NeoPatrick

I have read numerous posts and numerous guides and I guess there is no real definitive answer. I'll be in Asia for a little over two months and will be in China, Hong Kong, Thailand, Laos, Cambodia, and Vietnam. Some sites tell you what shots to have for one country but suggest different ones for another. We have a clinic here that my doctor is sending to me as they stock "all regular travel shots", but even he has said that if I ask them they'll be giving me "everything". Is there a current / up-to-date website for this information?

I'm a healthy sort of guy (except for my mild and controlled diabetes), but where can I go for a real definitive list of what immunizations I should really have for my travels there in August and September?

NoFlyZone

http://wwwnc.cdc.gov/travel/default.aspx

Go to the Yellow Book

Kathie

Yup, the cdc is the acknowledged expert on this. Read it, print it, and take it with you to your doctor or travel clinic.

I wrote a few summary articles on my blog which might be helpful, http://www.travelindependently.com/c.../travel-health

Craig

A good travel doc won't necessarily give you everything. After discussing with you the type of trip you are taking, he or she should be able to make the proper recommendations. Be sure to bring a copy of your complete itinerary and be prepared to discuss the types of accommodations you will be staying in, whether you plan to visit rural areas, have contact with animals etc.

NeoPatrick

OK, thanks. I did notice that the CDC lists exactly the same things for all the countries I'm visiting.

And I guess I just didn't have high expectations about the ONLY clinic in our town that does travel immunizations really knowing what's what and current. But I did set up an appointment for a "consultation" and the shots -- and was told to bring my intinerary -- maybe they'll know more than I think.

You must admit it's much a guessing game -- like Rabies. Well, I'm not camping or doing a lot of wilderness stuff -- but absolutely anybody COULD be bitten be a rabid animal even in a town.

flgirl0817

Talk about rabies - last year in Thailan we were visting the monkey temple and one of the women was bitten by a monkey and she had to go to the hospital and get rabie shots.

I did not get any vaccines or malaria pills for Thailand and Cambodia. This year I'm not getting any malaria pils for Vietam either. They suggest the pills if you plan on being in the rural area or the Mekon Delta, but I will be in the cities and those areas are not malaria prone.

The best plan is to take your itinerary to the travel clinic as they are the experts. However, when I called the travel clinic near me, they wanted to give me every shot known to man, so i thought that they were a rip off, but I'm sure your clinic will be reputable.

Happy Travels

Kathie

It's a matter of probablities. So for rabies, for instance, you would consider the prevalance of rabies in a country, your activities (bicycling, for instance, puts you at greater risk), and the availability of appropriate medical care (human immune globulin and the rabies vaccine) if you get bitten. If you have received the pre-exposure vacine, you won't need the immune globulin post-bite, but you'll need a course of the post-exposure vaccine.

The issue re: human immune globulin is that some places do not have it available and use an equine immune globulin which can cause serious side effects (but is better than nothing).

So if you were going somewhere with a high incidence of rabies (India has the hiighest incidence of human rabies in the world), if you were trekking or bicycling, and if you would be more than 24 hours from the closest medical care for rabies, I'd opt for the vaccine. I don't believe that is true for your itinerary.

BTW, if you were to get bitten, first aid is throuough cleansing of the wound with soap and water and an antiseptic, if available. Then get to somehwere than can give you both immune globulin and the vaccine.

NeoPatrick

Hee hee, flgirl, you're more confident in "my local" clinic than I am. Even my doctor said to find out first what I need for my countries as they will probably "sell" me everything they can -- sounds like your experience.

I suspect this would be different in NYC or DC or somewhere where there might be a variety or choice in travel clinics.

Kathie

Patrick, for all medical care it pays to be an informed consumer. That's why I recommend you take the printed cdc guidelines with you. If they recommend anything you think you may not need, question them about their reasoning. If they are omitting anything you think you might need, question them. We've heard reports here of good travel clinics and bad.

flgirl0817

NeoPatrick,

When I called the travel clinic in my area the woman was unbelievable - she was even telling me that I need a yellow fever vaccine, which I got 2 years ago when I went to Africa, so I knew she was ripping me off.

When I went to Africa I took the malaria pills and when I returned home I got such a bad reaction from the drug, that my doctor told me to stop taking them. Since then I have been reluctant to take them. Since my itineray for Vietnam is not in malaria areas, I'm not going to take the pills.

Last year I was surprised that people weren't taking malaia pills in Angkor Wat, but I didn't either.

But, that is me - everyone has to do what is right for them.
If I was going back to Africa or India, that would be a different story.

Kathie

flygirl, there are apalling examples like yours. As you likely know, there is no yellow fever in SE Asia, but you are not the first person to report being advised to get Yellow Fever vaccine for SE Asia.

BTW, note that there are a number of anti-malarials. The one most likely to cause side effects is Larium, the one you were likely given for Africa. It is not effective in Cambodia. Malarone (which has the fewest side effects) or doxycycline are the two that are effective in SE Asia. As you note, only limited areas of VN are considered malarial risk.

flgirl0817

Kathie,

As a matter of fact I took Malarone for Africa and I was lucky that the side effects started when I returned home and not in Africa.

You are absolutely right that there is no yellow fever in SE Asia. I believe in doing a lot of my own research so I am an informed consumer. As they say knowledge is power.

Now, on the other hand, when people say you can drink the water, I say no way - give me the botled water. When I was in Thaiand last year the stop I made everywher was to the 7 Elevn and stocked up on bottled water. I would be more afraid of the water than anything else.

Bokhara2

Patrick, it might be worth checking with the US authorities - there are some shots (I forget which) that I need to have in order to re-enter Australia if I've visited some countries; even though they're not strictly necessary according to the Travel Clinic doctors.

TerrieDiane

also, make sure you take a personal water bottle with a build in filter, or the light pen...well worth it. Katadyn is the best brand, in the Northwest REI has them, but I got mine on line; leaving for China in 2 weeks. No messing around looking for water to buy on trains, etc.
And, make sure you take your shot record with you, or a copy.
Typhoid for sure everywhere.

dgunbug

There is water all over in VN, Thailand and Cambodia. No need for built in filter systems. We took packets of gator aid to add to the water, which were particularly helpful to my husband who sweats profusely.

Clifton

I don't blame you for wanting to be prepped Patrick. The only nearby clinic that had any relation to travel we had in Memphis wasn't up on much either. Since it's been awhile since we were in these areas, a lot could have changed both in country and in medicine, so the CDC is best to show what you need now. Do make sure you take lots of mosquito repellent, no matter where you're going. Even if you're not worried about malaria due to where you're going, there's still the concern over dengue fever, which hasn't got a vaccine and doesn't sound like much fun either.

Oh, and ask them for come Cipro while you're there. Never a bad idea as an emergency item

Kathie

Yes, do take along an antibiotic. Cipro is no longer recommended for Thailand (or Nepal, but I don't think you are going there) but is fine for the other places you are going. Azythromycin is currently the antibiotic of choice for Thailand. There is a long, technical article about this on the cdc website. I wish they would put it in the summary, as lots of doctors aren't aware of it, and docs typically don't want to read a long article while you are sitting in the office.

Clifton

Thanks for the catch Kathie. I did not know that about Thailand and will have to remember that myself.

NeoPatrick

Phew. So when I called the medical center here they told me to come in two weeks before departure and have a consultation and get the shots. I leave in three weeks, so today I called to make an appointment.

I asked about Hepatitis A & B, as I think I should have both right? Now they say I need a shot one month, the next shot a month later, and a third shot 6 months after that. Four months AFTER I return? So it looks like I go without a hepitatus vaccination which all the sources indicate I should have? What am I missing here?

Kathie

I fear you were poorly informed by the medical center about when to get your shots. Nonetheless, do get your initial Hep vaccine, as it provides partial immunity. I believe there may be an accelerated schedule, so you might be able to get shot #2 just before you leave. Ask specifically about this. Also, there are places along the way where you may be able to get shot #2. Tell us where you will be when you need shot #2 and we can give you suggestions about getting it in SE Asia. And do get the final shot (there is actually a fairly large window for the third shot) as it assures life-long protection.