Costa Rica vaccinations or not?
 

We are vacationing in Punta Uva for one week the end of May with our 6 year old. I have read conflicting recommendations about needing both hepatitus A and B vaccines and malaria pills. I have called the pediatrician and they sent us to a "Passport Health" office that will charge us $105 for an office visit to tell us what we should or should not get. A lot of you have traveled to this area with children, any suggestions?

Here's a link to the CDC website which lists all the recommendations. They're pretty conservative, but it's your child's health you're putting at risk.

Here in Iowa every child has to be vaccinated against Hepatitis B to attend school. Hepatitis A vaccine is now routinely given to all children over one. Some states require Hep A vaccine for school.

Perhaps if you printed out the recommendations, your regular physician would be willing to give the vaccines and write prescriptions for the anti-malarials.

The problem with this comes when persons need yellow fever vaccine (you don't where you're traveling). Physicians who administer yellow vaccine injections have to have a 'stamp' which they place in a yelow immunization record for international travel. Most places don't have these, you do need to go to a travel clinic/passport health office to do this.

Good luck. My insurance did pay for the visit to my travel clinic, have you checked into that?

patty, it's really just your own personal choice; no vaccines or meds are required. We've never done it and haven't had any problems.

I gather from what I read here that most people on this board do not get any immunizations for travel to Costa Rica. I'm not saying they should or not. In the end, it's a decision you need to make with your health-care provider. I do because I'm in Costa Rica long-term.

As Jean mentions, Hep A and B have become pretty routine immunizations, travel or not.

Most large HMOs these days have a dedicated travel clinic/office that your primary-care physician will send you to for such things. That's probably why the pediatrician isn't dealing with it. And because travel is looked on as "discretionary," some insurances will not pay for such visits and immunizations.

I didn't take meds when I went to Costa Rica. I have been vaccinated against Hep A & B.

I did take anti-malarials, yellow fever, typhoid to go to far southern Panama. Overkill? Probably. But, the yellow fever vaccine is good for ten years.

All that said, the risk I would take for myself is far different than the amount of risk I would place on my children.

My thoughts for whatever it's worth -- I'm not a physician but I've traveled quite a bit with my son, who is now 9 years old. We were in CR two months ago.

I personally don't think CR poses any greater hepatitus risk than traveling in the U.S. or Canada. Getting the shots aren't a bad idea but I don't think you need a special appointment at a travel clinic to make that decision specifically for CR.

Based on everything I've read in terms of malaria statistics for CR (as opposed to CDC warnings or others who just repeat what CDC says), I just don't see the risk.

By the way, just to put things in perspective, the CDC recommends no ice, unbottled water, uncooked vegetables, unpeeled fruit, etc. for pretty much all of Mexico, the Caribbean, Central and South America... it's VERY conservative.

We went to a Passport Health Clinic because it was less expensive than our DR. (I believe it is a franchise) It was around $100 for the family, plus the costs of individual shots. The were very professional and provided us with alot of travel advice.

We all got Hep A (had Hep B previously) my husband got typhoid, we declined Malaria pills because of where we were going in CR. We also got Cipro to take with us.

When we returned we got a second Hep A at our physicians, 6 months later which is supposed to make it a lifelong vaccination. Our insurance paid for our child and me but rejected my husbands. (We have different primary care MDs) I think people forget that people in the US have died from Hep A. The incidence of Hep A is increasing. I believe that today a combo Hep A&B is given to prescholers routinely.

There was an outbreak of malaria in Quepos the last time I was in Manual Antonio. Maybe five years ago. It effected mostly young kids sleeping on the beach, but still...

Babies here in Iowa have had all of their Hepatitis B vaccines by the time they're one. Hepatitis A vaccine starts at age one (two shots six months apart).

You're right there are outbreaks of Hep A in the States. People died in Pittsburgh a few years ago, green onions, eaten at Chi Chi's Mexican restaurant.

I go to Belize multiple times a year, and don't take anti-malarials, but I would get them for my kids (assuming they were kids, my 'kids' are approaching 30).

Everyone, Thanks so much for all the great responses! The CDC does seem to be very conservative and that was one of the contradictions with some travel books and other sites I've researched. Thanks Jean for bringing up the routine vaccines (dah!) I checked my son's records and, of course, he has been vaccinated for both Hep A and B. The Passport Health Office told me up-front it isn't covered by insurance, so I still need to decide to keep or cancel the appointment. Thanks again for all the comments and helpful advice! If you have any more tips or advice for us I would be most appreciative.

I just want to say that I made an error in my last post. The malaria outbreak I mentioned was in Jaco, not Quepos. Sorry.

I was in CR at the beginning of April and I got mosquito bites. I've also been to India and taken malaria medication. Personally, with the availability of bug sprays (we took Picardin with us to CR, but bought Citronella spray there) I would not use malaria medication for CR. Wear long sleeves/pants when you can; use bug spray all the time and you'll be fine. The citronella spray seemed to work the best (or else I was already bitten and didn't notice any new bites!). However, as a Californian from the "garlic" end of the state--I can say--if they served more garlic, there might not be such a problem!!!

I was talking to one of our guides in the Osa and asked him what meds he takes for this sort of thing, and he said he didn't take any. Just takes precautions like wearing repellent, covering up, etc. When we've been in CR, the biggest talk has been about Dengue fever, and from what I understand there aren't any preventative meds for that.