By Dr Eddy Bajrovic, Medical Director of Travelvax Australia.
“What’s my health worth?”
It’s a question you should ask yourself when you’re planning overseas travel.
The reality is that the medications and vaccinations that provide protection from the more common disease risks in developing countries aren’t cheap. Sometimes, they can run into hundreds of dollars.
That’s why during pre-travel medical consultations doctors like my Travelvax Australia colleagues and I not only explain to patients which of the vaccine-preventable diseases pose the most significant health risks for their particular journey, we also help them make choices within their budget.
But, travel vaccines shouldn’t be thought of as a one-off cost each time you travel.
Instead, look at them as a long-term investment.
Immunity is often lifelong
Vaccination won’t just protect your health on your next trip, but during the many journeys that (hopefully) lie ahead.
In fact, some vaccines last for life and continue to protect at a high level year after year.
There are 3 types of vaccines for travellers: routine, recommended, and required.
ROUTINE vaccines are begun in childhood and protect against diseases like measles, which are still common in many parts of the world (they are not common in Australia, but we’ve seen lots of cases ‘imported’ from overseas countries by infected travellers). Travelvax recommends that, where necessary that these vaccines be boosted prior to travel.
RECOMMENDED vaccines protect against diseases present in your destination but not common in Australia. The list for your trip will depend on a number of factors, such as where you’re going, the time of year, and the length of your stay.
The list of REQUIRED or mandatory vaccines is short. Proof of Yellow fever vaccination is required for entry into many African and South American destinations and for return to Australia, while meningococcal meningitis is mandatory for pilgrims attending the annual Hajj in Saudi Arabia.
Modern vaccines are highly effective
Among the highly effective and long-lasting vaccines that might be recommended to travellers are:
HEPATITIS A
The first dose provides high-level protection, while the second (and final) injection at between 6 and 36 months generates 100% immunity for 10-20 years – probably for life.
HEPATITIS B
A course of 3 doses provides life-long protection for nearly all infants and children (over 95%), and most adults under 40 (90%). Older people individuals may need a further dose. (A combination Hep A-B vaccine offers similar long-term protection.)
MEASLES, MUMPS, RUBELLA (MMR)
The MMR vaccine is 95%-plus effective after 2 doses. Depending on their age, most Australians vaccinated in childhood need only a single booster before travelling overseas. The protection is assumed to be lifelong.
TETANUS
For those who have received their routine primary course of tetanus vaccination (it’s part of the infant/childhood immunisation schedule),a single tetanus booster is protective in over 95% of individuals. Boosters are administered every 10 years for travellers who are travelling to countries where health services are difficult to access, or every 5 years for those who regularly engage in adventurous activities like mountaineering, bike riding, rock climbing, and caving.
TYPHOID
There are 2 vaccines: The injectable vaccine and the oral vaccine both protect between 50 -80% of travellers from disease. Both last for 3 years – among the shorter duration periods for modern vaccines. Although taking an extra capsule (4 instead of 3) of the oral vaccine can extend protection to 5 years.
YELLOW FEVER
The vaccine offers almost 100% protection. In May the WHO announced that while booster vaccinations currently are still required every 10 years due to international health regulations, the vaccine’s protection is now considered to be lifelong. (The vaccine needs to be administered at an approved yellow fever vaccination centre.)
RABIES
The rabies vaccine offers long-term immunity – possibly life-long – once the course of 3 doses have been given before travel. Rabies vaccination is normally recommended for travellers on longer journeys of a month or more to rural or remote areas of high-risk countries. (A fully-immunised traveller should still receive 2 doses of vaccine if bitten by a potentially rabies-infected animal while overseas. An unimmunised one needs 5 injections. The WHO does not recommend boosters for most travellers, only those at ongoing occupational risk, such as veterinarians, animal control and wildlife workers.)
Give yourself (and us) plenty of time!
For some vaccines like rabies and hepatitis B, more than one dose is required before travel. So, schedule your appointment 1-2 months before departure.
Historically, rabies and Japanese encephalitis were regarded as more specialised vaccines, reserved for expats and people planning longer journeys, or those in higher-risk rural occupations, rather than short-stay travellers.
However, these days a case can be made for at least considering having these 2 vaccines if you intend to regularly visit regional areas of Asia (where both diseases are very common) for several weeks at a time.
So, if you are planning overseas travel and still haven’t had the basic travel vaccines, ask yourself one more question: “Is this my last overseas holiday?”
If the answer is ‘no’, take the long view on safeguarding your health through vaccination.
You’ll not only be protecting yourself this time, but also the following trip. And, the one after that…
Contact Travelvax Australia’s travel health advisory service (1300 360 164) for country-specific information and advice, including possible immunisations, for your next overseas travel. You can also make an appointment to have your vaccinations completed in a consultation with a team of medical professionals experienced in travel medicine.