Chinese Japanese Encephalitis Vaccine? Need help!

[doumeizhen]

I read in another forum that the Chinese produce a local Japanese encephalitis vaccine, and that the person in the post got it. For the past three months I have been calling around to see if anyone has it and I have been told, unanimously, no! and that I should just shell out more than RMB 3,000+ to get it at an international clinic.

Now, that's a lot of dumplings, and it would break my heart if I had to do it. So, does anyone know if there is such a vaccine, and whether or not they'd consider giving it to an adult? The person in the other forum never responded to my inquiry.

[JenniferW]

I'm now in the UK. I used to work in China - and had the Japanese Encephalitis vaccination. Since retiring and coming back to the UK, I've been back to China at least once every year, so have been keeping vaccinations up to date. Last week I talked with the specialist nurse dealing with this for me, and she suggested not automatically keeping this one up to date, that the need / risk very much depended on whereabouts in China I was going, and what my living conditions would be.

I can understand your wariness about a Chinese-produced vaccine, given the amount of counterfeit drugs around. The Wikipedia entry (which you may not have access to) refers to a Chinese vaccine:

Infection with JEV confers life-long immunity. All current vaccines are based on the genotype III virus. A formalin-inactivated mouse-brain derived vaccine was first produced in Japan in the 1930s and was validated for use in Taiwan in the 1960s and in Thailand in the 1980s. The widespread use of vaccine and urbanisation has led to control of the disease in Japan, Korea, Taiwan and Singapore. The high cost of the vaccine, which is grown in live mice, means that poorer countries have not been able to afford to give it as part of a routine immunisation programme.

In the UK, the three vaccines used (two of which are unlicensed) which are JE-Vax, Green Cross and IXIARO (licensed). JE-Vax however has subsequentally been removed from market. JE-Vax and Green Cross require three doses given at 0, 7–14 and 28–30 days. The dose is 1ml for children and adult, and 0.5ml for infants under 36 months of age. IXIARO the new vaccine has been produced by Intercell Biomedical Ltd and requires only 2 doses, and is currently licensed in the U.S., Europe (inc UK), Canada and Australia.

The most common adverse effects are redness and pain at the injection site. Uncommonly, an urticarial reaction can develop about four days after injection. Because the vaccine is produced from mouse brain,[5] there is a risk of autoimmune neurological complications of around 1 per million vaccinations. However in the case of IXIARO where the vaccine is not produced in mouse brains but in vitro using cell culture there is little adverse effects compared to the Placebo, the main side effects are Headache and myalgia.[6]

Neutralising antibody persists in the circulation for at least two to three years, and perhaps longer.[7][8] The total duration of protection is unknown, but because there is no firm evidence for protection beyond three years, boosters are recommended every three years for people who remain at risk [1]. Furthermore there is also no data available regarding the interchangeability of other JE vaccines and IXIARO and recommended those previously immunised with other JE vaccines receive Green Cross or JE-Vax or a primary course of IXIARO.

There are a number of new vaccines under development. The mouse-brain derived vaccine is likely to be replaced by a cell-culture derived vaccine that is both safer and cheaper to produce. China licensed a live attenuated vaccine in 1988 and more than 200 million doses have been given; this vaccine is available in Nepal, Sri Lanka, South Korea and India. There is also a new chimeric vaccine based on the yellow fever 17D vaccine that is currently under development.[9]

[roddy]

You could try if you haven't the nearest of these - immunization centers listed on the Chinese CDC website. Also known as 流行性乙型脑炎, and there are references to immunizations, albeit for kids.

If you know you're going to be at risk, fair enough, but I'd echo the above - I'm pretty sure I recall a conversation with a nurse in the UK about this, and being asked if I was likely to be camping near any pig farms in the tropics. I wasn't, and it was decided we could skip that one.

The costs in Hong Kong make me think that if you can find it it should be a lot cheaper (in fact if it wasn't for the need for a course of injections you could fly down and save money on 3000Y).

[LoisLane]

I recently went to the doctor for all of my China traveling vaccinations. He told me that the risky side effects and the cost of the Japanese Encephalitis vaccine usually outweigh the potential benefits. I'd skip it unless you're going to an area especially prone to Japanese Encephalitis outbreaks.