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Discussion Starter #1
I am going to Costa Rica to paddle at the end of January. Which immunizations do you recommend getting (if any)? I am really healthy. In fact I have never even had a flu shot and have not had a flu in at least 15 years or more. The thought of having anything injected in me really creeps me out.
 

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The thought of having anything injected in me really creeps me out.
I agree with you. I googled around looking for what vaccinations are required to enter Costa Rica (looks like none to me), and then to re-enter the US (looks like a lot are recommended by the CDC for going to Costa Rica, but none are required). Don't take my word for it of course, do your research.
Here are a few links I found:
===
Costa Rica. Hotels, travel agencies and tours
Search for "vaccin", and read #11.
This site implies that if you are going straight to Costa Rica from the US, you don't need any shots to enter Costa Rica. If you go to Costa Rica from many South American or African countries, you need a yellow fever shot.

Searching this page for "require" finds the following line:
Costa Rica Information, Facts and Visa Requirement
"Vaccinations:
There are no required vaccinations for travel to Costa Rica, although in some provinces there is a malaria risk, according to the Centers for Disease Control and Prevention, which posts its recommendations at www.cdc.gov."

Health Information for Travelers to Costa Rica - Travelers' Health - CDC
Reading the CDC site about Costa Rica, I see lots of vaccinations recommended, but nothing required. If you are going to Limón Province, malaria is an issue. Read all the malaria prevention advice, which helps with other insect-borne diseases also.

If you get any shots, plan on the possibility of feeling sick for a few days. You don't want to get shots right before getting on the plane.

Check out what it says on the label of the 2011-2012 Flulaval (influenza virus vaccine, the flu shot):
"... there have been no controlled trials adequately demonstrating a decrease in influenza disease after vaccination with FLULAVAL".
It states clearly... | Facebook

Anyway, have a great time down there!
 

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make your own decisions and nothing against CR as I get these shots for boating in the US.
consider tetanus just in case you get cut out in the jungle
and
Hep A which can also be spread by feces etc in the water. I love boating in CR but some of the popular streams are polluted. And, while a lot of the rural CR hotels etc have toilets just like ours, many will drain directly into a local stream.

The people are great, the boating is awesome and the food is excellent.
 

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Discussion Starter #5
Thanks for all the input...I have some decisions to make! Because I work in the medical field "alternative that is" I have access to what actually goes into most injections (very scarey!) I would NEVER have a flu shot. I work in close contact with sick people every day and I am healthy, so the thought of any other injections...:confused:
 

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Because I work in the medical field "alternative that is" I have access to what actually goes into most injections (very scarey!) I would NEVER have a flu shot. I work in close contact with sick people every day and I am healthy, so the thought of any other injections...:confused:
I would recommend doing research on the specific area you are traveling to, using govt disease control websites, and thoughtfully considering recommendations.

I know folks who "didn't take the meds", "got the disease", and trust me... the treatment for the disease is way worse than the prevention of an immunization (malaria case).

Also, immunizations have some of the largest data sets on the planet, and the safety and efficiency is very well documented from a scientific perspective. I don't think "scary" is a scientific way to look at things.

Do some research on malaria, polio, hepatits, typhoid... and I think that its clear that immunizations can have a major positive impact on human kind.

Also, being healthy now has absolutely no bearing on your ability to contract tropical diseases in foreign countries.
 

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The only reason immunizations look scary is because generations of immunization campaigns have nearly wiped out a whole host of disease in the US. The bulk of improved life expectancy in this country is due to immunizations. Back when families had to have 4-5 kids because 2-3 of them would die of disease, it kept things in context a little better.
If you paddle anything other than pristine headwaters, you'll drink way worse than you'll get injected.
Go to a travel clinic, get your shots.
 

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Discussion Starter #8
I did my homework

Here is the info I came up with:
Costa Rica has been relatively free of dangerous parasite diseases (malaria, dengue, yellow fever, typhoid) for a long time.
Some rivers in Costa Rica have had Hepatitis show up in analysis, but none of the Caribbean slope white water rivers (Pacuare, Sarapiquí, Peñas Blancas, Pejebeye) have ever tested "positive" to Hepatitis. (These are the rivers I will be paddling)

Warnings for Hep A/B Injections:
Tell your doctor immediately if any of these unlikely but serious side effects occur: fast/irregular heartbeat, fainting, severe headache (migraine).Tell your doctor immediately if any of these rare but very serious side effects occur: tingling/numbness, inability to make muscles of the legs/arms/face work (paralysis), vision changes, seizures, easy bruising/bleeding, mental/mood changes (e.g., unusual behavior, confusion, severe drowsiness, severe tiredness, stiff neck, visual sensitivity to light). Seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects.
 

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My county health dept had an immunization clinic that was staffed by a NP that was up on all the immunizations for "everywhere" and had the immunizations on hand. I thought it was a very good and was only $20 I think. Not sure if your area has one but if you do I would highly recommend that.
 

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Because I work in the medical field "alternative that is" I have access to what actually goes into most injections (very scarey!) I would NEVER have a flu shot.
Okay I am going to call you out. Why would you never have a flu shot? Flu shots are very safe and much better than getting the flu. Small kids cannot get flu shots and if people keep up the Jenny McCarthy scare mongering they can die because some adults are ignorant about the benefits of herd immunity and the safety of vaccines. This is even more important for really deadly things like whooping cough.

that said I went to Costa Rica with no shots (other than a flu shot) last year. no problems - although they won't allow you to donate blood for one year after you return.
 

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Unfortunately in our country, any time there is a medication trial the FDA makes the company list everything that every patient reported just in case it might be related to the medication. They don't, however, report how often it occured. Often, the study population will report things like headache at a lower rate than the general population, but headache will still be listed as a side effect.
So yes, if any of the things in the list of side effects happens, you should see your doctor. Of course, most of them make no physiologic sense for what's in the vaccine. But you'd really want to risk hepatitis? Horrible internal organ pain, massive swelling, and the chance for chronic liver failure all to avoid a shot? Unless you're paddling somewhere that nobody poops, I'd get vaccinated. I am.
 

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As someone who's seen firsthand the horrific effects of vaccine preventable diseases (in particular polio) I'm a firm believer in vaccines. I lived in Congo for a year and watching people drop like flies due to Malaria, Dengue Fever, and severe diarrhea wasn't pretty. Some things like Malaria and Filaria aren't vaccine preventable but you take a drug that kills off the parasitic load once a week. Can you say ewwww? Still, waaay better to prevent the diseases if it can be done than to get the disease itself. I'm grateful that we live in a country where vaccination programs have erraticated many afflictions to such a degree that most people have never had any experience with them. But- this is just my personal opinion of course.
 

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Discussion Starter #13
Okay I am going to call you out. Why would you never have a flu shot?

Mania...This is why I would never have a flu shot and I not had a flu in at least 15 years or more:
During the manufacturing process, antibiotics (neomycin, polymyxin B and gentamicin) are added to eliminate stray bacteria found in the mixture. The final solution can contain the following additives in any combination: Triton X-100 (a detergent); polysorbate 80 (a potential carcinogen); gelatin; formaldehyde; and residual egg proteins. In addition, many of the influenza vaccines still contain thimerosal as a preservative. Thimerosal (mercury) is being investigated for its link to brain injury and autoimmune disease.

But going back to Hep immunizations...I'm not going to the CONGO! I am going to Costa Rica.
 

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Mania...This is why I would never have a flu shot and I not had a flu in at least 15 years or more:
During the manufacturing process, antibiotics (neomycin, polymyxin B and gentamicin) are added to eliminate stray bacteria found in the mixture. The final solution can contain the following additives in any combination: Triton X-100 (a detergent); polysorbate 80 (a potential carcinogen); gelatin; formaldehyde; and residual egg proteins. In addition, many of the influenza vaccines still contain thimerosal as a preservative. Thimerosal (mercury) is being investigated for its link to brain injury and autoimmune disease.


But going back to Hep immunizations...I'm not going to the CONGO! I am going to Costa Rica.
The amount of thimerosal in these vaccines is trace amounts and is less than you will get from eating a piece of salmon. I can't believe that you are in the health care field and don't get a flu shot, you are putting your patients (most immunocompromized) at great risk.
It is interesting to me that parents can opt out of mandatory vaccinations for their kids and are still aloud to enroll them in school, if we really want to get some good herd immunity thats a good starting point.

I do agree with you that you will probably be fine without getting any vaccinations going to costa rica but some anti malaria medications and precautions might not be a bad idea. Have an awesome trip, such an amazing place.
 

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Thanks for all the input...I have some decisions to make! Because I work in the medical field "alternative that is" I have access to what actually goes into most injections (very scarey!) I would NEVER have a flu shot. I work in close contact with sick people every day and I am healthy, so the thought of any other injections...:confused:

Brenda, You are a complete and total idiot. Don't ever give medical advice to anyone. You are not qualified.
 

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Discussion Starter #16
CBROBIN...I will make sure I tell the doctor I work for what a "complete idiot I am" at work tomorrow while we are busy saving lives. Oh by the way...he doesn't take a flu shot either.
Oh...and I didn't think I was giving anyone "medical advice." What side of the bed did you wake up on this morning anyways. A little defensive eh!!!
 

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"final solution can contain the following additives in any combination: Triton X-100 (a detergent); polysorbate 80 (a potential carcinogen); gelatin; formaldehyde; and residual egg proteins"

Awww come on....they use polysorbate 80 in toothpaste, Jello has never killed anyone that I'm aware of and formaldehyde is widely used as a perservative in beer in 3rd world countries. I'd like to think I'm going to be well perserved from the inside out from my time abroad.....:D
 

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amednews: Too few health professionals getting flu shots :: Sept. 5, 2011 ... American Medical News

In many ways, experts consider the 2011-12 influenza season off to a good start. Manufacturers, who are expected to produce a record number of seasonal flu vaccine doses, have not reported delays. Vaccine is arriving in physician offices across the country. And this year's flu season is expected to be typical, similar to last season.

But experts worry that not enough health professionals and others who have contact with patients will get the flu vaccine.

Data show that 63.5% of health care personnel were vaccinated against influenza during the 2010-11 season, according to a Centers for Disease Control and Prevention study of 1,931 health care workers in the Aug. 19 Morbidity and Mortality Weekly Report. That is a slight increase from the 61.9% who received the seasonal flu vaccine during the influenza A (H1N1) pandemic in 2009-10.

Physicians and dentists, who were grouped together in the CDC's figures, had the highest immunization rate of 84.2% in 2010-11. The rate was 69.8% for nurses and 57.2% for administrative staff. Also included in the study were nurse practitioners, physician assistants, allied health professionals and technicians.

Despite the slight uptick, the vaccination rate for health care workers still falls below the Healthy People 2020 target rate of 90%.
Some health care workers have mistaken fears that flu shots will cause influenza.

This "is really discouraging," said Norman Edelman, MD, chief medical officer of the American Lung Assn. Health professionals "should know the flu vaccine is safe. They should know that transmitting the flu to people who are debilitated or with an impaired immune system can result in very severe illness."

Vaccinating health care workers against influenza has been shown to reduce transmission of the illness among employees and patients, some of whom are too young or sick to be immunized themselves, infectious diseases experts say. But persuading them to get the shot has been a challenge for years.

Similar to the public, some health care personnel have the mistaken impression that the vaccine will cause the flu, experts say. Some health workers also question whether the flu shot is effective, and they have the misconception that the flu is not a serious illness.

To help remedy the problem, medical organizations have focused on educating health professionals about influenza and how to prevent its spread. They also have urged getting the seasonal influenza shot every year.

The American Medical Association says physicians have an obligation to be immunized against highly transmissible diseases that pose a significant medical risk for vulnerable patients or colleagues, or threaten the availability of the health care work force.

Individuals with a medical, religious or philosophical reason to not get the shot should be willing to wear face masks or refrain from direct patient care to prevent passing the illness, the AMA says.
43% of Americans 6 months and older got flu shots during the 2010-11 season.

In 2010, the Society for Healthcare Epidemiology of America recommended that the annual seasonal flu vaccine be required for initial and continued employment of all health care employees, regardless of whether they had direct patient contact. The organization reissued the recommendation in August.

Experts say such efforts have helped increase the vaccination rate among health workers in recent years. For example, during the 2006-07 season, only 44.4% were immunized against the flu, according to CDC data.

In addition, health care personnel had a higher vaccination rate during the 2010-11 season than did Americans 6 months and older (42.8%).

But experts insist that more needs to be done to boost rates to protect patients. Many say education is no longer enough.

"We've been working on this now for over a decade and seem to be stuck at a vaccine rate of around 60%," said infectious diseases expert William Schaffner, MD, chair of the Dept. of Preventive Medicine at Vanderbilt University School of Medicine in Nashville, Tenn. "This leaves 30% to 40% of us unprotected and capable of transmitting infection to our patients. That's by far not good enough."

He said he has become a "reluctant advocate" of mandating the flu vaccine for all health care staff. "It's simply not going to work any other way."

Mandatory flu shot policy

Thirteen percent of participants in the CDC study worked at facilities where annual flu vaccination was mandatory. Among these workers, 98.1% were immunized.

Vaccine coverage was substantially less -- 58.3% -- for people who did not have an immunization mandate.

The first flu vaccine requirement for health care personnel was implemented in 2004 by the Virginia Mason Medical Center in Seattle, according to the epidemiologists' organization. Since then, facilities across the country, including Loyola University Health System in Maywood, Ill., have taken similar steps.

Loyola began requiring flu vaccination of all employees during the 2009-10 season, said Jorge Parada, MD, MPH, medical director and committee chair of Infection Control at Loyola University Health System. Before the mandate, about three in four health system employees were vaccinated. Since the requirement was implemented, the vaccine rate has climbed to about 99%, he said.

"Why should this even be considered an optional vaccine?" Dr. Parada asked. "There is ample, solid evidence to show that the vaccine is safe, protects people from getting the flu and decreases transmission" of the flu.

Infectious diseases expert Greg Poland, MD, said hospitals already require staff to have proof of immunity to an assortment of diseases, including measles, mumps and rubella. He said flu shots should be added to the mandatory list.

"It's a natural extension of the idea that you don't transmit diseases to patients that you could prevent," said Dr. Poland, a professor of medicine and infectious diseases at Mayo Clinic in Rochester, Minn.

But there are challenges involved in requiring seasonal flu vaccination, including employee resistance, because it is an annual vaccine, Dr. Poland said.

Starting in each practice

Dr. Poland encourages primary care physicians to require the immunization among employees in their practices. He suggests starting with a staff meeting to discuss the seriousness of influenza.

He said heads of the practice should serve as role models and receive the vaccine in front of staff. He encourages them to tell employees that vaccination is expected unless they have a valid medical contraindication to the immunization.

"Here we are at a point in history where we have more education and more available vaccine than at any other time in all of human history, and yet we cannot get ourselves immunized," Dr. Poland said. "It haunts me that vulnerable patients could have severe complications and even die as a result of the disease we pass on to them."
 

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I spent three winters in Costa Rica and if I did it again, I would re-up my tetanus shot and my Hep A -- just like okieboater already posted.

Hell, I drank the tap water, even in San Jose. I'm not suggesting it; I'm just saying I never got sick from it.

However, I disagree with okieboater about the food. It's not that good, unless you're from Oklahoma. But anything beats cream corn and momma's meatloaf I guess.
 

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OK Mr farp, what beats potatoes and chicken fry steak covered with gravy?

In CR the closest I could find was black beans / rice and pollo - I admit the cheap beer probably helps a bit. :)
 
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