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Cortisone shots, propiochrone, polio, hepatitis A, hepatitis B, anti-tetanus, typhoid. Suggestion?

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Practicing since : 1991
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I was about to do some vaccines (polio, hepatidis A, hepatidis B, anti-tetanus, typhoid) because I was planning on going to Indonesia/Sulawesi by the end of July. Unluckily for me, my dermatologist gave me a cortisone shot two days ago, without telling me that the medication was cortisone . I did not know that one cannot do any vaccines if taking cortisone. The shot he gave me is "propiochrone" and it acts slowly. So he basically told me that in 30 days it will be out of my system.

Can someone please advice me, of what I can do now? Because I was planning on leaving on the 28th of July. And I know that the vaccines need about a week-two weeks to work.

If I do the vaccines in 20 days (July 18th), considering that only 22 days will have past since the cortisone shot, will the vaccines work? And will I be ready to travel on the 28th of July? I am very upset that this happened because I was about to volunteer at a wildlife center there.

Thank you!
Posted Thu, 3 May 2012 in Vaccinations
Answered by Dr. Sumit Bhatti 38 minutes later

Thank you for your query.

1. Check the dose of the steroid with your dermatologist. If it is less than 1 to 2 mg/ kg, you may safely go ahead with your vaccination after two to three weeks.

2. If your dose was higher than 1 to 2 mg/ kg, there is no choice but to wait for a month. With live attenuated vaccines like typhoid vaccine, this period may extend up to three months. The other vaccines that you plan to take do not require a long waiting period. These are: Polio and Hepatitis A, which are killed virus vaccines. Hepatitis B is a fragmented virus vaccine. Anti Tetanus is an inactivated Toxoid.

3. It is unlikely that you will fall sick immediately on arrival if you are careful.

4. Remember that wildlife sanctuaries are more likely to harbor zoonotic infections.

Hope I have answered your query. If you have any follow up queries I will be available to answer them.

Above answer was peer-reviewed by
Follow-up: Cortisone shots, propiochrone, polio, hepatitis A, hepatitis B, anti-tetanus, typhoid. Suggestion? 4 hours later
Dr. Bhatti,

Thank you for replying!

I would like to ask you, before I visit the travol doctor tomorrow.
The shot the dermatologist gave me was 1ml and it contained : 2mg of Betamethasone (sodium phosphate), which says that it acts as soon as one takes the shot, and 5mg betamethasone dipropionate, which says that it is slow acting.

Is this dose more than 1-2mg/kg ? (I weight 41 kg)

As for the zoonotic infections you mentioned, they told me if I want to also take the rabies shot, but I have been informed that this vaccine might have some bad side effects. What do you suggest?

Thank you,
Answered by Dr. Sumit Bhatti 5 hours later

1. 1 mg of betamethasone is roughly equivalent to 8 mg of prednisolone. Therefore you have received a steroid dose of roughly 55 - 60 mg or 1.5 mg/kg as a single dose.

2. About 0.5 mg/kg will be released immediately and roughly 1 mg/kg will remain in your system for three to four weeks, but this is not a daily dose and will reduce exponentially.

3. Therefore it is safe to go ahead with your modified schedule. Delay your Typhoid as far as possible.

4. Rabies has no cure yet. All warm blooded animals can transmit rabies. Just like tetanus, no one can ethically suggest no vaccination. You may take pre-exposure prophylaxis with 1 ml injections (deltoid / arm) on days 0, 7, 21 or 28 with an inactivated rabies virus vaccine. Incidence of side effects is low. Cold chain has to be maintained.

Hope you have a wonderful trip.

Above answer was peer-reviewed by
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