Hep A vaccination

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BlueDevil

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Location
Melbourne, Australia
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500 - 999
I will be travelling to Indonesia and want to be sure that I have all my routine vaccinations up to date. So will be off to the doc to update my polio, tetanus and typhoid which are all due.

When I had the Havrix vaccine for Hep A about 10 years ago it was predicted that the vaccine would last around 10 years after having the second shot. I have recently heard that they are now thinking it may last up to 20 years. So given that my vaccine was 10 years ago do I need another one or not? Can you have a blood test for Hep A antibodies to see what your status is?

Thanks for any advice!
 
Probably cheaper to get a booster than to get blood tested, I think it is about $80. Heck, if it increases your titer, it is better, right?
 
My doc is well regarded here as well as a native of Mexico, travels back to practice there too, but we still look at CDC together when I have a travel question needing his input/prescription: Health Information for Indonesia | CDC Travelers' Health

From: Chapter 4 - Hepatitis, Viral, Type A - Yellow Book | CDC Travelers' Health
In adults and children who have completed the vaccine series, anti-HAV has been shown to persist for at least 5-12 years after vaccination. Results of mathematical models indicate that after completion of the vaccination series, anti-HAV will likely persist for 20 years or more. For children and adults who complete the primary series, booster doses of vaccine are not recommended (6). Serologic testing to assess antibody levels after vaccination is not indicated.
 
Confirming Dandydon's quote:

26 September 2003.
Authors of a review article in this week's issue of THE LANCET propose that booster vaccinations for hepatitis A virus (HAV) are unnecessary for people with a healthy immune system. The authors highlight how immune memory-the protective capacity of the immune system after specific antibodies have become undetectable-could result in immune protection for up to 25 years.
There are around 1.4 million cases of Hepatitis A reported worldwide every year; the actual figure could be ten times higher. Hepatitis A is one of the most common vaccine-preventable infectious diseases in the world. Effective vaccines against hepatitis A have been available for over a decade and are recommended for people at risk of infection such as populations in some less-developed regions of the world and western travellers to those regions. Two or three doses of vaccine provide long-term immunity against the infection. However, there is no worldwide consensus on how long protection will last or whether there is a need for HAV booster vaccinations. In most countries, booster-vaccination policy is guided by manufacturers' recommendations, national authorities, or both.

Jangu Banatvala (Emeritus Professor of Virology, Guy's, King's & St Thomas' School of Medicine, London, UK) and colleagues describe the outcome of a meeting held last year to review the long-term effectiveness of HAV vaccine in different population groups. Data have shown that after a full primary vaccination course, protective antibody amounts persist beyond 10 years in healthy individuals, and underlying immune memory provides protection far beyond the duration of anti-HAV antibodies. The group concluded that there is no evidence to lend support to HAV booster vaccination after a full primary vaccination course in a healthy individual. However, further investigations are needed before deciding if boosters can be omitted in special patient-groups.

Jangu Banatvala comments: "Evidence is accumulating to show that HAV vaccine elicits immune memory that persists even after loss of detectable antibody. We recommend that reliance be placed on immunological memory rather than booster doses to protect against symptomatic infection. The recommended schedules for HAV vaccines consist of a complete primary course, as described in the product license. Results of preliminary studies show that even one dose induces long-term immune memory. Therefore, the primary course can be continued without restarting, even after an extended interval before the second dose. Additional studies are needed to explore the long-term efficacy of a single dose. To date, no data lend support to the need for booster doses of HAV vaccine in immunocompetent individuals who have received a full vaccination course."
 
Thanks for the input guys. I will have a chat with my doctor, but it seems pretty convincing at this stage that I can save my $80 and an extra injection. And thanks for the helpful links Don.
 
You're very welcome. It's just prudent to see what the CDC and State Department advise for international travels, I think. Here is the latter: Indonesia Sounds a little worse than Detroit. :silly:
 
Hi Don, the issue of safety is one that concerned me quite a bit when I booked this trip especially since I am taking my family. The Australian Government website gives much the same warning that is to be found on your State Department link.

However a friend of mine who is on the trip that I am going on started a thread on ScubaBoard about this issue and all the replies seem quite positive that there is not an issue in the area we will be visiting. The resort have also stated that their is no real security risk in their area, and I guess the fact that many divers visit the Bunaken Marine Park region each year also gives me some comfort.
http://www.scubaboard.com/forums/indonesia/227587-north-sulawesi-security-concerns.html

Thanks again.
 
Yeah, I would think that you can avoid the problem areas. Out of curiosity, see what your government sources say about visiting Detroit MI or Washington DC...?
 
Can't find advice for specific areas, but for the USA in general they say:

We advise you to exercise caution and monitor developments that might affect your safety in the United States because of the risk of terrorism.

Pay close attention to your personal security and monitor the media for information about possible new safety or security risks.

The United States Department of Homeland Security's Advisory System Threat Level is at Orange for all domestic and international flights, indicating a "high" risk of terrorist attack. It is at Yellow or "elevated" for all other sectors, indicating a significant risk of terrorist attack.
 
:hmmm: Sounds almost as bad as Indonesia, huh? :lol2: Detroit and DC would probly sound worse if they did give local advisories. There are many American cities where you wouldn't want to walk downtown at night; Ft.Worth being an exception last time I did, but that was years ago.
 
https://www.shearwater.com/products/swift/

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