Wilderness Medical Society snowmass 2005 Page 138
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Immunization requires 3 doses to be given at weekly intervals, with a booster dose at 12
to 18 months and at 4-year intervals thereafter, if risk continues. This vaccine is now
available in the U.S. Reactions are infrequent in children, but occur in 0.6% of adult
Western recipients. There have been no reports of demyelinating disease or encephalitis
from the vaccine. Fever and local reactions develop in fewer than 10% of recipients.
Pregnant women and persons with malignant diseases or other current illness should not
take this vaccine.
Measles, Mumps, Rubella
Recommended as part of a standard immunization program regardless of travel.
One 0.5 ml dose given subcutaneously provides initial immunity. The MMR vaccine
provides adequate protection against all three viral diseases, but each vaccine is available
separately. May not be given if allergic to eggs or neomycin without special
desensitization. This vaccine must be given at least 14 days prior to or 6 weeks to 3
months after immune serum globulin. All persons born after 1956 should receive a
booster of measles containing vaccine to be considered immune. Side effects for these
vaccines are as follows. Measles: low grade fever (99º to 102º F, 37º to 39º C) may occur
5-12 days after injection, rarely a generalized rash develops; fever higher than 103º F
(39.4º C) occurs less than 15% of the time. Allergy to chicken eggs and neomycin may
cause an allergic reaction. Mumps: Burning and stinging of short duration at injection
site; occasional mild fever; fever above 103º F is uncommon; allergic reactions at the
injection site are extremely rare; swelling of the parotid salivary gland--low incidence;
testicle inflammation is very rare; seizures, deafness, and encephalitis are very rare.
Allergy to chicken eggs or feathers or to neomycin may cause an allergic reaction. Any
active infection is reason to delay receiving this vaccine. Also any blood disorders,
immune deficiency or use of corticosteroid is a contra-indication for vaccination.
Rubella: Occasional moderate fever (101-102º F) less commonly high fever (over 103º F)
burning at injection site; reactions are usually mild and transient, but include fever, rash,
sore throat, nausea, vomiting, joint ache. Avoid giving during pregnancy, to persons with
blood disorders, or to those receiving corticosteroid. Allergy to neomycin may cause an
allergic reaction. Avoid giving if active illness is present.
Meningococcal Meningitis
Recommended for travelers to sub-Saharan Africa during the months of December to
June. This vaccine is required for entry into Saudi Arabia during the period of the haji.
This vaccine should be considered for persons providing health care to refugee
populations in Africa. Universal immunization with the new Menactra® vaccine will
reduce carrier states.
This vaccine need be used only under special circumstances (military personnel in the
U.S. and persons traveling to areas of the world where meningococcal infection is
epidemic). The A/C/Y/W135 vaccine by Squibb-Connaught is given 0.5 ml
subcutaneously. Duration of protection is unknown, but appears to be at least 3 years in
