Hi, I know I can ask Ngaire, but thought I would post this since it might be of interest.

I know that Regent demands a yellow fever shot for cruises going to Rio and other Brazilian ports, even though none of the ports are in the yellow fever endemic area.

Has anybody successfully gotten a medical waiver and used it? I'm reading about the risks to those over 60, and it seems like something we'd like to avoid if we can. We are flying thru Panama, but Neville has said that if you're just in transit in the Panama City airport, you still don't need the innoculation for entry into Brazil itself.

What you really want to avoid over 60 is Yellow Fever. I recommend the shot.

If there is a letter from a Doctor stating you cannot take the shot that will work. I would still send that to RSSC or whatever cruise line you are on for approval first. THey are very serious about requiring that shot or you cannot sail.

How long is the Yellow Fever shot good for? We got our latest dose in 2002 (Navigator's World Cruise - Iguaçu Falls excursion). Before that, I hadn't had one since the 1950s and I don't think Pat ever had one.

We (you too, Wendy?) will be heading to Rio via Panama (airport only) in Feb 2010 to sail back to Ft Lauderdale via the Amazon on the Mariner.

I think the Yellow fever shots are good for 10 years.

Wendy,we both have had Yellow Fever shots every 10 years....absolutely no discomfort or side affects....Better to be protected than not as well.

Thanks for the reassurance. It's not the discomfort I'm worrying about but the risk of sudden death that's documented, especially for seniors.

LOL ,WE had NO problem there either...(we're both retired)

FYI- FROM THE CDC WEBSITE REGARDING YELLOW FEVER SHOTS:

Brazil Not required

For all travelers ≥9 months of age going to the following areas at risk for yellow fever transmission, including the ENTIRE states of Acre, Amapá, Amazones, Distrito Federal (including the capital city of Brasília), Goiás, Maranhão, Mato Grosso, Mato Grosso do Sul, Minas Gerais, Pará, Rondônia, Roraima, Tocantins, and designated areas of the following states: northwest and west Bahia, central and west Paraná, southwest Piauí, northwest and west central Rio Grande do Sul, far west Santa Catarina, and north and west São Paulo. (See CDC Yellow Fever Risk Map for Brazil.) Vaccination is also recommended for travelers visiting Iguassu Falls. Vaccination is NOT recommended for travel to the following coastal cities: Rio de Janeiro, São Paulo, Salvador, Recife, and Fortaleza. States of Acre, Rondônia, Amapá, Amazonas, Roraima, and Tocantins. Parts of states of Maranhaõ (western part), Mato Grosso (northern part), and Pará (except Belem City). There is also transmission in urban areas, including large cities such as Porto Velho, Boa Vista, Macapa, Manaus, Santarem, and Maraba, where transmission occurs on the periphery of these cities.

Confirmed


Atovaquone/ proguanil, doxycycline, or mefloquine

I just checked the CDC web site and for your post to be completely accurate, the following line should be inserted between "Brazil Not required" and the following paragraph:

The CDC recommends vaccination:

Here's a quote, FYI, from the Public Health Canada website:

In 2001, a syndrome of fever and multisystem organ failure was first described in recipients of YF vaccine and is now referred to as vaccine associated neurotropic disease (YFV-AND). All affected persons have required care in an intensive care unit, and the associated mortality rate is estimated to be between 70% and 80%. YFV-AND has previously been reported in young infants but has now also been reported in older adults. The risk of YFV-AND increases with age: the rate is estimated to be 1.1 per 100,000 doses in persons ≥ 60 years and 3.2 per 100,000 doses in those ≥ 70 years. From data collected through a passive surveillance system for adverse events following immunization in the United States, the reporting rate of any serious adverse event following YF immunization was higher among those ≥ 60 years than younger adults (4.2 per 100,000 doses compared with 0.7 per 100,000 doses, respectively). For YFV-AND specifically, the rate was 1.6 per 100,000 doses in persons ≥ 60 years.
[...]
On the basis of the recent reports of adverse events in older travellers, already discussed, immunization in those ≥ 60 years of age should be carried out only after an individual risk assessment.

Thank you Dave. You are correct. That sentence did get omitted in the copy and paste.

However, the most important part of the message is that the "Vaccination is NOT recommended for travel to the following coastal cities: Rio de Janeiro, São Paulo, Salvador, Recife, and Fortaleza"(as per CDC). Though, this information may have no effect on Regent's requirements. This is just an "FYI" for the LCT Board.

Bottom line is that no matter what the official requirements are, REGENT requires it even if you are ending the cruise in Rio and getting off the ship, unless you can get them to okay a medical waiver. I didn't want to get the shot, but did, and fortunately had no side effects whatsoever.