asked questions by travelers
can I get these vaccinations?
can go to either an infectious diseases specialist, a travel medicine
clinic, or your family physician. (Your family doctor will have
many of these vaccines in stock, but probably not rabies, Japanese
encephalitis, or yellow fever.) Yellow fever vaccine can only be
given at a registered yellow
fever vaccination center. For extended trips abroad, especially
in rural areas, its generally advisable to go to an infectious
diseases specialist or a travel medicine center. For a partial list
of travel clinics, go to the websites of the International
Society of Travel Medicine and the American
Society of Tropical Medicine and Hygiene.
should I make an appointment for these vaccinations?
one month or more before departure.
received some of these vaccines in the past. How do I know if I
need a booster?
is how long the vaccines are effective (i.e. if its been longer
than this since you were immunized, you need a booster):
A 10 years (after second dose; relatively new vaccine;
recommendations not finalized)
VI (injectable typhoid) 2 years
(oral typhoid) 5 years
B obtain a blood test to determine if still protected
- either revaccinate after 2 years or obtain a blood test to determine
if still protected
fever 10 years
encephalitis 3 years
lifetime (after second dose)
lifetime (after second dose)
lifetime (after a single adult booster)
is the basis for these recommendations?
recommendations are largely derived from the publications and websites
of the Centers for Disease Control and the World Health Organization.
The statements of Health Canada and other governmental agencies
have also been considered. For certain diseases, such as typhoid
fever, data are limited and official recommendations are somewhat
broad. If there is uncertainty in any given situation, we tend to
be cautious and recommend giving the vaccine.
do you do of there is a discrepancy between the advice of the Centers
for Disease Control (CDC) and the World Health Organization (WHO)?
err on the side of caution; i.e. in any given situation, if one
organization recommends giving a vaccine and the other doesnt,
we generally advise giving the vaccine. On most points, the CDC
and WHO are in close agreement. The chief area of discrepancy is
yellow fever vaccine. In countries where yellow fever occurs, the
WHO usually recommends yellow fever vaccine only for travel to those
parts of the country where yellow fever has actually been reported,
whereas the CDC generally recommends the vaccine for all travel
outside urban areas. We have adopted the latter set of recommendations.
Regarding malaria, the CDC recently revised its recommendations
to include atovaquone/proguanil (Malarone), which was recently approved
by the FDA. The WHO has not yet stated its position on the appropriate
use of this drug. Pending comment by WHO, we are following the CDC
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