10 Vaccines You Might Need Before You Travel

woman riding bike in front of ruins in Thailand

 

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You should visit your doctor before taking any far away trips. These are some of the vaccines he or she may want you to consider.

Typhoid

Typhoid is a common and serious bacterial infection around the world. It is spread when there is not enough sanitation, no clean toilets, and through contaminated food and water. It can cause persistent fevers, abdominal pain, diarrhea or constipation, loss of appetite, headache, and rash. Typhoid can be fatal and can require emergency abdominal surgery.

Especially in Southeast Asia, Typhoid is becoming increasingly resistant to antibiotics. Treatments, though available, may not be effective. It is best to try to prevent infection through vaccination before traveling to many parts of Asia, Africa, or Central or South America.

Hepatitis A

Hepatitis A is transmitted by contaminated water or food, especially shellfish or food touched by a cook or other food worker who is sick. It also occurs where sanitation and hand hygiene do not protect against it. It is a virus that causes liver diseases characterized by mild fever, joint and muscle pain, diarrhea, and then later abdominal pain, dark urine, pale stools, and yellow eyes and skin—also seen under the tongue.

Hepatitis B

Hepatitis B is a disease that can cause serious liver damage that is transmitted through blood exposure, sex, or needles. Those who are sexually active with a new partner, work in a medical clinic, plan for a tattoo or piercing, or plan to have a medical procedure should be vaccinated. The vaccine is routine at birth or in childhood in the US and many adults who were not vaccinated are routinely encouraged to be vaccinated.

Rabies

Rabies is a virus that comes from bites, licks, scratches, or other contact with infected animals and/or their saliva. There is little effective treatment so vaccination pre-exposure, as well as post-exposure before symptoms, are vital.

The virus (and sometimes a similar disease-causing, related virus) is largely found in dogs and bats in parts of Africa, Asia, and Central and South America. It can be found in other mammals, from cats to weasels to monkeys. In the US, cats are more likely to have rabies than dogs. Much of Europe, New Zealand, Australia, Antarctica, and the Caribbean (except Haiti and the Dominican Republic) are rabies-free.

The vaccination series takes three shots so you may need to plan ahead three weeks before travel. The vaccine can be expensive. However, rabies vaccines are not available everywhere in the world and if you are exposed you may need to evacuate quickly (in a day) for vaccination back home.

Polio

Polio is a virus that has almost been eradicated. However, vaccination is needed if one is traveling to any areas with currently circulating polio. As of 2018, only three polio-endemic countries (countries that have never interrupted the transmission of wild poliovirus) remain—Afghanistan, Nigeria, and Pakistan, according to the Centers for Disease Control and Prevention (CDC). Polio can also be found in the water, where it can be spread. There have been sightings in the past few years in the water in Israel and the West Bank, as well as India, and elsewhere.

However, wildtype Polio infections have only been found in two countries since 2015—Afghanistan and Pakistan. This is important. The virus can be eradicated.

For travel to these areas, a complete series and one booster shot for adults is needed. Vaccination is also recommended for travel to areas at risk for importation of polio such as Angola, Benin, Camaroon, Central African Republic (CAR), Chad, Xinjiang province in China, Djibouti, Egypt, Eritrea, Ethiopia, Ghana, Ivory Coast, Niger, Nigeria, Philippines, Republic of Congo, South Sudan, Sudan, Togo, Turkey, and Yemen.

Yellow Fever

Yellow Fever is a rare but serious viral infection spread by the same mosquitoes that spread Dengue. It is only found in a limited number of countries. Most have no symptoms or only mild symptoms. But some die. Some, three to six days after exposure, will have a high fever, headache, nausea, vomiting, muscle aches, and loss of appetite. About 15% of those with symptoms will go on to have jaundice, kidney failure, and bleeding; as many as half of these individuals will die. There is no specific treatment.

The vaccine is usually required for entry to countries with Yellow Fever—or travel from countries with Yellow Fever to another. These countries are largely in Central and West Africa and many areas of South America, particularly in the center of the continent and in the Amazon.

The list of countries that require Yellow Fever vaccines in any given year is provided by the CDC. Because the virus is not found throughout all of the countries listed, but sometimes only in certain areas, the vaccine may not be required for all travel. However, travel to many of these countries or from these countries often requires documentation of the Yellow Fever vaccination. The vaccine needs to be taken 10 days before travel. It may be difficult to find the vaccine and so planning ahead of time is helpful.

Japanese Encephalitis (JE)

This infection is rare and most infected do not become seriously ill, but for a few the infection is quite serious, debilitating, and sometimes dangerous. The virus, which can cause serious neurologic problems, is found in parts of Asia, including China and India.

Talk to your health care provider if this vaccine is needed for your travels. The vaccine given in the US requires two doses 28 days apart with the final dose one week or more before travel. It is not needed for all travelers to affected countries as transmission may not occur in all parts. For those traveling outside of urban areas for at least one month during the JE transmission season, the vaccine is more important, but it can be important for some short-term travel as well. It is licensed for those two months of age and older. Booster dosing may be needed.

Malaria

Malaria does not have a licensed vaccine. You should talk to your doctor about starting prophylaxis for malaria before you leave.

Dengue, Chikungunya, and TB

There is no vaccine. Be careful about mosquitoes in areas that might have Dengue or Chikungunya.

Zika

There is no vaccine for the Zika virus, but you should try to avoid mosquitoes, just like for malaria, dengue, and chikungunya, especially if you, your partner, or a future partner are pregnant or thinking about becoming pregnant. The virus can be spread by mosquitoes and by sex. Here are the symptoms of Zika.

Vaccinations You Should Be Up-to-Date With

Measles-Mumps-Rubella (MMR) 

You should have had two shots. If you are traveling with young children, they should have their vaccines early. If your child is between six months and a year, s/he should have one dose. If your child is at least one-year-old, s/he should have two doses (separated by 28 days), even though the two doses are usually given at 12 to 15 months and 4 to 6 years. You do not want to get Measles or let it spread to those who are more vulnerable.

Varicella (Chickenpox)

If you haven’t had the infection, you should get the vaccine.

Diphtheria-Tetanus-Pertussis 

Make sure you have had a tetanus vaccine in the last 10 years. Those who have a dirty wound and haven’t been vaccinated for tetanus in the last five years (10 years for a clean wound) will need a repeat tetanus vaccine. For this reason, some accelerate their tetanus boosters. You also don't want to get Diphtheria or Pertussis—or spread them to someone more vulnerable.

Influenza

You should have your annual flu shot. Don’t forget it may be winter in the other hemisphere. The influenza vaccines for the southern and northern hemispheres are chosen at different times but usually include similar strains. You wouldn't want to catch the flu and have a big work up for a tropical disease.

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