International Traveler’s Medical Clinic

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Vaccines

Vaccinations Available


About Vaccines

Travel Vaccines

Hepatitis A

This viral disease of the liver is transmitted by consuming contaminated food and water, usually by the fecal-oral route (passed by persons who use the bathroom and don’t wash their hands). The virus can survive on a dried surface for twelve days and can live on a person’s hands for up to four hours. The illness can be severe and recovery can be prolonged. Highest rates occur in the Caribbean, Mexico, Asia, Africa, India, China, South America, and Southern and Eastern Europe. The vaccine is recommended for all travelers older than 1 year of age visiting developing countries.
Hep A is a 2 shot series. The initial dose provides adequate antibodies in 2 weeks after the injection, and a second dose given 6 months after the first dose will confer a lifelong protection.

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Hepatitis B

A viral disease that causes severe liver infection that is transmitted by blood and body fluids. It causes severe liver infection with fever and jaundice, and can progress to chronic liver disease and cancer. The vaccine series is recommended for health care workers, prolonged travel, persons participating in adventure traveling, persons who may have unprotected sex, the possibility of acupuncture and tattooing, and for travelers with a high potential to seek medical care in local facilities.

Three doses are given at 0, 1, and 6 months. Adequate protection for travel is obtained after 2 doses, and the 3rd dose provides a life long protection.

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Twinrix

This is a vaccine that combines the Hepatitis A and Hepatitis B vaccines. The benefit of this vaccine is that your receive protection against both Hep A and Hep B with 3 shots, rather than 5 separate shots.

Three doses are given at 0, 1, and 6 months and confer lifelong protection.

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Typhoid Fever

This is a bacterial infection that is acquired by consuming contaminated food and water, resulting in fever, abdominal pain, and either diarrhea or constipation. It is especially a concern for persons traveling in smaller cities, villages or rural areas off the usual upscale tourist itineraries.

One dose of injectable typhoid (for ages >2 years) becomes effective in 1 week after injection, and protects for 2 years. Four doses of the oral vaccine (for ages > 6 years) taken every other day provides protection in 1 week and lasts 5 years.

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Yellow Fever

An often life threatening viral disease, it is spread by mosquitoes in the Amazon basin of South America and sub- Saharan Africa. Proof of yellow fever vaccination may be required for entry into certain countries and for persons who have traveled through yellow fever endemic countries.

One dose is given and becomes effective in about 10 days and protects for 10 years.

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Meningitis

This is a serious bacterial infection that affects the lining of the brain, and is transmitted by exposure to respiratory secretions secretions (coughing, sneezing, kissing, using utensils which may not have been cleaned properly). The disease cause severe illness with fever, rash and often may lead rapidly to death. The vaccine is recommended for persons who live in close contact with others (dorms, military barracks), persons traveling to the “meningitis belt” in sub- Saharan Africa, and persons traveling to Saudi Arabia for the pilgrimage to Mecca (Hajj).

Menactra, licensed in 2005, is given to persons 11-54 years of age. It is estimated to have a 10 year protection. Menomune is given to persons younger than 11 and 55 years of older. Both protect against 4 serotypes of the meningitis bacteria- A/C/Y/W-135.

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Rabies

Rabies is a disease transmitted through bites and scratches of animals, most commonly dogs, bats, cats, raccoons, skunks, and foxes. If not treated this disease is always fatal. The vaccine is recommended for persons working with animals, young children, persons with extensive outdoor activities in rural areas (trekkers and bikers), and persons with prolonged stays in endemic areas.

Preexposure vaccination consists of 3 doses given on days 0, 7, or 21-28.

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Japanese Encephalitis

This disease is transmitted by a mosquito and causes a viral infection of the brain. It is relatively uncommon in travelers. The vaccine is recommended to persons traveling to rice fields and pig farms in rural areas of India and Southeast Asia.

IXIARO by Novartis was licensed in March 2009 for persons 17 years of age or older, and is given as a 2 dose series, on days 0 and 28.

For persons younger than 17 years, there is a limited supply of JE-VAX by Biken, but supplies most likely will be depleted by 2010. Three doses of the vaccine given on 0, 7, and 30 days protects for about 3 years.

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Routine Vaccinations

Polio

This is a viral illness that is spread by contaminated food and water and can produce paralysis. All persons should have an adequate primary series and a one- time adult booster is recommended if traveling to Africa, India, and the Middle East.

The booster dose in the U.S. is an injectable inactivated vaccine.

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Influenza

The flu is a viral infection that causes fever, headache, muscle aches and lung infection and occurs year round in the tropics. The flu vaccine is recommended for all travelers over age 50, children ages 6-23 months and close contacts of children 0-23 months, pregnant women and all persons of any age with any chronic or immunocompromising conditions. A flu shot should be considered for any traveler wishing to decrease risk of influenza or non-specific respiratory illness.

Yearly flu vaccine provides protection for 6 months.

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Tetanus/diphtheria

Tetanus (lockjaw) is caused by contamination of cuts or wounds. Diphtheria is a potentially fatal bacterial infection that is spread by respiratory secretions. Pertussis (whooping cough) is a highly contagious respiratory disease caused by bacteria. All persons should have an adequate primary series and 1 dose of tetanus/ diphtheria within the last 10 years. Adults who have not received at least 1 previous dose of any acellular pertussis should receive Tdap vaccine at least once, in place of a Td booster.

Tetanus vaccine provides protection for 10 years.

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Pneumonia

Pneumonia is caused by bacteria transmitted from person to person through respiratory droplets and can lead to serious infections of the lungs, (pneumonia), blood (bacteremia), and the covering of the brain (meningitis).  The pneumonia vaccine is recommended for all persons over 65 and those with chronic diseases or compromising conditions, including persons with asthma or cigarette smokers.

1 dose for most adults, some adults may need another dose after 5 years.

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Varicella (chickenpox)

A viral illness spread by respiratory droplets, causing an itchy blister-like rash. Non-immune adults are at increased risk of severe illness. The vaccine is recommended for all persons who have not had chickenpox.

2 doses are given 4-8 weeks apart for persons 13 years and older, which confers lifetime protection. For persons younger than 13 years of age, the 2 doses should be given 3 months apart.

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Measles, Mumps and Rubella

Measles is a potentially serious illness with fever, cough, and rash. Mumps may cause brain infection or infertility in males. Rubella (German measles) causes a mild fever and rash but can be devastating to a developing fetus. These diseases are common in developing countries. The MMR vaccine is recommended for those born in 1957 or later without history of disease or 2 adequate doses of live vaccine at any time during their life.

The MMR confers lifetime protection after 1-2 injections.

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Shingles (Herpes Zoster)

Shingles is an outbreak of blisters and rash that affects just one side of the body, and usually causes very intense pain. It is caused by a reactivation of the dormant virus in the nerves of people who have previously had chicken pox. Anyone who has had chicken pox is at risk for shingles, but risk increases with age, and chronic conditions that suppress the immune system. A shingles vaccine (Zostavax by Merck) was licensed in 2006 for the prevention of shingles in persons over 60 years of age.

The shingles vaccine is just one shot. The duration of immunity is unknown at this time.

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HPV Vaccine (Gardasil) (Human Papillomavirus Quadrivalent Vaccine, Recombinant)

Gardasil is an inactivated vaccine to prevent cervical cancer and genital warts caused by 4 types of HPV.  It is currently recommended only for girls and women 9 to 26 years old.  Cervical cancer is the 2nd leading cause of cancer deaths among women in the world. 50% of sexually active men and women are infected with HPV at sometime in their lives.

Three doses are given at 0, 2, and 6 months. The duration of protection is expected to be long lasting.

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