Travel Vaccinations

"Health is the greatest gift, contentment the greatest wealth" - Buddha





So that we don't feed the lawyers: This information is not to take the place of advice from a real doctor, eat your vegetables, look both ways, and so on. :)



Check out the new travel medicine section for tips about staying healthy while vagabonding.

Are vaccinations really necessary?

No one enjoys needles, and paying for those shots with your own money adds even more insult! However when you accumulate mosquito bites in tropical and jungle areas and realize that any single one of those bumps on your skin could change your life forever, the peace of mind alone is worth a sore arm before you leave home.

Personal Experience
I was actually living in DengFeng, China when a Typhoid epidemic broke out in 2007. A quarantine zone was created, and a couple of people at my Kung Fu school became deathly ill. It was a scary time, no doubt, but I was able to sleep a little better than the other guys at night knowing that I had been immunized. Needless to say, I got my money's worth out of the $80 investment.

Sometimes proof of a particular vaccination, such as yellow fever, is required before you will be allowed a visa into a country. This is especially true in South America and parts of Africa. Keeping good record of what you received and when can save you pain and money!

The good news is that most of the immunizations last for 5 or even 10 years, so this is something you have do not do too often.

How do I get vaccinations?

Usually you will have to visit your local travel clinic to get the proper vaccinations which will probably include a counseling session with the doctor on staff. Many of the clinics are run by the universities, contact them or your family doctor for a referral. It may take time to get an appointment and you may require several visits to get a set of shots to complete immunization. Sometimes, such as in the case of the hepatitis shots, you have to wait 30 days between injections and then another 30 days for it to have an effect. Don't wait until the last minute to schedule your appointment, start early!

How much does it cost?

Some of the shots can be surprisingly expensive. Japanese Encephalitis, a vaccination recommended for rural areas of Southeast Asia, can be $80.00 a shot, and requires a set of three! The problem with travel clinic doctors is that they will always err on the safe side and recommend everything in the book. I was recommended a rabies shot, which I declined, just because there are a lot of stray dogs in Thailand. Do your own research, and make an educated decision. Average costs of a trip to Southeast Asia, with no prior immunizations: US$250 - $400. This may sound like a lot, but considering that many of these diseases are completely incurable and could afflict you for the rest of your life, it is well worth it.

Your health insurance may cover some of the shots, or just the anti-malarial tablets. It is definitely worth a call to them to review the policy. It is common for hepatitis-A and polio to be covered.

If you do not have health insurance at home, at least consider getting a disaster policy with a very high deductible ($5K). The monthly cost is cheap and covers you if you get run over by a tuk-tuk. Your travel insurance will only cover you while abroad, and if you come home with an injury you will be paying out of pocket.

EHealthInsurance.com can give you an instant quote from dozens of companies.

If you have been in the forces or worked as a public servant (fireman, policeman, etc) you undoubtedly received some of these vaccinations already. It does not hurt to get them again, but researching your prior immunization records could save you money.

Which vaccinations do I need?

Obviously we are not the final authority, but regardless of your destination, these are good basic immunizations to get which will protect you from a lot of nasties in developing countries.:

Hepatitis A	Useful everywhere and good for 10 years. Usually requires 2 shots. Definitely get this one!
Hepatitis B	Same as Hep-A, good for 10 years, but requires 3 injections. Make sure you get this one as well.
Tetanus+	Good for 10 years. You probably received this in school, but if it has been over 10 years, get another one.

Other common vaccinations that you will want in developing areas like South East Asia or South America:

Japanese Encephalitis	A nasty brain swelling disease that is carried by mosquitoes. Found in rural areas. This is unfortunately an expensive and painful series, but worth it if you plan to spend time in the mountains or jungle. Requires 3 shots.
Typhoid Fever	The good news about this one is that you can take pills instead of getting jabbed! Good for 5 years.
Yellow Fever	Required if you plan to travel South America and parts of Africa. Carry proof of the vaccination with you in your passport or money belt. Not required for South East Asia.

Research what vaccinations are required or recommended for your countries on the CDC Website.

TIP: Keep a record of your vaccinations in a folder. You will never be able to remember which ones you received 5 or 10 years later and getting duplicates is a waste of money and may let your protection slip.

Also, even though it is tempting to skip the return visit once you get home - GET YOUR BOOSTERS! Otherwise, you may have to start an entire series of shots over again just to guarantee immunity. There are better things to spend your hard-saved travel funds on. :)

Malaria

Click to enlarge the Malaria map

This section is not intended to preach doom and gloom, but to make people aware of the real risks. Malaria kills 2 people every minute. It has been estimated that between 700K and 2.7 Million people die of malaria every year. Malaria is a disease that is carried by mosquitoes and is present over most of the globe. Unfortunately, there is no vaccination for malaria, but there are preventative tablets you can take.

Several different types of anti-malarial pills have been approved for use. Your travel clinic will recommend the best one for your area or circumstances. The mosquitoes in certain well-traveled areas have already developed immunity to specific malarial tablets, so be sure to include specifics when talking to your travel doctor during the consultation.

Some of the anti-malarials bring unwelcome side effects such as sunburn, nightmares, or stomach problems. Female travelers should be aware that they will affect birth control. It is best to start your tablets (based on the advice of your doctor) at least 1 week before you leave home to make sure that you have no reactions and also to get them effective prior to you entering an infected area.

Many travelers get the tablets, which are often covered by health insurance, but opt not to take them because of the potential for side effects. Do this at your own risk, but bear in mind that the "fix" for malaria is to take a heavier dose of Doxycycline, one of the preventatives. Having them on hand to take when the first symptoms of malaria surface may save your life. Take measures to avoid mosquito bites (use repellent, nets, and coils) whenever it is practical, whether you are taking the pills or not.

Once again, the CDC website is the best source for up to date malaria information.

Get Malaria Info here

Dengue Fever

This is a very common yet usually not-fatal disease that is carried by mosquitoes. The mosquitoes have white and black markings and can be found all over Southeast Asia, Central and South America, Australia, and islands in the Pacific. Although it will not kill you, it will certainly make you hate life for a few weeks and may even end your trip completely. There is no vaccination at this time for Dengue, but being smart and avoiding mosquito bites whenever possible can greatly reduce your chances for becoming infected.

Bird Flu

Do not change your travel plans because of bird flu outbreaks. The truth is that infection is extremely rare, you have a greater risk of being killed crossing the street (especially in Cairo!). Even the over-cautious CDC does not issue travel warnings around Avian Influenza at this time. As usual, the best thing is to just be smart. Do not handle live chickens (which may be very common and walking around freely), if there is evidence that they have been doing their business all over the street, don't sit on the curb, etc. For now, you cannot catch the disease from other humans or by eating chicken so no need to avoid eggs or Pad Thai Gai !

What else other than vaccinations?

Some travelers opt for a pre-departure checkup. This is your choice, obviously a good bet if you are not feeling well before long term travel. If you take a regular prescription medicine, make sure you have enough to cover you for your trip.

Keep a copy of the prescription with the medicine so that you will not raise eyebrows with a load of pills coming through customs. Keep the pills in the original, labeled bottles if possible.

If you wear contacts, take along your glasses and prescription as a backup in case you loose one. Many of the environments will be extremely dusty during the dry seasons, which will be a nightmare for contact lenses.

See a dentist! You do not want to jeopardize your trip with pain. Worse yet, consider getting that tooth fixed in a developing country with a slow turning drill. Don't wait until the last minute in case you need several appointments to get a problem fixed.

In summary

Don't be depressed after reading about all the nasties out there. Chances are that you will feel more alive and healthier than ever thanks to exercise, sunshine, and lack of television! As always, survival is a matter of playing it smart and not taking stupid chances with the trip of a lifetime.

Step 1	Step 2	Step 3	Step 4	Step 5	Step 6	Step 7	Step 8	Step 9	Step 10	Hit the road!

Step 5 - Getting a flight