can you tell me how long in advance i can get my vaccine to india? if i am traveling in Jan can i have my vaccine in aug? thanks

I didn't know you needed a vaccination against India.

The efficacy of vaccines for different diseases varies. You need to ask your doctor about the specific vaccines you will be getting.

Some vaccinations (hepatitis for example) require multiple injections spread out over a few months, so you should start getting this sorted now.

Michael is right, you want to get started early on your vaccines, as all take at least 10 days to be effective, and several are multi-injection vaccines such as Hep A & B as Michael mentioned.

Take a look at wwwn.cdc.gov/travel Click on destinations and choose India This is the standard reference used by travel med docs. If I were you, I'd print it out and take it with me to your doctor visit.

I don't know what state you live in, but in Maryland, the GP will not be able to give you the shots and you will have to go to something like Passport Health. If you do go...keep good records..they destroy theirs!

Mincepie, the only vaccine a primary care doc cannot give is the Yellow Fever Vaccine. For that, you must go to a certified Yellow Fever Vaccine Center, typically a health department.

Other than that, there are no restrictions on who can give travelers vaccines.
Your point about keeping records is a good one. By law, a health care provider must keep records for a certain length of time, which does vary state to state. But you should always keep a copy of your own vaccine records. WHO used to provide a "yellow book" to contain your vaccination records. I still have mine from some 25 years ago, and still use it to keep my records.

Different countries do have different rules about giving vaccines and costs for the vaccines. So if you are not in the US, you may be referred to a separate clinic or charged differently than you are for routine medical care.

That's not true in this state Kathie..or maybe it is this county. It also maybe that the GP's will not give them.

Some docs may decline to give them, or some insurance plans may not cover them, but the only restrictions about who can give vaccines is about the Yellow fever vaccine.

I would be good to know exactly what happened in your experience, mincepie, so we can better advise others. If you can easily clarify what the issue was, I'd be very interested to hear.

My husband and I have received all our travel shots from our regular Doc including the Hep A & B series. He is part of a group of Drs of various specialities in a private clinic in our small Texas town.

We received our yellow fever shots from the other GP that offices with our Doc. He also advised us on the malaria meds. We had to go to him for YF because he is the Dr at the clinic with the required (state and/or federal) approval to give the shot and the certificate. Our insurance has covered the office visits and the shots including the YF.

We had first planned to go to a travel specialist in a large well known clinic in Houston for all the shots and malaria meds, but they wanted cash only in that division of the clinic and would not even do the paper work for our insurance. Plus the office visit and shots were way more costly.

Bottom line though is to start now so you have time to get all any series of shots needed. Most vaccinations are good for at least several years anyway,

I'm not complaining about the situation, Kathie, but maybe each state is different. Hobody here would give us the Yellow Fever, hepatitus shots or Dengue..they told us they could not get them. We also contacted local health department and they said the same thing. We also have excellent health insurance and nothing was covered.
So all I was saying is that a traveller should check this out ahead of time so they know what their costs are and where they have to go.

Mincepie, that is very odd.

First, as I mentioned, Yellow Fever must be given by a certified yelloe fever center (which can be an individual doc as cwn reports above).

There is no vaccine for dengue.

Hepatitis is a commonly given vaccine, not just for travel, but many believe you should have it to stay at home! Many daycare centers and schools require children be vaccinated for Hep B. So there is no reason your doc couldn't have given you Hep A&B unless the office has a policy of not giving vaccines. (Does your doctor make sure you are up to date aon routine vaccines such as tetanus?) But there is no legal or medical reason your doctor's office could not give them. Some public health departments do give vaccines, some do not. That depends on local rules, funding, etc.

Every insurance policy is different, but it would be unusual for insurance not to cover Hep A&B.

You are quite right, people need to know that costs, what is and is not covered by insurance, and practices of doctors do vary.

What you need for vaccines depends a lot on what kind of travelling you will do in India. You will need more if you will be hiking/roughing it and have less control over food and water, you'll need less or none if staying in 5 star hotels in major cities.

NOTE: not all vaccines are 100% effective (ie typhoid and cholera). You must still take food, water, and mosquito precautions regardless of what vaccines you get.

Hep A and B are good vaccines to have even if not travelling.

Bottom line, get information specific to your travel plans from a reputable travel doctor/travel clinic. Then have them come up with a schedule of injections for you. Start this process now, some vaccines take a few weeks to "kick in". Again you may not need any, but the hep shots. Update your tetanus if needed.

Check with your insurance carrier about coverage. Keep copies of documentation for any vaccines you do get.

I apologise about the Dengue fever info..however ..even if you are a health expert..different rules apply in different states. We have been travelling for years and NO doctor will give us Hepatis shots for tourists.

Our insurance company also refuses to pay for this...maybe it is different for you..but everyone should check this out ahead of time. And yes our doctor does check on our vaccines.

mincepie, I hope you don't take offense at my close questioning of you about these issues. I have rather taken it on myself to make sure the health info here is accurate, so I try to clarify everything I can.

There are differences in how this is handled from place to place. Your last response seems to indicate that the issue was that the vaccines were for travel, and therefore your doc wouldn't give them and your insurance wouldn't pay for them. Some insurance companies also make the distinction of whether a vaccine is for travel and won't pay for a vaccine for travel, but will pay for a vaccine (even exactly the same vaccine) for preventions of illness at home.

The good news about the Hepatitis vaccines is that while they were initially thought to be effective for 10 years, they are now considered to be effective for 20 years. Many believe that once the long term studies are done, the series will be considered to provide lifetime protection.

A dear friend of mine lives in Maryland, and when she last traveled to Asia, a few years ago, I understood that her primary care doc gave her the routine vaccines - Hep A, etc. She didn't require any unusual "travel-only" vaccines like typhoid, and of course, there is no Yellow Fever in Asia so that one was not an issue.

Thanks for trying to clarify this issue.

For future reference, Mincepie and other Maryland residents, here is a list of the places that you can get the Yellow Fever vaccine. http://www.ncid.cdc.gov/travel/yello...asp?StateID=21

The University of Maryland has a Travel Clinic. http://www.umm.edu/geomed/travel_clinic.htm

In Maryland, Hep A/Hep B is included on the state issued immunization schedules for children and adults. I can't understand why Mincepie was unable to get Hep A/Hep B unless it was a payment issue, as availability does not seem to be an issue. Vaccines can be very expensive if insurance does not cover them.

Just to add my info to the mix about what doctors will and won't do...

Before I last went to Thailand and Cambodia I realized I needed to update my Typhoid vaccine. This is available in both an oral dose and and injection.
I called my pharmacy and asked if I could get my doctor to give me a prescription, could they get the oral vaccine? They could. But my doctor refused to give me a prescription!
This had nothing to do with insurance. I was told emphatically, "we don't do that here, you have to go to a travel medical clinic". So, to the clinic I went, spend 3x the $$ and having to take the injection because they were out of the oral vaccine.
As an addendum, my Mom took the oral vaccine and got horribly sick after each dose and I was fine with my one shot!

Definitely get typhoid,the shot or pills.Hep A and B, and malaria pills. I did not need yellow fever for India but you might need Japanese Encephalitis, Rabies if you are going to be in certain areas. A booster of polio is also advised.
My son is living there right now and working and his vaccinations ran over $1200 before he left last year.

Just want you to know that there is a yellow fever shot shortage(at least there was one 3 months ago). The single dose vaccines are in short supply so most of the vaccines are in 5 person dosages that must be given within 1 hour when the first one is given. I, myself had to be put on a waiting list to get my shot(here in a Chicago suburb). When a family of four wanted the shot, I was contacted to come in with them. I needed my shot for work .Several people have told me that you cannot be an organ donor for over 7 years if you have had the yellow fever shot.

Of course I do not take offense Kathie.

Kristina, that is exactly what happened with out GP and the local health authority and yes, places like Passport Health are very exspensive.

Just to clear things up, I will call Dr's office and Health Authority tomoorow.

We are up to date on everything I think anyway.

I believe one important issue with the yellow fever vaccine is that you often want proof that you received it. Some countries require it when entering, usually when traveling from a country experiencing a yellow fever outbreak. So called "official" travel clinics/MDs provide you with a nice little booklet, that lists your vaccinations, and I believe there is a particular "proof of purchase/shot" so to speak, for yellow fever. I'm not sure if a regular MD can provide this. (Certainly, though, for ordinary vaccines, like Hep-A, general practitioners, pediatricians, give these all the time.)

Also, there are "regular" MDs who have some focus on travel medicine and can also provide you with such vaccination booklets. We just visited one. On the CDC website, where vaccinations are discussed, I believe, there is a drop down menu for "approved travel MDs" in the USA. They are listed by state and city. I simply chose one of those. While there are numerous travel clinics here in NYC, ironically, none of them accept any insurance. You pay, you submit, and you hope for reimbursement. Incredibly, my insurance plan covers some travel vaccinations - no doubt compensating for everything else it doesn't cover - and the MD I found was happy to take my insurance card. Now, we still have the typhoid shot to get, if we go through with that, and we will see if that is covered too.

You are quite right that if you get the yellow fever vaccine, you MUST have written proof. As I mentioned above, only certified Yellow Fever Vaccination centers/physicians can administer the vaccine. No other vaccines require this.

The cdc site does have a link that says Travel medicine clinics. Note that these are not "approved" or certified by the cdc in any way. There is a listing of Yellow Fever Vaccinations Clinics (which, of course must be certified) and there is a list by state of public health clinics. These links take you to a state page. There is no guarantee that any state clinic offers vaccines, it just take you to a state department of health web page (the one for the state of Washington was entirely unhelpful). There are also links to two different lists of travel med clinics: one from the International Society of Travel Medicine, the other from The American Society of Tropical Medicine and Hygiene. Note that as tengo mentions, these are not the only places that can give travelers vaccines.

Some doctors may choose not to give travelers vaccines because they believe it is outside their scope of practice. That's certainly a perfectly valid reason for refusing to do so.

mincepie, thanks for following up on this. It will be interesting to see what you find.

Kristina, I don't understand why the travel med clinic didn't write you a script for the oral typhoid vaccine. Sorry your mother had a bad reaction to the oral vaccine. It lasts 5 years rather than the two years for the shot, so I always try to get the oral vaccine.

Frankly, sometimes I think the referral to private clinics has to do with $$$$.

Kathie-That's why I wanted the oral vaccine, because it lasts longer and I hate shots. I don't know why I din't ask them for a prescription and it wasn't offered. This clinic dispenses everything from there. As for my mom, she had a pretty severe stomach/intestinal upset every time she took a dose. I took the oral vaccine 10 years ago and I don't remember a problem either, but everyone is different. She also had a really bad reaction to her last flu shot, so maybe she's just sensitive. ;-) This reminds me I need to reminder her to get her 2nd Hep A shot!