ILL EFFECTS FROM YELLOW FEVER SHOTS
 

will be traveling to Brazil in Nov.on Oceania's Amazon Adventure. I know yellow fever shots are required,Mine just expired and I have heard of some problems the second time around particularly if you are over 65.Has anyone had any experience with this?

I thought it was just the opposite: Problems are more likely the first time than subsequent times.

I had my third jab in 2002 and will be due for another in three years. I haven't reached 65 yet.

On the CDC's wesbite, under the "Who should not be vaccinated section" it does say:

<B>If you are 65 or older, discuss with your physician the risks and benefits of vaccination in the context of your risk for exposure to yellow fever virus based on your destination.</B>

It goes on to say:

<B>If you cannot get the vaccine because of a medical reason and proof of yellow fever vaccination is required for your travel, your doctor can give you a waiver letter. When planning to use a waiver letter, you should also obtain specific advice from the embassy of the country or countries you plan to visit.

If you cannot get the vaccine, discuss with your doctor other ways to prevent yellow fever.</B>

To me that sounds like there are cases where a waiver may be necessary, but then you'd have to clear that with Brazil and the tour operator.

YF not required for entry to Brazil would not bother.

Would be overkill on a luxury cruise anyway.

Just use lots of repellant works for malaria and dengue too

Actually severe reactions are much more common with the

second vaccine that the first because the first sensitizes

Reactions to Yellow Fever Vaccine

Reactions to yellow fever vaccine are generally mild. Vaccine recipients have reported mild headaches, myalgia, low-grade fevers, or other minor symptoms that may begin within days after vaccination and last 5-10 days.

Since 2001 there have been reports of rare but severe and sometimes fatal illness following receipt of yellow fever vaccine. Although reported in a very small proportion of approximately 500 million worldwide yellow fever vaccine recipients, those adverse events require further investigation.

The Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) are enhancing preexisting surveillance for yellow fever vaccine adverse events with special laboratory support.

Healthcare providers are encouraged to report adverse events that might be caused by yellow fever vaccination to the CDC/FDA Vaccine Adverse Events Reporting System .

So for me the risk would outweigh any small benefit.

Serious yellow fever vaccine related adverse events are rare. Nevertheless, vaccine-associated viscerotropic disease or neurologic disease are described. These are rare adverse events that have occurred at a rate of about 5 cases for every million doses of yellow fever vaccine administered. Individuals who are aged 60 years and older appear to be at increased risk for these vaccine associated adverse events. They occur in this age group at a rate of about one case per 40,000 doses of yellow fever vaccine administered. To date, these reactions have only occurred in persons receiving yellow fever vaccine for the first time.

When considering vaccination of travellers who are aged 60 years and older, it is essential to determine whether they will be at risk for yellow fever at their destination, and whether vaccination is required under International Health Regulations. Vaccine requirements may be found at the WHO site: http://whqlibdoc.who.int/publications/2005/9241580364_ country_list.pdf Therefore, a comprehensive risk assessment that balances the risk of the vaccine with the risk of acquiring yellow fever disease, should be undertaken for each individual.

Travellers should be encouraged to make an informed choice regarding vaccination against yellow fever. Travel to endemic areas without yellow fever vaccination should be discouraged and it may be prudent to consider a change to the planned itinerary in order to avoid the risk.

NaTHNaC have produced a yellow fever vaccination information sheet for travellers that may be helpful as the risks and benefits of vaccination are discussed.

Where yellow fever vaccination is contraindicated on medical grounds and travel is being carried out, a letter of medical exemption letter should be provided.

Further information about yellow fever vaccine can be found at

www.NaTHNaC.org/pro/factsheets/yellow.htm

To date, these reactions have only occurred in persons receiving yellow fever vaccine for the first time.

You are correct Jeff on severe adverse events

Think it is different for the milder reactions though

from my personal experience each one hurts worse...

Unless it was required I would not take it...

THANK YOU BOTH JEFF AND QUOVADIS FOR YOUR INFORMATION.I had asked my neurologist [I have Parkinson Disease] but he did not know I was particularly concerned about neurological damage.
Do you know if the waiver is accepted by the cruise line or the country? Thanks for your help.

You do not need the yellow fever vaccine if coming from the USA. A waiver is not needed.

Is the cruise line requiring the yellow fever vaccine? If they are, then you have to ask them if they will accept the waiver. Call them and ask.

We were in your position, Carmen, earlier this year. Late 60's, previous Yellow Fever shot only a month out of date. But coming from Australia, and having to travel back through USA on the way home from Brazil (Iguacu and Amazon) , didn't want to risk having to be quarantined on the way home, so we had the shots. Specialist doctor didn't seem to have a problem at all with our age, and we certainly had no ill effects, maybe a sore arm for a day or two. Happy travels!

PS.. Nobody on the borders actually asked to see our vaccination cerificates, but they could have. Maybe they were too busy as it was just the beginning of the swine flu scare.

Carmen the cruise ship is required by law to accept a waiver.

You get your doctor to write a letter, on his letterhead, stating the SPECIFIC reasons why you can't have the shot. Then you take the letter to the health dept that is authorized to give YF vaccinations. You are then given a card with the letter attached, with the health dept stamp and signature, EXACTLY as you would have if you had the shot. The card is titled Medical ContraIndication to Vaccination and is the same yellow as the vaccination card. Advanced age is one of the acceptable reasons. Anyone with a suppressed immune system should NOT get Yellow Fever shots.Egg Allergy is another common reason lots are allergic

Here's some pretty good info on what the cert should look like:
http://www.medic8.com/travel/yellow-fever.htm

Read this page from the CDC about the requirements for a waiver:
http://wwwn.cdc.gov/travel/yellowBoo...llowFever.aspx

Here is the approved waive form

MEDICAL CONTRAINDICATION TO VACCINATION
Contre-indication médicale á la vaccination

This is to certify that immunisation against
Je soussigné(e) certifie que la vaccination contre


__________________________________________________ ________
(Name of disease — Nom de la maladie)

for
pour


__________________________________________________ ________
(Name of traveller — Nom du voyageur)

is medically
est médicalement


contraindicated because of the following conditions:
contre-indiquée pour les raisons suivantes:

__________________________________________________ __________________________________________________ __
(Signature and address of physician)

Thank you all for your interest and help. QWOVADIS YOU ARE AMAZING .
Jeff the cruise line said send them a letter from the Dr. and they will also honor it.Will go to the Brazilian embassy to get my visa and intend to check with them also.
Carabella,did you have a good time/ Isn't Iguazu the loveliest? What did you do on the Amazon? Any hints for me?
Thanks folks for writing.\

Going to Iguazu Falls, Argentina in early January. How far in advance of the trip should I get a YF shot? I would like to be over the reaction period well before my vacation. Thanks!

Carmen, we stayed at the Ariau Towers for four days, and did the activities there - jungle trecking, piranha fishing, caiman spotting, visiting local families and trying yummy fresh brazil nuts etc, driving a golf buggy around at treetop level etc (see their site), and also spent a night in Manaus. Highlight was a performance at the wonderful opera house (a must, at least to tour). The night we were there, it was Belle Epoque grand piano and singers - a namesake for you - Carmen Monarcha, a Brazilian singer who sings with Andre Rieu too- it was all fantastic. Such a beautiful building and superb acoustics in the middle of the Amazon jungle! We also walked down to the wharf and organised our own private boat tour to the Meeting of the Waters and Ecological Park of January, for the Victoria Regens Giant lilies. Meeting of the waters was better from the plane as we were landing, but the lilies are amazing, and the tour was fun. We were picked up at the airport, but waited at the Tropical for our tour to start - there's a small zoo there for a close up view of some of the animals. But don't expect much wildlife unless you travel for days along the river - but you'll enjoy it anyway.


My hints...
Look up and enjoy the sky!
It's hot and humid - wear cotton or linen.
I found "croc" shoes practical, and easy to wash when they got muddy.
Drink lots of water.
Take a good hat.

I took stuff with us in case we got travel bugs - but we didn't need any of them.
Yes, we loved Iguacu - our second time there, and this time only a tenth of the waterfalls, because of ongoing drought. Still good though, and the Dragon's Throat had plenty of water. It was nice really, to see the plants behind the falls instead of just mist.

Would love to be going back. Enjoy it for me!

Thanks so for your hints,Carrabella.Very useful and appreciated. I always enjoy the anticipation almost as much as the actual trip. Will say Hi for you.

My pleasure, Carmen. Have fun

Carmen-
How was your trip? Did you end up getting the YF shot? We've never had it and suddenly are over 70 and it's needed for several places we'd like to go to. I'm kicking myself for not having gotten it when we were younger.
I know you can get a waiver and not have the shot, but (and here's the rub!)if you DON'T get the shot, you CAN get YF.
How did you manage it?

You manage it by using insect repellent, using clothing sprayed with permethrin (I found this really did help) and sleeping under mosquito netting. You can check the WHO website and see if there are recent outbreaks and modify your trip itinerary to avoid these areas. A lot of the recommendation to get YF vaccine is to prevent it from being carried across borders (and not really to protect you!)

http://wwwnc.cdc.gov/travel/content/...er-brazil.aspx

I had an annoying skin reaction for nearly two weeks and I'm not even 60 yet. I don't think I want another shot.

Thanks for asking,NGail. I got the waiver.Did not do any"deep rain forest treking" and agree with migb."A LOT OF THE RECOMMENDATIONS ARE NOT REALLY TO PROTECT YOU'
After all the hassle at the Brazilian embassy.No one even looked at the form.I never saw a mosquito.My Dr. thought that since I had the shot in 1998.I WOULD still have enough immunity to see me through.I think it all depends on where you go and take "reasonable precautions"
migb's suggestions are good ones.Good Luck !

Carmen-
Thanks for getting back to me.
Happy travels!