we did the twinrix (hep a/b) and when we asked about the malaria we were told we should be ok because the area's we are going to are not as bad but that we should be wearing bug spray with high deet when we do the rainforest tour. really depends on where you are going and what you are doing! The twinrix is recommended for all caribbean locations.
The one thing I was told by the health unit is to make sure to wash wash wash our hands. Flu bugs are easily spread around the ship..... especially from the buffet where thousands of people are using the same serving spoons then eating. According to her only 35% of Canadians wash their hands after going to the bathrom