Sunday, 23 March 2014

And the vaccinations continue

As our African trip looms ever closer (we leave in something like 38 days), last week we went in for Round 2 of the vaccinations.

Round 1 was a Twinrix (Hep A & B) first injection and a travel consult of what else we would need.

Round 2 was more. We got Twinrix part 2 (we need a final Twinrix in August). We got a yellow fever vaccine injection from a different clinic (apparently, not every travel clinic does every vaccine). And we got a typhoid fever vaccine, which is administered orally.

The oral typhoid pills need to be stored in the fridge and taken every 48 hrs for 4 days. Like yellow fever, typhoid is a "live" vaccine, meaning you actually get to get a really, really low dose of actual typhoid fever bacteria that has been slightly altered to a less virulent strain by passage through an intermediate host. I didn't know that typhoid was a salmonella bacteria variant. Turns out there's like a couple of hundred strains of salmonella, and of course, none of them are good for you.

Both Karen and I had reactions to the typhoid pills. Neither lasted a long time, but both were common examples of really low grade versions of typhoid. Karen's yellow fever injection site also bruised up really badly for some reason.

We also got specifications for our antimalarials to take to our family doctors. The provincial travel clinics we went to don't write prescriptions for these.

And interestingly, as of last week, there's a new "requirement" been introduced regarding mumps, measles and rubella (MMR). Used to be that if you were born before 1970, it was assumed that you got an MMR vaccine when you were young. As of last week, that rule has changed. Now, if you can't PROVE with a signed immunization record that you got the MMR vaccine (for me, it would have been in about 1964), or you have no RECORD of having had measles, mumps and rubella, you are "strongly recommended" to get an MMR vaccine.

Now, I personally don't have 50 year old vaccination records. I don't even have the yellow fever vaccination record from 1997 when I got it to work in South America (it doesn't matter; it's only good for 10 years anyway). But we squeaked in under the wire, and the new rule doesn't apply to us. I'm sure I got vaccinated, and I may have even had the mumps when I was really young.

The reason MMR is now recommended? Turns out that measles is on the rise, especially in older folks. Apparently, the hippies/pure lifers/religious groups of the 1960's that were anti-vaccination have created a substantive cohort in society that has reduced the overall herd immunity that was thought to exist. It's starting to manifest itself, especially as the anti-vaccination groups have grown over the years. For instance, this past week, there has been a 100 person outbreak in the Fraser Valley that started in a Christian school that had a low vaccination rate.