SAWASDEE 3 (2009 Thai thread restarted)

[AaronLV 12]

Yes, no vaccination records either. I think this is quite routine for the hospital (since many including my fiancee are from Isaan and don't even know what or when they were vaccinated with unless they have scars). They have a routine set up which is probably why they use the older forms : PE, Chest Rads, Vaccinations (MMR, dTP, varicella)

You may want to have her ask, or bring the new guidelines so you don't have to pay an extra 5000 for an unnecessary HPV vaccine. However, someone else said it, it's probably cheaper there and it's a good idea to do the HPV series if she hasn't had it and is young enough.

There are lots of complications with the HPV vaccination and is most likely why they removed it from the required vaccination for immigration. I would not necessarily recommend the vaccine for everyone, do some research and weigh the risks before deciding if she should have it done. We most likely would not have had it, if it had not been required when we went for our vaccinations.

[rsn 135]

There are lots of complications with the HPV vaccination and is most likely why they removed it from the required vaccination for immigration. I would not necessarily recommend the vaccine for everyone, do some research and weigh the risks before deciding if she should have it done. We most likely would not have had it, if it had not been required when we went for our vaccinations.

What specific complications did you uncover?

[JD63 4]

There are lots of complications with the HPV vaccination and is most likely why they removed it from the required vaccination for immigration. I would not necessarily recommend the vaccine for everyone, do some research and weigh the risks before deciding if she should have it done. We most likely would not have had it, if it had not been required when we went for our vaccinations.

Yeah, fair enough. It's a good and safe vaccine, if your fiancee is young and is an ideal candidate (i.e. sexual history/not pregnant) it's not a bad idea, but it's expensive and worthless if you already have HPV.

Mine got it because of her mother had a history of cervical cancer. To me it seems strange that varicella zoster is still routinely given even though it's not required and most everyone is seropositive already. I guess at least you're less likely to get shingles later on.

What specific complications did you uncover?

I assumed he meant pregnancy and/or previous exposure to HPV

[rsn 135]

I assumed he meant pregnancy

Yep, according to the CDC, there is no proof that it causes harm to babies, but there apparently isn't a lot of data on that.

[AaronLV 12]

Yeah, fair enough. It's a good and safe vaccine, if your fiancee is young and is an ideal candidate (i.e. sexual history/not pregnant) it's not a bad idea, but it's expensive and worthless if you already have HPV.

Mine got it because of her mother had a history of cervical cancer. To me it seems strange that varicella zoster is still routinely given even though it's not required and most everyone is seropositive already. I guess at least you're less likely to get shingles later on.

I assumed he meant pregnancy and/or previous exposure to HPV

It has been a over a year since I did the research, but there is a large percentage of girls that have an adverse reaction to the vaccine, which includes death. There has also data to support that the vaccine is not effect for more then 5 years. There is always a chance of negative effects of vaccinations, but this one just happens to have a much much larger percentage of bad effects over the other ones.

[JD63 4]

http://jama.ama-assn.org/cgi/content/abstract/302/7/750

Context In June 2006, the Food and Drug Administration licensed the quadrivalent human papillomavirus (types 6, 11, 16, and 18) recombinant vaccine (qHPV) in the United States for use in females aged 9 to 26 years; the Advisory Committee on Immunization Practices then recommended qHPV for routine vaccination of girls aged 11 to 12 years.

Objective To summarize reports to the Vaccine Adverse Event Reporting System (VAERS) following receipt of qHPV.

Design, Setting, and Participants Review and describe adverse events following immunization (AEFIs) reported to VAERS, a national, voluntary, passive surveillance system, from June 1, 2006, through December 31, 2008. Additional analyses were performed for some AEFIs in prelicensure trials, those of unusual severity, or those that had received public attention. Statistical data mining, including proportional reporting ratios (PRRs) and empirical Bayesian geometric mean methods, were used to detect disproportionality in reporting.

Main Outcome Measures Numbers of reported AEFIs, reporting rates (reports per 100 000 doses of distributed vaccine or per person-years at risk), and comparisons with expected background rates.

Results VAERS received 12 424 reports of AEFIs following qHPV distribution, a rate of 53.9 reports per 100 000 doses distributed. A total of 772 reports (6.2% of all reports) described serious AEFIs, including 32 reports of death. The reporting rates per 100 000 qHPV doses distributed were 8.2 for syncope; 7.5 for local site reactions; 6.8 for dizziness; 5.0 for nausea; 4.1 for headache; 3.1 for hypersensitivity reactions; 2.6 for urticaria; 0.2 for venous thromboembolic events, autoimmune disorders, and Guillain-Barré syndrome; 0.1 for anaphylaxis and death; 0.04 for transverse myelitis and pancreatitis; and 0.009 for motor neuron disease. Disproportional reporting of syncope and venous thromboembolic events was noted with data mining methods.

Conclusions Most of the AEFI rates were not greater than the background rates compared with other vaccines, but there was disproportional reporting of syncope and venous thromboembolic events

It looks I'd be careful about TEs if you're on birth control as well, that's probably what's confounding the disproportional amounts of thromboembolism.

[Audy_Rob 26]

I like how the people in the Sawasdee thread come together and have a nice, friendly, open and adult discussion. The topic starts with questions on the medical for BKK and we end up discussing HPV vaccination. I will learn a lot from everyone.

According to the CDC web-site, it seem both forms of the vaccine, Gardasil and Cervarix are safe. It is recommended for women in the age range of about 9 to 26 years of age with ideally vaccinating young girls in the 11 and 12 year old range.

My fiancee is 37 years old. I do not think it is right for her. We are monogamous and both disease free. I think we are OK on this.

Thanks for everyone's comments.

[JD63 4]

I think that's a fair decision. If i was your clinician I would agree, the benefits for your wife would be slim to none.

It's cases like yours that made that vaccine requirement quite a draconian regulation, and I think several groups including the OBGYN associations came out very strongly against making it mandatory when comments were opened to the public for the new regs.

[AaronLV 12]

I think that's a fair decision. If i was your clinician I would agree, the benefits for your wife would be slim to none.

It's cases like yours that made that vaccine requirement quite a draconian regulation, and I think several groups including the OBGYN associations came out very strongly against making it mandatory when comments were opened to the public for the new regs.

It was only required for woman under 26 when the rule was in place.

[Audy_Rob 26]

It was only required for woman under 26 when the rule was in place.

Oh, OK. Then that was certainly more reasonable as it does not make sense to get the HPV vaccination if you are over 26. But still, there is some controversy about it so I think it is best to allow the lady to make up her own mind if it is appropriate or not.

[JD63 4]

Yea, that will be entertaining for both of you.

Picked it up today, she'll be here next week. POE in Minneapolis. I decided against OHare as I got hung up there three times in the last two months, missing my connections. It gets ten times worse when it snows.

[rsn 135]

Picked it up today, she'll be here next week. POE in Minneapolis. I decided against OHare as I got hung up there three times in the last two months, missing my connections. It gets ten times worse when it snows.

Agreed, for domestic travel, O'Hare is horrible. But 4 of my last 7 international trips have been through O'Hare, and I've never had any problems. In fact immigration seems to go pretty smoothly there.

[Kang Lang 7]

question for the more recent visa recipients...were you required to submit employment letters? (i am only asking about the thai national) i read in another thread that it is asked? when my husband was interviewed they did not ask for it i would wonder if it would even be possible due to the number of cash type business that exist in thailand.

in my husband's case it would have been easy given the type of work, but i would think some of your s.o.'s might be able to provide that info in a formal letter?

[rsn 135]

question for the more recent visa recipients...were you required to submit employment letters? (i am only asking about the thai national) i read in another thread that it is asked? when my husband was interviewed they did not ask for it i would wonder if it would even be possible due to the number of cash type business that exist in thailand.

in my husband's case it would have been easy given the type of work, but i would think some of your s.o.'s might be able to provide that info in a formal letter?

I'm not sure why they would even ask for such a thing...

[daboyz 36]

I'm not sure why they would even ask for such a thing...

Yeah that doesn't make any sense for a marriage or fiancee visa. It definitely makes sense for a tourist visa. When my wife would talk to people in Thailand they kept telling her she wouldn't get the visa because she didn't have enough money in the bank or a house. Took me 3 months or more to get it through her head that they don't care about HER income, only mine.