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Wilderness Medical Society - snowmass 2005 (Page 139)

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Wilderness Medical Society - snowmass 2005
10
those over 4 years of age. A booster shot of 0.5 ml should be given every 3 to 5 years
based on new or continued exposure risk. There might be local redness at the injection
site for 1-2 days. Reactions are uncommon and usually mild. This vaccine does not
provide protection against the B serogroup of N. meningitidis which accounted for 28%
of the U.S. (between 1994 and 1997) and some of the foreign outbreaks.

Menactra (Meningococcal Group A,C,Y, and W-135 Polysaccharide Diphtheria Toxoid
Conjugate Vaccine by Sanofi (Pasteur) Aventis is approved in the US for persons 11 to
55 years of age. The vaccine is given as a 0.5 ml dose injected intramuscularly. Adverse
reactions are mild and consist mainly of pain, redness, and induration at the injection site,
headache, fatigue and malaise.

Pneumonia

Recommended for persons 50 years of age and over and those with high risk such as
exposure to large numbers of people and those with chronic lungs problems and
debilitating conditions.


The vaccine against streptococcal (formerly called pneumococcal) pneumonia is given
with one 0.5 ml IM injection in the deltoid muscle probably. This vaccine should be
boosted every 10 years. Local inflammation and pain at the injection site is relatively
common, especially with the booster shot.

Poliomyelitis

A booster of inactivated polio vaccine is recommended for all persons born after 1956
traveling to Africa.


Inactive polio vaccine (IPV) is the vaccine of choice for all infants, children, and
adolescents (up to their 18th birthday). The primary series is 3 doses, with dose 2 given
at least 6 weeks after 1 and dose 3 given 8 - 12 months after dose 2. A supplemental dose
is given to children at age 4 to 6 years. Anyone having a partial series may continue with
the next dose(s), regardless of how long before the last dose was given. Un-immunized
adults should be given the four full dose series of inactivated polio vaccine (IPV)(3
doses given at 1 to 2 month intervals, followed by a 4th dose 6 to 12 months after the 3rd
dose), if time allows, or a minimum of 2 doses of IPV given a month apart. No vaccine
associated disease has been reported with the injectable vaccine, although there is a slight
chance of allergy in people sensitive to cow serum, neomycin, and streptomycin.

Rabies

Recommended if traveling in remote areas of Iraq, Iran, central Africa and many parts of
Asia and South America.


A pre-exposure regimen of rabies vaccine is appropriate for persons routinely exposed to
potential rabid animals - including skunks, fox, raccoon and bats. It does not eliminate

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