Vaccine special issues: Yellow fever, rabies and Japanese encephalitis

Questions regarding immunization against YF, JE, and rabies arise frequently, and the health care provider must be prepared to assist the traveler in making reasonable decisions based on risk and benefit. Frequently, cost is a factor in the traveler's decision, because the price of vaccines for travel is not controlled in the United States, and often is not covered by insurance. Recommendations made by travel agencies, tour guides, fellow travelers, and friends at the destination often are misguided. The practitioner who offers such vaccines should use available sources of information, such as the CDC Yellow Book [3] and the Traveler's Health web site [29], the WHO International Travel and Health web site [30], and the assortment of high-quality texts that are now available on travel medicine [31-34] to remain up-to-date and informed on how best to counsel and serve the traveler.