Japanese Encephalitis Vaccination for Northern Viet Nam?
I plan to spend a week in and around Hanoi and Halong Bay in late January. One of my traveling friends has strongly suggested getting vaccinated against Japanese Encephalitis before the trip. It's costly, and I'm not sure if it's justified.
A non-optional evaluation at the travel medicine clinic would cost $50, followed by 2 shots of vaccine at $250 each.
Not justified. Sounds like your particular risk is way too small. Many of us who have lived for long periods of time in Asia where this disease is endemic do not get this vaccination. It's quite rare to find cases in expats who've lived for years in SE Asia.
1) This is an uncommon illness in travelers, and particularly the extreme versions of symptoms.
2) Your visit is short, and in winter. Hanoi and Halong will be cool and mosquitoes not so plentiful.
3) Presumably you will be staying in some sort of hotel (or on boat at Halong) in enclosure, not near rice paddies in primitive huts.
If you were going to be a Peace Corps volunteer living in rice farming (and pig-raising) villages for extended periods of time, I might advise differently. But this money is better prioritized for decent travel medical insurance, and other immunizations you're more likely to encounter, like Hep A.
I agree with jiejie - I've been to the area 4 times, and there is little if any risk. If you want to be concerned about something in that area, watch out for the absolutely worst road traffic! I'm not talking heavy traffic, but terrible drivers - I've never seen worse. Most every driver in Vietnam does his own thing, and at great cost to human life! I'm terrified driving in a cab from the airport - last time the driver was texting while trying to avoid kids crossing the highway at night (very very very few traffic lights in Hanoi). Pedestrians are forced to walk in many streets/highways along with large buses, trucks, thousands of motorbikes, push bikes and hand carts. Most dangerous thing you could do would be to take a sleeperbus long haul to another city,
A further suggestion: visit your local public health clinic and get THEIR advice. They also, often, provide the shots etc. on the spot at discount prices from what you would pay at a travel clinic.
I got my shots for a recent trip to India at a public health clinic for about half what a private clinic wanted to charge--and, they had all the stuff in stock, unlike the private guys.
In the USA where this poster is from, JE vaccine is not going to be available at most local public health clinics, it's a highly specialized (and highly pricey) animal. (For tetanus, hepatitis, etc. is a good choice though). And very few local public health clinics will be able to give well-considered advice on this sort of tropical medicine topic--they mostly look up the CDC recommendations and quote from that.
If OP is in a big metropolitan area where it's possible that at least one facility may have this in stock, s/he can certainly call beforehand and find out. Even many private travel medical centers will have to order JE, as there is relatively small demand for it. Again though, for this OP's plans and during this time of the year, chances of picking up JE are slim and none. The greater risks to health lie elsewhere.
I've been to the same area during the same time frame and didn't get the vaccine and I'm a big vaccination advocate. You might check your health care insurance for possible coverage.
Thank you for the info tkelvin69. Quoting from the reference you gave:
From 1973 through 2008, there were 55 published reports of travel-associated JE among travelers from nonendemic countries. Only 4 cases among people from the United States have been reported since 1992, when a JE vaccine was first licensed in the United States.
The overall incidence of JE among people from nonendemic countries traveling to Asia is estimated to be less than 1 case per 1 million travelers.
Boy, I'm sure gonna be embarrassed if I'm case #5!
If traveling seems to be part of your future life style, have a long talk with your health provider about getting the hepatitus A and B vaccines (if you haven't already). Neither are particularly inexpensive and require boosters over a period of time.