Health
Doing Shots Putting your vaccine questions out to Pasteur text by Ellis Friedman; photo by Littleones Kids & Family Portrait Studio
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he world of immunizations has changed a lot since Edward Jenner invented the smallpox vaccine in 1796, but the need for those vaccines hasn’t. Arguably the single most important factor in decreasing human mortality, immunization has virtually eradicated several infectious diseases. Most children receive routine vaccinations from the time they’re born, but there are some outside the regular schedule that kids – and adults – living in Beijing should consider getting. beijingkids spoke to Dr. Thilan Fellay, a family physician and pediatrician at International SOS, and Dr. Pauline Tan Ngo, chief of pediatrics at Vista Medical Center, for advice on vaccines. As always, it’s important to speak to your doctor for personalized advice. Dr. Fellay stresses that vaccination schedules can be complicated. If you’re trying to plan which ones to get and when, consulting with your doctor is a must – especially if you want imported vaccines.
Rabies “I really insist on the rabies vaccine,” says Dr. Fellay. Because doctors in the West do not routinely prescribe this vaccine, most do not mention it to patients who are leaving for China. According to the World Health Organization (WHO), China has the second highest number of reported rabies cases in the world. The good news is, it’s also the world’s largest administrator of rabies vaccines. Dr. Fellay insists on the vaccine not only because of the disease’s prevalence, but also because of the damage it causes. Without the pre-exposure vaccine, a person who contracts rabies through an animal bite immediately requires a series of time-sensitive injections, as well as a course of rabies immunoglobulin. If left untreated, rabies is fatal. In China, dogs are the most frequent rabies transmitters. However, Dr. Tan Ngo notes that the likelihood of contracting rabies in Beijing is fairly low, as most cases present in rural areas in the south. However, rabies is present elsewhere in Asia, and other countries are not as vigilant about vaccinating their animals. The most troublesome aspect of rabies is that there’s no way to tell that a person has contracted it until the onset of the virus, well past the point of treatment. If the animal is present, it can be tested for rabies within a few hours. While Dr. Fellay recommends the vaccine to parents and kids alike, she says that kids are more at risk of getting rabies since they are more likely to touch animals without thinking and may not report a scratch, lick, or bite. The pre-exposure vaccine is a series of three shots administered over the course of one month. After an animal bite, get to the doctor
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beijingkids
2013 August
within 24 hours regardless of prior vaccination. An immunized person will require two shots after exposure; an unvaccinated person requires four shots and a dose of rabies immunoglobulin. However, only locallymanufactured rabies immunoglobulin is available in China. Among the international hospitals in Beijing, only Beijing United Family Hospital (BJU) carries the rabies vaccine. Patients can also visit Chinese disease control centers across Beijing. Ask your health provider for the address of the center closest to you.
Hepatitis A Dr. Tan Ngo and Dr. Fellay both recommend the Hepatitis A (HAV) vaccine. HAV is transmitted via fecal-oral route – or, more bluntly, when fecal matter enters the mouth, usually via food handled by a carrier who did not wash their hands. “As with rabies, the Hepatitis A vaccine is one that doctors in the West [often] forget to advise,” says Dr. Fellay. “It is rarely fatal, but can cause severe illness in pregnant women.” She recommends that all travelers and expatriates in China consider vaccination, but especially women who are planning to get pregnant while in Beijing. “HAV is generally mild,” explains Dr. Tan Ngo, especially in comparison to rabies. “It’s usually a few weeks of diarrhea and nausea, but it can lead to liver failure – which is why the vaccine is important.” Other symptoms include fever and jaundice, and can last from three weeks to six months in some cases. The HAV vaccine is a series of two shots six to 18 months apart. In China, it is only available as a domestic vaccine. If you only feel