VACCINES (“shots”) for Travel

How do I know which vaccines I should get before I travel?

You should visit a travel clinic, or your regular clinic, and they can help you decide which vaccines are indicated for your travel.  It is best if you go at least one month before travel but if you need to go closer to your travel it is still better than not going at all.  There is also a website (http://www.cdc.gov/travel/) that can give you an idea of the vaccines and medicine you will need.  Make sure you bring any vaccine records you have with you to the clinic.

How does the doctor/nurse decide which vaccines they recommend to me?

There are benefits, risks and costs to all vaccines.  Your doctor or nurse will recommend a vaccine when the benefit of the vaccine (how likely it will prevent you from becoming ill) outweighs the risks and cost of the vaccine.  You should ask questions you have about each vaccine to your doctor or nurse.

What are the vaccines that my doctor/nurse may discuss with me?

There are 2 groups of vaccines.  Those that are routine vaccines, that you should have whether or not you travel, and those you only need to get if you travel internationally.

Routine or regular vaccines

There are several vaccines that are considered routine that your doctor or nurse may recommend.  Most of these you had as a child. 

--You should have a Tetanus every 5-10 years.

--You should have had at least 2 measles vaccines at sometime in your life.

--You should have a polio booster once as an adult after completing the primary series.

--If you are older than 65 years you should have a pneumonia (pneumococcal) vaccine.

--If you have never had the disease chickenpox, or the vaccine, you should tell your doctor.

--Most children and teenagers should have had a hepatitis B series.

Travel Vaccines

Hepatitis A

Hepatitis A is a very common viral infection that people catch from food and water.  If you were born in another country you may have had this disease as a child.  When you are a young child this disease is not severe.  If you get this disease as an adult you may become very ill and could even die.  You can have your blood checked to see if you ever had this disease (ask your doctor/nurse for details). 

 If you had this disease as a child you cannot catch it again.  If you do not know and don’t get the blood test you should get the vaccine before you travel. Two doses more than 6 months apart provide optimal protection, lifetime protection. However, at least one dose preferably 4-6 weeks but even up to the week before travel, will protect most travelers. The second dose provides the long term protection. You only need one vaccine before you travel and that will protect you during your trip.  You should get a second vaccine 6-12 months after the first and then you are protected for the rest of your life. 

Typhoid

Typhoid is another disease that usually comes from contaminated food or water.  It usually causes very high fevers and pain in the stomach area. It can become very serious and cause death.  If you are traveling to visit your friends and family in your country of origin you are the most likely kind of traveler to get this disease.  There is a pill and a shot form of the vaccine.  It takes 7 days to take all the pills and you need to finish these before you leave.  The pill form is more complicated but lasts for 5 years before you need it again.  The shot form is just one shot.  The shot lasts for 2 years before you need it again.

Meningitis

Meningitis is an infection around the brain.  There is a vaccine for the bacterial kind of meningitis that is especially common in some parts of Africa and if you are traveling to these areas your doctor/nurse will recommend this vaccine.  It is also required by Saudi Arabia for entry, if you plan to attend the Hajj because this disease is very common in these settings.  In other areas it might be indicated if you are staying with friends and family, especially if you will be there for a long-time.  Ask your doctor or nurse how long before you need another.

Flu

The flu (influenza) causes fevers, cough, headaches, muscle aches and can cause serious illness even death.  In North America it occurs in the winter but in the tropics it occurs year-round.  It is very common in travelers. The flu strain causing illness changes every year. To be protected, you need the vaccine each year.

Rabies

Rabies is a very serious disease that most people from a dog bite or a bite from a bat. Many other animals, like monkeys, skunks and raccoons, can also cause this disease. If you are bitten by an animal while you are traveling you should scrub the bite wound for at least 5 minutes with soap and water and see a doctor as soon as possible after the bite so you can start a series of shots immediately. Getting the vaccine is very important, as everyone who develops rabies, dies from rabies. There is not any treatment once you get sick.

There is a vaccine for rabies to prevent the disease in case of a bite, but it is expensive and you need at least 3 weeks (3 separate shots).  If you will be traveling for a long period you should consider getting these shots.  Children are especially at risk of getting bit by dogs and not telling anyone about a bite. So, it is important to think of vaccinating children.

Yellow Fever

Yellow fever occurs in parts of Africa and South America.  It causes very serious illness and usually death.  This vaccine is frequently required with travel to certain areas or may be required if crossing between countries during travel.  If you get this vaccine you will be given a “yellow card” that you should take with you to prove you got this vaccine.  People get this disease by mosquito bites so mosquitoes should be avoided (see Malaria handout).  This vaccine lasts for 10 years before you need another one.

Japanese Encephalitis

This disease is in Southeast Asia and South Asia.   People get this disease from mosquitoes,.  If you are visiting areas outside major cities, particularly in rural areas where there are rice paddies and or pigs for more than a month your doctor/nurse may recommend this vaccine for you.  You need at least three separate shots that must be started a few weeks before travel to be fully protected.