Sandi - I am confused on required shots

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Jun 17th, 2005, 09:59 AM
  #1
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Sandi - I am confused on required shots

Sandi:

I read your response and now am more confused than ever. My tour group (A&K) and travel agent read me the riot act and insisted I get the yellow fever shot as a minimum - AND said I have to bring the yellow sheet with me for proof of immunization. Why would they do that if it is not required? I got ill from that shot and now am thinking twice about any others. Is there something different because I am going to Kenya and Tanz? Should I not get the remaining Hep B and Diptheria shots as well? This is a bit disconcerting, please give any feedback/experience.
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Jun 17th, 2005, 10:59 AM
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I know YF isn't required for Kenya. I contacted the Tanzania Embassy in Washington DC (perhaps there's a better source I should be asking?) to ask about YF requirement for Tanzania. They said YF isn't currently required to enter Tanzania even if coming from Kenya. Now here's my question - that's what the embassy told me but what's the actual situation on the ground? Has anyone been asked to show YF cert when traveling from Kenya to Tanzania and if so, how recent?

As far as I know, no other vaccinations are or have ever been REQUIRED to enter either country. That doesn't mean you should or shouldn't choose to get them.
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Jun 17th, 2005, 11:08 AM
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sandi
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Canechick -

There's some history regarding the Yellow Fever inoculation for both Kenya & Tanzania. When we first visited, back in '96 no YF was required for Kenya. Then when we visited in '98, YF was required for Tanzania as were were arriving via land crossing at Namanga from Kenya. Yet, if we had been arriving in Tanzania by air direct, no YF was required. But since we had gotten the YF for '98 and it's good for 10-years, we never gave it a thought on subsequent visits. Though, at no time were we ever asked to show the Yellow Booklet.

Then last year, Tanzania lifted the requirement for YF inoculation for those traveling from western countries (only those visiting from countries where YF existed, required proof of inoculation). So as an American or Western European - no YF required. Funny though, for a while Zanzibar required the YF inoculation if arriving from mainland Tanzania - even for Tanzanian citizens. Welcome to Africa!

That requirement too was lifted shortly thereafter. So, NO YELLOW FEVER INOCULATION IS REQUIRED if you meet the requirements above. Tell A&K to "stuff it."

As to other inoculation, Hep-B isn't required... it's only recommended for those who plan to be in-country more then 3-4 months, will be working with refugees or in camps, e.g. NGOs. Hep-B is to cover for blood-borne illnesses.

On the other hand Hep-A is recommended for travel anywhere, even in your home country. Transfer can come from a chef forgetting to wash his/her hands when leaving the bathroom. And this inoculation, given in two shots, the second 6-months to 1-yr after the first, should also be good for 10-years. However, there is currently a combination Hep-A/B inoc called Twinex which some physicians are giving. It just covers you twice as much.

Tetanus - in case you fall on dirty wood or the like. A Tetanus shot omething that is automatically given to any accident victim in the US, but not so in other countries. So it's a good idea to have. This too is good for 10-years.

In addition, my physician recommended a Polio booster - since my initial one was way long ago. This one was easy enough and will last as long as I do.

Thyphoid is the only one I haven't done, though my physician did prescribe the pills for this prior commencing current trip. Bad girl, Sandi - I didn't order the pills. So this one is a toss up. Only you and your physician can decide this one.

Back to A&K - tell them to get their facts straight and current on the Yellow Fever inoculation for East Africa. So much for client's paying A&K a small fortune to travel with them - and they don't know what's what! As of now, you don't need Yellow Fever based on current requirements for entry into Tanzania, specifically - nor for Kenya.

Hope this helps.
 
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Jun 17th, 2005, 11:46 AM
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I agree it's very confusing. To complicate matters, though it is not required to enter the country, CDC.gov does recommend getting the yellow fever shot if travelling to Tanzania.
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Jun 17th, 2005, 12:48 PM
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The It is confusing, but the CDC does recommend YF vaccine for travellers to areas where YF is endemic, and that includes Tanzania, Kenya, etc.

This is different that what countries choose to require-- they are most worried about travellers coming from (even transitting through) areas where they could pick up YF and bring it into their country. That is why travellers who arrive from the US & Europe were exempt from the entry requirements-- these countries don't have YF. BUT if a US citizen travels thru a country where YF is endemic, they could demand it.
I think A&K wants you to get this because IF there is an outbreak in any of the countries you visit, you may not be allowed into a country that is YF free...and they don't want that hassle! (nor should you...that would be a major problem...extremely rare, but a big problem).

The CDC's language on their recommendation is copied below:


Centers for Disease Control and Prevention’s (CDC) recommendations for yellow fever vaccination were broadened this year to include all areas where there is a risk for yellow fever virus transmission. New recommendations do not make a distinction between “yellow fever-infected areas” and “yellow fever-endemic zones.” Yellow fever-infected areas, by World Health Organization criteria, are areas reporting yellow fever cases. CDC defines yellow fever-endemic zones as areas reporting cases but also includes areas where a competent vector, nonhuman primates, and the ecological conditions for yellow fever virus transmission exist. Because there is a potential for infection for travelers to either endemic or infected zones, the best protection is to be vaccinated when visiting such areas.

The list of yellow fever-infected areas on the Blue Sheet does not reflect this new interpretation of disease risk; therefore, the Blue Sheet was discontinued as of March 1, 2004.

The most current information on CDC yellow fever vaccination recommendations by country can be found at this website: http://www.cdc.gov/travel/yb/outline.htm#2.
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Jun 17th, 2005, 01:54 PM
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sandi
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The CDC is a bit alarmist and what was written above sounds like gibberish! The CDC is covering their butt. But that's what they're there to do.

There are rare instances where typical holiday visitors to Kenya or Tanzania will ever be in areas where YF might be, if it exists anywhere in these countries.

In the end, an adult traveler has to make these decisions in consultation with a medical professional with a specialty in tropical diseases - most general practitioners don't have sufficient experience.

What erks me is that A&K (and like operators) can insist upon something like this. There are people who are allergic, have pre-existing conditions, just don't believe in inoculations - how can they insist! They don't know your situation or thinking. Besides, A&Ks Terms & Conditions are written such that regardless you can't sue them.

So go with your own reading and medical professional guidance as regards any such requirements. I know people who have traveled with A&K and other biggies (CCA, Tauck, etc.) and haven't gotten YF since its need has been removed by Tanzania.
 
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Jun 17th, 2005, 04:25 PM
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Sandi,

>>> Back to A&K - tell them to get their facts straight and current on the Yellow Fever inoculation for East Africa. So much for client's paying A&K a small fortune to travel with them - and they don't know what's what! <<<

And here I thought that A&K's customers were paying double for their safaris in order to get those cool baseball caps and tote bags!

---For the umpteenth time, to anybody considering using A&K or Micato, you will be able to copy their exact same itinerary, send it out to other tour operators and get prices back that are at least 1/3, if not 1/2 lower!!!
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Jun 18th, 2005, 05:15 AM
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Roccco -

Only caps and tote bags... the Micato group we came across had hats, and green 24-26" duffle bags and a matching backpack - Whoopie! Probably cost a cool $75 total, if that much to Micato.

 
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Jun 18th, 2005, 05:10 PM
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One out of 20 people vaccinated for yellow fever get a mild flu-like illness of a short duration. More serious complications are extremely rare. You may have been that one out of 20. The other shots you mentioned are less likely to cause you a problem since I do not believe they involve a live virus but take my comment with a grain of salt because I am not a doctor. In any event, as my M.D (oncologist) neighbor says--the practice of medicine remains an art--not a science. That is why so many of us peek at the internet to gather info. Your tetanus/dpt and polio will probably be boosters which are recommended for adults anyway whether they go to Africa or not. Boosters cause fewer complications since your body has already encountered and tolerated the primary vaccination. Our travel clinic recommended we space our shots out to lessen the chance of an adverse reaction. We have had no problems with our shots. I have heard that A&K is very nice and there are alot of components to the tour experience such as the vehicles, the quality of the guide/driver, the company's response to emergencies, etc. that sometimes cannot be quantified so enjoy your trip and don't be too affected by those laughing over your financial choice. You are going with a well-known and reputable company. Finally, Africa's reporting of major diseases is inherently deficient. You are traveling into a region where the chance of contracting some of these occasionally fatal diseases, while rare, is much more common than serious or life threatening adverse reactions from your vaccinations.
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Jun 20th, 2005, 01:04 AM
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No-one can fault A&K's recommendations for YF because if they don't follow the CDC advice they are exposing themselves to litigation.

YF does exist in East Africa hence the CDC advice but it is really upto the traveller to decide whether or not to take the inoculations or not. If you are going to visit Africa again then it may be worth taking it as some African countries do require YF certificate especially if you are arriving from a YF zone. For example, South Africa requires YF certificate if you are arriving from Kenya, Tanzania or several other African countries. Another area to consider is that government regulations can change overnight in Africa and the last thing you would want is to get an injection at an airport. This sounds a bit alarmist but it has happened in the past.
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Jun 21st, 2005, 06:19 AM
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A friend of mine was travelling with A&K a few years ago, and their itinerary required crossing from Kenya to Tanzania over land. At the Tanz border ,some of the travellers were told that they were missing an innoculation, and could only enter the country if they had it on the spot. (And of course, if they can't all enter, it's going to screw up the itinerary for the whole group.) The Tanz offician had (in hand) a syringe/needle that had clearly seen previous use! The matter was settled by a payoff by the A&K guide...and was obviously a scam to get the payoff.
So in defense of A&K (and I have no real reason to defend them!) it could be that they have been subject to scams like this long enough to be concerned about passengers who don't have any innoculations that might be required (even just by a corrupt border guard).

Another post-er mentioned that you can minimize the chances of a reaction to vaccines by spreading the innoculations apart. Makes sense-- otherwise you are hitting your immune system with an avalanche of foreign substances at one time, and that can't be a good thing...
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