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***I am not a medical professional. Just sharing the research I’ve done regarding our trip. Talk to your doctor!***
Yesterday we went to our PCP to discuss medical concerns for cruising. At our Offshore Emergency Medicine course, it was recommended that we talk to our physicians and get a personalized approach to our medical care on board, other than what is recommended for cruisers in general. We have had the amazing luck to find a doctor (actually 2 doctors) here that are sailors and have chartering and cruising experience. We are also lucky to be young enough that there aren’t many concerns in terms of chronic health.
In preventative measures, we discussed vaccines for cruisers. I hadn’t put much thought into it other than what our course taught us. Our doctor was able to give us two vaccines in office and then referred us to the UTMB Travel Clinic to round out the rest of the vaccines. An excellent resources for information is the CDC website.
Last night I took a good hard look at what we expect we will need to get based on a rough idea of where we are traveling. The CDC breaks their recommendations down to “all travelers”, “most travelers”, and “some travelers”. “All travelers” means that you should have these vaccines for any travel you are doing and may be required for visiting countries. “Most travelers” means there is a risk in the country and you should protect against it. “Some travelers” means that is you are visiting rural situations or doing certain activities (eating local food in small villages or hiking where you may come in contact with wild animals) that put you at a greater risk. Here’s some of the vaccines we are looking at:
MMR (measles-mumps-rubella) – This is a standard vaccine administered here in the US. We have to track down our vaccine records, but are fairly certain we are covered here.
Tdap (tetanus-diphtheria-pertussis) – This is a standard vaccine in the states, and a critical one for cruisers, particularly because of the tetanus shot. Although we probably have had this in the past, our doctor gave us the vaccine yesterday, and it requires a Td booster every 10 years.
Hepatitis A – Transmitted through food and water contamination, Hep A is a concern in under developed countries without running water and sanitation systems. This vaccine requires two doses, at least 6 months apart, so we got our first dose yesterday and will get the second dose sometime after January.
Hepatitis B – Transmitted through sexual contact, contaminated needles, and blood products, Hep B is a concern particularly if we need to have medical procedures done in foreign countries that aren’t as medically developed as the US. Our doctor wanted to see if we had had this vaccine already before administering it to us.
Typhoid – Transmitted through contaminated food and water, the CDC recommends this vaccine for anyone visiting rural areas and adventurous eaters (that’s us!).
Yellow Fever – We are planning on traveling to several countries that have areas with a risk of Yellow Fever, including Trinidad & Tobago, Venezula, Colombia, Panama and Ecuador. Note that these countries are on the path of anyone who is traveling the south side of the Caribbean Sea from say Granada to the Pacific crossing. Most countries where there is no risk require proof of vaccine if you are coming from a country with a risk, so if you want to be let into those countries be sure to have your vaccine records with you while clearing into the country.
Rabies – We discussed rabies a lot in our class, and the recommendation was to get the rabies vaccine because the disease is so extreme. One of the benefits of traveling via boat is access to remote towns (with stray dogs) and hiking in beautiful scenic locations (with bats and other wild animals). When you get a bite it is recommended to get the vaccine and immune globulin immediately, but adequate vaccinations are not available throughout the world. Immune globulin is a fast acting shot to prevent infection. The pre-exposure vaccine is a series of 3 shots over 28 days. Once an unvaccinated human shows signs of rabies, there is a 99% chance of fatality. If you have received the vaccine and get bite that may expose you to rabies, the CDC recommends an immediate dose of the rabies vaccine and then 3 days later another dose.
Japanese Encephelitis – JE is a mosquito transmitted disease found in Asian and Pacific countries. Some countries we plan on traveling to where a risk exists are Australia, India, Indonesia, Malaysia, and Thailand. Since these countries are halfway across the world and it will likely be a while before we get there, we will consider the life span of the vaccine and the need for yearly boosters before we get it.
Polio – As of right now we are not planning on getting the Polio vaccine for two reasons; we’ve probably already had it and it is recommended for people providing medical aid in rural countries. According to the CDC, there are only 3 countries that are not polio-free in the world; Afghanistan, Nigeria, and Pakistan. As with any vaccines though, until the disease is completely eradicated, there is always a chance of getting it.
The CDC provides Vaccine Information Sheets about all of these vaccines. Did we miss any? We will probably have more information after our trip to the travel clinic, so keep an eye out for part 2!
**Update** After researching what was needed at the CDC website, I created a handy spreadsheet which shows the recommended vaccines for common cruising areas, according to the CDC. View it here.