Adventure Doc
keeping you healthy for life's adventures
Erik McLaughlin MD, MPH
Affiliates
VACCINES
VACCINES
Most everybody reading this has been vaccinated against something. The idea started with Dr. Jenner and his cows, vaccinating against pox viruses. He noticed that milkmaids were not getting a virus that was affecting everybody else. He took a needle and pricked the cow, then others. Those people did not get this virus. Vaccination was born and named after the latin word for cow…”vaca”.
HEALTH KIT
Travelers often require special immunizations. Always check with your travel health doctor about what vaccines you may need, based on where you are going and what you have already had. Some vaccines to know about are:
* CI = Contraindications
Cholera Vaccine
Vaccine type:
Parenteral (killed)
# of shots:
2, one week apart
Booster:
one shot booster after 6 months
CI:
pregnancy
Notes:
poor efficacy, not advised unless history of achlorhydria or ulcer disease, previous history of intussusception
PRODUCT REVIEWS
Hepatitis A
Hepatitis B
Vaccine type:
killed viral
Vaccine type:
recombinant viral protein
# of shots:
2 shot series given at 0 and 30 days
# of shots:
3 shot series given at 0, 30 and 60 days
Booster:
85% immunity after second shot, possibly boost if travel to endemic area
Booster:
none advised, immunity is believed to be lifelong if series completed
CI:
none
CI:
none
Notes:
A must have for travelers, regardless of destination
Notes:
Given at birth/infancy since mid 1980’s, adults may need catch-up
H. Influenza B (HiB)
Haemophilus Influenza is a bacteria that was originally believed to cause "the flu" and improperly named. "The flu" is actually caused by several different types of viruses.
One vaccine prevents bacterial infection and should not be confused with the other, a killed viral vaccine.
Vaccine type:
bacterial polysaccharide
# of shots:
3 dose series given at 2, 4 and 6 months old
Booster:
boost at 15 months old
CI:
none
Notes:
standard vaccine given to children in developed nations
Influenza virus
Vaccine type:
killed viral
# of shots:
1 dose
Booster:
yearly
CI:
egg allergy (anaphylaxis)
Notes:
covers CDC’s predictions of potential outbreak strains
Japanese Encephalitis JEV
Vaccine type:
killed viral
# of shots:
3 shot series given at days 0, 7 and 30
Booster:
may be needed after 2-3 years
CI:
less than 1 year old
Notes:
given SC, observe for 30 min. after admin for allergic reaction, can be given as young as 1 year old
Measles
The MMR (measles, mumps rubella) vaccine is a common vaccinization in developed nations, given to children.
Vaccine type:
live viral
# of shots:
2 shot series given as part of MMR at 1 year old and 4-6 years old
Mumps
Booster:
boost with MMR once in adult life
Vaccine type:
live viral
CI:
pregnancy, immunocompromised
# of shots:
1
Booster:
boosted with MMR once in adult life
Notes:
part of MMR vaccine given at 1 year of age and again at 4-6 years of age
CI:
pregnancy, egg allergy, immunocompromised
Notes:
part of MMR vaccine given at 1 year of age and 4-6 years of age, give SC
Rubella
Vaccine type:
live viral
# of shots:
1 dose at 15 months of age or older
Booster:
none advised, boosted with MMR once in adult life
CI:
pregnancy, possible of pregnancy within 3 months, immunocompromised
Notes:
part of MMR vaccine given at 1 year of age and 4-6 years of age, give SC
Meningitis
Vaccine type:
Bacterial polysaccharide
# of shots:
1 dose
Booster:
none
Pertussis
CI:
none
Vaccine type:
bacterial toxoid
Notes:
covers A, C, Y, W-135 serotypes. No protection vs. B type
# of shots:
4 dose series (DTP) given at 2, 4, 6 and 18 months of age
Booster:
boost at 4-6 years of age
CI:
use DTP series for children less than 7 years old
Pneumococcus (23 valent)
Vaccine type:
bacterial polysacharide
Notes:
given as part of DTP (diptheria, tetanus, pertussis) series
# of shots:
: 1
Booster:
none
CI:
none
Notes:
advised for persons without a spleen, commonly given to those over 65 years old
Polio OPV
Polio IPV
Vaccine type:
live attenuated
Vaccine type:
killed viral
# of shots:
oral drink given several times throughout childhood
# of shots:
4 shot series, first 2 shots given 4-8 wks apart, dose 3 at 6-12 mos after dose 2 and dose 4 given to children at 4-6 y/o
Booster:
boost in adulthood if travel to high risk area
CI:
no prior immunization and age above 17 y/o, pregnancy, nonimmune contacts, immunocompromised
Booster:
boost in adult life if travel to high risk area
CI:
none
Notes:
provides “herd immunity” through viral shedding in feces, rare cases of paralytic polio in non-immune contactsacquired polio
Notes:
does not produce “heard immunity”, no risk of vaccine acquired polio
Rabies HDCV
(human dipliod cell virus)
The rabies vaccine is generally reserved for those at high risk, such as animal handlers. The post-exposure treatment is for those who have already been exposed (bitten).
Vaccine type:
killed viral
# of shots:
3 shot series given at days 0, 7 and 21 or 28
Booster:
after 2 years or check antibody level
Rabies Post-exposure prophylaxis
CI:
none
Vaccine type:
RIG (rabies immune-globulin)
Notes:
produces 90% protection, complete last dose 3 weeks before starting chloroquine
# of shots:
1 given on the day of bite, give half into the area of wound and half in opposite limb
Booster:
must complete HDCV series on days 0, 3, 7, 14 and 28, in addition to RIG
CI:
none
TB/BCG
Notes:
some developing nations use animal serum (horse, mouse, duck) in their RIG shots and it can cause allergic reactions
Vaccine type:
live mycobacterial
# of shots:
1
Booster:
none
CI:
TB positive skin test, pregnancy
Notes:
commonly given to children in endemic areas (India, Africa, Middle East), causes a positive PPD skin test
Tick-Borne Encephalitis
Vaccine type:
chick embryo culture
# of shots:
3 doses over 6 months
Booster:
unknown, poor data
CI:
none
Notes:
only availbale in Europe
Tetanus and Diptheria
Vaccine type:
bacterial toxoid
# of shots:
4 dose series with first 3 shots given 4-8 wks apart and dose 4 given 6-12 mos after dose 3
Booster:
once every 10 years in adults previously immunized or every five years if skin break
CI:
immunocompromised
Notes:
common childhood immunization in developed nations
Typhoid Oral
Oral typhoid can make you have some stomach problems. The injectable typhoid often causes a "flu-like" illness for a few days. However, you have to choose if you are going to an area at risk!
Vaccine type:
live bacterial
# of shots:
1 capsule, taken every other day for 4 total doses
Booster:
After 5 years, repeat series
Typhoid Parenteral
CI:
pregnancy, recent antibiotic treatment, immunocompromised
Vaccine type:
killed bacterial
# of shots:
2 shots, 4 weeks apart
Booster:
boost after 3 years if continued risk
Notes:
may cause nausea
CI:
pregnancy, history of severe reaction to previous typhoid vaccine
Notes:
1-2 days of headache, malaise, nausea common after shot
Yellow Fever Vaccine
Vaccine type:
Live virus
# of shots:
1
Booster:
after 10 years
CI:
Egg allergy, immunocompromised, pregnancy, less than 9 months old
Notes:
Required by some countries
HEALTH KIT
