Do I need to pony up for the JE vaccine?
October 9, 2012 3:28 PM   Subscribe

How to decide if we need to get Japanese encephalitis vaccine for travel to SE Asia? For us? The kids?

We are going to Cambodia to spend the winter holidays, traveling with our toddler and preschooler children. We are staying in the capital mostly,but also flying to do some sightseeing in Ankor, and some nearby beach resorts. Trying to investigate vaccines that we need and it is really confusing! Most especially the Jap Enceph vaccine. Some say not to get it, bc we are staying a short time (just under a month) and staying in non-farming areas. Some say get it bc there is no cure and it is fatal, and we are leaving the capital. It is incredibly $ on top of all of it, so we want to understand before we "err" on the side of caution and just get it. We are talking $1200-$1500 for family of 4. Yikes! Besides the typhoid and Hep A and B for those of us who aren't up to date on that. Any experience, comments, thoughts would be appreciated. Apparently it is transmitted through mosquitos that, we are told, have a 1.5 miles flight range, so we need to figure out if we are within 1.5 miles of any pigs (where the disease originates? hence the rec against getting it if non-farming visit). It is very confusing. Can anyone break it down for me? Thanks, hive.
posted by dublin to Travel & Transportation around Cambodia (12 answers total)
Any time I travel internationally, I make sure to check the CDC Traveler's Health website to see what is recommended for the country I'm visiting (in your case, Cambodia). From there I make an appointment at a local travel clinic for a consultation. They will advise me, after discussing my itinerary, the recommended and required shots and administer them right there or write a prescription. It's relatively simple. I suggest you start there and ask what they want you and your family to do. I assume you're in Chicago--here's where you can find out more. Safe travels!
posted by therewolf at 3:42 PM on October 9, 2012

Response by poster: Thanks for the response. I should elaborate...

Did check the CDC website. Did consult with 2 travel clinics, and each one's advice is conflicting. So I was curious about anyone else's thoughts/experiences to help me understand the conflicting info. (Basically the conflict whether it is necessary for where and for how long I'm traveling in Cambodia during "low risk" season).
posted by dublin at 3:47 PM on October 9, 2012

Check out this site. I had a consultation with one of the doctors there as I will be in S.E asia soon too. He said it was not necessary to get the Jap Enceph vaccine because the chance of getting the disease is so remote. I did get a bunch of other jabs though.
Use lots of jungle strength DEET and don't drink from puddles.
posted by drugstorefrog at 3:47 PM on October 9, 2012

Have been to those regions and was kind of keen for the vacc-- my doctor was quite strong in suggesting that I not do so. I know many people who have travelled there and I was the only one who considered it even. So fwiw in Australia it is not the norm for tourist to get this. Anecdata, obv, but since you have the official version I think that's all we can offer?
posted by jojobobo at 4:00 PM on October 9, 2012

Also- I've been in rainy and dry seasons- the advice was the same.
posted by jojobobo at 4:01 PM on October 9, 2012

I was in the Philippines over the summer and was told it isn't really worth it for that length of trip, just make sure you're good about wearing repellant - maybe look into whether permethrin is safe to use on kids' clothing?
posted by brilliantine at 4:03 PM on October 9, 2012

I travel to Cambodia pretty often, and with my kids. I had the Jap. En. vaccination the first time I went twelve years ago, and never bothered renewing it because I rarely went to the countryside. Very few people I know travelling there get it. I would consider Angkor/Siem Reap and the beach resorts to not be the countryside either.

I would skip it personally for me and my kids (all routinely vaccinated) and spend the money on hand sanitisers, mosquito repellant (I used citronella stickers for the baby, and have used deet spray-on for the bigger kids) and good travel insurance. If anything more than a minor cut happens in Cambodia with kids, you basically want to get evac'd out to Bangkok or Singapore, not treated locally. The International SOS clinic is your best bet for treatment in Phnom Penh, and also handles cases in Siem Reap.

If it helps, outbreaks of Jap. En. would be covered in the local press widely.

One other vaccination for Cambodia that I highly recommend talking to your doctor about is tetanus. It's pretty cheap, and IMO worth the peace of mind.
posted by viggorlijah at 6:04 PM on October 9, 2012 [1 favorite]

IANYD and of course this is a question of risk tolerance, so a person less comfortable with any degree of risk may have a different answer than another person.

However, using the links from the CDC travel website:
"The Advisory Committee on Immunization Practices recommends JE vaccine for travelers who plan to spend ≥1 month in endemic areas during the JEV transmission season. This includes long-term travelers, recurrent travelers, or expatriates who will be based in urban areas but are likely to visit endemic rural or agricultural areas during a high-risk period of JEV transmission."

Check the page I linked to for details on special extenuating circumstances, such as being uncertain about your itinerary, which would change the recommendation, although I suspect none of these apply to you.

You are staying under a month, and at least from what I can tell, are not planning to visit rural or agricultural areas. Therefore, I deduce that the vaccine is not recommended for you. But as I said, if you are uncomfortable with risk, then you have to ask yourself which is worth more, $1500 or your peace of mind.
posted by treehorn+bunny at 6:05 PM on October 9, 2012

viggorlijah, I believe the OP is located in the USA, where the vast majority of people are already vaccinated against tetanus routinely as long as they have a primary care physician and see them at least every 10 years, or unless they have requested an exemption.
posted by treehorn+bunny at 6:08 PM on October 9, 2012

Was one of the travel clinics you consulted a for-profit one? I used one of these before spending a year traveling around Asia and, while I had a great experience with them, I felt that the nurse tried to push many more vaccines on me than I felt were necessary. (she was totally cool when I refused). From my small-ish sample size, it seems that the more necessary the vaccine is, the cheaper (hepatitis and tetanus – 100% covered by my insurance). Full disclosure – I got the Jap. En. vaccine, but that’s because I did not think I’ll be vigilant with using mosquito repellent, I would probably skip it now.
Safe travels whatever you decide!
posted by Dotty at 7:17 PM on October 9, 2012

I was just in Angkor a few weeks ago (rainy season). JE was not a worry there. enterovirus was, for local kids. probably HFM disease from running barefoot.
Deet up whenever you go out in the evenings. wear long sleeves, etc.
I was told by my doc that the JE Vaccine carries a risk of anaphylaxis for 7 days after it is administered. this seems a greater risk than skeeter bites, which can be avoided by and large.
We took malaria pills and worried about dengue, took the basic precautions and did not get any kind of sick and had a wonderful time. Cambodia and Cambodians are wonderful.
posted by OHenryPacey at 12:58 AM on October 10, 2012

I came here to say what OHenryPacey said - it is riskier than most vaccines so there is more to be reckoned with here than just monetary cost; getting the vaccine is not necessarily equivalent to erring on the side of caution as, depending on your itinerary, you may be more at risk from the vaccine than from the disease. I say this as a hobbyist vaccine collector: I got vaccinated against Hep B on my gap year, in an entirely 'on the safe side' way, and had an MMR booster at college rather than going to the trouble of a blood test to prove my immunity*. I basically love vaccines, but I would think twice before getting the JE one.

*I had been immunised against mumps twice, and rubella and measles three times on top of actually having measles when I was two, but my medical records were back in the UK and wouldn't get there in time.
posted by Acheman at 10:05 AM on October 10, 2012

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