There’s a lot of hoopla about vaccinations these days, and I can’t help but think that’s because we have very short term memories and have grown up in a privileged, largely disease-free world. But travel vaccines are not commonly discussed. I had some before I went to Tanzania, some by requirement and others just to be safe.
So I asked doctor Joan Ingram from the Auckland Travel Medicine Service to give me some advice about what vaccines are required for which countries and why…
Travel jabs can be confusing: weird names, different number of doses etc. I will try to simplify them.
Yellow fever vaccination is recommended for travel to most of Africa and South America. Border officials may want to look at your yellow fever vaccination certificate before allowing you to enter their country and if you don’t have one you may be quarantined or vaccinated on the spot- neither of these are recommended! It is one of the few live vaccinations we use (containing weakened virus) so certain people with impaired immune systems shouldn’t have the vaccine. (They may be advised to avoid yellow fever countries or have a waiver.) Some people feel unwell a few days after the vaccination (a few seriously so) so don’t leave it till the last minute.
Influenza circulates year round in the tropics and may be the most common vaccine-preventable illness that travellers get. So it’s good to have had an influenza vaccination in the 12 months before you leave. It is also important to be up to date with routine vaccinations like measles as the chance of measles is increased in many developing countries. Have a tetanus booster too if it’s longer than 10 years since your last one so you don’t have to get one if you have an injury when away. Polio is now very uncommon apart from a few countries such as Nigeria. A booster may be recommended if you are going to such countries.
Hepatitis A and typhoid are infections which circulate where water and sanitation are not good. One hepatitis A injection will protect you for around a year and a second dose at least 6 months after the first gives long term protection. It is sensible for most travellers to areas other than Europe, North America, Japan and Australia to have hepatitis A vaccinations.
Typhoid risk is highest in India and nearby countries and Samoa. Typhoid vaccination can be done with an injection or with a series of 3 oral capsules. They work for about 3 years. Typhoid and hepatitis A vaccinations are available in a combination injection, which is convenient. Hepatitis A vaccine can also be combined with hepatitis B (people who have had their NZ baby vaccinations since 1988 will have had hepatitis B vaccinations.) Hepatitis B requires a month at least to complete.
If bitten by a mammal such as a dog or monkey in most countries you need to get a series of 4 rabies injections and some special rabies immunoglobulin into the bite because of the risk of rabies. You can have 3 doses of rabies vaccine before your trip then if you are bitten it is much less stressful and disruptive as you just need 2 doses of vaccine and not the hard-to-find immunoglobulin. Travellers who may have contact with animals should get vaccinated before their trip but they are a good idea for any traveller especially those going to Asia. The 3 pre-travel doses take a month to have and are unfortunately expensive. They are a long-term investment though as you will be ready for bites on future trips also.
There are injections to protect against meningococcal meningitis which are different from the meningococcal vaccinations used in NZ about 10 years ago. Young people spending time with others in crowded situations should consider one as well as people spending time in parts of Africa. If sleeping in rural parts of Asia the Japanese encephalitis vaccine may be sensible. Finally there is an oral cholera vaccine that reduces the risk of traveller’s diarrhoea somewhat.
It is best to have your injections 4 or more weeks before you go but there is still some benefit even if you have them later, so don’t talk yourself out of them if you are close to departure! They’re usually not as painful as most people expect.
It is important to remember that there aren’t any vaccines for many things which travellers want to avoid: malaria, dengue, accidents etc etc. So as well as your vaccinations you need lots of advice, insurance, condoms, repellent, etc.
For more information, contact Joan at the Auckland Travel Medicine Service>>>
What are your thoughts about travel jabs? Let me know in the comments below 🙂