CDC recommended immunizations...do you really need them?

[oskarNZ]

On 8/20/2019 at 7:06 AM, slowkat said:

We are going from Sydney to Honolulu, thru Samoa, fiji and New Caledonia.  The CDC recommends Hep A & Typhoid but if you are on a cruise ship and not drinking the water or eating on shore, are these really needed?.  They are very costly too $85-120.00 each. Anyone have any experience with this??

 

Thank you

The risk of getting either is low, but not non-existent, so only you can decide what the risk is worth.  

 

The Pacific Island destinations you mention are popular vacation spots for people at my end of the world and I know people often travel to them unvaccinated. Probably the same way many people visit the Caribbean Islands unvaccinated, despite the fact that both of these vaccinations are widely recommended there also.   

 

I would argue though that the Hep A vaccination is worth getting regardless.  Especially if you enjoy travelling. It’s recommended for destinations all over the world, so it’s long-term piece of mind by getting yourself covered.  I travelled a lot before getting it and feel a bit silly for doing so.  It is expensive, but once you’re covered, you’re covered for life.  

 

I have been to Fiji on resort-based holidays quite a few times.  I’ve been to Honolulu a few times and I’m cruising to New Caledonia in December. and decided, based on the specific locations I visited and activities I chose to do, not to get the Typhoid vaccine.  I’m not saying that to sway you one way or another, just providing a personal account.  

[evandbob]

On 8/20/2019 at 3:19 AM, Extra Kim said:

How is getting a Hep vaccination a bad advice? Even if you never leave your home country you could get Hep.

 

 

SW FL is currently experiencing an uptick in Hep A among its residents.  Great point!

[clo]

9 hours ago, wheezedr said:

Well in fact I am a retired physician with over 40 years of practice in pediatrics and immunology (hence my screen name) and I have and will continue to recommend Hepatitis A vaccine to travelers on this and other travel sites. Hepatitis A is endemic through most of the US and outbreaks can occur even in the absence of travel.  During my years of practice we saw many cases and a few large outbreaks.  The latter were primarily sourced at school and college cafeterias and the result of poor hygiene in food service workers who were asymtomatic carriers.  This is a simple vaccination that has been routine in pediatric practice for many years now.  There is no downside to someone  recommending a course of action, as the person receiving the recommendation still has the ability to pursue whether or not it is appropriate for them.  

 

To the OP, if you are still monitoring this thread, I would definitely recommend the Hepatitis A.  Typhoid is always a +/- decision, because the frequency is much lower and the vaccine is clearly not as effective nor does the protection persist as long.

Thank you so much for weighing.  It's opinions like your that make a difference.

[slowkat]

Thank you so much for your insights doctor!

[new_cruiser]

On 8/21/2019 at 7:04 AM, clo said:

Thank you so much for weighing.  It's opinions like your that make a difference.

 

Wheezedr made the same points that I did in the post to which you objected. I.e.; that Hep A exposure can happen anywhere and has a vaccine that is long lasting and highly (near 100%) effective while Typhoid vaccine coverage is short duration and not as effective so the decision to get Hep A is clear cut decision (unless one has a strong medical reason not to such as allergy to the vaccine components) while whether to get Typhoid vaccine is more of a question.

 

Also, I pointed out that there is a choice of two Typhoid vaccines and the differences between them.

 

I'm not a doctor, but I am an engineer well trained and experienced in evaluating data. BTW, for a recent cruise visiting a country where the CDC recommends Typhoid vaccine, my husband decided not to get it. I decided to get the oral Typhoid vaccine because in the 5 years it covers I expect to do some additional land travel to countries where it is recommended. I probably wouldn't have gotten it just for the cruise.

 

[clo]

3 hours ago, new_cruiser said:

 

I'm not a doctor,

Anyone is allowed to give any kind of advice clearly.  I think it's a mistake.  I've communicated that to TPTB here and on a couple of other sites.  An anonymous person is giving advice to anonymous people.  We don't know their medical background, their family history and a host of other things.  Plus I promise that there are crazy people here just like elsewhere online.  They can take snippets of good advice and screw it up.  I've never researched if sites or members of site have any legal liability.  The doctor who gave that advice gave good advice but *I* wouldn't have given it if I were he.  Maybe the "Good Samaritan" rule kicks in.

[sanger727]

2 hours ago, clo said:

Anyone is allowed to give any kind of advice clearly.  I think it's a mistake.  I've communicated that to TPTB here and on a couple of other sites.  An anonymous person is giving advice to anonymous people.  We don't know their medical background, their family history and a host of other things.  Plus I promise that there are crazy people here just like elsewhere online.  They can take snippets of good advice and screw it up.  I've never researched if sites or members of site have any legal liability.  The doctor who gave that advice gave good advice but *I* wouldn't have given it if I were he.  Maybe the "Good Samaritan" rule kicks in.

 

Good grief. The person recommended a vaccine that is a routine childhood vaccine in the US. They aren’t sending them a shot to inject themselves. You still have to see a medical professional in person to get a vaccine and even on a flu shot that do a basic history to determine if the vaccine is safe and appropriate for you. Lighten up. A doctor/nurse will still ultimately consult with the person to determine if the vaccine is appropriate for them specifically.

[Extra Kim]

2 hours ago, clo said:

  An anonymous person is giving advice to anonymous people.  The doctor who gave that advice gave good advice. 

Read this again and then think for a second.

By the way, I'm Batman 😉 Point taken?

Edited August 23, 2019 by Extra Kim

[clo]

1 hour ago, Extra Kim said:

Read this again and then think for a second.

In English when one is deleting parts of a quote three "..." indicate that to anyone reading.

[Extra Kim]

[mom says]

4 minutes ago, Extra Kim said:

This poster is not unlike CB at Sea. Except she posts more often and feels the necessity of imposing her standards on everyone else. I suggest treating both poster's posts with the same mindset.

[clo]

30 minutes ago, mom says said:

This poster is not unlike CB at Sea. Except she posts more often and feels the necessity of imposing her standards on everyone else.

I've been very clear that this is MY opinion.  So is MY opinion less valid than YOUR opinion?

[kochleffel]

I'm not a doctor and I don't even play one on TV, but before a cruise that included countries (Estonia and Russia, in this case) for which the CDC recommended Hepatitis A and B vaccinations, I started the series. I also travel to the Caribbean, for which the same immunizations are recommended. Although I'm at personally low risk for Hep B, I chose Twinrix anyway.

 

I suspect that many cruise passengers don't get them, but I figure that, if I'm going to eat or drink anything on shore, it's prudent to have the Hep A vaccination -- and prudent, as I see it, to have it even if you never leave North America. I haven't had a Typhoid immunization.

 

Cruise passengers, however, need to read the CDC web site carefully if visiting a country for which Yellow Fever immunization is recommended. For example, it's listed for Colombia but not required for the common cruise ports. However, it is possible that a country you might visit later would require it if you've recently coming from certain other countries.

[K32682]

In the OP's situation I would get Hep A but not typhoid. I have great respect for the CDC but it and the other major health organizations can at times be overly cautious and their recommendations must apply to every situation and visitor.  As the OP notes they will not be eating and drinking onshore so typhoid immunization should not be necessary. 

 

I've run into a similar situation on an international work project when I stopped taking a specific medication against the CDC's advice based on the information of a local physician and other facts more pertinent to my immediate circumstance.     

[SimplyMarvie]

If the OP is concerned about cost Hep A really should be available at your primary care clinic since it's on the CDC schedule for everyone -- which means it should be covered by health insurance if you haven't been vaccinated and you shouldn't need to go to a fancy travel medicine clinic for that one. Which makes it an easy choice. 

 

Typhoid... I got it before my last trip. Typhoid sounds miserably un-fun and spreads through contaminated food and water, and I'm the kind of traveler who likes street food. It was worth it to me to have the extra protection, but I was able to do it for a low-cost and I'm a vaccine maximalist -- if I can reduce my chance of getting something icky by throwing money at my doctor, I'm going to do it, because you never know what might happen (so I'm vaccinated against cholera and yellow fever and all sorts of weird things). Your mileage may vary.

[cb at sea]

NONE are required by the cruise line.  It's up to YOU and your physician whether you need them or not.

[SRF]

On 8/24/2019 at 6:22 AM, clo said:

In English when one is deleting parts of a quote three "..." indicate that to anyone reading.

 

How do you know that the "doctor" is a doctor????

 

[SRF]

On 8/24/2019 at 7:58 PM, K32682 said:

As the OP notes they will not be eating and drinking onshore so typhoid immunization should not be necessary. 

 

Planning to not do so, and actually not doing so, are two different things.

 

Even a quick drink with ice can be your downfall.

[kochleffel]

On 8/25/2019 at 3:22 AM, SimplyMarvie said:

Hep A really should be available at your primary care clinic since it's on the CDC schedule for everyone

 

Where I live it is available for adults only at the county health department. There's not enough demand for primary-care offices or pharmacies to stock it.