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Ms Gordon asked...

Tags: travel

Could you let me know the approximate cost for a full set of vaccinations if travelling to Thailand for a minimum of six months at the end of September 2015. I would be predominantly based in city areas as far as I'm aware.

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The Answer

Thank you for contacting Health at Hand. The vaccines that you will need for travelling to Thailand depends very much on the vaccines you have already had and  others that are optional depending on your particular activities and areas you travel to which may put you at greater risk.

You may need a booster of some of the vaccines you have had in the past depending on when you last received them. The vaccines generally recommended for travel to Thailand from the UK for 6 months are as follows:-

Diphtheria and Tetanus are available in a combined vaccination with Polio: 

Approximate cost is £32.00

Hepatitis A and Typhoid vaccines:

These are available as a combined vaccine at an approximate cost of £85.00

Or as separate vaccines: 

Hepatitis A approximate cost £49.00

Typhoid  vaccine approximate cost £35.00

Cholera Vaccine:

Consists of two doses separated by an interval of 1-6 weeks. It is a liquid medicine that you drink as oppose to an injection. The first dose must be taken at least two weeks before your travel and the second dose must be taken at least 1 week before you travel to Thailand. You should not eat or drink anything including taking medicines one hour before and one hour after taking each dose of the vaccine.

Full two dose approximate cost £56.00

Vaccines to be considered are Hepatitis B, Japanese Encephalitis, Rabies and Tuberculosis.

Hepatitis B

Hepatitis B is spread through infected blood and blood products, contaminated needles and medical instruments and sexual intercourse. You may need the course of Hepatitis B vaccine if you are at high risk of catching it.You may be at high risk if: 

• You are working as a doctor or a nurse or other occupation dealing with blood products or hypodermic needles

• You are going to stay in Thailand for long period of time

• You are a  frequent traveler,

• You are a child or have children as they are more exposed through cuts and scratches.

• You are an individual, who may need, or request, surgical procedures abroad.

Hepatitis B vaccine --------3 doses are needed to provide full protection

A 0, 1, 6 months schedule gives optimal protection at month 7 and produces high antibody concentrations.  Hepatitis B is transmitted through contaminated body fluids so may be considered The approximate cost of each dose of Hepatitis B vaccine is £40.00 

Japanese B Encephalitis 

Japanese B Encephalitis is spread through the bite of an infected mosquito. This mosquito breeds in rice paddies and mainly bites between dusk and dawn. Risk is higher for long stay travelers to rural areas, particularly if unable to avoid mosquito bites.

Japanese B encephalitis consists of two doses. First dose at Day 0.

Second dose: 28 days after first dose . If an accelerated dose is needed then the first dose is at Day 0 then the second dose is given only 7 days after the first dose. The approximate cost  of each dose is £89.00

Rabies Vaccine

Rabies Vaccine is spread through the saliva of an infected animal, usually through a bite, scratch or lick on broken skin. Particularly dogs and related species, but also bats. Risk is higher for those going to remote areas (who may not be able to promptly access appropriate treatment in the event of a bite), long stays, those at higher risk of contact with animals and bats, and children. Even when pre-exposure vaccine has been received, urgent medical advice should be sought after any animal or bat bite.

If you are at high risk of catching rabies then you will need a Pre-exposure schedule so you have a vaccine on days 0, 7 and 28. The earliest day that the 3rd dose can be given to achieve effective immune status is day 21. The approximate cost of each dose is £57.00. If you should get bitten or licked by an animal then you will need further two doses at separate intervals post exposure.

Tuberculosis

Tuberculosis (TB) is spread through inhaling infectious respiratory droplets through coughs and sneezes from someone who has TB. Most travellers are at low risk. Travellers at higher risk include 

• healthcare workers,

those who are visiting friends and relatives (particularly young children), 

• long stay travelers, and those who have close contact with an infected individual

The vaccine used to combat TB is called BCG or bacillus calmette-guerin

• You may need a BCG vaccine if you are in the high risk group and have not previously had this vaccine. Tuberculin skin test negative health care workers younger than 35 years of age. This recommendation is irrespective of duration of stay.

• There are specific contraindications and adverse events associated with BCG vaccine. A careful risk assessment should be made before administration and specialist advice sought as appropriate.

The BCG vaccine

In the UK, tuberculin skin testing (TST or Mantoux) is used either prior to BCG, in order to determine whether there has been previous infection with Mycobacterium tuberculosis (BCG should not be given if TST indicates previous exposure), or as an aid to diagnosis [18,20].

If needed then BCG vaccine is given as a single dose. The approximate cost of the TST or the Mantoux test is £75.00 and that of the BCG is £30.00. I include the web links below that I think you will find useful for further information:

http://www.fitfortravel.nhs.uk/destinations/asia-(east)/thailand.aspx and http://nathnac.org/

Answered by the Health at Hand nurses

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