05-14-2010, 06:21 PM
I am not clear on whether or not you received any vaccines at your visit. If you were declined the hepatitis A vaccine, I would disagree with both providers.
Hepatitis A has a very long incubation period (the time between exposure and illness) so the vaccine may be given up to 2 weeks after exposure, or anytime prior to travel. When travel is imminent, single-antigen vaccine (not the combination) is recommended because this vaccine has twice the antigen content of the combination vaccine. It is given in two doses at least 6 months apart for long-term protection, but the first dose is over 90% effective, at least in the short term. Certain people are recommended to get immune globulin instead, if it is available.
The combination hepatitis A and B vaccine, Twinrix, contains half the hepatitis A dose of the single-antigen hepatitis A vaccine and exactly the same hepatitis B content as the single-antigen hepatitis B vaccine. It is best if this combination vaccine series can be completed before travel, either on the regular (0, 1, 6 month) or accelerated (0, 7, 21 day) schedule. With the latter schedule a booster is recommended at 12 months but there is very good short-term protection after the three doses. Since you have less than 2 weeks before travel, I would recommend 1 dose of single-antigen hepatitis A vaccine, 1 dose of single-antigen hepatitis B vaccine if you wanted it (there is about 30% response after 1 dose and you could complete the series later), one dose of typhoid vaccine and a single dose of polio vaccine if you have not had a dose of polio vaccine as an adult, and a prescription for malaria prophylaxis. (There is an oral typhoid vaccine, but it must be taken over 6 days and you do not have time.) If you will be making similar trips in the future, make sure you complete these vaccine series.
A reference for you:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5641a3.htm
also go to CDC.gov/travel and look up India
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