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Doctors' Answers to "Frequently Asked Questions" - Vaccination

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Naval Anthraz Vaccine [posted 10/20/98]
Question: My son is in the Navy and he and his ship have been told they have to take the anthrax vaccine and they are all upset. Can you tell me something about the vaccine and why they are all against it.

Answer: They are all getting it because of international concern over countries that have little morals or committments to agreements not to use biologic warfare. This vaccine has been given for years to vets, etc. in certain high rish exposure occupations(vets, etc.). The vaccine could clearly be improved and is less pure than other vaccines that we possess. Occasional adverse reactions will occur with this vaccine.

Overseas Vaccination
Question: We have lived in Egypt since Aug 96 and will be here until Aug 98. Before coming we all (2 adults, 2 children) had all relevant vaccinations but unfortunately failed to take one booster when it was due. This was the Havrix, for Hepatitis "A", The booster was apparently due after 9 months. My first question is: should we repeat the vaccination or will boosters, given so many months late, be effective for both us and our children who had the Havrix Junior? My second question is about the vaccine for Meningitis A & C. We were not advised to have this by MASTA(London School of Hygiene & Tropical Medicine) when we first came to Egypt, but now we are about to go on a cruise to Lake Nasser in Upper Egypt(some 50 miles north of Sudan) which is apparently a high risk area for this disease. However, we shall be on a 5-star cruise ship, with only escorted tours to sites on land and extremely limited contact with local people. I hate to vaccinate unless strictly necessary. Do you think that normal hygiene and good living conditions render this immunization unnecessary? Question 3: I am allergic to Penicillin. What is the drug of choice in the treatment of meningococcal meningitis in such a case? These questions have great relevance in a country with limited health care facilities, this isn't just paranoia!

Answer: I'd certainly go ahead with the Hepatitis A vaccine. The wait won't hurt the rise in titers at this date. Regarding Meningitis, I doubt if you are at any risk. One option would be to take small doses of rifampin on a daily basis(how we eradicate carriers or casual contacts). Can you take cephalosporins? This is probably the next best followed by erythromycin or chloramphenicol.

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