Parents in Beijing have many health questions, but one of the hottest topics is vaccinations. There are quite a few internationally standard vaccines, but there are also some Beijing-specific vaccines.

For routine vaccines, which start during childhood, most countries cover the same basics. If you are unsure if your vaccines are up-to-date, check your home country’s vaccination schedule. A typical problem with adults is that they may not know about adult boosters or new recommendations. For example, most need a tetanus booster every ten years. Also, many countries, including the US, are recommending a pertussis booster for adults. Fortunately, there’s Tdap, an easy combination booster for adults that combines tetanus and pertussis into one quick jab. Unfortunately, at this time the international private clinics in China are not allowed to give imported vaccines such as the Tdap, and there is no Chinese version yet. I now recommend adults try to get this back in their home country when traveling. This booster is especially important given the recent waves of pertussis infections in California and other areas.

Another common issue involves people who began their Hepatitis B vaccine series but never finished the three-shot series. It’s very important that people are fully vaccinated for this, as chronic HBV infections are a serious public health issue in China. Also, for all my patients, I recommend a vaccine against Hepatitis A.

The rabies vaccine is the most controversial. The following scenario is common in clinics: a parent comes in and their unvaccinated child was bit by a neighbor’s dog while playing around. Unfortunately, if we don’t know the dog’s history, the child needs the entire five-shot rabies series, plus a painful and very expensive rabies immunoglobulin shot. If the child had already been vaccinated against rabies, he would only need a post-bite treatment.

Rabies is not common but is found all over China, especially in rural areas, and a few thousand people die from it annually. The scary thing about rabies is that it may take over a year to develop symptoms — and it is 100 percent fatal. And yes, expats in Beijing have died of rabies. The vaccine is a three-shot series given over one month.

I often recommend a rabies vaccine for patients, especially children. Children are the most vulnerable to rabies as they often play with stray dogs and cats, and parents may not even be aware that their child was bitten. However, it’s a risk-and-benefit analysis each family needs to make. If you think your exposure is very small, then the vaccine may not be for you. But if you plan to hike around rural China and India for a few weeks, you should definitely consider it.

Another controversial vaccine is Japanese Encephalitis. It protects against a mosquito-born virus that can cause a serious brain infection, and is fatal in some cases. It’s more of an issue in southern China and tropical Asia, but Beijing has had cases, and it’s a required vaccine for Beijing infants. This vaccine series is good if you plan to live here for a few years, and will also protect you during your travels around Asia.

For those of you concerned about vaccine safety and side effects, I always recommend you read the evidence-based sources online, including the US CDC vaccine page at www.cdc.gov/vaccines. All vaccines have side effects, but I am convinced that vaccines have been dramatically effective all over the world in eradicating many terrible childhood diseases, saving millions of lives.

For more information on vaccines, please read my previous articles about vaccines.

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(This article was originally printed in Beijing Kids magazine, where I am a contributing editor. You can click here to read the rest of my BeijingKids “The Doc Is In” columns.)

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