Vaccinations for Travel

Health is the greatest gift, contentment the greatest wealth. – Buddha

So that we don’t feed the lawyers: This info is not to take the place of advice from a real doctor. Also, eat your vegetables, look both ways before crossing the street, etc…

Are Vaccinations for Travel Really Necessary?

No one enjoys needles, and paying for those vaccinations with your own money adds even more insult! However, some of the nasties you can get while traveling will last a lifetime. You don’t need souvenirs in your bloodstream — get vaccinated!

I’ve met lots of travelers who never got a single vaccination. They were fine. You may survive and thrive, or you may get an unhealthy dose of incurable hepatitis beating up your liver. Ultimately, making the choice of how much risk to accept is on you.

Whether you get all of your needed vaccinations or not, seriously consider getting backpacking travel insurance for your trip at the very least.

Vigilance isn’t always a guarantee that all will go well. You may avoid drinking the local water, but local restaurants don’t wash dishes in bottled watered. One bead of water on a wet plate could contain human feces — and viruses such as hepatitis — without you knowing.

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 Shaolin kung fu school became dangerously ill. I was able to sleep a little better than the other guys knowing that I had been immunized. Needless to say, I got my money’s worth out of my typhoid vaccination.

Sometimes proof of a particular vaccination — such as yellow fever — is required before you will be allowed into a country. This is especially true in South America and parts of Africa. If you’ve traveled there, other countries free of yellow fever may require proof that you were immunized. Keep records of your vaccinations; carry them with your passport.

The good news is that most of the immunizations last a long time. Some, such as the typhoid capsules given in the U.S., last for five years. Other immunizations last 10 years or even a lifetime. Most of the cost is up front; you shouldn’t have to go to the clinic very often.

Where to Get Vaccinations?

Usually, you will have to visit your local travel clinic to get vaccinations. Don’t wait too long to make an appointment! Sometimes — as in the case of the hepatitis shots — you have to wait 30 days between injections, and then another 30 days for it to be fully immunized. Don’t wait until the last minute to schedule your appointment — start early!

Some travelers opt to get vaccinated once arriving at their first destination (e.g., Thailand) because it’s way cheaper. This is usually safe, assuming you go to a proper clinic to get vaccinated. Remember that many vaccinations require some time (see above) to work, so you’ll be exposed to local water, etc, in the meantime.

How Much Do Travel Vaccinations Cost?

That depends. Some of the vaccinations for travel can be surprisingly expensive. Japanese Encephalitis, a shot sometimes recommended for rural areas of Southeast Asia, can be US $80.00 a shot, and requires a set of three! It doesn’t even last that long. The problem with travel clinic doctors is that they will always err on the safe side and recommend everything in the book. Why wouldn’t they? They can make the clinic profitable while covering themselves.

Sometimes recommendations are over the top. I was recommended to get three rabies shots — which I declined — just because there are a lot of stray dogs in Thailand. I saved hundreds of dollars by declining. Do your own research, and make an educated decision about risks. Gather a consensus of data from the CDC and WHO when making a decision.

Your health insurance may cover some of the shots or anti-malarial tablets. It is definitely worth a call to them to review your policy. Sometimes tetanus, hepatitis-A, and polio are covered.

If you have been in the armed forces or worked as a public servant (e.g., fireman, policeman, or nurse) you undoubtedly received some of these vaccinations for travel already. Researching your prior immunization records could save you money. See if any are still valid.

Which Vaccinations For Travel Do I Need?

Rregardless 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 life if you do it right the first time. Usually requires two to three shots. Definitely get this one!
Hepatitis B	Same as Hep-A, good for life, but requires three injections. Make sure you get this one as well. Some clinics combine the hepatitis A and B vaccinations.
Tetanus+	Good for 10 years. You probably received this in school, but if it has been over 10 years, get another one. Tetanus is often combined with Diphtheria in a single injection known as a TDaP.

Other common vaccinations recommended for developing areas like Southeast 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, and the shots do not guarantee immunity. You can skip this one unless you plan to live in rural areas for a long time.
Typhoid Fever	In the U.S., you can opt for pills rather than getting jabbed! The pills are good for five years; injection is good for two or three years. You should probably get this one because it comes from dirty water, which you will encounter frequently.
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 Southeast Asia or India unless you’re coming from an infected country.

Research what vaccinations for travel are required or recommended for your countries on the CDC Website or the World Health Organization website.

Tip: Keep a record of your vaccinations in a spreadsheet. You will never be able to remember which ones you received five or 10 years later; getting duplicates is a waste of money.

Even though it is tempting to skip the return visit to a clinic once you get home, GET YOUR BOOSTER SHOTS WHEN NEEDED! 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 Pills

Taking antimalarial medication is hit or miss. A doctor will tell you to do so; I have not taken them in 11 years of feeding mosquitoes in tropical dungholes and have been fine. Even still, every time you are bitten by a mosquito at night, you play a little Russian roulette with your bloodstream. Most experienced travelers I encounter don’t take the pills. The pills won’t help you from many strains of malaria, and you’ll be given the same pills if you contract malaria.

Doxycycline, a common antimalarial drug, is actually a strong antibiotic. Taking it daily will cause you trouble. Women should note that doxycycline can reduce the effectiveness of birth control.

Read more about Malaria information for travelers on our site and how to avoid insect bites. You can only get malaria if you are bitten in the first place, so avoid those mosquito bites!

Dengue Fever

Although I haven’t met many travelers who got malaria, I have met many who suffered through dengue fever.

This is a very common-yet-nonfatal disease that is carried by mosquitoes. Watch out for the biters with white-and-black (tiger) markings that bite during the day. Dengue is a serious problem all over Southeast Asia, Central and South America, Australia, and the islands in the Pacific. Although dengue fever will probably not kill you, it will certainly make you hate life for a few weeks, and may even end your trip completely.

A dengue vaccination is still in the works, but isn’t available widespread yet. Being smart and avoiding mosquito bites whenever possible can greatly reduce your chances for becoming infected.

Don’t think that dengue fever is something you only get when hacking through the jungle — it’s especially prevalent in urban areas where mosquitoes breed in flower pots and discarded tires.

Other Health Considerations

Some travelers opt for a pre-departure checkup. This is your choice, obviously a good bet if you are not feeling well before starting long-term travel.

• If you take a regular prescription medicine, make sure you have enough to cover you for your trip. Know other names for the medication, not just the brand from your home country.
• Keep a copy of the prescription with the medicine so that you will not look like a drug mule packing large quantities of pills 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 lose one. Many of the environments will be extremely dusty during the dry seasons, which will be a nightmare for contact lens wearers.
• You might want to see a dentist. Tooth pain in a place where dentists still use medieval tools is no fun at all! Don’t wait until the last minute in case you need several appointments to get a problem fixed. If you are in Southeast Asia, Bangkok and Chiang Mai have a big dental tourism scene.Get your fixes done there for cheaper.

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, lots of water, and a lack of television! As always, survival is a matter of playing it smart and not taking stupid chances with the trip of a lifetime.

Along with many other unique-and-unexpected lessons learned on the road, you may discover that medical treatment in some countries (e.g., Thailand) is cheaper, more efficient, and superior to that of your “developed” home country.

Check out the backpacking medicine section on our site for tips about staying healthy while vagabonding.