Travel Immunisations - Hepatitis A, Tetanus etc?
Hello, my 16 year old son and I are going to Belgium, France and Turkey in April. The travel doctor website recommended we have injections for: Hepatitis A Tetanus Diphtheria Now I'm a bit confused because I'm not sure if tetanus injections are always combined with diphtheria and pertussis ... if they are, then I'm good to go on that front having cut my finger last year and getting a shot. In 2006 my son had a DTP at school and also a Hepatitis B injection - but only one. I thought Hepatitis B was something you had several shots of? Lastly, does the Hepatitis B immunisation cover Hepatitis A or are they completely separate? Just trying to work out which injections each of us needs. Thanks in advance to anyone who can clear this up for me. I rang our local nurse who was not much help at all but suggested we might like to consider another MMR and flu shot ... aaargh - so confused!
Infectious Diseases - 4 Answers
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1 :
Here's what the Centers for Disease Control recommends - see the 3 links below. Hope you have a wonderful trip.
2 :
DTPa (attenuated) is usually how the tetanus shot is given, but it's best to check his immunisation record. I think you need a couple of booster shots if that was the first dose of tetanus he had, but check with a GP to be sure. Hepatitis B is a three-shot course: First day, one month and 6 months. He needs at least one more shot before you go, as his immunity will have declined substantially in the 5 years since he had his first shot. Hepatitis A is separate virus, and needs a separate vaccination, however I believe the current schedule is that you only need one shot of Hep A. That said, extra shots won't do you any harm. Hep A and B are available in a combined vaccine called Twinrix in Australia, so you only need one needle instead of two. If he hasn't had MMR for a while it's probably best to get a shot. My immunity to rubella had dramatically declined as an adult, despite 2 childhood MMR shots and another one a few years before the blood test. So that can be another one you might want to consider - though there aren't going to be those diseases in the community in the countries you're going to - they're pretty advanced - so the risk will be minimal. The travel doctor will be best able to advise you.
3 :
Hepatitis A & B are two separate vaccines. The Hepatitis A vaccine is given in two doses and the Hepatitis B is given in three doses. There is also a combination vaccine for both Hepatitis A & B which is given in three doses. If your son had only one Hepatitis B shot, he can continue where he left off and get the two additional vaccinations. Children get five doses of DTaP (Diptheria/Tetanus/acellular Pertussis) from age 2 months through age 4-6 years. Afterwards they receive the Td vaccination (just the Tetanus/Diptheria) every ten years through out life. Recently a new vaccine, the Tdap, was developed and recomended for adolescents and adults as a one time booster instead of the normal Td vaccination to boost the immunity to Pertussis. If you or your son have not had the Tdap, it would be wise to get it. The vaccine you received in the hospital was most likely just the Td, not the Tdap. It is recomended that everyone receive two doses of the MMR vaccine. Normally children get dose one at 12-15 months old and the second at 4-6 years. If either one of you has not had the second dose, it would be wise to get one. The flu vaccine is also a good idea. This years flu vaccine has the H1N1 included.
4 :
Hepatitis A and B are separate vaccines, unless you get the combination vaccine, Twinrix. If your son got one hepatitis B shot, he might be able to get the other 2 before you leave, depending on when in April you are going. The second and third shots must be at least 8 weeks apart, as long as the first and third are at least 16 weeks apart. Hepatitis A vaccine is given in 2 shots at least 6 months apart, but there is good protection, at least for the short term, after the first dose. You may very well have had the Tdap vaccine when you cut your finger. Either that or a Td; both contain tetanus toxoid and diphtheria. Tetanus toxoid may be given by itself but usually is not unless you said you could not take diphtheria vaccine. Your son would have had the Tdap (the DTP or DTaP are used in children under 7). Both are good against tetanus, diphtheria, and pertussis, just in different doses.
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