Do I need a typhoid vaccine for a trip to Hong Kong and Taipei?

November 8, 2015 8:24 PM

I'm taking a trip in six weeks to Hong Kong and Taipei. I called my doctor's office and asked if I needed any vaccines for the trip, and she said because I was staying in cities and not going into the countryside, I didn't need a typhoid vaccine. However, since then, my mother's doctor, my husband's doctor, and my brother's doctor all recommended typhoid vaccine for the same trip.

The CDC guide suggests the vaccine if you are an "adventurous eater", which isn't clear to me (it could be anything from "eats raw chicken regularly" (not me) to "eats something other than imported packaged food") (definitely me). I'm just not sure if I should bug my doctor about this again, or let it go.

posted by SockISalmon to Health & Fitness (17 answers total)

I've been to Taiwan many times and taken my young daughter 3 of those times, and not only have I not gotten a typhoid vax but her pediatrician didn't recommend one for her either. Can't say anything about HK, though.
posted by town of cats at 8:26 PM on November 8, 2015

Why not just get the vaccine? I needed it to go to India and it was not in any way a big deal. I believe my insurance covered it, as well, at no charge to me beyond the small copay I had to pay for the overall doctor's visit/battery of jabs I ended up needing.

I think it's fine not to get if your doctor really doesn't want to do it for some reason, but jeez, it's a two-second needle jab and then you move on with your life, totally immune to typhoid.
posted by Sara C. at 8:39 PM on November 8, 2015 [1 favorite]

You can just contact your doctor again, tell her "I'd like to get the typhoid vaccine just in case," and get the vaccine. I doubt she'll feel annoyed by this; she's probably more used to people arguing about whether they really need travel vaccinations. The different analyses are probably just due to different assessments of the risk involved--IANAD or a statistician, but I think the odds that you would encounter typhoid are vanishingly small (but not zero), as are the odds that you'd have a negative effect from getting the vaccine.

I don't recall whether I got one when I went to Taiwan or not. Probably I did; I remember getting the Japanese encephalitis vaccine for the trip. It's not likely I would haven gotten it, but I didn't know where all I might be going while I was there. The general attitude that I recall from the doctors at the Stanford health center about travel vaccines for Taiwan in general was "Ehhh...you're not going to need this but you might as well have it."
posted by wintersweet at 8:47 PM on November 8, 2015 [1 favorite]

The typhoid vaccine I took wasn't a needle jab, but some pills that were an attenuated live vaccine. They had to be refrigerated until I took them, and I had to take them for a couple days. I had some very mild nausea during those days. So it's not nothing but it's still pretty easy, and I enjoyed being able to say that what I ate for breakfast that morning was typhoid! I recommend getting the vaccine. I think it lasts for like 3 years or so.
posted by aubilenon at 8:50 PM on November 8, 2015

(There are two versions of the typhoid vaccine, one a jab and the other the more complicated pills. The jab is more common nowadays. I could see declining it if your doctor only offers, or your insurance only covers, the pills, and taking some pills over a couple days would be inconvenient for you.)
posted by Sara C. at 8:57 PM on November 8, 2015

This is from Taiwan's Centers for Disease Control on typhoid cases/stats

Be aware that the risk now in Taiwan (Tainan to be specific) is dengue fever, with thousands having been infected in southern Taiwan this summer. It's still warm on the island, so I would just be careful if you're traveling to the southern parts of the island.
posted by wallawallasweet at 9:08 PM on November 8, 2015 [2 favorites]

When it comes to vaccines, I feel "the more, the merrier." If you don't want to see your doctor again, you could get one at your local health department. I'd just call ahead to make sure they have them available and see if you need to schedule an appointment or can simply walk in.
posted by smorgasbord at 9:08 PM on November 8, 2015

I've been living in Taipei for 12 years. No, you don't need a typhoid vaccine. You won't catch anything eating from any of the night markets or stir-fry restaurants. You will be much more danger from scooters riding on the sidewalk or taking a bus between two cities. As wallawallasweet said, there were about 10,000 cases of dengue fever in the Tainan area a couple months ago, so you could factor that into your plans.
posted by alidarbac at 12:00 AM on November 9, 2015 [3 favorites]

I did research in Taiwan for one month and the food hygene is generally very good. I would generally deem it as safe as any Western place. I don't know about Hongkong but I would guess the same.

Nonetheless, I believe that a typhoid vaccination is a good idea for anyone who travels. The vaccination has very little side effects or risks but can save you a lot of pain. I would recommend the type that you swollow (which here in Germany is the most modern type, not the jab one, but you have to be consistent in taking it or it wont work!). Some of the more modern types, such as Thyphoral-L by Norvatis have shown not only to guard you against typhoid but also against a high percentage of common "stomach bugs" which is convenient.

Fun travels!
posted by Fallbala at 1:01 AM on November 9, 2015

>"...it's a two-second needle jab and then you move on with your life, totally immune to typhoid."

Just a little note to say that the vaccine is not 100% effective. Ask me how I know. :/
posted by Halo in reverse at 1:43 AM on November 9, 2015

I was coming in to say what Halo in reverse said. I was the proud recipient of typhoid when traveling in India and Nepal despite having the vaccination. This was going on 17 years ago now, so things hopefully have changed. When I took my kids to India I opted to not vaccinate them against travelers illness because we were staying with family in a big city, and were only going for 10 days. I felt that I would be extra diligent with what they ate and keeping things sanitary, boiling the dishes they used, etc. Neither got sick.
posted by momochan at 4:23 AM on November 9, 2015

I eat the street food all the time in Hong Kong, Bangkok, et al and it never occurred to me to get a typhoid jab. Now dengue is something to worry about, but there's not much you can do except wear repellent, long sleeves/pants and use a mosquito net/window screens.
posted by TWinbrook8 at 4:25 AM on November 9, 2015 [1 favorite]

Best answer: You might find the clinician view of the CDC recommendations more helpful than the traveler view -- I find it breaks down the required / recommended / maybe vaccinations a little more clearly. Taiwan clinician view, Hong Kong clinician view.

Typhoid is recommended for most travelers to Hong Kong; Hepatitis A, yearly flu vaccination, and being up to date on other routine vaccinations are also on the list for most travelers. If you dig further into the typhoid recommendations, you'll find that the following qualify as "adventurous eating":
- Food served at room temperature
- Food from street vendors
- Raw or soft-cooked (runny) eggs
- Raw or undercooked (rare) meat or fish
- Unwashed or unpeeled raw fruits and vegetables
- Peelings from fruit or vegetables
- Condiments (such as salsa) made with fresh ingredients
- Salads
- Unpasteurized dairy products
- ”Bushmeat” (monkeys, bats, or other wild game)

I'd say that, except for the fruit peelings, dairy, and bushmeat, that all seems like stuff that I eat routinely when I travel. If that's true for you, too, you may want to go ahead and get the typhoid vaccination. Keep in mind that it's not 100% effective, though -- you'll still want to eat and drink carefully.
posted by ourobouros at 4:28 AM on November 9, 2015 [2 favorites]

No, you don't need it. I have lived in HK for 15 years and travel to Taiwan frequently. I have never come across anyone with typhoid. You probably have a better chance of winning their lottery.
posted by clark at 4:47 AM on November 9, 2015 [2 favorites]

You'll be fine. I ate loads of street food while living in Hong Kong and while traveling through Thailand, Malaysia, and Indonesia, but I never got typhoid.

I don't think dengue is an issue in Hong Kong yet either, so you won't need to worry about it there.
posted by astapasta24 at 7:30 AM on November 9, 2015

I got the typhoid vaccine (pills) before going to Hong Kong and I don't regret it. It was recommended to me because we planned to eat from a lot of street vendors like the Temple Street night market. No weird side effects, so why not get it?

Also I would recommend visiting a Travel Medicine clinic rather than your regular old doctor. No insult meant, but this is what Travel Medicine clinics specialize in and they will know for sure what you need these days.
posted by joan_holloway at 9:04 AM on November 9, 2015

Response by poster: Thanks, everyone. I decided I'd rather be anxious about possibly being an annoying patient than be anxious about even a miniscule chance of getting typhoid, so I'm following up with my doctor about getting the vaccine.
posted by SockISalmon at 9:23 PM on November 10, 2015