IMMUNIZATIONS - Medicine for Mountaineering and Other Wilderness Activities - page 47

CHAPTER 5
IMMUNIZATIONS
James A. Wilkerson, M.D.
Principal Contributor
In developing countries, infections are a constant threat. Preventing illnesses in wilderness
areas, where disease is coupled with inaccessibility, has obvious advantages. Immunization
is the easiest and most reliable method for preventing infections. Only a limited number of
effective vaccines are available, but those that are only partially effective can significantly
reducethelikelihoodofinfectionandlessentheimpactshouldinfectionoccur.(Theimmun-
ologic principles upon which immunizations are based are discussed in Chapter 23: Aller-
gies . The prevention of malaria and some other infections for which immunization is not
possible is considered in Chapter 22: Infections .)
SOURCES OF UP-TO-DATE INFORMATION
Recommendations for immunization change frequently. The U.S. Department of Health and
Human Services' Centers for Disease Control and Prevention (CDC) maintains very com-
plete information about all aspects of immunization at www.cdc.gov .
The International Association for Medical Assistance to Travelers (IAMAT;
www.iamat.org ) is a volunteer organization of health care centers and physicians that
provides travelers with access to physicians who speak English or French and who meet
IAMAT's standards, which are similar to U.S. medical licensing standards. Membership in
IAMAT and a directory of its affiliated institutions in more than 115 countries are free.
Theorganizationoffersanumberoffreepublications,includinginformationalpamphletson
malaria, schistosomiasis, and Chagas' disease, and its World Immunization Chart lists the
potential risk for over a dozen infections, country by country, in a quick reference format.
The address of the U.S. affiliate is IAMAT, 736 Center Street, Lewiston, NY 14092.
Travel medicine clinics not only provide up-todate recommendations about immuniza-
tions for travelers but also usually have the vaccines available along with a staff to admin-
ister them. The International Society of Travel Medicine maintains a list of travel medicine
clinics and their addresses at www.istm.org .
The yellow International Certificate of Vaccination or Prophylaxis is the best way to re-
cord immunizations and is required for entrance into a number of countries. The current
form has been in use since December 15, 2007, and must be used to document yellow fever
vaccinations. However, the old form is acceptable as documentation of yellow fever until it
expires ten years after the date of vaccination.