Vaccination against Japanese encephalitis
introduction
Japanese encephalitis is a rare tropical disease. It is triggered by viruses that are transmitted to humans by mosquitoes. The disease occurs seasonally, especially in the rainy season, in Southeast Asia. A new inactivated vaccine against Japanese encephalitis has been available in Europe since 2009. The vaccination against Japanese encephalitis contains killed, i.e. inactivated, viruses. These are bound to an aluminum salt, which acts as an enhancer for the immune system. As a rule, two vaccination doses are necessary for complete vaccination protection.
Read more on the topic: Japanese encephalitis
Why should you vaccinate?
At this point in time, there is no causal treatment for Japanese encephalitis. Only medication to treat symptoms is available.
Read more on this topic: Does vaccination do more harm than good?
Mosquito bites should be avoided. Tourists should use mosquito nets and wear protective clothing. However, if you stay in a risk area for a long time, the World Health Organization (WHO) recommends vaccination. It should be remembered that the mortality rate when Japanese encephalitis breaks out is not low (approx. 5-30%). In addition, permanent neurological damage often occurs. You should therefore seek advice from a travel doctor before traveling or staying for a longer period in a corresponding risk area. Vaccination against Japanese encephalitis is recommended, especially when staying in rural areas, away from the tourist centers.
Vaccination costs
A dead vaccine against Japanese encephalitis has been approved in Germany since 2009. It's called IXIARO® and can be used from the age of 2 months. The cost of one vaccination dose is around 100 euros. In order to achieve complete vaccination protection, two vaccination doses are necessary at an interval of 4 weeks. So the total cost of the vaccine is 200 euros. Since travel vaccinations are not covered by the statutory health insurance, many doctors also have to pay for travel vaccinations yourself. The costs usually amount to 5 to 10 euros.
Who pays for the vaccination?
Since it is a travel vaccination, the patient must first pay for the vaccine and vaccination. However, it is worth asking your own health insurance company. Many statutory health insurances are now at least partially reimbursing the costs, even if it is a private holiday stay. You should therefore contact the health insurance company and clarify individually which costs can be reimbursed for which travel destination. If it is a work-related stay abroad, the employer naturally bears the costs of the vaccination.
How often and at what intervals do you have to vaccinate?
If you have not yet received a vaccination against Japanese encephalitis, a basic immunization is necessary. This basic vaccination consists of 2 vaccinations, which should be given 4 weeks apart. Alternatively, in addition to the conventional vaccination schedule, there is also a fast vaccination schedule, in which the second dose is given after 7 days. Adequate vaccination protection is not guaranteed before the second vaccination. It is also important to know that the basic vaccination should be completed at least 7 (better 14) days before possible contact with the pathogen in order to have 99 percent vaccination protection.
Side effects of vaccination
The vaccine approved in Europe is called IXIARO®. It contains killed, i.e. inactivated, viruses and is therefore known as a dead vaccine. Vaccination is an intramuscular injection, usually into a muscle in the upper arm. As with any syringe or blood sample, local reactions can occur. For example, it can lead to reddening or swelling in the area of the vaccination site.
Pain or a feeling of tension in the affected extremity are not necessarily worrisome after a vaccination. Most local symptoms go away after a few days without special treatment. As with any drug, non-specific general symptoms can also occur as a side effect, such as Headache, fatigue, gastrointestinal complaints.
Serious side effects are rare. Allergic reactions to the vaccine or one of its components are only described in individual cases in the literature.
If you are concerned about possible side effects, talk to your doctor. He can advise you individually.
Read more on this topic:
- Fever after vaccination
and - Pain after vaccination
Duration of vaccination protection and booster
In order to have a complete vaccination against Japanese encephalitis, two vaccinations are required every 4 weeks. Complete vaccination protection is only guaranteed 7 to 14 days after the second vaccination. Once this primary vaccination has been completed, a booster vaccination (1 dose) does not have to be given again until after 3 years.
Which doctor can do the vaccination?
In principle, any doctor who is vaccinated can give the vaccine against Japanese encephalitis. The easiest way is to make an appointment with a general practitioner (“family doctor”) for travel vaccination advice. There are also special tropical medical advice centers at large clinics that also offer travel medical advice. It is important to get general advice on which vaccinations are required before traveling. You should present yourself there at least 8 weeks before you travel. If several vaccinations are required, your doctor will create an individual travel vaccination plan for you.
For which countries (risk areas) do I need the vaccination?
The German Society for Tropical Medicine recommends vaccination if you are staying in a risk area for a longer period of time (see below). This includes both family visits and long-term travelers who are in the country for more than a month. Even travelers who have an increased risk of infection should be vaccinated, regardless of the length of the journey. This includes above all overnight stays in rural regions, especially during the rainy season and afterwards. If the traveler wants comprehensive protection, after a detailed consultation, they can also be vaccinated at the patient's request.
Risk areas according to the World Health Organization (as of September 2017):
Bangladesh, China, India, Indonesia, Japan, Cambodia, North and South Korea, Laos, Myanmar, Nepal, the Philippines, the Indus Delta of Pakistan, Sri Lanka, Taiwan, Thailand and Vietnam.
