Hep A vaccination for Oaxaca/Huatulco?
 

We're going to Oaxaca City and Huatulco in two weeks and stupidly did not think to get vaccinated against Hep A in time. How much of a concern is it there? Do we have to avoid margaritas, fruit, salads, etc.? If so, it seems like we'll have to pass up a lot of good food!

HepA is highly recommended - the first of the two doses is about 98% effective, so you still have "time".
I have a water purification/filtration system in my house in San Miguel de Allende, but don't drink the water. I do get "turista" from the wonderful fresh Salsas in some restaurants.
M (MD ABIM, ABNM, ABR).

Get your Hep A shot as soon as possible because it is not always readily available and sometimes involves a lot of money. The best thing to do is not to say you want it for travel.

I agree with the others- I travel to Oaxaca frequently and have had the shots. On the other hand I have brought quite a few people with me to Oaxaca without the shots and no one has had a problem. Tourist places are trying to be very careful with the food the provide. If you can get the shots, however, why not?

Judysue: why do you advise not to say the shot is for travel? I would think a Dr. would usually ask why you want it? Just curious, I have had hepatitis and definately don't want it again. I have been wondering if I should get a shot. I leave for Oaxaca next weekend. I am thinking about calling my dr. this week and seeing if he will give me a shot. Is there a time before leaving that makes it "too late?"

Particularly considering that the US Centers for Disease Control and Prevention recommends the Hepatitis A vaccine for travelers to Mexico (and a LARGE number of other destinations worldwide) I see no reason not to tell your health care professional why you're interested in the vaccine. If there's any factual basis for "JudySue's" comment at all it's probably that she's confused the Hepatitis A vaccine with the Hepatitis B vaccine. Although the latter is now part of the standard infant/childhood vaccination regimen, for adults the vaccine is still administered more because of individual risk factors than universally, because of the combination of cost and the difficulty in having people who do not believe that they are at risk return to get all of the three injections needed for lifetime recommended.

If you are absolutely and positively sure that you have had Hepatitis A in the past (proof positive being that you titer positive for the Hepatitis A surface antigen) and not either some other form of Hepatitis or another similar illness, there's no need for the vaccination as having Hepatitis A once will engender a lifelong immunity. You should, however discuss this question with your health care professional particularly if you aren't absolutely sure (there aren't any adverse effects to getting the vaccine if you're already immune).

Finally, with regards to the question about when is it "too late" to get the vaccine, there's isn't a strong set of data showing exactly how soon after the vaccination you develop immunity. It is known that within one month after the initial vaccination the 72-90% of the population responding the the vaccine (not 98% as an earlier person posted) will show measureable immune response in the desired range. To bring the immune population to close to 100% and to create lifelong immunity the second vaccination 6 months to a year later (six months is recommended) is needed. Again you need to discuss this question with your health care provider as if they classify you to be at risk of severe complications should you suffer a Hepatitis A infection they may decide to also vaccinate you with Hepatitis A Immune Globulin, which will impart short-term (2-week to 1 month) protection.

ETee,
Your comments re: HepA may not be entirely state of the art.
However, as I was involved in many interventional procedures in my professional life, I was "required" to get the various Hep B vaccines.
I never "converted" until the third series last year.
A recent post stated HepA and Yellow Fever vaccines were $120. at the person's County Medical clinics which seems reasonable.
M

I just decided to call my dr. today and get an appt to discuss the need for any vaccinations before leaving. Hard to believe a Hepatitis shot is $120!! Wow. Hopefully, my record will substantiate that I don't need one after a previous bout with the disease. I haven't had a tetnus shot in 20 years so it is probably time I get one. I might as well be safe. thanks for the info

nonstop,
The $120. was for both HepA and the Yellow Fever immunizations.
I checked my receipts: I paid $284.32 for the series of two HepA and three HepB at my internist's (large group practice) office.
M

I'll let you know tomorrow what my dr. says(and charges)

I saw my dr. today and after much discussion he was not leaning towards a strong recommendation to get the shots. We discussed using common sense about where you eat, avoiding certain situations etc a person would probably be fine but did say they are vacinating children against hep now so that could be an arguement for getting the shots. However, at the end of the conversation he said "if you have had hepatitis before it may be worth the peace of mind to go ahead and get the shots" but was fine if I decided not to. In the end, I decided to go ahead with the shots. The costs are $90 each for the two hepA shots and the three hepB shots are $75 each. His nurse said she didn't think most insurance would cover them. But she also said since I have had Hepatitis before the insurance company might be willing to pay. So I guess we will see. But for now at least I have more peace of mind. Also got the tetnus based on his recommendation to go ahead with that.