged by these services can be close to $500 or more. Travelers are then so thrown off by the expense, more often than not, many just leave and don't do anything.
So if one is forewarned and has asked questions and reviewed the CDC sites they know what to ask of the specialist/clinic and then can make a decision.
That is one reason why I "suggest" that with such information, people try to get the innoculations spread out over a a few months/year prior travel.
You are absolutely correct that a traveler should contact a Travel Clinic or specialist in Tropical Diseases.
However, when one does this with no previous experience or having inquired of other travelers, you can be shocked when you're advised what innoc, meds you need and the cost. The prices charged by these services can be close to $500 or more. Travelers are then so thrown off by the expense, more often than not, many just leave and don't do anything.
So if one is forewarned and has asked questions and reviewed the CDC sites they know what to ask of the specialist/clinic and then can make a decision.
That is one reason why I "suggest" that with such information, people try to get the innoculations spread out over a a few months/year prior travel.
Aug 6th, 2003, 07:04 PM
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We were able to get some of our vaccines from our local health department for a small fee. They offered Hepatitis B, and DPT. Our insurance doesn't cover vaccines so it was much cheaper than a doctor's visit. We were vaccinated against Hepatitis A a few years back. For Cambodia, the anti-malarial we used was Malarone, it had few side effects. Cipro or Ciprofloxacin was readily available in Thailand and is much cheaper than in the US, so if cost is a factor you could pick it up once you get there to have on hand for traveler's diarrhea.
Aug 6th, 2003, 08:33 PM
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Sandi, your point is well taken. I guess I've been sheltered from the "real world" by Kaiser, who never charged us for any shots. We had to pay for the Malarone, but only because it was new and not on their drug list. No charge for Lariam, but we felt the $80 each was well worth it.
Aug 7th, 2003, 04:38 AM
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Marilyn - And the $80 for Malarone was a good deal. Luckily on our frst few trips to Africa, when we were taking Lariam (bm = before Malarone) my travel partner was able to get his free (a California Med Plan) and surprisingly, the pharmacist gave him enough for me - so I saved on that trip. Next time I had to pay for my own and at $9/$11 pill can be costly.
Luckily, my own HMO physician is smart enough to realize that if she doesn't put down "travel innocs/med" rather "innoculation updates, preventative medicine" I need only pay my copay for the office visit. Otherwise, HMOs won't pay for travel purposes.
Unfortunately, our general physicians do not keep specialized innoculations on hand, and the patient has no choice but to go to a Public Health Clinic, Travel Clinic or Tropical Diseases Specialist - and they have to pay high numbers, especially at the last two. And last year, would you believe, there were lots of Public Health Clinics that didn't have Tetanus on hand - actually out-of-stock - we assume because of the large number of military personal getting ready to ship out.
Lesson - don't leave this part of your travel experience to the last minute - keep current with your innoc and then you can plan to travel just about anyplace.
Luckily, my own HMO physician is smart enough to realize that if she doesn't put down "travel innocs/med" rather "innoculation updates, preventative medicine" I need only pay my copay for the office visit. Otherwise, HMOs won't pay for travel purposes.
Unfortunately, our general physicians do not keep specialized innoculations on hand, and the patient has no choice but to go to a Public Health Clinic, Travel Clinic or Tropical Diseases Specialist - and they have to pay high numbers, especially at the last two. And last year, would you believe, there were lots of Public Health Clinics that didn't have Tetanus on hand - actually out-of-stock - we assume because of the large number of military personal getting ready to ship out.
Lesson - don't leave this part of your travel experience to the last minute - keep current with your innoc and then you can plan to travel just about anyplace.
Aug 7th, 2003, 05:43 AM
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Another note on medical insurance coverage. My medical insurance does pay for the innoculations and the doctors visit at the Travel medicine Clinic, as well as most of the cost of the malarone (I only pay the $25 copay). So check with your insurance company before assuming it won't be covered.
Many county health departments do have lower cost innoculations. Also, if you live near a medical school, they typically have travel medicine or tropical medicine clinics at reasonable prices and with excellent expertise. I've heard variable reports about the expertise of those in private travel clinics.
Many county health departments do have lower cost innoculations. Also, if you live near a medical school, they typically have travel medicine or tropical medicine clinics at reasonable prices and with excellent expertise. I've heard variable reports about the expertise of those in private travel clinics.
Aug 9th, 2003, 09:39 AM
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Hi Dani01!
This may be a travel forum, but you are getting excellent, excellent shots advice here.
Before you travel, get your shots. Even if it costs $500, that is a piddly amount compared with your medical costs if you get sick overseas, or, God forbid, carry some infection with you for the rest of your life!
I used to have to travel a lot for my job, sometimes as much as 80% of the time, frequently to Europe and Asia, and I can't emphasize it enough, GET YOUR SHOTS! My health card, with its updated log of shots, is as important to me as my passport.
If you like jumping off a precipice without knowing where you are going to land, then go without your shots. Otherwise, it's just elementary common sense - and you will enjoy your trip that much more, knowing that you have taken a few medical precautions!
Just my opinion!
This may be a travel forum, but you are getting excellent, excellent shots advice here.
Before you travel, get your shots. Even if it costs $500, that is a piddly amount compared with your medical costs if you get sick overseas, or, God forbid, carry some infection with you for the rest of your life!
I used to have to travel a lot for my job, sometimes as much as 80% of the time, frequently to Europe and Asia, and I can't emphasize it enough, GET YOUR SHOTS! My health card, with its updated log of shots, is as important to me as my passport.
If you like jumping off a precipice without knowing where you are going to land, then go without your shots. Otherwise, it's just elementary common sense - and you will enjoy your trip that much more, knowing that you have taken a few medical precautions!
Just my opinion!
Aug 9th, 2003, 10:42 AM
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FYI - Kathie:
My comment on the impact of SARS on getting shots was based on if your 'fighting' something else because you didn't have the shot/medication then you may be more prone to getting SARS if exposed to it.
So aside from the medical benefit of getting the shots, at the border they may be more diligent on screening people who don't have 'all' of the required ones.
Z
My comment on the impact of SARS on getting shots was based on if your 'fighting' something else because you didn't have the shot/medication then you may be more prone to getting SARS if exposed to it.
So aside from the medical benefit of getting the shots, at the border they may be more diligent on screening people who don't have 'all' of the required ones.
Z
Aug 9th, 2003, 12:49 PM
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Anna k
"Cipro or Ciprofloxacin was readily available in Thailand".
How available? Did you have to go to a clinic or doctor for a prescriptions? There was mention by another poster of antibiotics available at pharmacies without prescriptions! Is this true?
"Cipro or Ciprofloxacin was readily available in Thailand".
How available? Did you have to go to a clinic or doctor for a prescriptions? There was mention by another poster of antibiotics available at pharmacies without prescriptions! Is this true?
Aug 9th, 2003, 02:54 PM
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My husband and I are both pharmacists in the US so it's always interesting for us to visit local pharamacies when we visit foreign countries. In Thailand, you can buy anything except narcotics without a prescription. You should be able to buy the Cipro at any pharmacy, we paid less than $5 for 20 tablets of ciprofloxacin 500mg.
