What Shots do I Need?

Travel Shots

Before you venture off to a different country it is always a good idea to investigate the travel shots you need before you take off. While there should be a simple answer to what vaccination you need before you go, this answer has generated great anxiety and uncertainty among both backpackers and medical professionals. Unfortunately the answer is- “it depends”. Most doctors will immunize you based on your exposure to risk as opposed to where you are going. Doctors will generally asses your propensity to risk based on a number of factors:

  • Age – certain age groups are more susceptible to diseases or engage in high risk behavior;
  • Duration of trip - i.e. 2 weeks vs. 6 months;
  • Goal of trip - will you be immersed in a local community i.e. are you volunteering;
  • Time of year; and
  • Location – some diseases such as Japanese encephalitis are only found in rural areas vs. diseases such as dengue fever are generally found in urban areas

Therefore, its always good to spend the extra money and visit a travel doctor before you head out to ensure you have your bases covered. This list provides a general catalog of all necessary travel shots.

Travel Shots:

Yellow Fever (Compulsory)

This disease is transmitted through a mosquito and attacks your liver. Due the high mortality rate associated with this disease, it is required in several countries in Africa and Asia. Travelers to these countries are often asked for vaccine certification in order to receive entry to the country. The vaccine works within 10 days of the travel shot and provides protection for 10 years.

Countries where the yellow fever vaccination is compulsory:

  • Angola- a yellow fever vaccination certificate is required from travellers over 1 year of age.
  • Benin- yellow fever vaccination certificate is required from all travellers over 1 year of age.
  • Brunei Darussalam-yellow fever vaccination certificate is required from travellers over 1 year of age coming from countries with risk of yellow fever transmission or having passed through areas partly or wholly at risk of yellow fever transmission within the preceding 6 days.
  • Burkina Fasco- a yellow fever vaccination certificate is required from all travellers over 1 year of age.
  • Burundi- Country requirement: a yellow fever vaccination certificate is required from all travellers over 1 year of age.
  • Cameroon- a yellow fever vaccination certificate is required from travellers over 1 year of age.
  • Central African Republic- a yellow fever vaccination certificate is required from travellers over 1 year of age.
  • Congo- a yellow fever vaccination certificate is required from travellers over 1 year of age.
  • Cote D’Ivorie- a yellow fever vaccination certificate is required from travellers over 1 year of age.
  • Democratic republic of the Congo (formerly Zaire)- a yellow fever vaccination certificate is required from travellers over 1 year of age.
  • Fiji- a yellow fever vaccination certificate is required from travellers over 1 year of age entering Fiji within 10 days of having stayed
    overnight or longer in countries with risk of yellow fever transmission.
  • French Guiana- a yellow fever vaccination certificate is required from travellers over 1 year of age.
  • Gabon- a yellow fever vaccination certificate is required from travellers over 1 year of age.
  • Ghana- a yellow fever vaccination certificate is required from all travellers.
  • India- Anyone (except infants up to the age of 6 months) arriving by air or sea without a certificate is detained in isolation for up to 6 days if that person (i) arrives within 6 days of departure from an area with risk of yellow fever transmission, or (ii) has been in such an area in transit
  • Malaysia- yellow fever vaccination certificate is required from travellers over 1 year of age coming from countries with risk of yellow fever transmission or having passed through areas partly or wholly at risk of yellow fever transmission within the preceding 6 days.
  • Mali- a yellow fever vaccination certificate is required from all travellers.
  • Niger- a yellow fever vaccination certificate is required from travellers over 1 year of age.
  • Rwanda- a yellow fever vaccination certificate is required from travellers over 1 year of age.
  • Sao Tome and Principe- a yellow fever vaccination certificate is required from travellers over 1 year of age.
  • Sierra Leone- a yellow fever vaccination certificate is required from all travellers.
  • Singapore- certificates of vaccination are required from travellers over 1 year of age who, within the preceding 6 days, have been in
    or have passed through any country with risk of yellow fever transmission.
  • Togo- a yellow fever vaccination certificate is required from all travellers over 1 year of age.

For more information regarding compulsory vaccination please visit the WHO’s Country list: Yellow fever vaccination requirements and recommendations; and malaria situationhttp://www.who.int/ith/ITH2009Countrylist.pdf

Meningococcal disease (Compulsory)

This disease is transmitted from person to person through close contact (such as coughing, kissing, sharing food). At first it appears as a mild illness but it quickly progresses into a life threatening disease resulting in shock or coma. This travel shot is recommended to all travelers traveling to areas where the disease is highly prevalent. The “meningitis belt” in Africa presents a high risk to travelers during the winter season between December to May when outbreaks are widespread. As well, due to previous outbreaks, pilgrims to Saudi Arabia must get this shot. This vaccine is highly effective and lasts anywhere from 3-5 years.

Malaria (oral medication)

This disease results in a parasitic infection of the bloodstream and is transmitted through the bite of the female anopheles mosquito. While symptoms may begin to spring up as soon as 10 days after infection others do not experience symptoms until weeks later. Malaria is very hard to differentiate from the average flu; however, Malaria suffers will often experience a high recurring fever. Unfortunately Malaria is prevalent is many parts of the world in both rural and urban centres and it is usually seasonal. Anti-malarial medication does not prevent malaria rather it controls the symptoms of the infection by killing the parasites either in the liver or as they leave the liver and enter the bloodstream.

I used both Doxycycline and Malarone and had no adverse symptoms to either. Doxycycline must be taken a  day before entering a malarious region and 4 weeks after leaving. This drug should be taken with plenty of water and taken at a time when you will be standing/ sitting up for at least 2 hours as it can irritate your esophagus or even get caught in your esophagus giving you days of awful heartburn. It also causes photosensitivity, diarrhea, stomach aches and may cause women travelers to suffer from yeast infections. Malarone, the newer anti-malarial pill is essentially symptom free and must be taken only a day prior to entering a malaria filled region and 7 days after leaving the malarious region. While this pill is great it is very pricey (at almost $5 a pill) therefore it is only recommended for those taking short trips.

You can protect yourself against malaria by:

  • Wearing light coloured clothing- you are less likely to be bitten by a mosquito if you are wearing white.
  • Sleeping under a mosquito net
  • Using bug repellent such as DEET

Typhoid (highly recommended)

This bacterial infection is transmitted either though infected blood or water. The incubation period lasts anywhere from 7- 20 days and symptoms include: headache, fever, cough, abdominal pain and more serious reactions include neurological problems and bleeding from the bowel. The vaccines are about 70% effective and last up to 3 years.

Hepatitis A (highly recommended)

This viral infection which attacks the liver is transmitted through infected water or food or through person-to-person contact. After the incubation period which lasts a few weeks, victims of this disease can suffer a range of symptoms including: nausea, fever, weakness and fatigue followed by jaundice. This travel shot should be administered at least 2 weeks prior to departure and the individual should receive a booster shot 6-12 months later which will protect the patient for up to 10 years.

Hepatitis B (highly recommended)

This viral disease attacks the liver and is transmitted through infected blood and unprotected sex. This disease differs from Hep A due to its ability to cause severe acute or chronic  liver disease.

Cholera (depends on risk exposure)

This bacterial infection of the small intestine is passed on through infected water or food and causes diarrhea and may result in death. This disease is not common among travelers who stay on the beaten path, do not venture into regions where there has been a cholera outbreak and are are wise about the water they consume.

Japanese Encephalitis (depends on risk exposure)

This viral infection which attacks the brain is common in rural areas of Southeast Asia and Asia. It is transmitted by mosquitoes and is prevalent in where there is rice paddies and pig farming. Most cases involving travelers are asymptomatic; however, this disease can cause both death and disability.

Rabies (not necessary prior to departure but if infected, the vaccine is required to prevent fatality)

This viral infection is transmitted through a bit, scratch or even a lick from an infected animal. Rabies attacks the nervous system and is fatal without proper pre- or post exposure vaccination. This problem is particularity prevalent in countries/ cities where stray dogs, cats and even monkeys ran rampant. If you get bit, wash the wound immediately with soap and water then head to the nearest hospital to receive the vaccine.

Tick-Borne Encephalitis

This viral infection attacks the brain and is transmitted through ticks which jump off of plants and trees onto unsuspecting passersby. It is commonly found in rural areas of Eastern and Western Europe. The vaccine consists of 2 doses administered 1- 3 months apart.

There are an array of travel shots any traveler may require – make sure you visit your travel doctor before heading abroad.

Backpacking Bex