Vaccinations?

Hi, what vaccinations are necessary for round the world travel? It is really confusing! Thanks!

peterdraper 16/04/13    Travel health and safety Link Report

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I use a site like this as a good start – http://www.cdc.gov/vaccines/ – Following this, a trip to a trusted physician. And then price comparisons at travel clinics and your doctor.

But money will never be more important than your health.

PirateAt50 16/04/13    Link Report

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  • It depends on which country you are visiting really, but Pirate is right, the CDC website or even the world health organisation (WHO) websites are good places to start for up to date lists and epedemic information.

    Just to let you know I am a qualified staff nurse, so I hope my advice will be of some use to you.

    Basically there are three types of vaccination.

    Routine vaccinations.

    These are the ones everyone should already have. These routine vaccinations include the BCG, hepatitis B, polio, DTP (diptheria, tetanus and pertusis), heamophilus influenzae type b, pneumococcal conjugate, rotavirus, rubella and measles. Human papillomavirus (HPV) is recommended for girls to prevent cervical precancers and cancers. When giving advice on recommended vaccinations, it may be assumed that you will already have these routine vaccinations and are up to date on any boosters. They are available on the NHS in the UK, so if you do not have them for whatever reason or if you had them more than 10 years ago and may need a booster, go and get them regardless of where you are going. Check with your GP or practice nurse who will have access to your notes.

    Recommended travel vaccinations.

    These vaccinations are not always required in every country, and recommendations do change from time to time as the spread and nature of certain diseases change. Dependent on the specific country or countries you are visiting, any or all of these vaccinations may be classed as not required at all, sometimes recommended, strongly recommended or recommended (which is to be read as essential).

    Some vaccinations are very specific to certain countries and are technically only recommended if you are visiting that region or put yourself within a certain risk category (such as medical treatment, contact with animals, extensive travel in rural areas etc).. However it is wise to get inoculated against these diseases regardless, especially if you are travelling extensively throughout different regions and will be heading to more rural parts of certain countries.

    It is up to you to assess the risk for yourself and decide whether you want the recommended vaccines or not, no one can force you to get them after all, but from a health professional point of view it simply isn’t worth taking risks when it comes to your health.

    Depending on the country, you may be advised to get these recommended vaccinations:

    Cholera.

    Cholera is rare in backpackers, but is spread by contaminated food and water in areas with poor sanitation. It is recommended to travellers heading to rural areas in particular, slum or refugee areas or conflict zones where access to medical facilities is limited. Outbreaks occur sporadically throughout the world.

    The vaccination is administered over a period of 2 to 3 months. Once you have the vaccination, you will be immune for up to 2 years, after which you will need another vaccination.

    Hepatitis A.

    This is a virus present in faeces and is usually caught by consuming contaminated food or water. It is common throughout Asia, Africa and Central and South America. The vaccination is particularly recommended to those travelling to any developing country where sanitation is poor. Good personal hygiene is also important.

    This vaccination should be administered at least 2 weeks before travel, and a further reinforcing dose will be required 6 to 12 months later. Once you have it the duration of immunity can be up to 20 years. You can also get this as combined vaccination with hepatitis B or Typhoid.
    Hepatitis B.

    This virus attacks the liver and is spread through blood to blood contact and is prevalent throughout the world. Those travellers who may place themselves at risk by undertaking activities such as unprotected sex, injected drug use, contact sports, medical or dental treatment or undertaking relief aid/work are highly recommended to get this vaccination.
    You will need three spaced doses of this vaccine at least 6 months prior to travel, and the immunity lasts for approximately 5 years. You can also get this as combined vaccine with hepatitis A.

    Japanese encephalitis.

    Japanese encephalitis is a viral disease causing a severe flu like illness spread by mosquitoes throughout South East Asia, particularly in rural areas such as rice and paddy fields, and can be more prevalent in wetlands. Chances of contracting the disease are low, but the consequences if you do get it can be fatal. It is recommended to all travellers to the region, but particularly those travelling to rural areas for extended periods or those travelling during the monsoon seasons.
    You will need two doses of this vaccine spaced 28 to 30 days apart, so you should get your first dose at least a month before travelling. The immunity period is approximately 1 year.

    Meningococcal meningitis.

    There are two types of meningitis vaccine for the four different strains of meningitis, A, C, W and Y. The meningitis C vaccine is a routine vaccination for all UK children, and most travellers will have had this during their childhood. Vaccination against the other strains are recommended on top of this routine protection. Outbreaks have occurred in many regions throughout the world and in many cases the chances of contracting the disease are significantly higher than in the UK.
    The vaccines are administered as a single dose and immunity lasts for 5 years.

    Rabies.

    Rabies is spread through the bite or saliva of an infected animal (especially if you have open wounds such as a cut or graze). It is not normally a recommended vaccine for travellers unless they are travelling for extended periods in areas with rabies and will have limited access to immediate post exposure medical facilities. The vaccine does not grant immunity to rabies, but it does give you extra time to get treated with post exposure prophylaxis (PEP). Even if you have the vaccine, you will still need this. If you get bitten or suspect the saliva of an infected animal has entered your bloodstream (such as through an open cut), then seek help immediately even if you have the vaccine, as cases are almost always fatal once you become symptomatic.
    The vaccine is administered in three doses, spaced a week, then a month after the first dose, and will last for 3 to 5 years.

    Tick borne encephalitis.

    This is a potentially serious virus spread by the bite of infected ticks found in wooded or forested areas of Central, Northern and Eastern Europe, with sub types found in Russia, Siberia and parts of China and Japan. Backpackers who travel to these areas and spend extended periods outdoors, especially in forested areas, are at risk.

    The vaccine is administered in three doses, spaced 1 month then 6 months after the initial dose, so will need to be started at least 6 to 7 months before travel, and is effective for approximately 3 years.

    Typhoid fever.

    Typhoid is called by bacteria called Salmonella and can contaminate food or drink in areas of poor sanitation. It can be very serious and even potentially fatal and the vaccination is recommended for all travellers to affected regions, especially the Indian subcontinent, Asia, South America and Africa, and particularly if they will be spending extended periods exposed to poor sanitation or hygiene conditions.

    There are two types of vaccine, an oral and injectable variety, but the injectable variety is recommended. It is administered in a single dose and lasts for up to 3 years. It can also be administered in a combined injection with hepatitis A.

    Yellow fever.

    This is a serious disease that is spread through the bite of infected mosquitoes that tend to feed during daylight hours. It is prevalent throughout tropical Africa and South America. Symptoms can range from flu like fever to vomiting, jaundice or bleeding which can be fatal. The vaccination can only been given at accredited centres such as most GP practices and can take at least 10 days to become effective. The certificate is only valid 10 days after your injection too, so leave enough time to get your vaccination before you fly.

    The vaccine is administered as a single dose injection, and a booster dose is required every ten years.

    Required travel vaccinations.

    Whilst the vaccinations themselves remain recommended in a health sense for most countries where the disease is prevalent, certain visa restrictions by the governments of particular countries have made proof of these vaccinations mandatory for approved entry, which is what makes them ‘required’. (Read required for visa/entry).

    Yellow fever.

    Proof of vaccination is required by many countries throughout South America and Africa etc as a condition of entry if you are coming from a country where yellow fever is present. Failure to provide a valid certificate may lead to you being denied entry and turned away, or even quarantined and immunised.

    Meningococcal disease and polio.

    Proof of vaccination is required for visitors to Saudi Arabia who visit Mecca and Medina during Hajj or Umrah.

    When getting any of these vaccines, plan well in advance. Some take a few doses and months to administer, and you can’t get them all at once either, so start getting thema good few months at least before you travel.

    Also look into Malaria tablets too. Dependent on where you go, you may need to protect yourself against Malaria and also Dengue with preventative measures.

    I hope this answers your questions.

    Michael Huxley 16/04/13    Link Report

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  • There is actually no vaccinaton or prophylaxis for dengue. The recommended preventative is using RID as a repellant, a it is the only one which contains the most important ingredient to repel the Aedes aegypti mosquio that transmits dengue.

    Ozziegiraffe 17/04/13    Link Report

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  • Maybe my last sentence wasnt clear ozzie, i didnt mean to say there was prophylaxis for dengue, only that the op should look into malaria tablets and protect himself from malaria and then protect himself from both malaria and dengue too through preventative measures such as nets and repellants. I admit the sentence wasnt that clear as it was only an addendum to the long post on vaccinations, more a reminder than anything.

    Michael Huxley 17/04/13    Link Report

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  • Wow, thanks for the response everyone! Especially Michaelhuxley, really helpful! Pirateat50 I’ve checked out that website too, extremely useful, I didn’t even know it existed! Thanks again!

    Michael what Malaria tablets are the best?

    peterdraper 22/04/13    Link Report

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  • It depends on a) where you are going, (you may not even need them depending on where you go) and b) your med history. You need to speak with your GP or practice nurse who will both have access to your medical notes and known allergies. Some people react very differently to one type of prophalaxis than others do, some will display no side effects at all whilst others will get very serious ones. Do this early, as you should ideally do a trial run of your meds first, to ensure that you don’t get any adverse reactions (you really don’t want to find out you are getting them a few days into your trip).

    As I said above too, also be mindful of preventative measures such as spray and nets.

    Michael Huxley 22/04/13    Link Report

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  • Michael is very correct about malaria prophylaxis. Also know that most doctors you`ll encounter will have had little experience with malaria.

    I`ve spent the greater part of 4 years in India (mostly in the same place) and my doc (across the street from my flat) and I discuss malaria and dengue quite often – there are a number of malaria cases each year about 1-2Km from where I live.

    Study up on malaria and once you know (roughly) what the risk will be where you`re heading, the better you can protect yourself.

    If http://en.wikipedia.org/wiki/Permethrin is available to you, a good 1st step is to treat your clothes and sleep sheets. It`s not available everywhere, and I don`t think we know yet where you are.

    PirateAt50 22/04/13    Link Report

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  • Just my two cents worth – Doc said I should take anti-malarials and prescribed Doxycycline. He advised these for my first two trips to SEA. On later trips, doc was booked out so I saw my other doc instead. His attitude? You don’t need them. It does largely depend on the doctor – Doc G is a bit of a worry wort and takes the “best to be on the safe side” line, while EJ is more, if you don;t need, don’t worry about it.

    Needless to say, I didn’t get malaria an any of my trips. Make sure the insect repellent you use has DEET. I use Bushman’s and find that very effective.

    Captain Courageous 18/05/13    Link Report

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