Hey FF, lets talk about immunizations - Do YOU?
 

With all the talk about the measles outbreak in the U.S. (not sure if its elsewhere) and bird flu and Lord knows what else, I'm curious if other frequent flyers take extra precautions.

Sometimes on flights you end up next to someone who is either hacking away, constantly clearing their throat, or just overall looks sick. The only time I recall having an ailment is a very bad sore throat on a flight home from the Philippines (drank a ton of tea with honey). And after spending 15 hours in Dhaka airport (thanks to the volcanic eruption in 2009) I had a very bad intestinal bout.

As a FF, (and avid cruiser), I always do take antibacterial wipes and wipe down my seat, table, remote (including I do this in my hotel rooms/cruise cabin/ bus seat if doing a tour). I don't go crazy, but just as a precaution. I've never been healthier. Since moving to South Florida from the northeast in 2008, I do not get colds, or flus anymore. I do get a flu shot every year.

Before I went to South Africa in 2012 I did get some extra immunizations b/c I was going to do so some safaris/interaction with animals.

I was seeing news reports advising adults to get reinoculated for MMR. Then read another article that adults who received vaccines prior to 1957 are immune, period. I was born 1954.

I started thinking, of all my travel on flights, which I travel extensively for work to many countries far and wide. I really try not to think about those closed in flights with so many germs and no way to get away from people who may be infected. I would go nuts if I really thought about it. Instead, I just blow it off, because I love to travel. But maybe I need more immunizations, especially as I get older.

My daughter and I are heading to Australia for a month in a couple of weeks and in addition to spending a few days on Kangaroo island, we will take many tours that have such titles as Wine & Wildlife; Wildlife extravaganza; and so on. (Yes, I've heard of the Koala herpes scare). I am an avid wildlife enthusiast and while I avoid any facilities that drug their wildlife for tourists, I will partake with those that do not and have experienced many sanctuaries for some prime time interaction.

I would love the opinion of other frequent flyers and their thoughts on staying germ free? Any getting boosters or updated immunizations?

As a loyal watcher of Animal Planets Monsters Inside Me, I know I can easily die from or get very sick from a mosquito bite in my Florida back yard.

Three thoughts on this:

1. Many of the diseases that you'd be concerned about are viral, not bacterial. Antibacterial wipes do nothing for those.

2. There is an alternate school of thought (inspired in part by statistics like kids growing up on farms in Switzerland playing in the dirt next to the farm animals having way fewer allergies than kids brought up in sterile city environments) that a little bit of "training your immune system" with slight amounts of germs actually may protect you better than avoiding all germs at all costs (because you can't really do the latter).

3. Do you also wipe down (or otherwise always avoid touching with your hands) the handle of any public bathroom door before you exit (including on the plane but also in restaurants and at work)? That's a way bigger a source of germs than the things you mentioned wiping down. In fact, it may be worse to wash your hands, then touch the handle of the bathroom door while exiting, than to not wash your hands at all (and avoid that handle), that's how germ-prone those door handles have been found to be.

For the most part, use a paper towel to open bathroom door. I've also gotten in the habit or using a slip on disposable glove for pumping gas. But trust me, there are plenty of times I am not able to wipe down public used things.

As this is a general, non-program related travel topic, this post will likely do better here in the TravelBuzz forum.

Thanks!

Moderator, Information Desk

so BOTH germs and things like malaria and yellow fever?

very different issues, with things like yellow fever being regional

I'm kind of with you. I have seen the stats about kids so protected these days that they don't have much natural resistance to various diseases. And it makes sense to me.

I flew during SARS without concerns. You have just as much chance of catching a disease on a bus or in a grocery store or at the movies. If someone is noticeably sick (red eyes, sniffling, coughing) I will ask the FA to change my seat. But someone that sick is quite often stopped at the gate and not allowed to board.

I keep up with my shots and take a glance at the CDC's website before I go to a developing country. I'd like to avoid hepatitis A, thankyouverymuch.

Other than that, I think basic precautions are more important than anything else. Don't eat at a street food stall with no customers, the food has probably been sitting out for a while (and probably isn't very good if no one wants it!). Aim for foods cooked with high temperatures and served immediately. Be careful about mosquitos in dengue regions. Be careful about ice, but ice that looks like it's from a central manufacturer is probably fine (look for the round ice cubes with holes).

I once spent a month in Thailand followed by five weeks in Mumbai without getting sick. Currently in Penang for ten days before flying up to Thailand again, haven't gotten sick yet despite eating all the street food I can find in Georgetown. :)

The only time I've ever gotten a serious bout of traveller's diarrhea was in France of all places.

I follow the NHS travel advice for the country I'm travelling to. If it says you should have a vaccination, I have it. I think this is also a condition of most travel insurance policies that cover medical care.

Prior to 2012, I'd often travel to places (urban and rural) like Sri Lanka, Vietnam, India etc without prior immunisation. However, a good friend and colleague of mine (doctor) passed away from Typhoid after a 4 week trip to the subcontinent - I decided the risk wasn't worth it.

Hep A and Typhoid immunisations last 5 years? - and sets you back $140 in Australia

Do note that, AFAIK, the typhoid vaccine isn't 100%—precautions should still be taken. That said, I'd definitely get the vaccine.

Oh absolutely - well, no vaccine is 100% in preventing disease - but something is better than nothing!

Antibacterial wipes can also kill viruses (inasmuch as viruses are alive).

I'm always reminded of one of my hiking instructors's mantras: if it were that easy, we'd all be dead by now (as he ate a piece of food he'd dropped on the ground).

People evolved with germs. Something like SIX POUNDS of the average adult's body weight is directly attributable to bacteria. Antibacterial wipes are snake oil - they may kill some germs right where they're wiped, but you're still surrounded by bacteria and viruses inside and out. Your mouth, for example, is on average home to about 100 million individual bacteria. The germophobia we've developed as a society is really a triumph of people marketing anti-germ products.

Absolutely I agree that kids should play in the dirt to train their immune systems.

As for vaccinations, I get whatever's recommended for the place I'm going.

I keep my vaccinations current (hep A, hep B, typhoid, polio, yellow fever, MMR, tetanus) and take malarone when I'm in a malarial zone. But the frenzy for anti-bacterial wipes just makes me laugh. I believe 100% in "immunization by exposure" to general germs, and 100% in vaccination to guard against preventable diseases that can kill or permanently damage you. Science is a wonderful thing.

Both malaria and yellow fever are transmitted by insect (mosquito) vectors.

I have a few friends who do NOT vaccinate, and actually got Dr's to lie on the form so the kids could get in school(this was over 20 years ago when it was very strict). their reasoning was everyone else had vaccines done, so their kids should be ok.
I have a simple opinion--I dont really care to debate the whole should I vaccinate or not, I just think if youre NOT going to vaccinate you should think twice about where you take your kids. Its really scary and unfair to those people who have compromised immune systems due to cancers, etc , those from other countries, etc. It just doesnt seem fair or right. But who knows? I always had to have all my titers for work and vaccinated my daughter as well.

germs versus prescription/vaccine

Is the OP recommending MMR jabs if planning to visit the USA?

Actually, the assumption is that those born before 1957 have immunity by actually having had measles (and mumps, but not rubella). However, if you are not sure that you actually had measles, then that may not apply to you.

Some measles vaccines given from 1963-1967 were less effective or ineffective, so revaccination is recommended in that case. Pre-1979 mumps vaccine has similar issues.

http://www.immunize.org/askexperts/experts_mmr.asp

For an individual born before 1957, ask yourself (for each of measles, mumps, and rubella) whether you had the actual disease or have had the vaccine other than the less effective or ineffective types. If not, then it may be worth considering getting the vaccine.

Dunno about the OP, but I recommend MMR jabs as a matter of course whether you intend to travel or never leave town. The CDC also recommends it for anyone travelling overseas. I'm not aware of any national health system that does not recommend measles vaccination. Not required if you already have immunity from previous immunization or having had the disease of course.

Measles is a nasty virus that results in about 140,000 deaths a year, mostly in the developing world, add to that the ones who survive but have permanent hearing or neurological impairment and its not a pretty picture.

Anybody that tells you measles is just a nasty rash needs to pull their head out of their posterior.

I can already hear the lawyers salivating about the malpractice cases that might have been.

Your friends are, in a word, terrible people. By not vaccinating their kids they put at risk other kids who CAN'T get vaccinated because their own health is too fragile.

This thread reminds me I need to check up on my shot records and such. I do know I had the standard vaccines when I was a wee lad back in the mid 80's for measles and other so called childhood diseases. About 20 years ago when I was in middle school I had a hepatitis B vaccine that I had to get in 3 stages.

Wonder if these things wear off over time and you have to get them again?

Some of the vaccines do need to be repeated, some of them don't.

As to measles, you probably want to talk to your doctor, but a second measles shot is now recommended (wasn't when we were kids).

If you haven't kept up your tetanus boosters as an adult (every 10 years), you definitely want to get that updated.

I get recommended shots prior to travel.

I hadn't thought about a 2nd measles shot, but I suppose it's something I should investigate: I got mine in the 1970's.

I can't believe that people in a so-called educated, developed region of the world are still having discussions about whether or not to vaccinate for things like measles.

That's because we're three generations from people watching their neighbor's kids, their sister's kids, and their kids get deathly ill from these diseases that are so easily prevented.

It will take a generation's kids getting blinded, deafened, heart damage, nerve damage, or death. Then we'll get another 2-3 generations of universal vaccination.

Absolutely. I see no reason to get sick from something almost completely preventable. As was mentioned above, people quickly forget what it's like to watch people suffer or die all around them from things we can prevent these days. I've definitely picked up various sicknesses while traveling, I'd like to avoid the ones that only lurk in far away lands now.

Only think I probably need to update is my tetanus shot. I've had them, but I can't exactly pinpoint the year of the last one. I'm mega-immune from measles. I've had the original vaccine, booster when I went to college and I actually had the measles as an infant. I try to not even get into the argument with people right now in the measles debate. Anyone questioning vaccines can call my mother have her tell you what it was like to see her infant almost die from measles.

I travel extensively for work in far east, South East Asia, South Asia and Africa and I have all my jabs and when in malarial zone take the tablets (even though the people I visit including expats don't bother). Two years ago I came back from Malaysia with a cough which turned out to be atypical pneumonia and I was in hospital for 8 days and off work for a month plus phased return.

As a category, vaccines are one of the great success stories of modern medicine that have saved untold millions from needless suffering that historically was accepted as inevitable. I'm glad I live in a modern age and hope brilliant innovations in new vaccines will keep coming. Anyone intentionally turning their back on such a proven incredible modern success story is just plain acting stupid.

A wise precaution. I was in East Africa about a month ago. The colleague I was working with (who was from our Nigeria office) was clearly not feeling well. She just wrote me that she was back in the office after having dealt with both malaria and typhoid fever.

Hi guys, old thread, but relevant, I would be traveling around SE Asia for maybe 1 to 3 months. Just got a titer test and I am immune to MMR and all hepatitis.
So, researching : typhoid $120 one shot, Japanese Encephalitis 2 shots $375/shot total 750, Rabies 3 shots $380/each total 1140, Total 2085 with exam. Those for only 3 immunizations. I am not sure now how to prioritize as that seems like a lot of money but also I don't want to be ignorant. Going to Indonesia, Singapore, Thailand, Vietnam, Laos, Cambodgia and Malyasia. Please share your thoughts on those countries. Thanks.

Are you planning to stay mostly around the cities or plan to do deep jungle trekking? If it mostly urban, for the countries you listed, you can skip most of the jabs you listed above IMO.

Everything I have ever heard about Japanese encephalitis vaccine is that it is not particularly effective; nor is the disease particularly prevalent. I've never been vaccinated for that, and have been to most of SE Asia without incident. Neither have I ever been vaccinated for rabies; I am fairly confident of my ability to avoid being bitten by a rabid animal (not that I have ever come across one). I have had the typhoid vaccine.

Hepatitis A and B, MMR, tetanus, and yellow fever vaccines seem quite important, as is malaria prophylaxis and trying very hard to stop mosquitoes from biting you. The rest is likely to be overkill, IMO.

Mostly cities, but in Bali staying at an Eco house, yoga, lalala they don't spray for anything like mosquitoes, or anything else.

$380 per shot?

My vet does it for $35/per pet. Hard to believe it's 10x more expensive for a person. Call a local vet and ask where they got their shots as most vets get them due to working hands-on with animals.

SO, if I am immune according to the titer test, to all hepatitis and MMR, I shouldn't do it, correct?
The cdc sites do not mention malaria, how does the malaria work?
SO, you are saying yellow fever, thypiod fever, those are not the same correct?
All of the countries I checked have low risk of malaria, do I carry the pills just in case? Thanks again!

Christ, that's expensive. I, of course, don't know what type of health insurance you have, but if it's through Kaiser, they have a travel nurse that'll help out with all that, and the vaccines are $5-$25 each depending on if they're part of their formulary.

However, I've had to get hep A, typhoid, and Tdap shots/pills (in addition to the routine stuff you get as a kid) for the countries you listed (minus Indonesia and Laos) and stayed in large cities. Unless you're going to be handling or going to be in close proximity to animals, not sure you need the rabies vaccines. Check out the CDC's website for their recommendations.

For anti-malarial pills, they were recommended to me when I traveled to Myanmar, but I just sprayed on a ton of DEET instead and was OK.

Yellow fever and typhoid are not the same thing.

If you're only going to be in cities and use a lot of mosquito repellent, you can probably not bother with malaria prophylaxis, but if you're going to be in the countryside at all I'd take it. You can't just "carry pills;" you have to take them regularly, starting before the trip and finishing after it. There are several types of malaria prevention medications, including Lariam, malarone, and others; the type you take will vary by what geographic area of the world you're traveling to, because not all strains of malaria are the same. The various medications also have different dosage forms and different side effects.

I do not think you need to worry about yellow-fever vaccination unless you are transiting an affected part of Africa on the way there. The only yellow fever in Asia is a handful of people in China who acquired it last year from Angola.

But you probably want to consider antimalaria pills unless you are staying urban, as others have said. They are expensive in the USA but I have gotten by with cheap doxycycline purchased in India and Thailand (as well as basic mosquito avoidance), taken daily from two days before travel to a month after. Of course, please do your own research as I am not a health specialist.

Seth

Guys, thanks for all the info, I am getting more and more confused... So, if I am to do Jakarta to Borobodur and the temples around and then Bali (not staying in touristy ares) and the rest are cities, except for Vietnam, Angkor Wat i Cambodgia, how do you consider those? They are touristy but are they rural? My first trip so not much experience. Thanks!

I get your concern regarding a trip with a vast array of different geographies. The best thing might be to make a list of places you intend to visit and then visit your primary physician. From my experience, for major SE Asian cities, you need hep A, typhoid, and Tdap. The other shots/pills mentioned here then depend on where else you plan to go. But, like I said, go see a doctor.

Those last two are not recommended for the average traveler.