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.