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Author Topic: Travel to the tropics and yellow fever vaccine  (Read 900 times)

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Offline karry

  • Member
  • Posts: 259
Travel to the tropics and yellow fever vaccine
« on: March 02, 2013, 09:05:42 AM »
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.
Take it a day at a time....and be positive about it too!

Offline ad2san

  • Member
  • Posts: 182
Re: Travel to the tropics and yellow fever vaccine
« Reply #1 on: March 02, 2013, 09:33:53 AM »
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   ;D

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

Have a nice trip  !!!

Cheers
Feb   2009 CD4 358 VL 2000 16%
May  2009 CD4 305 VL 3069  14% <---- Started TVD+ATZ/r
Jul  2009 CD4 512 VL <50   18%
Jul 2010 CD4 418 VL <50 24%                     
Switched to Kivexa (Epzicom) + Norvir + Reyataz (due to sleep problem)
Aug 2010 CD4 606 VL <50 25%
Apr 2011 CD4 523 UD 21%
Jul 2011 CD4 494 UD 23%
Switched to Kivexa (Epzicom) + Viramune XR (due to kidney problems)
January 2012 CD4 564 UD 31%
October 2012 CD4 684 UD 29%
January 2013 CD4 594 UD 26%
Switched to Kivexa (Epzicom) + Isentress due to BIG increase GammaGT
Feb 2013 CD4 699 UD 28%
May 2013 CD4 385 UD 28%
July 2013 CD4 CD4 636 UD 25%
Oct 2013 CD4 588 UD 39%

Offline karry

  • Member
  • Posts: 259
Re: Travel to the tropics and yellow fever vaccine
« Reply #2 on: March 02, 2013, 09:39:11 AM »
Thanks a lot for your response ad2san
K.
Take it a day at a time....and be positive about it too!

Offline Souledout

  • Member
  • Posts: 145
Re: Travel to the tropics and yellow fever vaccine
« Reply #3 on: March 02, 2013, 09:52:27 AM »
Great bit of info there, thanks.
Infection sometime April-August, no noticable seroconversion symptoms
Not currently on medication
13/09/12 CD4 672 (33%) VL <40 (diagnosis date)
18/09/12 CD4 ?               VL 43
27/09/12 CD4 ?               VL 127
19/11/12 CD4 676 (38%) VL 959
03/03/13 CD4 642 (32%) VL 291
04/07/13 CD4 791 (33%) VL 26,437 (active cold sore, tooth infection)
18/07/13 ------retest------VL 3704
18/11/13 CD4 802 (36%) VL 65

Offline karry

  • Member
  • Posts: 259
Re: Travel to the tropics and yellow fever vaccine
« Reply #4 on: March 06, 2013, 07:00:00 PM »
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
Take it a day at a time....and be positive about it too!

Offline newt

  • Member
  • Posts: 3,867
  • the one and original newt
Re: Travel to the tropics and yellow fever vaccine
« Reply #5 on: March 06, 2013, 08:12:24 PM »
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
"The object is to be a well patient, not a good patient"

Offline bocker3

  • Member
  • Posts: 3,254
  • You gotta enjoy life......
Re: Travel to the tropics and yellow fever vaccine
« Reply #6 on: March 06, 2013, 10:28:21 PM »
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
Atripla - Started 12/05
Reyataz/Norvir - Added 6/06
Labs - Pre-Meds
Sep05 T=350/25% VL98,559
Nov05 288/18%  47,564
Current Labs
May2013 691/31% <20

Offline karry

  • Member
  • Posts: 259
Re: Travel to the tropics and yellow fever vaccine
« Reply #7 on: March 07, 2013, 04:00:07 PM »
@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.
« Last Edit: March 07, 2013, 04:03:27 PM by karry »
Take it a day at a time....and be positive about it too!

Offline karry

  • Member
  • Posts: 259
Re: Travel to the tropics and yellow fever vaccine
« Reply #8 on: March 22, 2013, 09:07:24 AM »
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.
Take it a day at a time....and be positive about it too!

Offline ad2san

  • Member
  • Posts: 182
Re: Travel to the tropics and yellow fever vaccine
« Reply #9 on: March 22, 2013, 09:13:32 AM »
you're all set   ;D

Enjoy your trip
Feb   2009 CD4 358 VL 2000 16%
May  2009 CD4 305 VL 3069  14% <---- Started TVD+ATZ/r
Jul  2009 CD4 512 VL <50   18%
Jul 2010 CD4 418 VL <50 24%                     
Switched to Kivexa (Epzicom) + Norvir + Reyataz (due to sleep problem)
Aug 2010 CD4 606 VL <50 25%
Apr 2011 CD4 523 UD 21%
Jul 2011 CD4 494 UD 23%
Switched to Kivexa (Epzicom) + Viramune XR (due to kidney problems)
January 2012 CD4 564 UD 31%
October 2012 CD4 684 UD 29%
January 2013 CD4 594 UD 26%
Switched to Kivexa (Epzicom) + Isentress due to BIG increase GammaGT
Feb 2013 CD4 699 UD 28%
May 2013 CD4 385 UD 28%
July 2013 CD4 CD4 636 UD 25%
Oct 2013 CD4 588 UD 39%

 


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