The Ultimate Guide To Travel Vaccinations.

Travel vaccinations are an essential way to protect yourself and your health when you are travelling the world, but many travellers are confused by conflicting advice, aren’t sure which vaccines they need or are put off getting them for the wrong reasons. 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 any travel vaccines you may need sorted out before you go, and if you are clinically able to get them and they are recommended for the destinations you are travelling to, then it is important that you consider getting them.

This means making sure that your routine vaccinations, the ones that you get throughout your childhood and early teens as part of the normal vaccination schedule, are all up to date, and that you get any specific travel vaccinations that are recommended for the specific destination you are heading to.

Of course it is important to state that no matter what it is always your choice on wether to get vaccines or not, and the strength of recommendation will change dependent on specific risk factors, outbreaks and epidemics, specific destinations and your own past medical history, among other things, but you always have consent. It is hardly surprising many travellers find it confusing.

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.

For general information 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, one on one 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 Get The Vaccinations.

It is always a good idea to shop around as prices can vary between private clinics, specialist pharmacies 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. 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 Do You Need To Consider Before Getting Vaccinated?

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 Will Your Nurse Or Doctor Consider Before Vaccinating You?

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. On top of that there will also be clinical considerations such as any local outbreaks, epidemics, pandemics and other considerations such as availability of medical facilities.

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 always require the same vaccines as the next traveller who will be spending months volunteering with animals in a rural community.

A traveller who has a past medical history of severe reactions to general vaccines or specific anaphylaxis will obviously not be recommended to get any given vaccine regardless of the need, and will often be exempt from any mandatory ICVP regulations. In these circumstances advice on other precautions become paramount.

This is why it is important to seek out qualified, specialist advice.

What Travel Vaccinations Can You Get?

These vaccinations are not always required in every country, and recommendations do change from time to time as the spread and nature of certain diseases change.

Dependent on the country or countries you are visiting and a variety of other individual risk factors, any or all of these vaccinations may be classed as not required at all, sometimes recommended, strongly recommended or recommended (which is to be read as essential).

Some vaccinations are very specific to certain countries and are technically only recommended if you are visiting that region. However it may be wise to get inoculated against these diseases regardless, especially if you are travelling long term and extensively throughout different regions and will be heading to more rural parts of certain countries.

It is up to you to assess the risk for yourselves and decide whether you want the recommended vaccines or not, no one can force you to get them after all, but from a health professional point of view it simply isn’t worth taking risks when it comes to your health.

So despite the fact that certain vaccinations may not be required in certain countries, and obviously you should pay attention to the vaccinations that are more strongly recommended first, as a health professional I would still strongly recommend you get all of them if you can. Obviously it is up to you and your consent at the end of the day, but that is my advice.

So what vaccinations should you condider for your travels?

Hepatitis A.

This is a virus present in faeces and is usually caught by consuming contaminated food or water. It is common throughout Asia, Africa, the Middle East and Central and South America. The vaccination is recommended for most travel if you haven’t received it as part of your routine schedule, but is particularly recommended to those travelling to any developing country or region where sanitation is poor and there is a noted risk of the disease. Good personal hygiene is also important to prevent the disease as it is spread through the feca oral route and yes, that means hand washing and is exactly how it sounds.

This vaccination should be administered at least 2 weeks before travel although can be administered up to the day before in an emergency but this is not ideal. A further reinforcing dose will be required 6 to 12 months later and if you can plan ahead and get this second dose before you travel that is the best option. Once you have the second dose the duration of immunity can be up to 20 years. You can also get this as  combined vaccination with hepatitis B or Typhoid.

Hepatitis B.

Hepatitis B is spread through blood and body fluids, so any action such as unprotected sex, injecting drugs or contact sports are a risk factor. This vaccine should be given as part of your routine schedule but if not it is recommended for most travellers who are travelling for long periods and will be engaging in activities that raise their risk factor.

Vaccination against hepatitis B is recommended if you’re travelling in parts of the world where hepatitis B is common, especially if you’ll be doing activities that increase your risk of developing the infection.

The hepatitis B vaccination is given over a course of 3 injections taken 3 weeks to 6 months apart, depending on how quickly you need protection. A combined hepatitis A and hepatitis B jab is also available if you’re likely to be at risk of both these conditions while travelling.

Polio.

Poliomyelitis is an infectious disease that can in rare cases affect the central nervous system and cause temporary or sometimes permanent paralysis. It is very rare now because of vaccination efforts and the vaccinne is part of the routine vaccination programme for children in the UK. It is always highly recommended that you are up to date with your routine vaccinations and boosters.

Despite common misconceptions that it has been eradicated, Polio does still exist and in the small pockets where it is still present such as in Pakistan, Afghanistan and Nigeria, it can be recommended that travellers get a further booster. Additional doses of the vaccination are given in a single 3-in-1 Td/IPV (tetanus, diphtheria and polio) injection.

Cholera.

Cholera is a bacterial infection that is spread by contaminated food and water in areas with poor sanitation such as sub Sharan Africa, South and Southeast Asia, the Middle East and Central America and the Caribbean.

Cholera is generally not recommended for the vast majority of travellers unless they are in a specific at risk group or an aid or medical worker.

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 and the final dose should be completed a week before you travel. 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.

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). Most commonly a dog but other animals such as cats, monkeys and bats can carry it too. There is no treatment or cure for rabies once it becomes symptomatic, and at this stage it is almost always fatal, but treatment and vaccination before this is extremely effective.

For many countries it is not recommended for travellers to get the vaccine at all because of the low risk and chance of contracting it. However, the vaccine becomes much more strongly recommended for any traveller who falls into an at risk group, including those who are travelling for extended periods in countries where Rabies is present and problematic, or conducting activities that may expose them to the disease such as volunteering or working with animals and will have limited access to immediate post exposure medical facilities.

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. The vaccination once administered will last for for up to ten years, after which time a booster should be considered.

You may still need to be treated with post exposure prophylaxis (PEP) if you contract it or there is a chance you may have done.

The vaccine does have some rare side effects in some people including fever, headache, muscle pain and vomiting. Not everyone will get these symptoms and they are temporary.

Japanese Encephalitis.

Japanese encephalitis is a viral brain infection causing a severe flu like illness spread by mosquitoes throughout South and Southeast Asia and beyond. Despite it’s name it is not only found in Japan (where it is rare thanks to mass immunisation).

It is recommended for any traveller travelling for longer than a month in any given region, particularly in rural areas such as rice and paddy fields, and can be more prevalent in wetlands and during the rainy seasons. Anyone with increased exposure to mosquito bites (ie extended time camping or working in rural areas) is at higher risk.

Chances of contracting the disease are low, very rare in fact, but the consequences if you do get it can be fatal. That is why it is important to discuss your personaal risk factor with a professional.

You will need two doses of this vaccine spaced 28 to 30 days apart, and the final dose should be given at least a week before your departure date to ensure you are fully protected from any exposure. The immunity period is approximately 1 – 2 years after which time a booster will be required.

Meningococcal Meningitis.

Meningococcal meningitis is an acute bacterial disease that can cause a severe flu like disease and is transmitted by sneezing, coughing or direct contact with respiratory secretions. There are 13 different serogroups of meningitis of which groups B and C are most common in the UK, and vaccinations for various strains of meningitis form part of the routine vaccinations for life in the UK and other Western countries.

Epidemics of the disease predominantly occur in the African meningitis belt from Senegal in the west to Ethiopia in the east. These serotypes have also been responsible for outbreaks in Saudi Arabia and other countries as far as Russia.

If travelling to a high-risk area, you should be vaccinated against meningococcal meningitis A, C, W and Y with a MenACWY vaccine, also known as the quadrivalent meningococcal meningitis vaccine. This includes those who have already had the meningitis C vaccine as a child.

This is a single injection that should be given 2 to 3 weeks before you travel and immunity lasts for 5 years.

Pilgrims travelling to Saudi Arabia for Hajj are required to have a valid certificate of vaccination against the disease for visa purposes

Tick Borne Enchephalitis.

This is a potentially serious virus spread by the bite of infected ticks found in wooded or forested areas of Central, Northern and Eastern Europe, with sub types found in Russia, Siberia and parts of China and Japan. Backpackers who travel to these areas and spend extended periods outdoors, especially in forested areas, are at risk.

It is a viral infection that can cause flu like symptoms. Many travellers will recover from this initial phase, however there is a risk that the virus can spread to the protective layer of tissue that covers the brain and spinal cord (meningitis) or the brain itself (encephalitis). This can lead to some serious complications including paralysis and even in rare cases, death.

The vaccination requires a course of 3 injections for full protection. The second dose is given 1 to 3 months after the first and provides immunity for about a year. A third dose, given 5 to 12 months after the second, provides immunity for up to 3 years.

The course can sometimes be accelerated if necessary. This involves 2 doses being given 2 weeks apart. Booster doses of the vaccine are recommended every 3 years, if necessary.

Typhoid.

Typhoid fever is a potentially serious bacterial infection that can affect multiple organs with severe complications and in some cases be fatal.

It is caused by a bacteria called Salmonella Typhi (not to be confused with the Salmonella that causes food poisoning) and can contaminate food or drink in areas of poor sanitation or through infected fecal matter or urine on the hands of anyone who doesn’t wash their hands properly after going to the toilet.

The vaccination is recommended for all travellers going 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.

In the UK, there are two types of licensed vaccine, an injecatble vaccine and an oral one.

• Vi vaccine – given as a single injection
• Ty21a vaccine – given as three capsules to take on alternate days

Both are effective for up to three years, after which a booster is required, but the injection is often preferable due to simple convenience. Combined typhoid and hepatitis A injections are also available for people aged 15 or older.

Yellow Fever.

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 but is actually very rare in travellers. There have been less than 50 cases since 1970, but it is at constant high risk of outbreaks and has a significant fatality rate, which is why ICVP procedures are enforced. 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 and can take at least 10 days to become effective. You should be issued with an International Certificate of Vaccination or Prophylaxis when you have the vaccine. This certificate is valid for life. The certificate is only valid 10 days after your injection too, so leave enough time to get your vaccination before you fly.

The vaccine is administered as a single dose injection, a booster is no longer required for the majority of people as it has been found the single dose gives lifelong immunity. A booster may still be given for very specific at risk groups but this is not common.

Required Vaccinations.

This term is slightly misleading as the term required doesn’t refer to the health risk or vaccine recommendation, but the necessity of an ICVP, or International Certificate of Vaccination or Prophylaxis for visa and border entry purposes.

The reason for the ICVP is to control the spread of very specific diseases that pose a significant public health risk. They do not apply to all recommended vaccinations, in fact they are only currently required for Yellow Fever, Meningococcal disease and Polio, and are only required in some countries or under very specific circumstances. If you are heading to or from a country that has disease control restrictions in place you will need to show this proof of vaccination before entry.

If you have specific contraindications against getting the vaccines then there are exemptions to the ICVP regulations.

Yellow Fever ICVP.

If you are heading to any country where yellow fever is present, it is strongly recommended that you are vaccinated against it. Proof of vaccination via an International Certificate of Vaccination or Prophylaxis (or ICVP)  is required for some countries in Africa and South America for entry, and by many countries throughout the world as a condition of entry if you are coming from a country where yellow fever is present. Failure to provide a valid certificate may lead to you being denied entry and turned away.

There are exemptions to this condition of entry for those who cannot get the vaccine for clinical reasons such as those with a risk of anaphylactic reactions to the vaccine or any of the components of it such as egg or chicken enzyme, those who have a weakened immune system due to disease or treatment, those with Thymus disorder or a wide range of other clinical contraindications.

Meningococcal Meningitis ICVP.

Proof of vaccination is required for visitors to Saudi Arabia who visit Mecca and Medina during Hajj or Umrah, and is sometimes required by other countries such as Libya or Gambia during outbreaks. This is because with the sheer amount of pilgrims in such a small area (over 2.5 million Muslims attended Hajj in 2019 for example), there is a significant rise in public health risk.

This ICVP may look slightly different to the normal yellow booklet. If you have the yellow booklet when you recieve this vaccine it may be recorded in their, but if you don’t you may be issued with a seperate certificate that will be officially stamped by the prescribing nurse.

Polio ICVP.

For the exact same reason as the Meningococcal Meningitis ICVP, proof of vaccination in your yellow book may be required by certain countries if you are travelling from somewhere wehere there is a significant risk or outbreak, or for travel to certain events such as Hajj or Umrah.

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Related Articles.

Common Backpacker Illnesses And Diseases.

Everything You Need To Know About Travel Vaccinations But Were Afraid To Ask.

How To Decide What Travel Vaccinations You Really Need.

The Ultimate Guide To Travel Vaccinations.

What Vaccinations Do You Need?

Why Travel Vaccinations Are Important.

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 20 years travel experience, I am also a qualified nurse who specialises in emergency nursing and travel medicine.

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