Vaccine Advice Please (not COVID Vaccine related)

[BillyWest]

Hello, I am planning to travel in southeast Asia for the next couple of years, beginning in Indonesia for a month, then Thailand for a month or so, and then Philippines, etc. My Covid vaccine/boosters are up to date, as well as typical childhood vaccines. The ones I don't have are listed below and are recommended by the CDC for visiting the countries I mentioned.

Hep A
Hep B
Typhoid
Yellow Fever
Japanese Encephalitis
Polio - Booster
Cholera?

I am currently uninsured and pay for my medical needs, as I go, out of pocket.The vaccines listed cost about $1000 total here in America when you don't have insurance. The same vaccines in Thailand, out of pocket, cost less than $100 total. So I was considering waiting until I get to Bangkok (my first stop in Thailand) to secure these vaccines. The concern I have is that my current itinerary is to arrive in Jakarta April 20, visit with friends in Depok, travel to Denpasar, Bali, Nusa Penida, down the west coast of Lombok from the Gilis to Kuta Beach, then fly back to Depok. Then head to Bangkok on May 15th.

My question is, considering my itinerary, how risky do you think it would be to wait until I reach Bangkok to get some or all of the listed vaccines? Did you all get all of these vaccines before visiting or moving to Southeast Asia? I just don't know how common it is for people to get exposed to or contract these diseases in the places I am visiting. If it is relatively low risk, I would prefer to wait until Bangkok.

Thank you, in advance, to anyone offering their perspective.

Kind regards,

Will

[marcus]

(1) ...My question is, considering my itinerary, how risky do you think it would be to wait until I reach Bangkok to get some or all of the listed vaccines?

(2) Did you all get all of these vaccines before visiting or moving to Southeast Asia?

(3) I just don't know how common it is for people to get exposed to or contract these diseases in the places I am visiting...

(1) I don't know , sorry .

(2) From your list I got Hep B (in 1995) , Yellow Fever (in 1994) , and maybe Polio when I was a child (not sure) but no booster .

(3) I heard a lot about Hep A and Typhoid only , so better be careful specially with food and water . I myself never got any of these diseases but I always eat at home , I go out only for the life necessities , drink mineral bottled water , and use mosquito net in my bed (although there are not too many mosquitos around) .

But unfortunately my experience does not applies to your travel plan . I live in Bandung and rarely go to Jakarta (were there around 10 days in my more than 23 years in Indonesia) . Have never been in the other Indonesian cities you mentioned .

I suggest you to search more information in the internet (for example , searching for : travel health advice to people going to Indonesia)

Notes :
- Tap water in Indonesia is not for drinking (I don't use it even to brush my teeth and make my food/coffee) . Better also avoid ice in your drink . Bottled water is sold everywhere in Indonesia .
- Don't eat from the street food sellers as the Government has not control on them . I don't know if there is a health control over the normal restaurants too .

http://www.expat.or.id/info/sitemap.html (About Indonesia)

http://www.livinginindonesiaforum.or...1738#post21738 (tips for a newcomer)

[marcus]

...until I reach Bangkok to get some or all of the listed vaccines?...

Is there a reason to get the vaccines in Bangkok instead of in Indonesia ?

[From Google : ...In Indonesia vaccines can be gotten in hospitals, clinics, health centers, or private doctors who provide vaccination services.

For example the price for the hepatitis B vaccine..starts from...IDR 399,000 (around US$26).]

My Indonesian wife says even private "midwifes" can also vaccinate you . We call these professionals as "Bidan" and they are more than just midwifes (they work in big cities too, to provide cheaper services than doctors and hospitals) . Just now they are also applying vaccines for Covid-19 in cooperation with the Government .


From https://news.detik.com/berita-jawa-b...id-19-di-jabar
By Yudha Maulana - detikNews , Oct 2021

[12,500 midwives were deployed to help with the COVID-19 vaccination process in West Java...

"So the strategy is no longer only in vaccination centers, but we partner with practicing midwives. They will be entrusted with vaccines for injections either door to door or the public will come to the midwife's places...

"We have communicated with the midwives association, nurses association and doctors association, that we will give authority to practicing midwives to inject vaccines," said Dedi Supandi (Head of the West Java KPCPED Vaccination Acceleration Division)...]

https://www.prodia.co.id/id/hubungi-kami (an Indonesian well known private clinical health laboratory , 3 doses of Hep B vaccine @ Rp1.002 million , around US$66 - 1 dose @ Rp391'000)

[BillyWest]

Marcus, Thank you for the great info and for the suggestion! No, I was thinking Thailand because I have found it much easier to find medical information, including vaccine costs, for Thailand than for Indonesia. Since posting, I have found an affordable source here in the USA for Hep A and B and the Polio booster. At this point, I would love to find a clinic in Depok where I could secure vaccines for Typhoid,
Yellow Fever, Japanese Encephalitis, Dengue and Cholera. I have tried to Google "Depok Vaccine Clinic" and "clinica de vacunas depok" and mostly get Covid vaccine dispensing locations and other medical facilities, but drilling down, can never find vaccine services (other than COVID). So I had kind of given up on securing vaccines in Indonesia. If you know of a clinic in the South Jakarta/Depok area that has posted vaccine lists with pricing, that would be super helpful. Or if there is a name for a facility where Bidan operate and dispense vaccines, that would be great! Thank you!

[marcus]

...I have tried to Google "Depok Vaccine Clinic" and "clinica de vacunas depok" and mostly get Covid vaccine...

I guess the best search would be for : rumah vaksinasi di Depok .


https://www.lagidimana.me/hore-di-si...-biaya-dokter/ (vaccines' price in many cities, including Depok)

http://www.klinikraisha.com/daftar-harga-vaksin/ (vaccines' price in Tangerang, 50 km from Depok , Whatsapp +62.81.5876.8016)

[BillyWest]

Marcus, THANK YOU so much. This info is very helpful. I have figured out how to get the vaccines in Depok, thanks to your assistance. I really appreciate your help!

[marcus]

From https://www.cnnindonesia.com/gaya-hi...sia-6-45-tahun, Ago 2022

[..."Indonesia is the first country globally to approve TAK-003 for dengue prevention in individuals aged 6-45 years," Takeda (the Japanese manufacturer) wrote, in an official statement received by CNNIndonesia.com, Wednesday (24/8).

This vaccine was approved based on the results of a phase 3 research trial involving more than 20 thousand healthy children and adolescents aged 4-16 years living in dengue endemic areas.

Based on research, the vaccine is proven to provide continuous comprehensive protection against DHF for up to three years after administration of the vaccine...

Previously, Indonesia itself had used a dengue vaccine called Dengvaxia which was produced by Sanofi Pasteur. However, citing the Indonesian Pediatrician Association (IDAI) website, this vaccine only has the best efficacy results in children aged 9-16 years. Meanwhile, if given at the age of under 9 years, the vaccine will increase the risk of hospitalization due to dengue infection.

In fact, continued IDAI, DHF cases in Indonesia mostly attack children under nine years of age.

In the first half of 2022 alone, Indonesia reported more than 63 thousand DHF cases with nearly 600 deaths spread across 34 provinces...]


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From https://sehatnegeriku.kemkes.go.id/b...teknologi-ini/, Feb 2023

[...Based on data from the Ministry of Health, in 2022, the number of dengue cases reached 131,265 cases, of which around 40% are children aged 0-14 years. Meanwhile, the number of deaths reached 1,135 cases with 73% occurring in children aged 0-14 years...

Vaccine development...has actually been carried out since 2016. At that time the vaccine being developed was the DENGVAXIA vaccine to prevent dengue fever caused by dengue virus serotypes 1,2, 3 and 4, in children aged 9-16 years.

Then the second vaccine is the QDENGA vaccine. This vaccine is to prevent dengue fever caused by dengue virus serotypes 1, 2, 3 and 4 with a target age of 6-45 years. The QDENGA vaccine has received a marketing authorization from the BPOM (Badan Pengawas Obat dan Makanan/National Agency of Drug and Food Control) in August 2022 and is currently awaiting a recommendation from ITAGI (Indonesia Technical Advisory Group on Immunization) ...]

[marcus]

You better check further about dengue vaccine because the first page of Google's search for "dengue vaccine age limit" states :

Who is eligible for dengue vaccine?
The dengue vaccine is only recommended for individuals 12 to 45 years old who had a previous documented dengue infection. It is not recommended for individuals who have no previous dengue infection as they are at an increased risk of having severe dengue, should they become infected subsequently with the dengue virus. Jan 10, 2023