Vaccinations required for long term travel

There’s so many benefits to travelling long term, but nothing in this world is for free, except for free stuff.

One of the downsides to travelling long term, besides making you think you’re cooler than all of your friends, is the health risks you expose yourself to. This is more prominent in some areas such as Southeast Asia, Central America, Africa and South America.

The vaccinations required for long term travel don’t differ a whole amount from region to region, there are certain risks that transcend specific areas which makes it easier to try organise yourself for multiple regions.

Of course you should always seek professional opinions if you’re travelling anywhere, for the most up to date information.

In this post I don’t only want to look at the types of vaccinations required for long term travel, but also I want to give some examples of the costs of the vaccinations required for long term travel so that you can make an informed decision on what is worth it to you and what is a bridge too far.

These costs are from personal experience, having recently gone through all of these vaccinations myself, and having the majority of the receipts to be as accurate as possible.

To help understand the vaccinations required for long term travel I will also briefly touch on the diseases that we as travellers are trying to avoid, and give out any generic health tips that spring to mind along the way.

Please use the table of contents at the top of this page to find the parts that interest you as this post will be long, detailing;

1. General health practices.
2. The types of diseases: Descriptions and whether vaccines are available.
3. The vaccinations I got: Including my reason for doing so, the cost I paid, the administration course, and any other relative things I think of.
4. The vaccinations I didn’t get – Including why I didn’t get them and whether you should.

Enjoy!

*Disclaimer

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Disease Overview

Diseases spread through a number of different ways, this can be magnified in less developed countries and regions. Access to clean drinking water for example is something that most of the western world would expect straight from the tap, but it isn’t the way things work.

There are some general health precautions that can lower the likelihood of you picking up a disease. To skip these, please feel free to use the table of contents above and go directly to the vaccinations side of things. This is all common sense.

Clean your hands before eating!
I use hand sanitiser personally to avoid using soap and water. These travel sizes are perfect and it doesn’t take much at all to clean your hands.

Water safety!
This is a good one to follow, but assume that tap water isn’t safe to drink unless told otherwise by a trusted source. Water can be contaminated even when it looks clean, this also applies to the ice in your drinks.

Any bottled water is more often than not perfectly fine, as are canned drinks and fizzy drink. However these leave quite the trail of trash, especially in somewhere as humid as Southeast Asia where the humidity is so high that you will always be drinking.

I use the GRAYL Geo-Press filtered water bottle (you can read about why in my packing list post) and also carry a spare filter to change to if I need to order another on Amazon. This does not make salt water safe, it still needs fresh water to work. Lifestraw is also a common brand with high regard, but must be consumed through the straw.

There are also water purifying tablets and UV light solutions that can be used instead, or as some people like to do, you can combine any number of these methods for super effective results and for your own peace of mind.

If you’re making tea or coffee, or are out camping, know that boiling water will make it safe and kill bacteria.

Food safety!
Raw food, food washed under contaminated water and food prepared on the same table as raw food are three things to watch out for.

A place with high turnover that is busy is more likely to be cooking to order and all produce is more likely to be freshly cooked, as well as being of a certain quality. However this doesn’t mean you need to avoid street food, which is often the cheapest, just have a look around and see what looks best.

Mosquito safety!
Wear long sleeves, long pants, loose fitting and repellent as required. Sleep in air-conditioned accommodation whenever possible and use sleeping net protection if it’s provided. Alternatively you can carry your own.

For more detail check out my malaria posts for Southeast Asia and the other for South and Central America.

Bodily fluids safety!
Use some common sense. If you’re not with a common trusted partner then use protection. There’s all sorts of things that can go wrong if you don’t.

It’s also important to have yourself tested so you know if you’re clean, because not all people show symptoms of carrying STIs.

These diseases can also be transferred through dodgy tattoo parlours, blood infusions in hospitals and intravenous drug use. Common sense is a necessity.

Food and water borne disease

Diarrhoea

Description: This can be caused by a number of things including salmonella and E. Coli. It is on the less serious side of things for the majority of travellers, but all travellers should carry medication in case of getting a severe problem that is hard to stop.

There are diarrhoea stoppers that are recommended for all cases except where blood is present. In this case antibiotics are needed. Rehydration is very important. Seek immediate medical aid if it does not fix itself within a day or two.

Vaccinations: N/A – Medications only.

Typhoid

Description: Typhoid is a disease spread through contaminated food or water that causes diarrhoea. Typhoid is common in developing countries with poor sanitation and limited access to clean water. It is common in parts of India, Africa, Asia, South and Central America and the Middle East.

Vaccinations: Yes

Cholera

Description: Cholera is found in places with poor water and waste services. It spreads through contaminated food or water and causes severe diarrhoea and dehydration.

The risk of acquiring cholera is very low. Cholera vaccination is not required for most travellers. Humanitarian disaster workers for example might get vaccinated as they’re at a much higher risk.

Vaccinations: Yes

Hepatitis A

Description: .Hepatitis A is a liver infection that causes jaundice, which results in yellow skin, a yellow tinge to the eyes and possibly yellow bodily fluids.

Most people in the developing world have immunity to it, but for travellers in developed countries, the body is not used to it and will be effected.

Vaccinations: Yes

Polio

Description: An illness caused by gastrointestinal infections. It was almost wiped out, but still remains prominently in Afghanistan and Pakistan, as well as some outbreaks appearing throughout the world.

Vaccinations: Yes

Mosquito borne disease

Malaria

Description:. Malaria is a potentially fatal disease that infects the liver and then the red blood cells. It can be treated if it is detected early. There are 5 strains that can infect humans, with P. Falciparum the most dangerous of them all.

It is spread by the Anopheles mosquito which is active from dusk until dawn. For more information on Southeast Asia malarial requirements or for South and Central America requirements click the links.

Vaccinations: No, but medications are available as preventative measures and as treatments after the fact.

Yellow Fever

Description:. A potentially fatal disease that is carried by mosquitoes in South America and Sub-Saharan Africa. It is often a requirement to be vaccinated to be allowed to enter certain countries, or to re-enter your country of residence after travelling to an effected area.

Vaccinations: Yes

Japanese Encephalitis

Description:. A rare but dangerous infection found in Southeast Asia, all the way up through Japan and Russia. Most common in the wet season in rural areas where ducks and pigs are also present.

It is spread by the Culex mosquito which is active in the evening and during the night.

Vaccinations: Yes

West Nile Virus

Description: Also spread by the Culex mosquito, this disease is found in Europe, North America, Central Asia and the Middle East.

It is a disease that can cause problems with your nervous system and it is becoming increasingly common.

Vaccinations: No

Dengue Fever / Zika / Chikunganya

Description:. These diseases are spread by the Aedes mosquito which is active during the day, unlike the Culex and Anopheles mosquitoes.

Dengue fever causes fever, rashes and body aches. Chikunganya is very similar with an emphasis on joint pain and Zika although not as dangerous to adult is very dangerous for unborn children.

This applies to not only pregnant women, but men and women who are planning on having children as well.

Vaccinations: No / No / No

People borne disease

Influenza

Description:. More commonly referred to as the flu. It is a very common virus that spreads throughout the world whether developed or not. Vaccines are updated every year to adjust to the differences in the disease.

The flu can be deadly, more common in the elderly, but it is not to be taken lightly.

Vaccinations: Yes

Measles / Mumps / Whooping Cough / Diphtheria

Description: Measles is the most contagious airborne disease in the world and poses a risk for travellers. It is wiped out in more developed countries.

Mumps, Pertussis (whooping cough) and Diphtheria are all airborne diseases that can be prevented with vaccinations.

Vaccinations: Yes

Meningococcal

Description:.Is dangerous and is spread through very close contact with an infected person, normally through mucus.

Symptoms include a rash and fever. Meningococcal can affect people of all ages, but can be prevented with vaccination. Meningococcal disease is treated with antibiotics.

Vaccinations: Yes

Hepatitis B

Description: Hepatitis B is a contagious disease, spread by body fluids from infected people. Hepatitis B affects the liver, with symptoms including abdominal pain and dark urine.

It is most commonly spread via unprotected sex.

Vaccinations: Yes

HIV / Ebola / Hepatitis C

Description:.These three are rare, usually contracted via sharing of needles, unprotected sex or sharing of bodily fluids in some way.

Vaccinations:.Ebola vaccine has recently come on the market as of December 2019. HIV has no cure. Hep C has a cure but no vaccine.

Other diseases

Rabies

Description: Transmitted through the bite, or saliva of an infected animal. If rabies goes untreated you will die. Animals that infect humans include but are not limited to;

• Dogs
• Cats
• Monkeys
• Bats
• Raccoons
• Foxes

The most common is from dogs and cats due to humans constant interaction with these animals. Avoid petting strays at all.

Vaccinations: Yes – However these do not offer immunity, they only grant you more time to seek treatment.

Tetanus

Description:. Tetanus is caused by a bacteria found in soil. It can cause muscle spasms and lockjaw. It can kill about 1 in 10 people who get the disease, so it definitely needs to be taken seriously.

Vaccinations: Yes

“As you can see he has a large area of autism that wasn’t present before the vaccinations”

Vaccinations required for long term travel that I decided to get

To give you a brief overview of costs involved and the reasoning behind some of the vaccinations I’ll share what I decided to get, why I decided to get it, and I’ll let you know what is involved in each vaccination administration. This will hopefully help you envisage what it is that you want from your trip, or decide what is a little bit too excessive and not worth your time or money.

I do recommend anyone who is planning to travel starts to consider these things at least 6 months before the departure date, as you will see some of the courses are spread out over longer time periods, while others involve just the one shot in the arm.

Yellow Fever

Name of vaccination: Stamril

Cost: $85 AUD

Administration: 1 Shot given at least 10 days before entering the area of risk *Live Vaccine

Lifetime: At least 10 years, but usually immunises for life.

My reasoning: I didn’t have a choice on this one. If you’re travelling to certain countries in Africa or South America then you need to be vaccinated to even get into the country in the first place. To be honest I’d have gotten it anyway.

Hepatitis A + Typhoid

Name of vaccination: Vivaxim

Cost: $130 AUD (for the one dose, does not include follow up Hep A shot)

Administration: Vivaxim is a combination vaccine. For Typhoid it is recommended you receive another immunisation every 3 years (if travelling).

Hepatitis A requires 2 doses, one is obviously administered here, then a second monovalent (Hep A only) vaccine is required 6-12  months after the initial shot for the complete course.

Lifetime: Protection from Typhoid will reduce over time and a booster dose is recommended every 3 years. Hepatitis A protection lasts at least 1o years, sometimes for life.

My reasoning: Hepatitis A is recommended for all travellers, it is one of the most easily preventable diseases for those visiting countries where there could be what is considered a less sanitary standard of food and water.

Typhoid I would have got regardless as it’s probably one of the essentials that are common to travelling all areas.

Hepatitis B

Name of vaccination: Energix B

Cost: $41 AUD (each time)

Administration: Course of 3 shots given on day 0, 1 month after, then finally 6-12 months after the original shot. There is an accelerated course that can be done in 4 months.

Lifetime: Hepatitis B vaccine, once the full course is done, should last for at least 10 years but is usually for life.

My reasoning: Again, this falls into the category of ‘vaccinations required for long term travel’ without question. It’s one of those essential ones.

Japanese Encephalitis

Name of vaccination: Imojev

Cost: $250 AUD

Administration: 1 shot *Live vaccine

Lifetime: 5 years

My reasoning: This to me was just a “why not”? It isn’t cheap by any means but if there’s a disease out there that I can protect myself against then I am likely to do it. It allows me a little more peace of mind to go into rural areas and at least be covered for one of the many mosquito borne diseases.

Measles, Mumps, Rubella (MMR)

Name of vaccination: Unknown

Cost: Free

Administration: 2 shots given 4 weeks apart (some adults only require one) *Live vaccine.

Lifetime: Reported to be for life against measles and rubella, but resistance to mumps is about 90%

My reasoning: This is a really common one that everyone should get. Regardless of travel or not. It is free in most countries in the western world and covered under immunisation schemes.

Influenza

Name of vaccination: Fluquadri

Cost: $25 AUD

Administration: 1 shot / year (only if you choose)

Lifetime: The flu strain changes every year, and every year a new shot is offered.

My reasoning: I actually don’t get this flu shot ever, I only decided to be safe because I was travelling and likely to be in busy areas, such as public trains and buses frequently, as well as possibly having a weaker immune system as I travel and have poorer sleep. So I decided to do it this year, but normally don’t bother if not travelling.

Diphtheria, Tetanus, Pertussis (Tdap)

Name of vaccination: Unknown

Cost: $35

Administration: 1 shot

Lifetime: You will have this as a child but it is recommended to do it again after 10 years.

My reasoning: So this I actually got this because of my recently born nephew. I think the branded version was roughly twice the price, this one did the same job. I would have had this regardless for travel as these three diseases are worth protecting against.

Polio

Name of vaccination: IPOL

Cost: $40 AUD

Administration: 1 shot

Lifetime: Booster doses are recommended every 10 years for adults at risk or going to at risk areas.

My reasoning: Before leaving the country, The Philippines had a brief outbreak of polio, so I decided to quickly add it to my list of vaccinations. It just goes to show that things can change quickly so it is best to be prepared.

Rabies

Name of vaccination: Rabipur

Cost: $115 AUD (each time)

Administration: 3 shots, administered on days 0, 7 and 21-28

Lifetime: Until bitten

My reasoning: There is no immunity to rabies. The vaccine only allows you to have a far less serious treatment course post bite then you would otherwise need without these infections. If you  have been immunised, you require 2 doses of rabies vaccine 3 days apart.

If you have not been immunised you will require 4 injections of HDCV vaccine over 2 weeks as well as a course of HRIG, which isn’t always carried in every city you might be in.

Since rabies is 100% deadly if untreated, I wanted to give myself the best chance should anything happen. The money seems like nothing if something goes wrong. I do also plan on being in semi remote locations where help is further away so it just made complete sense to me to have it.

Dogs like this roaming the beach are a commmon sight in some areas of Southeast Asia. However they should not be fed or approached.

Vaccinations required for long term travel that I didn’t bother with

There’s a number of vaccinations I didn’t get, because I deemed them to be a bit excessive, or unnecessary for the areas that I want to travel to.

Cholera

Name of vaccination: Dukoral

Cost: $55 AUD

Administration: Orally taken, liquid vaccine, 2 doses. 

The second dose is taken 6 weeks after the first.

Lifetime: 2 years.

My reasoning: This is an easy enough vaccine to do if you feel like you want to be covered, with the price being very reasonable. In saying this though, it was never recommended to me, it is often recommended to people travelling to areas such as India, Pakistan and the Middle East.

It may also be recommended for aid workers who will be exposed to unsanitary conditions throughout their work. If I ever need it, I can easily get covered.

Meningococcal / Meningitis

Name of vaccination: Nimenrix (for MenACWY)

Cost: $57 AUD

Administration: One shot.
**MenB vaccines are 2 doses, 8 weeks apart (Bexsero) or 6 months between doses (Trumenba).

Lifetime: 5 years.

My reasoning: For the regions of Southeast Asia and South or Central America, this isn’t generally recommended. It’s not expensive to do it if you want, but I considered it unncessary for now.

It is recommended for those going to sub-saharan Africa, or to visit mecca on religious gatherings. It is also a necessity to show you immunisation proof to get a visa to Saudi Arabia.

Those travelling to religious gatherings will often need to have extra vaccinations to protect from the close proximity to thousands of people.

My recommendations and things to consider

This hopefully has given you a lot of information to take home and consider when you think about what you might be doing on your holiday. This guide does not replace professional medical advice in any way whatsoever.

My own recommendations for all travellers are;

• Hepatitis A + B
• Diphtheria / Tetanus / Whooping Cough
• Typhoid
• Polio
• Measles / Mumps / Rubella
• Influenza

After all of these are done, many of which you might already have (but boosters might be needed), then you can look at some others. These I think are more dependant on your travel style;

• Yellow Fever (necessary for South/Central America and parts of Africa)
• Japanese Encephalitis (for those in Southeast Asia going to rural areas)
• Rabies (for adventure travellers who might be in remote areas with limited medical facilities)
• Cholera (for those heading to do aid work, or for those in India, Pakistan or locations with low quality water and sewerage standards)
• Meningacoccal (for extra safety, for those going to the ‘meningitis belt‘, or large religious gatherings)

With all of that in mind, there’s some things you need to consider when you start looking into vaccinations required for long term travel, such as;

Live vaccines

The consideration with live vaccines (MMR, Yellow Fever and Japanese Encephalitis) is that they either need to be given on the same day, or 4 weeks apart.

This means you might need to consider how exactly you will get through all of your vaccines if you are getting close to your departure dates.

Your age and country of birth

Depending on your date of birth, you may have had some of these vaccinations throughout school as a government initiative. A lot of these things changed through the 90’s, so your date of birth could mean you have more vaccinations at no cost to you before you even look at getting any for travel.

This will change from country to country on when these programs were introduced.

It also depends on how long you have gone since your last vaccination, for each separate disease, so this can only really be figured out by you and your doctor to decide the best course of action.

Starting early

If you need Hep A + B vaccines, you should be aware that the full course for adults requires doses 6 months after the original dose. Hepatitis B requires a dose in the middle of the course as well at the 1 month mark.

It is also recommended that these vaccinations have time to take effect, so generally will be taken a month before you enter the at risk areas.

Combination vaccines

There are a lot of these vaccinations that can be combined. For example – I had Hepatitis A + Typhoid combined, but my second dose of Hep A will not be the same drug, it will be a monovalent Hepatitis A vaccine.

If you have partially had some of the vaccinations already, it is important to consider which combinations you can have with your doctor, using your vaccination history to assist in coming up with a plan.

Do the vaccinations hurt?

After having the vaccination, it is recommended you rest for the rest of the day, have plenty of fluids, and wait at the medical clinic for 10 minutes after administration to make sure there are no side effects.

As far as pain goes, none of them hurt to get the vaccine.

The only vaccine that gave me a sore arm afterwards was the combined Diphtheria, Tetanus and Whooping cough vaccine. With all of the others, I often had one in each arm, so I could combine my live vaccines on the same day, and I was perfectly fine the following day. I was able to lift heavy things without drama.

My sources

That’s it from me folks, I hope this has been enlightening, because it wasn’t exactly fun to write because it is a very large post.

I know it won’t be the most interesting of subjects to read, but if you would like further information take a look at the immunisation handbook. This link goes to Hepatitis B, just as an example, but you can search for any disease, this website includes common vaccination names and administration doses.

The immunisation was used as my source only for the things I couldn’t cover from experience. I used my own vaccination handbook as well as receipts to give accurate prices and drug names, whenever I had the information.

Good luck and happy travels!

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