As a qualified nurse with specialisms in both emergency nursing and travel medicine I cannot emphasise enough how important travel vaccines are to protect yourself when you are travelling the world. So to help steer you through all the confusing jargon and give you the essentials you need to know, here is my ultimate guide to travel vaccinations on your gap year.
If you are planning a gap year, round the world trip or even a short trip to a specific destination, it is absolutely essential that you get your travel vaccines sorted out before you go.
Luckily by reading this article you have the advice of someone who is not only a qualified nurse but is also a world traveller so I know first hand how, where and why vaccinations are useful.
What are vaccines?
Vaccines are simply compounds that contain small amounts of inactivated viruses or bacteria that cause disease. These will not give you the disease because they have been altered and are inactivated, but they will stimulate your body to produce the antibodies required to fight the disease if it is encountered naturally.
Where to get advice about your vaccination needs.
There are plenty of reputable sources online such as the Travel Health Pro (formerly NaTHNaC) website, the Centre of Disease Control and Prevention (CDC), or the NHS’ Fit For Travel website. The Fit For Travel Destination Map is a genuinely useful resource that can give you specific recommendations based on what country or countries you are travelling through. These are excellent resources but it is important to remember that there is just as much false information online too, so your own online research should never be a substitute for qualified advice.
My online travel clinic cannot physically administer the vaccinations to you but is the ideal place to get immediate qualified advice online of what you need, and I can advise you where to go next.
There are a lot of places you can get good, qualified advice about which vaccinations to get. Your GP is a good general all rounder to start off with, and pharmacists are medication specialists who can give you solid information on each vaccination. Your local travel clinic with a qualified travel nurse specialist is often your best bet though (and you will need to make an appointment with them when you actually want the jabs anyway).
Where to go for the vaccinations.
It is always a good idea to shop around as prices can vary between private clinics and your GP. GPs are often cheaper and can provide individual advice based on your past medical history, but the cheapest option isn’t always the best either if you have to wait a lot longer for them to order in stock or want specialist advice.
In the UK, GP surgeries provide the hepatitis A, typhoid and combined diptheria, tetanus and polio vaccines free of charge if you do not have them already. Polio and meningitis vaccines are also sometimes offered at a significant discount.
Private travel clinics are often a good idea too if you need to be seen quickly, but they aren’t always the cheapest option and depending on where you live they aren’t always the closest option either.
In the UK Masta have a variety of travel clinics run by specialist travel nurses in many pharmacies and some major STA travel stores as well. The London Travel Clinic is handy only if you live in the capital or are prepared to travel. The NHS has a travel clinic in the Hospital for Tropical Diseases in London and the Liverpool School of Tropical Medicine has the Well Travelled Clinics in Liverpool and Chester. High street pharmacies such as Boots and Superdrug also have travel clinics available in limited locations.
Yellow fever vaccinations can only be given out at accredited yellow fever vaccination centres.
What things do you need to consider as a patient?
There are a variety of things that you will need to think about when deciding what travel vaccinations you should get before you head off on your round the world adventure.
First and foremost you need to plan well ahead when you are getting your vaccines. Some vaccines such as rabies need multiple visits, and others have to be timed so that they are given a certain length of time apart or be allowed time to work effectively before you travel. This is why you need to visit your GP or travel clinic at least 2 months before you travel depending on how many vaccinations you need.
It is also important to note that whilst vaccinations are amongst the best protection you can get they are not 100% either, and it is still essential that you take reasonable precautions and preventative measures to stop you becoming ill or contracting a disease from food, water, insects and other animals.
What things are considered by your nurse or doctor when advising what vaccines are necessary?
When deciding on what travel vaccinations will be needed there are three primary things that need to be considered. Your past medical and vaccination history (which includes your general health, age and other physical factors), where you are going and what you will be doing there. These three things will determine the strength of the recommendation for any given vaccines.
For example if two travellers are heading to the same tropical country with the same list of needed vaccines, the one who is spending just a few days there staying in an air conditioned hotel in a major city will not require the same vaccines as the next traveller who will be spending months volunteering with animals in a rural community. There is also the fact that there are regional outbreaks and local conditions specific to each country to take into account, such as the current prevalence of rabies and the lack of vaccine stock in Bali which strengthens the recommendation for that vaccine considerably.
This is why it is important to seek out qualified, specialist advice.
What Travel Vaccinations can you get?
Hepatitis A is a serious viral infection that can cause liver problems or even failure. This is a virus present in faeces and is usually caught by consuming contaminated food or water. It is common throughout Asia, Africa and Central and South America.
The vaccination is recommended for travel anywhere, but is particularly recommended to those travelling to any developing country where sanitation is poor. Good personal hygiene and hand washing – especially before eating – is also important to prevent the disease.
This single dose vaccination should be administered at least 2 weeks before travel, and a further reinforcing dose will be required 6 to 12 months later. Once you have it the duration of immunity can be up to 20 years. You can also get this as combined vaccination with hepatitis B or Typhoid.
Common side effects include a sore injection site, and occassionally a little tiredness or a high temperature. These symptoms are temporary.
Hepatitis B is an often symptomless viral infection that can cause serious long term damage to the liver, but unlike Hepatitis A this is transmitted from person to person through the exchange of bodily fluids, so basically anyone getting a tattoo or having sex is at risk.
The vaccination comes in three individual doses administered by injection. These have to be timed with the second injection given a month after the first injection and the final one 5 months later. This can be given as an accelerated dose at a minimum of two weeks after the second injection.
A booster will be required 5 years after the vaccination.
Common side effects include a sore injection site, and occasionally a little tiredness. These symptoms are temporary.
Cholera is a bacterial infection that is spread by contaminated food and water in areas with poor sanitation. It is rare in backpackers and is not often recommended as a vaccine, but is recommended to volunteers or those heading to rural areas where the disease is present for long periods of time, in particular, slum or refugee areas or conflict zones where access to medical facilities is limited. Outbreaks occur sporadically throughout the world.
The cholera vaccine is mixed with water and given orally as a drink. You should avoid eating, drinking or taking oral medication for an hour before and after having the vaccination. Two doses of the vaccine taken 1 to 6 weeks apart are needed to protect against cholera for two years. After this, a booster is required if you continue to be at risk.
Rabies is a viral infection that is present worldwide and is spread through the bite or saliva of an infected animal (especially if you have open wounds such as a cut or graze).There is no treatment or cure for rabies, and if you become symptomatic it is almost always fatal.
For many countries it is not recommended at all, and it is only a sometimes recommended vaccine for most travellers. However, the vaccine becomes strongly recommended for any traveller who falls into an at risk group, including those who are travelling for extended periods or conducting activities that may expose them to the disease in areas with rabies and will have limited access to immediate post exposure medical facilities. It is also recommended for those volunteering or working with animals.
The pre exposure vaccine is administered in three doses via an intramuscular injection. You need to start these injections at least one full month before travelling. The second dose will be given 1 week after the first, and then the final dose will be given 21 – 28 days after the first.
You may still need to be treated with post exposure prophylaxis (PEP) if you contract it.
The vaccine does have some side effects in some people including fever, headache, muscle pain and vomiting. Not everyone will get these symptoms and they are temporary.
Typhoid is caused by bacteria called Salmonella and can contaminate food or drink in areas of poor sanitation. It can be very serious and even potentially fatal and the vaccination is recommended for all travellers to affected regions, especially the Indian subcontinent, Asia, South America and Africa, and particularly if they will be spending extended periods exposed to poor sanitation or hygiene conditions.
There are two types of vaccine, an oral and injectable variety, but the injectable variety is generally recommended for most patients. It is administered in a single dose and lasts for up to 3 years, after which time you will need a booster. It can also be administered in a combined injection with hepatitis A.
The vaccine causes some side effects in some patients, including soreness and a little swelling and redness around the injection site, a high temperature after the injection is also quite common. Less common are abdominal pain, headache, nausea and diarrhoea. These symptoms are temporary.
Japanese encephalitis is a viral disease spread by mosquitoes throughout South East Asia, particularly in rural areas such as rice and paddy fields, and can be more prevalent in wetlands. Chances of contracting the disease are low, but the consequences if you do get it can be fatal. Many patients experience very mild or no symptoms at all, but because it is a viral infection that affects the human brain there is a chance it can lead to inflammation and swelling of the brain, and in very sever cases can lead to brain damage or even death.
You will need two doses of this vaccine via injection spaced 28 days apart, so you should get your first dose at least a month before travelling. The immunity period is approximately 1 year, after which you will need a booster.
Side effects include abdominal pain, dizziness, headache, nausea and diarrhoea. These symptoms are temporary.
Polio, Tetanus and Diptheria.
This is a combined vaccination used to combat the common viral and bacterial infections and diseases of polio, tetanus and diptheria. Many travellers will already have had this vaccine as a teenager as part of a routine widespread vaccination scheme.
If your vaccination was over 10 years ago, you will need a booster. This is a single dose injection and will protect you from all three diseases.
Soreness at the injection site is common after the vaccination and some people may feel nauseous or get a headache or fever, but these are short lived.
There are several strains of meningococcal meningitis that can affect travellers, including A, C, W and Y, and is passed from person to person. These are all bacterial as opposed to viral and can be very dangerous, causing an inflammation of the meningeal tissue around the brain and spinal cord.
The meningitis ACWY vaccination protects you from the bacterial infection for up to 5 years, after which you will require a booster. The booster consists of one single dose by injection and should be given at least three weeks before leaving for your trip.
Common side effects include soreness of the injection site and a mild temperature. These symptoms are temporary.
This is a serious disease that is spread through the bite of infected mosquitoes that tend to feed during daylight hours. It is prevalent throughout tropical Africa and South America. Symptoms can range from flu like fever to vomiting, jaundice or bleeding which can be fatal.
The vaccination can only been given at accredited Yellow Fever Vaccination centres such as most GP practices and can take at least 10 days to become effective. The certificate is only valid 10 days after your injection too, this is not one that you can leave until the very last minute so leave enough time to get your vaccination before you fly.
You will need to have proof of this vaccine (the yellow passport) to enter most countries if you are arriving immediately after being in a country where yellow fever is present.
The vaccine is administered as a single dose injection, and up until very recently a booster dose used to be required every ten years. Now the yellow fever ‘booster’ vaccination given ten years after the initial vaccination is not necessary.
The World Health Organisation (WHO) has stated that the Strategic Advisory Group of Experts on immunization (SAGE) has reviewed the latest evidence and concluded that a single dose of vaccination is sufficient to confer life-long immunity against yellow fever disease.
The side effects of the yellow fever vaccine are usually mild and temporary. They involve headache, a mild fever and muscle pain around the injection site. These symptoms are temporary.
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Have you read all the information but still need a little more specific advice? Is there a travel health issue that you are worried about and need a little reassurance on? Need some information on malaria, or which vaccinations you will need? Is there a travel health issue you would like to ask about in complete confidence?
Well I am here to help.
Apart from being an experienced backpacker with over 10 years travel experience, I am also a qualified nurse with an interest in emergency nursing and travel medicine and practical experience volunteering as an expedition medic.
The Bemused Backpacker Travel Clinic is an indispensable online resource for you to gain a one on one consultation with a medical professional giving you personal reassurance, expert information and qualified advice for any and all of your travel health related questions. To head into the Travel Clinic, click here.