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Vaccinations for traveling abroad?
May 2, 2011 10:02 AM   Subscribe

What kinds of vaccinations would you recommend for my friend's trip to Haiti? Is it possible she'll get severe reactions since she's never been vaccinated?

I have a friend leaving in two weeks to visit Haiti for a month, who has never been vaccinated and is worried about suffering adverse effects from a lot of shots. A friend had their arm swell up and got quite sick after they were vaccinated for the first time. So, is it advisable to get all the recommended shots, or is it advisable to travel to Haiti without getting any vaccinations?

Thanks!
posted by ajarbaday to Health & Fitness (14 answers total) 1 user marked this as a favorite
 
Only your friend's physician can advise her on this; everything else is uninformed speculation and vaccination is not the sort of thing laypeople have informed opinions about (cf. anti-vaccine movement in the US).
posted by Inspector.Gadget at 10:11 AM on May 2, 2011


She needs to go to a travel medical specialist who is up to date on what inoculations are REQUIRED (vs. what is just recommended) and can tell her what's best for her based on her age and previous medical history. Some shots will be useless at this point because she needs them six weeks in advance. Make sure she gets one of those yellow inoculation cards that tracks what she received and when, and make sure that it's clipped on to her passport for future reference.

Yes, she might experience some swelling. Yes, she may experience some flu-like symptoms.

Or she may not.

This is why a travel medical specialist will be helpful.
posted by HeyAllie at 10:19 AM on May 2, 2011 [1 favorite]


Definitely get all the recommended vaccinations, starting as soon as possible. To do otherwise would be incredibly stupid. Start with the CDC Vaccinations and Travel Checklist.
posted by Ery at 10:20 AM on May 2, 2011 [1 favorite]


Agreed with Inspector.Gadget - her doctor and perhaps a guidebook or State Department health advisory website are really the only sources she should trust on this.

Anecdotal:

When I went to India three years ago, I had to get a big ole pile of vaccinations. Aside from two sore arms, I did not have any adverse reactions to any of the vaccines I received.

If your friend has never had any vaccinations at all the list of required shots might be quite long. She should definitely be consulting her doctor, STAT, if this is the case. And not because she's afraid her arm will swell up.
posted by Sara C. at 10:20 AM on May 2, 2011


Just to clarify, no vaccinations/inoculations are required for travel to Haiti - only recommended.
posted by ajarbaday at 10:21 AM on May 2, 2011


Make sure she gets one of those yellow inoculation cards that tracks what she received and when, and make sure that it's clipped on to her passport for future reference.

If and only if Haiti requires this for entrance to the country, of course. Not all countries do (I believe it's only likely if the country requires a yellow fever vaccine for entry).

Basically she should do whatever her doctor, the relevant government(s), and perhaps her travel guidebook tells her to do. This is not a great subject to crowdsource.
posted by Sara C. at 10:24 AM on May 2, 2011


I am not a health worker and nothing here should be construed as medical advice. Your friend should consult with a doctor. There are very real risks to traveling to a developing country, and I would never go unvaccinated.

That said, I do manage a lot of people's international travel in the developing world, including Haiti. We follow CDC advice, which for Haiti, includes MMR, DPT, polio, hep A, hep B, and typhoid, as well as malaria prophylaxis. (Rabies is also recommended, but our work doesn't involve much work with animals.)

Anecdote: I was up-to-date on all of my vaccinations (so this wasn't my first set of shots), but a few years back, had to get yellow fever, typhoid, DPT booster, polio booster, and hep A on the same day. I had mild flu-like symptoms for a few days, and had a lot of arm pain (I blame the typhoid) that passed within three days.

The risk of flu-like symptoms and arm pain almost always outweigh the risks of actually contacting the diseases. It is absolutely advisable to get all of the recommended vaccines, unless your friend and her doctor decide otherwise.
posted by quadrilaterals at 10:38 AM on May 2, 2011


Yikes. This is what a travel medicine clinic is great for. They have clinicians that literally specialize in answering this very question and administering any necessary prophylaxis. They can help advise her on the risks of going completely unvaccinated and help her decide what to do. A google search for "[your location] travel medicine" ought to come up with a nearby clinic if you're not out in the middle of nowhere. Or just check the CDC's list of travel medicine clinics. It's generally a better idea to see a doctor for this kind of thing earlier than two weeks before departure, but better late than never. Vaccinations aren't necessarily effective immediately, so you friend probably should get in as soon as possible. Make sure your friend tells them when she's leaving.

Haiti is also a malaria zone and your friend may well need a supply of antimalarial drugs for her trip as well, so it's very much worth discussing this trip with a doctor no matter what she ultimately decides to do in terms of vaccinations.

In addition to these prophylaxis issues, there are other critical health concerns to be aware of when traveling to Haiti. They are in the middle of a cholera epidemic as I understand it, and it's apparently a particularly virulent strain. This isn't traveler's diarrhea; it is a serious bacterial infection that can cause death within hours. Treatment is complicated by the severe lack of adequate health care resources in Haiti. Your friend should definitely be talking to a doctor about the sanitation measures she needs to be taking and should probably inquire whether she needs to be carrying a supply of antibiotics and oral re-hydration solution. See the CDC's advice.

Finally, is your friend simply going to Haiti for a month by herself? If she's going with a group of some kind, I'd be rather concerned if they aren't providing extensive advice and services related to health care.
posted by zachlipton at 11:06 AM on May 2, 2011 [1 favorite]


When I got a slew of vaccinations in anticipation of travel I was advised by the travel clinic to go for a long slow swim afterward to prevent stiffness. I did that and was not terribly sore at all.

Adverse effects from shots, unless you have known medical issues with inoculations, pale in comparison from the adverse effects of these diseases.
posted by ambrosia at 11:28 AM on May 2, 2011 [1 favorite]


In addition, your friend ought to have read the State Department Travel Warning for Haiti. To quote a few choice passages:
The Department of State strongly urges U.S. citizens to avoid all travel to Haiti unless essential and only if travel is fully supported by organizations with solid infrastructure, evacuation options, and medical support systems in place.

In a number of cases in the past year, travelers arriving in Port-au-Prince on flights from the United States were attacked and robbed shortly after departing the airport. At least two U.S. citizens were shot and killed in such incidents. Haitian authorities have limited capacity to deter or investigate such violent acts or prosecute perpetrators.

During the most recent disruptions, airports throughout Haiti were also closed for several days, making it impossible for U.S. citizens to depart the country once they were able to leave their shelters.

U.S. citizens who choose to travel to Haiti despite this Travel Warning are urged to confirm before traveling to Haiti that the organization they will be working with has the capability to provide food, water, transportation, and shelter for its employees and volunteers, including during extended periods of time when they may be forced to shelter in place. All relief organizations should have a security plan in place to protect and evacuate their personnel to the United States or other safe haven.
Frankly, I can't imagine that any reputable organization would take volunteers to Haiti without proof of all appropriate vaccinations and providing a full array of health care services. Haiti is a downright dangerous place right now that is not equipped to provide services to their own people let alone foreigners. In the event of illness or injury, your friend will probably require emergency evacuation by air ambulance to the United States at the cost of tens of thousands of dollars.

Short of some active war zones and perhaps Sudan and Somalia, Haiti is easily one of the most dangerous countries to visit right now, especially when the security and health threats are combined. I would be incredibly wary of any planned trip to Haiti right now that did not have firm plans for pre-departure travel medicine services with mandatory vaccinations, secure in-country transportation, safe and secure shelter, clean food and water, and the capability to quickly evacuate to the US in the event of medical emergency or further deterioration in the security situation.
posted by zachlipton at 11:46 AM on May 2, 2011 [4 favorites]


I have a friend leaving in two weeks to visit Haiti for a month, who has never been vaccinated and is worried about suffering adverse effects from a lot of shots. A friend had their arm swell up and got quite sick after they were vaccinated for the first time. So, is it advisable to get all the recommended shots, or is it advisable to travel to Haiti without getting any vaccinations?

There is a third option, which is to advise someone who has never had any vaccinations to avoid places like Haiti. Has your friend considered the possibility of simply not traveling to someplace where the benefits of herd immunity may not be available?
posted by deanc at 1:01 PM on May 2, 2011


Hi! Judging from the tone of the responses, I probably shouldn't have phrased my question the way I did. So I apologize - I realize the internet is not a substitute for medical advice, i guess it just seems like there's a big difference between recommended and required, and my friend was nervous about the effect of a lot of immunizations considering that she hasn't had any in the past. She's working with a student organization and will have access to the infrastructure that zachlipton mentions once she gets into the country.

There is a travel clinic in the area, but they are understaffed and she's had trouble getting in an appointment with them for a while, plus she is uninsured, so she was looking for more information. I think she will take whatever shots they recommend, thanks all.
posted by ajarbaday at 1:43 PM on May 2, 2011


Another good reason to get the shots so far in advance is if she does get sick, she'll have a chance to recover.

I was allergic to the MMR and spent a week (as a kindergartener) vomiting and with a bump on my arm/shoulder swollen to the size of a baseball. (Which is kind of big on a little kid.) So I had a doctor give me an exemption note for the 5th-grade booster shot.
posted by IndigoRain at 12:27 AM on May 3, 2011


Of course she should get the vaccinations. Why wouldn't she? Having a sore arm for a few days is much much better than getting typhoid.

IANAD but I have travelled in Africa & Asia and always got the full gamut of shots pre-trip. The worst side effect I had was a dizzy spell after the yellow fever shot, and typhoid does give you a sore arm (but no worse than rubella).
posted by jasperella at 12:58 AM on May 3, 2011


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