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Vol 1. No 3. December, 1997
Do I Need Vaccinations?
Question: I've recently moved to Thailand and I'm wondering about vaccinations. Do I need them?
The recommendations regarding what vaccinations you should get when coming to Bangkok differ from country to country. Mostly those differences are based on what is considered routine in the country you are coming from and on the vaccinations you have therefore received already. It is smart to start with finding out which vaccinations you have already received in your lifetime and it is also wise to get your shots before actually moving out here. Here is what is generally recommended for Thailand by western vaccination authorities.
Tetanus/Diphtheria/Polio:
A full vaccination course consists of 3 inexpensive
vaccinations within the period of one year. Most of us
will have been submitted to this regimen during the first
year of our lives or somewhere during childhood. If this
is the case, then all that is needed is a boostershot if
you did not receive one during the last 10 years.
Typhoid:
You have a choice between two cheap, painful shots, four
weeks apart, that can leave you rather feverish, and a
less torturous but more expensive course of capsules
taken within a five day period. Both offer protection for
some three years against Salmonella typhii, one of the
nastiest kinds of food-poisoning.
Hepatitis A
A self-limiting liver infection not leading to chronic
liver disease, but the illness itself can keep you in bed
for 2-6 weeks. Very common in many countries, less so
nowadays in the western world. If you have ever been
infected with hepatitis A, you have lifelong immunity.
Whether this is the case can be detected by a bloodtest,
looking for so-called IgG antibodies.
If you have never had hepatitis A there are two options:
1. passive immunization: shot(s) with relatively inexpensive gammaglobulins (=external antibodies) giving protection to a maximum of 3-6 months
2. active vaccination: a course of three moderately expensive shots within half a year, that give you at least 10 years protection
Hepatitis B
Also a viral liver infection, often more agressive than
hepatitis A during the active course of the disease.
Self limiting in 90% of cases, but 10% of those infected never manage to clear the infection and develop chronic hepatitis with greatly increased chances of developing liver failure or liver cancer.
Hepatitis B is spread by blood products, secretions and sexual intercourse and rather common in Southeast Asia. Vaccination in western countries is only advised for so-called risk groups, but should be routine for people residing in Bangkok for longer than a vacation.
Vaccination is possible with a couse of 3 expensive shots within half a year. If vaccination is succesful (in rare cases it isn't, your vaccination course should be concluded with an antibody check one month after the last shot) protection is now considered to be lifelong.
Japanese encephalitis
A rare but serious infection of your brain. Vaccination
is recommended for visitors to Southeast Asia who will be
spending 1 month or longer in rural areas during the
summer months and rainy season, when mosquito populations
are high. Not needed for most Bangkok residents
therefore.
Malaria
Not an issue in Bangkok, but definitely an issue along
the Thai/Myanmar and Thai/Cambodian border. Check the
latest recommendations regarding prophylaxis when
travelling there and just make sure to limit the number
of musquitobites by using repellent, wearing long sleeves
and trousers at twilight/night and using a musquitonet.
Vaccinations for cholera, yellow fever and meningitis are not part of the recommendations for Thailand.
Doctor Boonmaar is an Aids researcher in the Kingdom. Questions can be addressed to him in care of Pink Ink, or by sending email to pinkmonthly@hotmail.com.
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