Vaccines for Vietnam

Hepatitis B: why Vietnam lists it for every age

On most Asian pages, CDC limits its hepatitis B advice to unvaccinated travelers under 60. The Vietnam page drops that limit: the vaccine is recommended for unvaccinated travelers of all ages. For an older couple on a cruise stop in Ha Long Bay or a retiree spending the winter in Hoi An, that is the line that differs from neighboring Thailand or Cambodia. Past records or a blood test, reviewed with a clinician, show whether the series is needed at all.

Two adult schedules exist. The two dose vaccine is given 28 days apart and costs $149 a dose at the median US price; the three dose vaccine spreads over 180 days and costs $90 a dose. A departure more than 28 days away leaves room for the first schedule, and the last dose of the longer one can be given after the return.

Food, water and the other two "most travelers" lines

Hepatitis A (for unvaccinated travelers one year old or older) and typhoid complete the main list. Pho stalls in Hanoi's Old Quarter, herbs washed in tap water in the Mekong Delta and ice in iced coffee are where the two diseases come from. One dose of hepatitis A before departure is enough for the trip. The typhoid shot works after 14 days and the oral capsules after 13 days counted from the first capsule, and CDC points out that the vaccine is not 100% effective, so washing hands and choosing cooked food still count.

Where malaria is, and which tablets CDC lists

Vietnam's malaria map is split three ways. In the cities named by CDC (Da Nang, Hai Phong, Hanoi, Ho Chi Minh City, Nha Trang and Quy Nhon) there is none. In the Mekong and Red River Deltas, cases are rare and CDC advises only insect bite precautions. In other rural areas, tablets are advised, but the list depends on the province. Ten provinces, mostly in the Central Highlands and the south (Binh Duong, Binh Phuoc, Dak Lak, Dak Nong, Gia Lai, Khanh Hoa, Kon Tum, Lam Dong, Ninh Thuan and Tay Ninh), take atovaquone-proguanil, doxycycline or tafenoquine, without mefloquine. Elsewhere in rural Vietnam, mefloquine is on the list too. CDC reports resistance to chloroquine and mefloquine.

A motorbike loop through the Central Highlands around Buon Ma Thuot or Da Lat crosses that first group of provinces. For a week there, atovaquone-proguanil means 16 tablets (about $23 at the price pharmacies pay) and doxycycline 37 tablets; in other rural areas, weekly mefloquine means 7 tablets, about $26. Which one fits is a prescriber's decision.

Japanese encephalitis in the countryside

Rice paddies cover the deltas and the terraces of Sapa, which is the rural setting CDC's advice on Japanese encephalitis is about. CDC lists the vaccine for some travelers to Vietnam: people moving there, staying a month or more in affected areas or traveling there often. For shorter stays, CDC says to consider it with rural visits, hiking, camping, nights without air conditioning, screens or bed nets, or an unclear itinerary, and not for short trips to urban areas. Adults aged 18 to 65 take the two doses 7 days apart, which means starting 14 days before departure; other ages wait 28 days between doses and start 35 days ahead. Each dose costs $375 at the median.

No yellow fever certificate, from any route

CDC's entry line for Vietnam reads that the vaccine is not required, with no exception for travelers coming from risk countries. A trip that combines a safari in Tanzania or the Amazon with Vietnam therefore asks nothing at Vietnam's border. The certificate question returns only if the next country on the route has its own rule: Thailand, Cambodia and the Philippines ask one from travelers arriving from risk countries, so the order of the stops matters more than Vietnam itself. The certificate page sorts the countries by rule.

Rabies and chikungunya

CDC notes that dogs infected with rabies are sometimes found in Vietnam and that rabies vaccines are typically available throughout most of the country if a bite happens. Pre-exposure doses are a "consider" line, weighed with a clinician for cyclists, cavers, long stays and work with animals; two doses cost $838 at the median. Chikungunya vaccination is generally not recommended for Vietnam, and bite prevention is CDC's main advice, which also covers dengue, the subject of a global CDC notice.