Hepatitis A Caribbean Cruise

[ShipShapely]

We will be going on a 14 day cruise to many different Caribbean ports. CDC says Hepatitis A is recommended. I had it in 1998 (two doses) before travelling to the Med. My husband never did. We were wondering if we really need it. It is not cheap (but getting sick is obviously much worse). 39 per person for consult at Infections Disease and Travel medicine dept plus each shot is about 86.00 (you need two each) - one of them at least 10 days before travelling and the second one six months later. Some people have said that Hep A can be contracted almost anywhere - it is a food and water borne virus.  Two shots I heard are said to confer immunity for up to 20 years. I may only get one shot as a booster. However, I know so many people who go on Caribbean cruises and I have never heard of anyone talking about or having gotten this immunization. The CDC however, does suggest it. Just curious about what my fellow cruisers know and think about this topic. 

[CruiserBruce]

Have cruised the Caribbean several times, never thought about the Hep A vaccine...neither DW nor I, and we were both in the health care business.

 

That being said, there was need for me to get the vaccine a couple of years ago, so did. Your insurance won't cover the shots? There may easily be cheaper places to get the shots...like local pharmacies.

[ShipShapely]

Would never have thought about getting it again (first time for husband) but i saw something mentioned on a message board about it. - Found out that CVS has it in stock and with our insurance a little under $80.00 per shot. I called BC/BS directly and they said not covered - but the pharmacist put it into the computer for me and found out that insurance actually WILL cover a portion of it. BC/BS rep on the phone was wrong.  They often are.... it takes so many calls and digging around and due diligence for just about everything these days - almost like a full time job. Thanks for your reply.

[Shorex]

If you know the CDC suggests it, then you have probably visited their Hepatitis A vaccination website page here. That information is more valuable and reliable than opinions (even mine!) on a public cruise forum. Basically, it's a risk analysis decision. Given your age and health, are you willing to tolerate the risk of contracting Hep A? Does your personal physician have any reservations about you being immunized?

 

Hep A is about $60 pp per administration at our Costco (no consultation fee). Whether one dose is valuable as a "booster" is a question for your physician or pharmacist.

 

What other random people on the internet do should have no influence on your decision making process about your health. Timely immunizations for Hep A, Tdap, flu, and a couple others are part of our health maintenance routine. That's us - do what's right for you.

 

 

[ShipShapely]

 What other random people on the internet do should have no influence on your decision making process about your health.

 

Really? Gee I never would have figured that out on my own.  I realize what you are saying. People come to message boards for opinions which i find helpful. I do believe I have the adequate IQ and intelligence to come to the correct conclusions but thanks for the warning "Mom". 

[mom says]

32 minutes ago, ShipShapely said:

I do believe I have the adequate IQ and intelligence to come to the correct conclusions but thanks for the warning "Mom". 

?? Then why are you asking the question here? If you have read all of the CDC advisories and information on Hepatitis A, why do you need input from total strangers who likely have zero medical background? 

 

And the statement from some travellers that they've visited the area more than once and didn't contract it carries no weight since it IS present in the area, just as it is present where you live. Therefore there IS a chance you could come down with it. Do you feel lucky? Well do ya?

 

And FTR,  we keep all of our recommended immunizations up to date, including Hepatitis.

Edited September 17, 2019 by mom says

[HerbertandB]

I got my Hep A immunization before we cruised.  I told my doctor where we were going and she looked up which immunizations were recommended by the CDC for those locations- easy peasy.

[ShipShapely]

1 minute ago, Shorex said:

If you know the CDC suggests it, then you have probably visited their Hepatitis A vaccination website page here. That information is more valuable and reliable than opinions (even mine!) on a public cruise forum. Basically, it's a risk analysis decision. Given your age and health, are you willing to tolerate the risk of contracting Hep A? Does your personal physician have any reservations about you being immunized?

 

Hep A is about $60 pp per administration at our Costco (no consultation fee). Whether one dose is valuable as a "booster" is a question for your physician or pharmacist.

 

What other random people on the internet do should have no influence on your decision making process about your health. Timely immunizations for Hep A, Tdap, flu, and a couple others are part of our health maintenance routine. That's us - do what's right for you.

 

 

 

50 minutes ago, mom says said:

?? Then why are you asking the question here? If you have read all of the CDC advisories and information on Hepatitis A, why do you need input from total strangers who likely have zero medical background? 

 

And the statement from some travellers that they've visited the area more than once and didn't contract it carries no weight since it IS present in the area, just as it is present where you live. Therefore there IS a chance you could come down with it. Do you feel lucky? Well do ya?

 

And FTR,  we keep all of our recommended immunizations up to date, including Hepatitis.

 

 

CDC also suggests Typhus vaccination in the same sentence where they suggest HEP A yet most ppl would not get and do not need Typhus vaccine. 

[donaldsc]

Don't most medical professionals suggest a Hep shot regardless of whether you cruise or not?

 

DON

[CruiserBruce]

11 minutes ago, donaldsc said:

Don't most medical professionals suggest a Hep shot regardless of whether you cruise or not?

 

DON

Yes, many do. Hep A and Hep vaccines have been pretty standard.

[new_cruiser]

26 minutes ago, ShipShapely said:

 

 

 

CDC also suggests Typhus vaccination in the same sentence where they suggest HEP A yet most ppl would not get and do not need Typhus vaccine. 

If you read carefully, the CDC recommendation for Typhus vaccination is not as strong as that for HEP A:

Hepatitis A	CDC recommends this vaccine because you can get hepatitis A through contaminated food or water in Barbados, regardless of where you are eating or staying.
Typhoid	You can get typhoid through contaminated food or water in Barbados. CDC recommends this vaccine for most travelers, especially if you are staying with friends or relatives, visiting smaller cities or rural areas, or if you are an adventurous eater.

The text above is an example from the CDC Barbados web page: 

https://wwwnc.cdc.gov/travel/destinations/traveler/cruise_ship/barbados?s_cid=ncezid-dgmq-travel-single-001

For Hep A, it says: "regardless of where you are eating or staying". For Typhoid, the recommendation is more targeted to those going where food sanitation might not be as well controlled: e.g. smaller cities and rural areas; or for adventurous eaters. 

 

On the CDC website about the vaccine, it doesn't mention any need for boosters.

https://www.cdc.gov/vaccines/hcp/vis/vis-statements/hep-a.html

For adults, it only mentions getting the vaccine if you have not had it previously.  I've not seen a recommendation for getting a booster anywhere.

 

There have been Hep A outbreaks in the US, some where restaurants were the source. Since you only need to get the two shot vaccine series once (or 3 shot series if you do the combined Hep A / Hep B vaccine), it makes sense for an unvaccinated adult  such as the OP's husband to go ahead and get the vaccine. 

[cb at sea]

NO vaccinations are required to cruise the Caribbean....If you have impaired health, you should talk to your physician and see if they recommend any precautions.  You are quite unlikely to come into any contact with anyone/anything that you don't in your daily life at home on a cruise.

If you were going to spend weeks hiking in the "wilds" of some countries, then a vaccination for everything might be in order.  Not so much on a cruise.

[ShipShapely]

1 hour ago, new_cruiser said:

If you read carefully, the CDC recommendation for Typhus vaccination is not as strong as that for HEP A:

Hepatitis A	CDC recommends this vaccine because you can get hepatitis A through contaminated food or water in Barbados, regardless of where you are eating or staying.
Typhoid	You can get typhoid through contaminated food or water in Barbados. CDC recommends this vaccine for most travelers, especially if you are staying with friends or relatives, visiting smaller cities or rural areas, or if you are an adventurous eater.

The text above is an example from the CDC Barbados web page: 

https://wwwnc.cdc.gov/travel/destinations/traveler/cruise_ship/barbados?s_cid=ncezid-dgmq-travel-single-001

For Hep A, it says: "regardless of where you are eating or staying". For Typhoid, the recommendation is more targeted to those going where food sanitation might not be as well controlled: e.g. smaller cities and rural areas; or for adventurous eaters. 

 

On the CDC website about the vaccine, it doesn't mention any need for boosters.

https://www.cdc.gov/vaccines/hcp/vis/vis-statements/hep-a.html

For adults, it only mentions getting the vaccine if you have not had it previously.  I've not seen a recommendation for getting a booster anywhere.

 

There have been Hep A outbreaks in the US, some where restaurants were the source. Since you only need to get the two shot vaccine series once (or 3 shot series if you do the combined Hep A / Hep B vaccine), it makes sense for an unvaccinated adult  such as the OP's husband to go ahead and get the vaccine. 

 

Thanks New Cruiser.  Appreciate. This stuff is not cut and dried which is why I posted in the first place. UPenn Infectious disease and travel med  and the CDC state that immunity lasts for twenty years after two shots. I’m about twenty two years since. they said that one shot for me  might suffice as yes a “booster”.  

[leaveitallbehind]

My advice would be to talk with your physician, who would best know your medical history and any potential risks you would face, and follow their guidance.

 

Our suggestions or experience really would have no bearing on you individually, and as you seem to be concerned about this, your doctor would know best how to advise you.

Edited September 18, 2019 by leaveitallbehind

[evandbob]

There are counties in Florida experiencing Hep A outbreaks : https://fortmyers.floridaweekly.com/articles/hepatitis-a-cases-continue-to-climb-in-state-outbreak/

 

You don't have to travel outside the US to risk exposure.  I think the article says 2,246 cases were reported in Florida so far this year.

 

I got my Hep A & Hep B immunizations about 15 years ago when I was working in the addiction field and then vacationing in the isles.

 

Oh and you want more bad news?  The Villages, a huge 55+ community north of Orlando Fl has the highest rate of STD's in the USA, go figure.

[kochleffel]

There is a risk of Hepatitis A everywhere, including wherever you happen to live. The risk is higher where sanitation standards are low, but that can even be in your favorite restaurant near home.

 

Hep A immunizations are routinely given to children now, the first dose between ages 1 and 2 and the second dose six months later. Where I live, it is difficult to find Hep A immunization for adults -- because of low demand, doctors other than pediatricians tend not to keep it on hand, and the same is true for pharmacists who can administer it.

 

I had been to the Caribbean twice without the vaccination, but when I noticed how my travel plans were developing, including more travel to the Caribbean and to eastern Europe, and read the health inspection reports of some local restaurants, I decided to get it. In my area, it is available to adults only at the county health department, where it's $65/dose (you need two), or $80 if you choose the combination Hep A/Hep B vaccine (Twinrix). I chose Twinrix even though my personal risk for Hepatitis B is fairly low.

 

On the subject of hepatitis: if you are in, more or less, the baby-boomer age cohort, you should be tested once for Hepatitis C. It's a devastating disease that is now curable.

[ShipShapely]

2 hours ago, leaveitallbehind said:

My advice would be to talk with your physician, who would best know your medical history and any potential risks you would face, and follow their guidance.

 

Our suggestions or experience really would have no bearing on you individually, and as you seem to be concerned about this, your doctor would know best how to advise you.

 

FLY EAGLES FLY! ( also from Philly) We are both going to get the HepA vaccines. Thanks for all the input from everyone here.

[kochleffel]

4 hours ago, ShipShapely said:

CDC also suggests Typhus vaccination in the same sentence where they suggest HEP A yet most ppl would not get and do not need Typhus vaccine. 

 

I believe it's immunization for typhoid, not typhus, that the CDC suggests, depending on individual risk. They're not the same disease. Typhoid is spread through contaminated food or water. Typhus is spread by insects (fleas, lice, chiggers, mites).

[Malleykatt]

As stated previously Hep A could be picked up any where. I live in the U.K. and on a weekend away on the South Coast I was infected. Believe me the last thing anyone expected. I couldn't eat for 3 weeks and turned a very fetching shade of yellow. My weight dropped by a stone and a half. Since then we've travelled all over the Mediterranean area, West Coast of America and the Middle East. My rule of thumb is .....buy nothing from street traders. My infection was traced to a burger seller in Portsmouth and I wasn't the only one. 

[MicCanberra]

I would make sure your vaccines are all up to date for travel anywhere.

[SRF]

I travel a lot for work internationally.  To many third world countries.

 

I get every vaccination I can get.  🙂

 

 

[ShipShapely]

I have learned a lot from some of these posts. Thats the point of a message board. Its not to pre-empt medical advice, certainly. To the person who wanted to know why I posted  this question at all.... that's why. 

[evandbob]

12 hours ago, kochleffel said:

 

I believe it's immunization for typhoid, not typhus, that the CDC suggests, depending on individual risk. They're not the same disease. Typhoid is spread through contaminated food or water. Typhus is spread by insects (fleas, lice, chiggers, mites).

 

We have a land vacation to Egypt in 6 months, and typhoid oral or injection was recommended by the CDC.  My PCP concurred.  The other recommendation was Hep A & B protection, which I have had, and Evelyn is starting hers today, just in time for the 6 month time frame.

[new_cruiser]

10 minutes ago, evandbob said:

 

We have a land vacation to Egypt in 6 months, and typhoid oral or injection was recommended by the CDC.  My PCP concurred.  The other recommendation was Hep A & B protection, which I have had, and Evelyn is starting hers today, just in time for the 6 month time frame.

Wow - six months! Have you decided between oral and injection for typhoid. When I've taken it, I've chosen the oral because it lasts for 5 years. The shot is only 2 years. You should still be careful about where you eat. Typhoid vaccine is only moderately effective (estimates from 50 to 80% effectiveness). 

[mjkacmom]

My husband and I got hepatitis A most likely from Disney World decades ago, missed 4 - 6 weeks of work, it was like a stomach bug that lasted many weeks. Dropped so much weight, and pretty much had to stay quarantined. You can catch it anywhere.