Travel vaccinations

• Find out about disease risk — Estimate your risk for each destination. This may be an entire country or part of a country.
• You may need vaccinations for rich countries — You need to be properly vaccinated, even for travel to rich countries.
• You may already have some vaccinations — Know what vaccinations you already have and whether you need a booster for any of them.
• Pay special attention to Yellow Fever — You may be required to show an International Certificate of Vaccination for yellow fever if you travel from a “yellow fever country” to a country trying to block yellow fever. 

Too many travelers fail to get vaccinations recommended for their destinations. They figure that they got vaccinated as a child for all the most common diseases and that where they’re going isn’t so hazardous. Some of them are shocked when they end up bed-ridden, being treated for something they thought they were immune to.

You don’t have to be going to an unhygienic tropical destination to get sick with a preventable disease. A modest amount of homework into your vaccination history and research into what is recommended for your destinations is not so hard.

Travel vaccinations

In addition to the childhood vaccinations, there’s a smorgasbord of vaccinations recommended for various destinations.

Localized outbreaks

These diseases can occur almost anywhere outside the high-income countries.

• Cholera & typhoid — Because these water-borne diseases break out suddenly, there’s no reliable source of current information about them, not even the WHO or CDC. But there’s usually lots of local publicity about an outbreak. Talk to people and monitor the news — if you avoid the areas where the disease is breaking out, you can also avoid the vaccination. If you do find yourself in a place with a cholera or typhoid problem, reduce risk by consuming only bottled beverages and well-cooked food. Better yet, leave the area.
• Rabies — Should you get rabies vaccination before you go? Most travelers do not and it is quite expensive. Rabies is a bit of serious bad luck. Even rich countries have the occasional rabid raccoon, skunk or bat, although almost all human cases come from dog bites. There’s rarely any news about the presence of rabid animals. Your risk increases if you’re spending time in rural areas, especially forests and caves. If you are bitten by an animal — any animal — clean the wound immediately and get rabies shots as soon as possible. 

Our non-medical take is not to bother with vaccinations for any of these localized diseases unless you are deliberately putting yourself in a high risk situation and not practicing common sense.

Regional prevalence

You can get a general idea of disease distribution from this World Health Organisation map. The map is not entirely reliable. For much better information check the CDC site.

• Japanese encephalitis — Occurs in a wide belt of South, East and South-East Asia, PNG and northern Queensland, Australia. But unless you’re spending time around live pigs and chickens, your risk is low.
• Tick-borne encephalitis — Occurs in deciduous forest, even in most of Europe, during the summer. If your recreation includes forest activities like hiking and camping, there is a small risk. Consuming unpasteurized milk from infected animals is also a risk.
• Yellow fever — Occurs in a wide belt of north-central South America and central Africa.

Many other diseases — most notably malaria — have no vaccine. You avoid them by staying away from where they’re prevalent and/or modifying your behavior to reduce risk.

Where do you get vaccinations?

Your local public health authority will have the “routine” vaccines.

For travel vaccines, you should visit a travel clinic or specialized doctor. So many people are traveling to so many places now that you may be able to get even less common vaccines from a local clinic near your home.

The International Society of Travel Medicine has a searchable online directory of travel clinics worldwide. You do not have to log in as a member to search the database. If you can’t find a clinic nearby in the ISTM directory, ask a doctor (or the doctor’s receptionist).

Your International Certificate of Vaccination

Government health services and clinics issue “International Certificate of Immunization” documents — a yellow booklet where the vaccinations you receive are recorded. These are official documents and are sometimes required by immigration authorities upon arrival. You need the original booklet, not a copy (a copy should be in your digital vault).

Yellow fever is the main concern. Countries with a yellow fever problem will want to see your valid vaccination before allowing you to enter and other countries will want to see the vaccination when you are arriving from a country with yellow fever. For example, if you show up in a South African airport from another African country with yellow fever prevalence and cannot show proof of yellow fever vaccination, you could be forced to receive an expensive yellow fever shot on the spot. In some cases, they will even isolate you and put you on the next plane back where you came from.