Choosing the right travel vaccinations

Trying to work out exactly which travel vaccinations are needed for a trip like mine is not the easiest thing in the world. The same goes for advice on avoiding Malaria.

Different ‘expert’ websites give differing advice for different locations. My GP herself admitted she wasn’t expert enough to give me the kind of advice I was looking for, and I don’t entirely trust the commercial travel clinics (figuring they’ll be over-cautious with advice in the interest of getting more money out of you). Opinions from travellers themselves is even more confused, with the hyper-paranoid types who get vaccinated against every disease under the sun ‘just in case’ at vast costs at one end of the spectrum and the hardcore backpacker types who claim never to get vaccinated against anything and avoid malaria pills too, all the while ranting about clueless money-grabbing doctors, at the other.

The more I read, the more confused I got – obviously I want to protect myself against anything that could happen, but at the same time, I’m also aware that you can’t protect against everything, and I don’t want to spend a fortune on something that is highly unlikely to happen. In the end, on one of my google quests I found that the London Hospital of Tropical Medicine (one of the things I love about London is that it actually has a hospital of tropical medicine) also run a travel clinic. I figured if anyone was going to give accurate and up-to-date advice, it’d be them.

So I popped down yesterday morning and am very glad I did, as the service was great, and the staff very knowledgable – I was mostly dealth with by a specialist nurse, but she also asked advice from a consultant on a couple of specific points.

So what have I ended with? I was already up-to-date with Hepatitis A & B and Typhoid from previous foreign trips, as well as Polio, Tetanus & Diphtheria, so I knew I wouldn’t need those ones. Yellow Fever was one I knew I’d have to get, as you need proof of vaccination to get into certain south american countries.

The ones I was most uncertain about were Japanese Encephalitis, Rabies, and Malaria prevention, and in each case I ended up with a different result to what I was expecting.

Most websites I read highly recommended getting vaccinated against Japanese Encephalitis, so that was one I was prepared to get, despite the high cost (3 shots at £40-£50 each). However, the consultant pointed out that the risk was less than one in a million per month, and that as it is transmitted via daytime mosquitoes, I’d be better off avoiding being bitten (which is essential anyway to avoid Dengue Fever, which can’t be vaccinated against) by using regular applications of DEET. So I went with the advice and have skipped that one.

On the other hand, I’d decided against getting the Rabies shot, and was talked round by the nurse – pointing out that the vaccine provides protection for life, by describing how sever rabies can be, and ultimately that it was most important for travelers going to remote locations where they may be far from a hospital if emergency treatment is needed. Given that bits of Indonesia that I’m hoping to visit are likely to be very remote indeed, I figured it was worth the cost.

The final surprising advice was on malaria prevention. This was one I’d been particularly concerned about, due to the fact that different drug regimes are recommended for different parts of the world, and that in most cases treatment is only recommended for a limited period, rather than the nearly twelve months I’ll be in potential risk zones. While most countries I’m visiting (all apart from Australia & New Zealand) have some level of risk, it does vary even within countries. Luckily, the consultant’s specialism was in malaria, and the advice was that I should focus on bite prevention for most of my trip, with malaria tablets only being advised for Laos & Cambodia, plus if I decided to go into the amazon while in Bolivia.

I’m really glad I got the expert advice, as I’d been hearing everything from being advised to take Malarone every day (at £3 per day that would be quite an expensive option!) through to taking nothing anyway and relying on the DEET. Instead, the advice was properly tailored to my itinerary, and is one that I feel happy with.

I also managed to finally get an expert recommendation on what concentration of DEET to go for (minimum 30%, no need to ever go above 50%); on avoiding and dealing with altitude sickness; and antibiotics for dealing with most cases of travelers’ diarrhea.

So with just over four weeks to go, I’ve ticked off three of the big four must-dos – booked my ticket, bought my backpack and now sorted the vaccinations. Now there’s just finalising the insurance still to do, and I’m ready to go.


10 responses to “Choosing the right travel vaccinations

  1. Malaria for just Laos and Cambodia…now, I can’t remember, where else in SE Asia are you going? I’ve been thinking we may need malaria protection for Northern Thailand, Laos and Vietnam. Your agent gave you the same advise we got – tailor the malaria prevention to the itinerary and be vigilant in bite prevention. Feels good to tick off the boxes doesn’t it?

  2. Indonesia & the Philippines, possibly Vietnam too, although the last half of my itinerary is deliberately vague, I’ll just go where the mood takes me. Was very pleased to have no side effects at all from either jab too.

    It’s great ticking off the boxes, not long to go now!

  3. Nice to hear that I received similar advice to you, Geoff, even if I am on the other side of the world (Australia)! Rabies was essential for me as I am doing volunteer work with animals in India, but I also skipped the JE vaccination. All the best with your preparation, I leave in 4 days, so I can relate to what you’re going though!

  4. Good luck with all the final planning for the big trip…vaccinations included!! If you need to know anything else about Mexico City or Mexico please let me know..

  5. I use a combination of the Center For Disease Control Traveler’s Health section and a bit of common sense before deciding which vaccines and malaria pills to take, if necessary. I know a few who won’t go with the malaria pills, but I always do when recommended.

  6. Malaria and hepatitis shots a must. Don’t really mind the rest, it’s all about clean eating and clean living when going around and about. Goodluck with your travels!

  7. With regards to Malaria, each country seems to have a different opinion. I’ve heard Malarone is expensive, but effective and has very few side effects. Most doctors in Australia prescribe Doxycycline, an antibiotic which is also useful for treating chest infections. I’ve used doxy before, and there are minimal side effects. The only one is that it may irritate your skin, feeling like you have a minor sunburn.

    There is an excellent book you can buy called Travelling Well. It lists the most common ailments that travellers come across on the road (apart from dodgy taxi drivers), and the suggested medicines to bring and the doses. It even lists the step by step symptoms, and what to do if they persist. It’s worth investing in one of these. It also includes a handy Yellow fever and Malaria Map. The site is:

    Cheers, and happy travelling.

  8. You are an absolute legend!

  9. Great Blog!……There’s always something here to make me laugh…Keep doing what ya do :)

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