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Recommended SHOTS really necessary?

Posted by sputnik0 on 4/6/2008 at 11:32

Hi everyone,
My two girl friends and I are backpacking through Vietnam, Cambodia, and Thailand this June. The doctor recommended that we get Hep A, Typhoid, Polio, Tetanus, and Malaria pill.

We will only be in SE Asia for 15 days.
3 days in Ho Chi Minh, 4 days in Phnom Penh and Siem Riep total, 4 days in Bangkok, and 4 days in Chiang Mai.

Since we'll mostly be in big cities and for short periods of time, is it really necessary to get all those vaccines? I heard there are unpleasant side effects (hair loss, nausea, etc.) Also, we are coming from Los Angeles and the shots are pretty expensive. What do you experienced travelers suggest?

Thanks!

#1 sputnik0 has been a member since 24/4/2008. Location: United States. Posts: 10

Posted by somtam2000 on 4/6/2008 at 12:51 admin

This is a common type of question, and as I'm not a doctor, my advice is hardly expert, but:

Malaria: No. We've got a story on malaria medication on Travelfish -- I'd suggest reading that and making a decision from there, but looking at your itinerary, I think you'd be better served taking general precautions to avoid being bitten (use repellent, a mosquito new, dress sensibly and don't sleep naked in a swamp). Also this will better protect you against Dengue Fever which is far more common than malaria.

Hep A: Yes, I'd get the shot.

Typhoid: Yes. You can get this as an oral treatment or as a shot -- the latter is more effective, but neither protect you 100% against Typhoid. Also I've heard of Typhoid and Hep A being administered in a single dose, so that could save you some cash.

Tetanus: Ahhh, I guess, if I had to pick one not to get, this would be it and only because (and I'm not 100% on this) if you get a puncture wound, then you can be given a tetanus shot at the time.

Polio: Yes. You may have been vaccinated against this as a child, in which case you'll just need a booster.

You've got to be unlucky to pick any of these up in Asia, but people do pick them up -- that's why doctors suggest you get your shots up to date.

Hope that helps

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Posted by SBE on 4/6/2008 at 17:47

Yes do what the doctor says minus the Malaria pills.

Being up to date with tetanus jabs is necessary even in your own country especially if you live in the countryside. This is what wikipedia says:

Tetanus is a global health problem, as C. tetani spores are ubiquitous. The disease occurs almost exclusively in persons who are unvaccinated or inadequately immunized.[1] Tetanus occurs worldwide but is more common in hot, damp climates with soil rich in organic matter. This is particularly true with manure-treated soils, as the spores are widely distributed in the intestines and faeces of many non-human animals such as horses, sheep, cattle, dogs, cats, rats, guinea pigs, and chickens. In agricultural areas, a significant number of human adults may harbour the organism.

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Posted by exacto on 5/6/2008 at 04:24

I'm not sure I'd rely on wikipedia for health information, but the advice from Somtam and SBE sounds spot on accurate to me too. You shouldn't need the anti-malarials for the places you'll be visiting and I think from an overall health perspective will be much better off using the precautions that Somtam recommends like a good bug spray and mossie nets, covering up at dawn and dusk, etc.

I'd also lean towards getting those shots your doctor recommended, particularly since the doc didn't go overboard and recommend everything you could possibly get. Perhaps you can spread them out to reduce any side effects they might have on your system. I suppose you could postpone the tetanus shot, but I'd go ahead and get that one anyway, because like SBE says, it can come in handy to have for protection at home as well as on the road. Hope that helps. Cheers.

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Posted by SBE on 5/6/2008 at 18:44

I posted the wikipedia link because many people don't know how these diseases are transmitted.

Japanese encephalitis, malaria, dengue and filariasis, .... which, BTW is very endemic in Indonesia and can cause things like elephantiasis Somtam, not that I want to alarm you unduly, ;-)... are all transmitted by mosquitoes.

Polio, typhoid, and Hep A and tetanus are all transmitted by fecal contamination. The first 3 are by the fecal-oral route (contaminated food and water) and the latter is through wounds ... not very likely in towns in SEA where you are going Sputnik, but might happen if you're a keen gardener or something back home.

Hair loss shouldn't be a problem AFAIK though it is a reported side-effect of long term use of Nivaquine... This drug is no longer used in SEA (and most of the world) because of widespread resistance.

And no I'm not a doctor either but I did get a degree in biology a long time ago and have spent most of my adult life living in the tropics so I got kinda interested in the topic...especially after getting malaria repeatedly (in sub Saharan Africa) despite taking the WHO recommended prophylaxis religiously and also cholera in Ethiopia during an epidemic there. In fact MY doctor always insists I don't need Hep A as he reckons I must have had it at some point and be immune to it by now! Not so sure myself but have never had a problem.

One thing you didn't mention is Hep B...sexually transmitted so if you put yourself at risk of that you also put yourself at risk of AIDS. Be safe! Happy hols.

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Posted by somtam2000 on 5/6/2008 at 19:01 admin

SBE tks for heads-up - we're just about to have bubster#2 so are pretty up on this at the moment...

Two weekends ago at the prenatal class the midwife ran a series of videos on what your kids can pick up if they're not inoculated -- whooping cough, tetanus, cholera, hep, MMR, polio etc -- was pretty eye opening. I've always been vaccinated up to the eyeballs as have been in SE Asia much of my life, but this was the first time I'd seen so many images of what these diseases really can do to you.

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Posted by exacto on 6/6/2008 at 07:21

sbe,

isn't there a titre test to determine if you have the hep a immunity you mention? i could swear that on my last physical at bamrungrat hospital in bangers they included a titre test for hep a immunity. or am i confusing that with a hep b test? cheers.

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Posted by sputnik0 on 6/6/2008 at 10:09

Wow guys, thank you so much for all your responses. This is really helpful.
We've decided to get the Hep A and Thyphoid vaccines and just follow the insect precautions that you all recommend. Thanks again!!

#8 sputnik0 has been a member since 24/4/2008. Location: United States. Posts: 10

Posted by SBE on 6/6/2008 at 13:13

I hadn't thought of that exacto! Might be worth doing About 20 years ago someone I knew actually died of acute Hepatitis A...in Brittany (France) after eating raw seafood.

I know there's a test to see if you're still covered for hep B, had that done years ago at a tropical medicine clinic in Paris.

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