Innoculations for India

I am heading to Rajasthan in the spring. I need boosters for diptheria/tetanus/polio, which is given as one jab in the U.K. and I have already had measles/mumps/rubella, so I don’t need this again. These are free in the UK.

We are sticking to the cities, not travelling to remote parts. We have been asked to consider if we want rabies injections - these would cost us £180 in the UK.

A slight reaction to a jab is better than getting the full disease.

I tend to think the Rick Steves Travel Forum is not the best place to get medical recommendations. Have you looked at the CDC website for travel to India? There are exceptions for most of the vaccines, except Hep A and typhoid, which are both quite benign vaccines.

Of course, routine vaccines should be up-to-date, too, which would typically just be a tetanus shot... perhaps a MMR if you are older and got only one dose as a kid.

I just looked at the CDC recommendations. It is broken down so you can decide. Also consider that 'inlaws' most likely put them into an older category of traveler, and it is known that over a certain age people react to a lot of things that they didn't as younger people. You have to consider that when making decisions on two people's reactions.
Twinrix is a Hep A and B combo. If you are going to get the A, then consider the B.
What do you consider 'North India'? Check the Malaria maps for the areas of your travel to assess your risks. Use more than one website. I would err on the side of caution. It isn't a pleasant disease. As well as being potentially fatal, even is surviving, it never goes away. Also know your altitude as over 2000 in the Himalayas generally do not require meds.
https://www.cdc.gov/malaria/about/distribution.html
https://www.canada.ca/en/public-health/services/catmat/appendix-1-malaria-risk-recommended-chemoprophylaxis-geographic-area.html
If you think your travel med office is only going to recommend what is going to be from a financial perspective, then go educated and go with a list you agree to.....thus eliminating your concern that they will use fear to induce more fees. They can at least have the immunizations and meds handy, know the side effects to recommend against, and the correct malaria meds for your region of travel.

I've been to India three times in the last ten years in the north central area. I agree that the CDC, your local travel clinic, and your physician are the best places to seek medical advice about your health and safety while traveling especially because recommendations change depending on specific needs, outbreaks, warnings, risks, etc. With that said, at the time of my travel, it was recommended that I receive a booster for tetanus (it was a combination of d/t for adults); Hep A; Typhoid protection (injection or pill form); and that my immunizations were up to date. I brought Malaria medication to take while there and a prescription of Cipro just in case. This was all specific to my needs, based on my travel itinerary. Hope all goes well!

It would be quite a statistical anomaly for both of your in-laws to have same severe reactions to vaccine and not feel well for a year. There may have been some other factors happening there. I followed the CDC suggestions went I went to Africa. I had no reactions to vaccine and no health problems.

You should go to the International health clinic. Mine was at my county health dept. I received a lot of good information on how to stay healthy and the required immunizations.

It strikes me that no immunisations are needed. If you get sick you will hope that you had had the one for whatever made you sick.

I've known two people, on a woman in her early 20s and another a woman in her 40s who both returned from India quite unwell.

I don't know what each person had.

Unfortunately that is the limit of my experience.

The med folks would make more money if you get sick. Most of those diseases can kill you. Your call. Just don't bring them back with you to spread to the rest of us.

Why on earth would you take a chance on contracting a deadly and fatal disease? We had the necessary innoculations etc., before going to Africa and would not have gone without them, at the Tropicsl Medicine Dept.of a Montreal hospital, at no charge, of course, However I would gladly have paid to keep myself safe in Africa.

Do I understand you are basically second-guessing the CDC? While anything can happen, I think the CDC is pretty much the go-to for travelers and doctors.

Are you looking for people who may read your post and say they went to India without taking the advice of the CDC and survived?

In addition to immunizations, I would also recommend that you talk with your doctor about precautions you can take with air pollution....mask and over-the-counters, if you have issues.

We recently met a young doctor and his wife, who were both raised in India but live in the states now. He said they have to take the same precautions when traveling to their previous home country, because their systems are no longer used to the risks there.

If you do not trust your local international medicine place (and apparently you do not), find another one. Is that provider recommending shots beyond what the CDC advises? If so which ones specifically? Help us to understand why you think they are layering on with an interest in just selling you everything imaginable!!! What have they recommended beyond those of the CDC? In which city/state are you located?

Hey, I went to Barcelona, got stinking drunk night after night, then wandered around Las Rambles until sunrise with my life savings and passport stuffed in my back pocket, and I was never pickpocketed - no money belt for me! I've traveled to lots of developing countries and had unprotected sex with so many random strangers I lost count, I drank the tapwater, got a bunch of tattoos, and sold a kidney in a back alley to finance it all. Some people told me these things were dangerous and I should be more careful, but I had no problems at all.

You'll be fine. Stop worrying so much and ignore those egg-heads at the CDC, what do they know anyway?
I figure you only live once - get out there and have some fun!!!

(Note: my lawyer insists I add this disclaimer: the above is sarcasm and should not be taken seriously; just because one idiot got away with playing Russian roulette with his life doesn't mean you will always be equally lucky)

I don't know what the CDC is nor whether it's a reputable organisation (I assume it is, since so many have mentioned it). But when we went to India, whilst living in England, we closely followed the NHS advice and that was also a lengthy list of new/booster jabs. I doubt the NHS was suggesting them as a money-making scheme (rather it's probably keener that one doesn't come back with some disease it has to spend a fortune treating). I don't remember exactly which jabs we had, but looking at the current on-line list, they seem familiar, as do the ones Jennifer mentions, although I also recall typhoid. I do recall that in the part of India we were going to, anti-malarial tablets (there was no vaccination), weren't considered necessary by the doctor who gave us our other medicines and so she didn't give us those tablets

A cautionary tale (and apologies if I don't have the details 100% correct):

Some years ago a young man--a medical student as a matter of fact--took a trip to Thailand. He was bitten by a stray dog; they were common there at the time. The traveler was a needle-phobe, so he opted not to have the series of rabies shots normally recommended in his situation. Before he died, he was able to document all his symptoms. Russian roulette didn't work out well for him.

Really, get the CDC-recommended vaccinations. Many of them are a very good idea for any travel--or even for staying at home.

Discuss with your doctor when you should use an antibiotic for gastric distress and when you should not.

CDC is Center for Disease Control. It is a US organization that conducts research on disease prevention and treatment and has some of the most noteworthy researchers in the fields working with it. They investigate any outbreaks of disease within the US and in many places round the world. The Ebola issue in Africa was one of their recent research and treatment opportunities. Many of the currently used vaccines were developed by them.

They also have published a very thorough pamphlet on how to handle the coming zombie apocalypse.

I feel their guidance for visiting certain areas around the world that you might contract a life threatening disease should be followed.

has anyone else actually read the CDC site? It lists 'all travelers' 'most travelers' and 'some travelers'.....so there actually is room for making up your own mind. Rabies is often very dependent on your activities. Yes, there can be a dog bite, but if in urban areas, immunoglobulin is available - even in India. Immunoglobulin being the treatment regardless of pre travel injections or not....the pre travel injections just buy you more time. Vaccine is also quite expensive and there has been a recent North American limited supply.
It is not unreasonable for a person to educate themselves and make personal decisions....we do this every day getting behind the wheel of a car.

But as Nick mentions, you can compare to the UK and Canadian travel sites for their recommendations to see whether there is consistency to recommendations. I usually use the 3 with regards to travel 'safety' as some are overly cautious for certain countries and I find one to be the more rational voice of reason.

Nick (and others unfamiliar with the acronym): The "CDC" is the US Centers for Disease Control and Prevention, a US federal government agency that "conducts and supports health promotion, prevention and preparedness activities in the United States, with the goal of improving overall public health."

They've been around a long time and AFAICT they have been and remain "the gold standard" for disease-related medical issues in the US and to a great degree around the world. When someone contracts Ebola or some other scary thing, it's the CDC that picks up the ball. Highly regarded (at least by most rational people I know - I'm sure that the anti-vax loonies see them as part of some galactic conspiracy) and the authority for travel medicine.

Even as a skeptic when it comes to advice handed out by the US federal government, I might (and often do) scoff at US State Department warnings about overseas travel, but if the CDC says I'm gonna grow a second (or third) head if I do X, Y or Z, I take their advice seriously.

Website here: Centers for Disease Control and Prevention

My typhoid vaccine earlier this year (in the US) was oral. Several doses taken a few days apart, as I recall. And the Hepatitis A/B is a two-shot series, the second being some months after the first. But it's still worth starting on that even if you can't squeeze both of them in before the trip. There is definitely some value in having the first shot (per my doctor).

By the way, my doctor recommended that I check vaccine prices at my drug store to see whether they might be appreciably cheaper than getting them in her office or the related traveler's clinic. I remember that one of them (probably the oral typhoid) was close to $100 cheaper at CVS. She was happy to write the necessary prescription for me. Some of the vaccines do have to be pre-ordered, and the oral typhoid needed to be take right home and refrigerated, no shopping on the way.

Most insurance plans will not cover travel-related vaccinations, and the cost can add up. Far better than contracting a deadly disease though. I haven't checked recently, but not all that long ago I read that diphtheria had a 50% fatality rate. That's a frightening statistic.

but if the CDC says I'm gonna grow a second (or third) head if I do X, Y or Z, I take their advice seriously.

Is that how Zaphod Beeblebrox got his?

Younger people got the hepatitis vaccines as part of their routine childhood immunizations. This suggests to me that they are a good idea even if you don't travel much. Why run the risk of a serious illness unnecessarily? It may just be because I have the same insurance as medical school faculty , but my insurance paid the entire cost of my hepatitis shots, so you should at least ask; sometimes they will pay if you get the shots at the pharmacist but not at your doctor's office. And I had no reaction, not even a sore arm from them. With regards to malaria, a few years ago, a teacher in Alabama died of malaria she contracted on a trip-doctors don't immediately suspect and treat diseases that are not common here, although I think she waited too long before even going to the doctor.

The CDC list for "most travelers" didn't seem that long to me. Under "some travelers", I would not get the cholera vaccine if I had medical evacuation insurance unless I was already in poor health. I say this as someone who has gotten almost every vaccine known to American medicine except flu shots (because I never get the flu even when surrounded by those with it). The effective treatment for cholera is easily obtainable anywhere that the water is clean. I read somewhere that Americans going to Haiti do not usually get this shot because it doesn't provide immunity for very long. People die of Cholera in places, like Haiti, where clean water and rehydrating salts are not readily available. The clinicians section of the CDC website has easily understandable "Clinical Updates" about the need for polio and cholera vaccines and it does recommend the cholera vaccine if eating at homes of locals.

Honestly, I don't fear things that are sporadic and out of my control, like terrorist attacks. But if you have any knowledge of history, it is sensible to fear viruses and bacteria for which we have vaccines.

betz,

For travel to India, there are some vaccinations that would be a really good idea. You may want to have a look at these websites and then pay another visit to your local Travel Medicine clinic.

• https://www.iamat.org/country/india (click on the tabs on the left for more information)
• https://travel.state.gov/content/travel/en/international-travel/International-Travel-Country-Information-Pages/India.html
• https://travel.gc.ca/destinations/india (Canadian government website - information is presented a bit differently)

Given that Malaria, Dengue Fever, Zika and Chikungunya are present at times, be sure to pack some DEET or whatever to prevent mosquito bites. If the travel medical clinic recommends antimalarial med's, I'd advise extreme caution in using Lariam. If I were making the trip, I'd choose one of the other antimalarial med's.

Good luck!

No OP reply? Spam?

The best thing to do is to go to a hospital travel clinic. Bring your itinerary with you, and let the physician make the recommendations. When I visited Central America, the doc recommended a typhoid vaccine because of one of the specific places that we were visiting. You can do this a couple months before your trip. Not sure what type of place you went to, but my experience at a local teaching hospital was good and the physican carefully read the itinerary before making recommendations.

Having worked as a supervisor in Disease Control and Prevention, I reported many diseases, contracted by returning tourists from India, to our State Health Department.
And, if you are in close contact with someone with a bad cough, hold your breath and move away. There is a lot of TB there too.

I wish the OP would react.

Maybe OP didn't like the fact that people who responded agreed with the CDC.

Perhaps it wasn't a genuine question - just a rant against the system

A lot of first-time posters come and ask a question, get answers they don't want to hear, and then they're never seen again.

....or they aren't set up to receive notifications that anyone replied.....apps or mobile versions of these websites are often stripped down and not so intuitive for new users. And heaven forbid that life gets in the way so they don't check back the same day. Yep, it would be nice to have closure or see if anything said was useful, but this isn't supposed to be our entertainment. Like a gift, there should be no strings attached to advice.