Travel to the tropics and yellow fever vaccine

[karry]

I am facing a small dilemma here.

I will be travelling to a tropical African country in the summer. Having a yellow fever vaccine is a MUST for entry.

My current health condition: Positive 6yrs now; no meds; CD4 740 and vl 600 (last tests february 11 2013). I saw my HIV doctor a week ago, and he does not recommend the vaccine for HIV + people, but then he said considering my numbers I can still get it.

I checked on a tropical disease centre web page and they seem to say nothing about the yellow fever vaccine and people with CD4 above 499.


Does anyone have any personal experiences with this or any info?

I know I can get a waiver, but then I also want to see if based on my numbers I am at no risk taking the vaccine. I have an appointment for end of March to meet with a Dr who specialises in tropical meds.

Thanks.
K.

[ad2san]

Hi there,

I had that same problem as well. One doctor said "yes" another said "no" another said "yes" ... so I went to the university for a consultation with a professor in tropical medicine   

Result: when more than 600 CD4 you can have the vaccine.

Have a nice trip  !!!

Cheers

[karry]

Thanks a lot for your response ad2san
K.

[Souledout]

Great bit of info there, thanks.

[karry]

Updates: Just got a call today from the nurse at the HIV clinic  telling me that my doctor is asking that I not take the vaccine. They are proposing to give me a waiver...knowing where I am going, this will make things even more complicated for me.
I am stuck here thinking I should just go to a travel clinic and get the damn vaccine and deal with the consequences!

Karry

[newt]

The American Advisory Committee on Immunization Practices says that yellow fever vaccine may be given to those with a CD4 count of 200+ traveling to high-risk areas.

UK HIV guidelines are similar.

Normal exclusions eg egg allergy, pregnancy/breastfeeding apply.

- matt

[bocker3]

I've been talking to my ID doc about the Yellow Fever vaccine, because we are going on a safari in Tanzania next year (for my 50th....).  He has no issues with my having the shot because of my HIV -- however, he's not convinced that I need to have it.  It's not required for visiting Tanzania, only suggested and he doesn't think anyone should take it if you aren't going to an endemic area.
We will discuss a little more -- but I am leaning toward taking the shot anyway.

M

[karry]

@newt and bocker:
Thanks for your input.
All the documents I have consulted so far online convince me I can safely have this vaccine. Even  the  Canada public health agency states that:
 
http://www.phac-aspc.gc.ca/publicat/cig-gci/p04-yfev-fiej-eng.php#tphp

"Travellers thought to have mild to moderate degrees of immune suppression who will be at significant risk for acquiring YF (e.g., travel to an area of endemic or transitional transmission risk), should be offered YF vaccine and advised of the theoretical risks."....

..."HIV-infected
... YF vaccine may be considered for people who have asymptomatic HIV infection and who are not severely immunosuppressed (i.e., CD4 count greater than 200 x 106/L) but vaccination should take place well in advance of travel in order to monitor potential adverse events, and antibody titres should be considered to assess efficacy of the vaccination. Persons with HIV respond suboptimally to YF vaccine with lower antibody titres, more often demonstrate non-protective titres, and may experience a more rapid decline in antibody titres following vaccination. Booster doses may be required."


so I will go ahead and argue my way into having my shot.

Thanks.
K.

[karry]

Hi all
Just wanted to update that I finally got my vaccine!...and even more. On same day got Vivaxim for Hep A and typhoid as well as boostrix-polio for tetanus, diphtheria , pertussis and polio.....The tropical disease specialist I saw had worked in the tropics and had experience with HIV pos patients. I found her really nice.

I also got prescriptions for mefloquine and ciprofloxocin to cover malaria and diarrhea.

I had no side effects, apart from the usual sore feeling at the site of the injection.

Happy here and finally set to  travel
Yupee
K.

[ad2san]

you're all set   

Enjoy your trip