I plan on going to Mexico city this summer. Travel information for Mexico suggests getting Hapetitis A and typhoid vaccination. Should I still get this even though I 'll be spending most of my time in an urban area? Should I also get a rabies vaccine?
The typhoid vaccine is oral now so it’s really no big deal. Hep A (a gamma globulin shot I’d assume) hurts a little.
I got both when I traveled to Bulgaria, even though I was staying with the American University… basically they protect you from unsafe food handling practices.
Hep A:
Here is an excerpt from what the CDC says about the risk of hepatitis A for travellers. Note particularly the last sentence:
"The risk of acquiring HAV infection for U.S. residents traveling abroad varies with living conditions, length of stay, and the incidence of HAV infection in the area visited. Travelers to North America (except Mexico), Japan, Australia, New Zealand, and developed countries in Europe are at no greater risk for infection than in the United States. For travelers to low-income countries, risk for infection increases with duration of travel and is highest for those who live in or visit rural areas, trek in back country areas, or frequently eat or drink in settings of poor sanitation. Nevertheless, many cases of travel-related hepatitis A occur in travelers to developing countries with “standard” tourist itineraries, accommodations, and food consumption behaviors. "
If you are middle-aged or older or if you have travelled extensively in less developed countries you may have had hep A in which case you are immune and don’t need any shot. However, for most people it is probably simpler and cheaper to just get the vaccine than to have a test done to find out if you are already immune. If you are young and have not travelled much out of the US you are probably susceptible and the hep A vaccine gives you safe and effective protection against a disease that can be very debilitating. The vaccine not only protects you when you go to Mexico this summer, it will protect you for the rest of your life whenever you go to a country with less than perfect sanitation. (In contrast, if you get an immune globulin injection, your protection will last only a few months and you will need another injection the next time to make a similar trip.)
Typhoid vaccine
Here is an excerpt from what the CDC says about typhoid vaccination:
“Typhoid vaccination is not required for international travel, but it is recommended for travelers to areas where there is a recognized risk of exposure to S. Typhi. Risk is greatest for travelers to the Indian subcontinent and other low-income countries (in Asia, Africa, and Central and South America) who will have prolonged exposure to potentially contaminated food and drink. Vaccination is particularly recommended for those who will be traveling in smaller cities, villages, and rural areas off the usual tourist itineraries. Travelers should be cautioned that typhoid vaccination is not 100% effective and is not a substitute for careful selection of food and drink.”
If you stay in cities and are careful about what you eat and drink, you don’t need the vaccine.
Rabies vaccine
Here is an excerpt from what the CDC says about rabies vaccine.
“Preexposure vaccination with human diploid cell rabies vaccine (HDCV), purified chick embryo cell (PCEC) vaccine, or rabies vaccine adsorbed (RVA) may be recommended for international travelers based on the local incidence of rabies in the country to be visited, the availability of appropriate antirabies biologicals, and the intended activity and duration of stay of the traveler. Preexposure vaccination may be recommended for veterinarians, animal handlers, field biologists, spelunkers, missionaries, and certain laboratory workers. Table 3–14 provides criteria for preexposure vaccination. Preexposure vaccination does not eliminate the need for additional medical attention after a rabies exposure, but simplifies postexposure prophylaxis in populations at risk by eliminating the need for rabies immune globulin (RIG) and by decreasing the number of doses of vaccine required. Preexposure vaccination is of particular importance for travelers at risk of exposure to rabies in countries where locally available rabies vaccines might carry a high risk of adverse reactions. Preexposure vaccination can also provide protection when there is an unapparent or unrecognized exposure to rabies and when postexposure prophylaxis might be delayed.”
From what you say about your travel plans, it seems unlikely that getting vaccinated against rabies would be worthwhile for you because your risk of exposure will probably be low and if you do get bitten you can get post-exposure prophylaxis.