Yellow Fever Shot - Is it that risky to get if you're healthy?

[Ken the cruiser]

We've been holding back booking cruises to places such as the Amazon River because we heard the yellow fever shot can be tough on folks over 60. My DW is 65 and I'm 66 and we were thinking about just getting the shot now since we are healthy and the certificate will be good for 10 years. We're going to ask our doctors their opinion when we see them in June, but thought we'd pose the question here to those folks who got their yellow fever shot for a cruise when they were over 60. Basically, how was the shot and did you have any noticeable reaction to it?

[UnorigionalName]

https://academic.oup.com/jtm/article/23/5/taw045/2579333

 

to sumarize, overall pretty safe.  about 3.8 severe adverse reactions for every 100,000 doses of vaccine.  They give the warning since people 60-69 have a higher than average relative risk for adverse reactions at 6.5 per 100,000 doses.

 

https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5907a1.htm

 

The more detailed guidelines from CDC has more data.  It seems like minor reactions are fairly common (25%) though not to the point it impedes daily activities (<1%).  It notes that travelers from the US have died contracting yellow fever abroad.

 

"During 1970--2009, nine cases of YF were reported in unvaccinated travelers from the United States and Europe who traveled to West Africa (five cases) or South America (four cases) (54--63). Eight of these nine travelers died (19,40) ... for South America, the risks for illness and death are five cases and one case per 100,000 population, respectively (40)." 

 

 

Edited April 2, 2019 by UnorigionalName
old link

[Mura]

I always the problem was more with older passengers than all passengers.  I'm at the age when I wouldn't have the shot now but I had no problem getting the shot in 1976 when I was, ahem, rather younger.

[Missymo]

Went to the Amazon 5 years ago. Hubby and I were 67.  Neither one of us had any problems with the shot.  However, we were also given Malaria pills to start taking 3 or 4 days before arriving in Manaus.  Hubby didn't t take it but with my health issues, I did start taking 4 days before and by the second day had terrible reactions, dizziness, and couldn't keep balance. .  Stopped immediately, and when we reached Manaus, had to cancel my tours.but I was well enough to walk down to the Opera House and see a complete tour.   By the 3rd day of not taking them, I recovered my equilibrium.  

[Ken the cruiser]

1 hour ago, UnorigionalName said:

https://academic.oup.com/jtm/article/23/5/taw045/2579333

 

to sumarize, overall pretty safe.  about 3.8 severe adverse reactions for every 100,000 doses of vaccine.  They give the warning since people 60-69 have a higher than average relative risk for adverse reactions at 6.5 per 100,000 doses.

 

https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5907a1.htm

 

The more detailed guidelines from CDC has more data.  It seems like minor reactions are fairly common (25%) though not to the point it impedes daily activities (<1%).  It notes that travelers from the US have died contracting yellow fever abroad.

 

"During 1970--2009, nine cases of YF were reported in unvaccinated travelers from the United States and Europe who traveled to West Africa (five cases) or South America (four cases) (54--63). Eight of these nine travelers died (19,40) ... for South America, the risks for illness and death are five cases and one case per 100,000 population, respectively (40)." 

 

 

Thank you so much for providing this information! It really helped us minimize our worries associated with the YF shot.

[Starlaker]

Missymo, We had the same issues with the malaria tablets.  We stopped taking them when they made us dizzy and sick at our stomach.  We both had the Yellow Fever shots when we were 64 and had no reaction other than a few days of soreness at the injection site.  My friend got very sick from the shot.  

[Ken the cruiser]

26 minutes ago, Missymo said:

Went to the Amazon 5 years ago. Hubby and I were 67.  Neither one of us had any problems with the shot.  However, we were also given Malaria pills to start taking 3 or 4 days before arriving in Manaus.  Hubby didn't t take it but with my health issues, I did start taking 4 days before and by the second day had terrible reactions, dizziness, and couldn't keep balance. .  Stopped immediately, and when we reached Manaus, had to cancel my tours.but I was well enough to walk down to the Opera House and see a complete tour.   By the 3rd day of not taking them, I recovered my equilibrium.  

Thanks for sharing your experiences. Did the cruise ship folks mandate you take the malaria pills because of some eminent threat in Manaus or was it just a suggestion and they gave you the pills onboard for free?

[ano]

6 minutes ago, Ken the cruiser said:

Thanks for sharing your experiences. Did the cruise ship folks mandate you take the malaria pills because of some eminent threat in Manaus or was it just a suggestion and they gave you the pills onboard for free?

We are going to a port where Yellow Fever exists, but probably won't even get off the ship. The letter from Oceania says they never give any medical advice on this, and will never enforce any medical requirements, but proof of vaccination is required at some ports by the country.

[cbb]

we both were vaccinated for Yellow Fever and had no reactions.  Mr Wonderful had very very bad reactions to the Malaria pills and went to the onboard physician.  (ATW16 was in Brazil/Amazon area as well as both western and eastern Africa so we wanted to be proactive.)

 

the physician typed a few things into the computer, swiveled it around so dave could read it and it was a list of the side effects and he had every one of them.  Some of the other worldies were feeling terrible and I asked them what their symptoms were and as soon as I heard them, I told them to go see the doc--they were taking  malaria pills as well.

 

so we wore long sleeves, socks, & long pants, which we had  coated with mosquito repellent at home and put into a plastic bag, covered the rest of the skin with other mosquito repellent, and made sure we weren't out after dark...did not get bitten and did not get sick....but he'll never take another malaria pill again! 

[Ken the cruiser]

7 minutes ago, cbb said:

we both were vaccinated for Yellow Fever and had no reactions.  Mr Wonderful had very very bad reactions to the Malaria pills and went to the onboard physician.  (ATW16 was in Brazil/Amazon area as well as both western and eastern Africa so we wanted to be proactive.)

 

the physician typed a few things into the computer, swiveled it around so dave could read it and it was a list of the side effects and he had every one of them.  Some of the other worldies were feeling terrible and I asked them what their symptoms were and as soon as I heard them, I told them to go see the doc--they were taking  malaria pills as well.

 

so we wore long sleeves, socks, & long pants, which we had  coated with mosquito repellent at home and put into a plastic bag, covered the rest of the skin with other mosquito repellent, and made sure we weren't out after dark...did not get bitten and did not get sick....but he'll never take another malaria pill again! 

We're definitely going to use those suitable substitutes instead of taking those malaria pills. They just don't sound like a lot of fun. When we were at the AFB the other week getting our Japanese encephalitis shots for our upcoming SE Asia cruise, they also said the malaria pills were recommended, but only if we were going to be staying awhile and going into the jungle areas. It sounded like you had to take their a 2 week period before as well as after the visit. So we passed and figured we'll just use the alternative precautions as you suggested.

[cbb]

we try and watch for the Consumer Report reviews of the mosquito repellents--they were great info for us in 2016 and will keep an eye on the reports before 2020 just to make sure that nothing much has changed.  

[Missymo]

1 hour ago, Ken the cruiser said:

Thanks for sharing your experiences. Did the cruise ship folks mandate you take the malaria pills because of some eminent threat in Manaus or was it just a suggestion and they gave you the pills onboard for free?

The cruise line did suggest we take the malaria pills in its information folio., We got the prescription thru the same Dr. and not the ship .  As I had never traveled to the Amazon, I wanted to be as safe as possible.  As I had stated, hubby did not want to take, and as we found out later,  You only need to take the pills if traveling deeper into the jungle, or camping out  at night.  PS  we did not have any mosquito problems. 

[Ken the cruiser]

7 minutes ago, Missymo said:

The cruise line did suggest we take the malaria pills in its information folio., We got the prescription thru the same Dr. and not the ship .  As I had never traveled to the Amazon, I wanted to be as safe as possible.  As I had stated, hubby did not want to take, and as we found out later,  You only need to take the pills if traveling deeper into the jungle, or camping out  at night.  PS  we did not have any mosquito problems. 

Thanks!

[Shawnino]

Please consult an immunologist.

As someone who has to travel unvaccinated, I can assure you that immunologists have lots of great advice whether you get vaccines or not.

 

I think fewer over 60s are opting for YF vaccine after this:

https://www.theguardian.com/uk-news/2019/jan/11/top-cancer-scientist-prof-martin-gore-dies-after-rare-reaction-to-yellow-fever-vaccination

This gentleman was a huge loss to medical research in general.

[GeezerCouple]

1 hour ago, Shawnino said:

Please consult an immunologist.

As someone who has to travel unvaccinated, I can assure you that immunologists have lots of great advice whether you get vaccines or not.

 

I think fewer over 60s are opting for YF vaccine after this:

https://www.theguardian.com/uk-news/2019/jan/11/top-cancer-scientist-prof-martin-gore-dies-after-rare-reaction-to-yellow-fever-vaccination

This gentleman was a huge loss to medical research in general.

 

How sad.

 

It can sometimes be tricky, the risks of prevention vs. risks of disease itself.

 

I hadn't realized that malaria pills could make one so sick, but that info provides a bit of an explanation of another sad occurrence.

A dear colleague from the past was doing some fieldwork in Africa again, and he got malaria.  Despite being evacuated to London (his home location), he died relatively quickly.  I never understood if he hadn't taken any precautions, or if they just didn't help with prevention.  Now I understand why he might not have taken them, IF that's what happened. 

 

GC

[Rob the Cruiser]

Kaiser Permanente insisted that we get the YF vaccination and take anti-Malaria pills. They weren't so insistent for the pills but they said if we chose not to take the YF shot then don't go. We took the shot last year at ages 63 and 64. No problem with the shot other than soreness for 3-4 days. We started taking the anti-Malaria pills when we arrived at Devil's Island and then through the Amazon segment. No problems with the pills either. 

Edited April 3, 2019 by Rob the Cruiser

[Mura]

I'm interested in these comments about bad reactions to malaria pills.  We haven't had them in many years (when we were in our 30s and 40s) but had no problems at all.  I'm wondering if that was at least partly because of our younger ages OR if the formula for the pills has changed.  No one on our Kenya-Tanzania safari in 1987 had any problems at all ... then again, most of us were much younger then than the typical Oceania passenger is now.

[Andee]

We  (68 & 70) got the YF shot in November because the CDC recommended either getting the shot or not going to Brazil. No ill effects.

We took Malarone for a 2014 safari in Tanzania. No ill effects.

[robbie21]

There are six antimalarial drugs recommended by the Center for Disease Control. Each of these drugs is effective only for certain strains of the disease.  The drug recommended for you will depend on where you are going and the strain(s) of Malaria endemic to that region.  Obviously there are different side effects of each drug. For some areas there are more than one drug needed or there are two or more drugs that can be effective.

 

If you are going to a malarial infected area please consult with a clinic or immunologist specializing in travel. Your general medical clinic/family practice/internist likely does not have the expertise.

 

Robbie

[Rob the Cruiser]

Our prescription was atovaquone - projuanil. 

 

Here's the link to the CDC article that robbie21 was probably talking about.

Edited April 3, 2019 by Rob the Cruiser

[StanandJim]

16 minutes ago, robbie21 said:

There are six antimalarial drugs recommended by the Center for Disease Control. Each of these drugs is effective only for certain strains of the disease.  The drug recommended for you will depend on where you are going and the strain(s) of Malaria endemic to that region.  Obviously there are different side effects of each drug. For some areas there are more than one drug needed or there are two or more drugs that can be effective.

 

If you are going to a malarial infected area please consult with a clinic or immunologist specializing in travel. Your general medical clinic/family practice/internist likely does not have the expertise.

 

Robbie

I agree in principle but it should also be noted that those "recommendations" generally apply to very wide swaths of people. Some folks intend to get out in the country and will spend long periods of time outdoors.  Others alternate between air conditioned tour busses and air conditioned museums. Think about what your exposure will be.

Edited April 3, 2019 by StanandJim

[robbie21]

36 minutes ago, StanandJim said:

I agree in principle but it should also be noted that those "recommendations" generally apply to very wide swaths of people. Some folks intend to get out in the country and will spend long periods of time outdoors.  Others alternate between air conditioned tour busses and air conditioned museums. Think about what your exposure will be.

Sure, but remember that the downside with malaria, particularly in elderly people, is a significant probability of death or dealing with a long term debilitating disease. Please consult with an expert.

[cbb]

we took Malarone; I had no problems, dave was so sick.   He usually has no problems taking any meds/vaccines, but this was not a good one for him.   

[HokiePoq]

We took the yellow fever vaccine after age 65 with no problems.   We were glad we did on our Amazon cruise....not because of any incidence of the disease, though.   When the ship was en route back to Ft. Lauderdale, we stopped at St. Lucia.   You had to show your vaccination record to be allowed off the ship.   We had stopped at Devil's Island where they have cases from time to time.   I had a malaria RX filled but didn't take it after the pharmacist told me you really could not go out in the sun taking that med (doxycycline).  That was for India and when we were there there were no issues.   Guide told us they treat standing water during the rainy season.  We weren't there at rainy season.

In Manaus the guide told us they did not have a mosquito problem because the soil is very acidic and they cannot breed there.  I cannot speak regarding the other ports on the Amazon.

We did see some giant mosquitoes at Iguazu Falls...which was the first place we traveled that the yellow fever shot was recommended.  

 

[Sopwith]

I can think of a couple of things that are much more risky than a yellow fever shot at an age over 60:

 

1. Taking medical advice from an internet chat forum;
2. Driving to the cruise terminal.

😉