by Ricardo

On occasion we post important content from our book, The NuNomad. This post is one such excerpt.

This is the time of year when we get questions about pre-travel preparations. You know, the stuff you have to do before going. It’s when one is in their final weeks of preparing for that first big nomadic adventure that the pressure of getting your ?to-do check list? completed can disrupt one’s peace of mind like a pebble in a flip-flop. Yes, pre-travel preparations can be as maddening as it can be exciting. It could also be a bit trepidatious. Example: travel vaccinations.

Let me get the first question in your mind, Do I really need them? out of the way. It’s ?yes.” (Well, probably.) If you’re planning to base yourself in Western Europe, Australia or Canada, you may not need immunizations. But for most everywhere else, you’ll need the protection!

But don\’t get your knickers in a twist. The series of immunizations is not the daunting task you may think it is.

Let’s start with cost and where to get them. If you get them from the county or local government health department, the price may range from free (if your government is not the USA) to $150-250 USD. However, many private health insurance programs and HMOs often provide them to their members free of charge. (Note: be sure to get the International Certificate of Vaccination?yellow card?which records all of your vaccinations and the date you received them. Some countries may want to see your yellow card before they will allow you to enter.)

If you want to save some money, check to see if the country you’re heading to can provide travel immunizations cheaper than at home. If you’re traveling to a lesser-developed country, such as Thailand, you could save some big bucks. I got my last booster series in a hospital in Bangkok for a fraction of what it costs me at home (USA).

Okay, so what immunizations are recommended? Here’s our list!

The Nu Nomad List of Most Common Travel Vaccinations
(You may not need all of these.)

Immunization

Duration of Effectiveness

Cholera (optional, and you don’t get a lot of protection from it)
Japanese Encephalitis1unknown
Tetanus and Diphtheria5 years
Typhoid (injection or in tablet form)25 years
Hepatitis A (series of 2 vaccinations, over 2 months) 35-10 years
Hepatitis B (series of 3 vaccinations, over 6 months)5-10 years
Measles/Mumps/Rubella ? only 1 booster is needed once you’re an adult 4
Polio ? only 1 booster is needed once you’re an adult 5
Meningococcal Meningitis3 years
Yellow Fever10 years

1 The new JE Vax will be replacing the now widely used vaccine for Japanese Encephalitis. 2 The typhoid vaccine is either tablet or injection. In Asia it is injection since it is cheaper and doesn’t need a strict “cold chain.” If the tablets aren’t kept at the right temperature they don’t work. 3 The hepatitis A and B vaccines are now available in a single vaccine for those who need both, it means one less shot. 4 Those with HIV or immune suppression should avoid the MMR vaccine and the oral polio vaccine. 5 For the polio vaccine, it comes as either a shot or as an oral solution. The shot is safer, has less chance of side-effects, but is slightly less effective. The oral liquid is not recommended for those who have never had it before.

(

Special thanks

goes to Dr. Nick Walters, MD?tropical and preventive medicine specialist at Mission Hospital, Bangkok, for his help on this article.)

But wait! There’s more! If you plan to do a lot of trekking in places such as in Asia, Africa or South America, it is worth considering the rabies vaccine. It takes a month to give the series of three. However, if you get bitten by a rabid animal it is still vitally important that you get several more booster shots of the rabies vaccine, even if you’ve had the rabies vaccine before the incident. Any mammal can carry rabies.

Rabies cases are 100% fatal.

Additionally: If you are traveling during flu season, you may want to get that shot too. (The flu shot is yearly.) Those with lung problems or heart problems should have a pneumococcal vaccine once every 10 years. And a Tuberculosis test is a good one to have as well. (Be sure to keep your certificate showing the negative result.)

Want more Info? Check out The (US) Centers for Disease Control and Prevention .

What About Malaria? (I’ll cover that in my next article.)

Photo by: mksphotos

19 responses to “Before You Travel: Vaccinations You May Need”

  1. Vaccinations bring up a lot of differing opinions among people. I've always been the type to go for minimal medical intervention as much as possible. That said, I've been a dog lover all my life and yet in our last two nomading adventures to Costa Rica and Brazil I have been bitten by dogs each time. I would really take seriously considering the rabies vaccine if you're getting ready to travel.

  2. wanderlustjourney says:

    This is crucial information for any traveler, it's very important both for your own personal health but also for your enjoyment. You don't want to succumb to a disease while you're on vacation!

  3. joanna_haugen says:

    The vaccination part of travel is one part I wish we didn't have to deal with … no fun!

    I received one dose of my Hep A and two doses of Hep B within the allotted time period that you note above, but I just went to finish them both off (5 years later) and was told that it was okay that such a long duration of time had passed. I think you're supposed to have them within the allotted time that you've noted, but I don't think it's a requirement.

    • Thanks for reading, Joanna. It's interesting to hear that your doctor was ok with 5 years in between doses. It would be nice to feel like there were reasons for these guidelines to be firm but perhaps it's not so rigid.

  4. Lol, I think I've had them all and pumped the kids full of this stuff too. It worked though and none of us got sick:)

  5. Ayngelina says:

    I actually decided to get my Yellow Fever shot on the road. It was going to cost me $150 in Canada and I heard it was a fraction of the cost outside the country.

  6. Wow, Carmen, as a Waldorf family, I'm really surprised to see you so very conservative with vaccines as I know many world traveling Waldorf families who have never had one vaccine. Most are very anti-vaccine. I respect your view, but think it is also important to remind people that they do not have to get any vaccines and there are many world traveling people ( even doctors) who do not get any vaccines.

    It is a tricky issue and many have lots of views about them. This is my very favorite article about vaccines and travel:

    http://www.mothering.com/health/far-off-adventures

    I think we too often get hype when it comes to vaccines and the medical community. Like most things I think people should do their own thorough research instead of just relying on a travel clinic or MD that are not unbiased as they make money off of creating fear.

    Some of your facts are off here, I believe ( like the rabies).

    Sometimes ( and especially for some people) the vaccine can be riskier than the disease. Many people and babies have died or had serious harm done from the hepatitis vaccine ( some who had no risk factor for the disease).

    I had hepatitis ( eating raw clams in Haiti when young) …quite a severe case and did not even know it until I turned very yellow. Like most people I was symptomless and have had no problems with it since ( been over 30 years now and I'm still in great health). PLUS I got to pass REAL natural immunity onto our child via long term nursing. Yet many people have irrational fears about it. I had all the typical childhood diseases so also pass that REAL and natural immunity onto my daughter ( who will be able to pass it on to her kids when she breastfeeds them long term).

    That is the other point, vaccines do not guarantee immunity. so gives a false confidence. I've been through quite a few break outs and it is always the vaccinated kids who get the disease!

    One should check blood titers before getting any shots because sometimes we obtain natural immunity without ever having the disease.

    So far we have not done any vaccines and we have been to rural Morocco & Turkey ( I've been to Brazil, Russia, Ukraine, Haiti, Azerbaijan, Mexico, Georgia etc without any travel vaccinations or meds). My child has never had a vaccine in her life and is extremely healthy ( rarely even gets a cold). Our doctors have advised against getting any for our travels to Asia. There are also homeopathic and alternative medicines that you can take with you.

    I'm not suggesting nobody should get any travel vaccinations, but I think it really varies for each individual and one should realize that vaccines harm and kill people too ( and many say cause autoimmune diseases later on) so should be taken carefully. I've seen normal children turn into vegetables in families that I loved, after having a vaccination, so have seen it first hand. ( There are safer ways than others to take them and some vaccines are more harmful than others and some batches of particular vaccines are more dangerous than others. Some still have mercury in them like most flu vaccines ). Mixing vaccines tend to make them much more dangerous.

    The best defense against any disease is a good hygiene habits, good immune system, healthy eating and water.

    • Hi Jeanne,

      You're right that it is not our viewpoint being expressed here. You may not
      have noticed that the post is written by Ricardo, my partner at NuNomad with
      the help of an MD. I specifically asked Ricardo to keep the post in first
      person singular because I do differ with some of the views expressed. I
      also mentioned that in my comment about rabies. However, Ricardo did double
      check the rabies facts and we had the guidance of a doctor in writing this
      so I feel fairly confident that it reflects current medical (albeit
      mainstream, western medical) practice.

      NuNomad

    • Soultraveler3. Though I'm the author of that post, I often shy away from immunizations that are not considered either essential or considered proven effective for the region I'm in. (My next article on Malaria, due out next week, will touch on this.) I like that you're highlighting the fact that immunizations are not for everyone and for every location. But since I tend to live in more remote places in Southeast Asia, where a lot of diseases are prevalent, I tend to recommend caution for those who stay off the beaten path. I know you've been all over the globe quite a bit, so I'm guessing that your immune system (which I believe mine is) may be stronger than newbie nomads.

      Anyway, thank you for taking the time to comment and for offering another perspective on the subject. (Which is why blogs are so great.)

      • Thanks Ricardo. I respect your perspective and know it is the majority view, but did just want to add my thoughts to show that there are many ways to look at this issue. I just wish people would look deeper into this issue and not just do them automatically without any deep research. It is a personal choice with no easy answers as there are risks with every choice.

        Nunomad types tend to be out-of-the-box thinkers and would benefit by thinking out of the box here and doing due diligence with their research.

        Sadly, many people are not even aware that they have a choice & do not have to do ANY vaccines or that HOW one gets vaccines ( if one chooses to do so) can make a BIG difference ( and lower risks).

        I love these quotes by the doctor who wrote the piece I linked to:

        “I have been a globe-trotter for most of my adult life. In the past 25 years, I have traveled to more than 40 countries. I have never been asked for a vaccine record, nor have I ever felt the need for any vaccines, even when traveling to remote, exotic destinations.”

        “For most diseases around the world, common-sense precautions are the best way to stay healthy. Since for nearly every destination in the world vaccinations are only recommended, not required, a trip to your doctor for vaccines is one item you can cross off your pre-trip “To Do” list. Go and have fun!”

  7. Thanks Carmen for clarifying that.

  8. Jadam939 says:

    Its amazing how people who are not knowledgeable about a field want to believe that they can do some quick internet research and then know enough to dispute doctors. There is no extra “hype” about vaccines. You need to get them. Or, you can travel to Nigeria or Uganda or India and don’t, but do not complain if you get Polio or hepatitis. Now, just because you don’t get vaccinated doesn’t mean that you will catch the disease when you step off of the plane. But why take the stupid risk. I’ve known people with hepatitis. While some have no symptoms, others are VERY SICK. And even if you have no symptoms, you are spreading it to others.

    BTW, I believe some of the info up top is incorrect.Typhoid fever vaccination injections are only good for 2 years. I work in an office that actually gives travel vaccinations and provides standard primary care. If you knew how many people didn’t know they had hep b or c (no vaccine for hepatitis c though) who didn’t know until we did our screening you’d be surprised. They had no symptoms, but they had passed it on to their multiple sex partners who may have had symptoms–they weren’t our patients.

    • Richard Hamel says:

      Jadam,

      One certainly can’t fault someone for siding on caution. When it comes to travel vaccinations, I get them all. I’ve spent enough time in such places as India, Burma and Sri Lanka to know that only the imprudent (unless one really knows their body well) do not take the recommended precautions before entering such undeveloped countries. But the Internet is like any other important resource: the information offered depends on the source and reputation. Case in point. The Centers for Disease Control provides a list of travel immunizations on their website?which is where my list originated from. I believe them to be a reliable source for information. And though you are correct to say that one should get a Typhoid Fever booster shot every 2 years, that requirement depends on the vaccine used.
      According to the CDC (source located at: http://www.cdc.gov/nczved/divisions/dfbmd/diseases/typhoid_fever/) If one is receiving the ViCPS (Typhim Vi, Pasteur Merieux) vaccine, then boosters should be done every 2 years. However, if one is receiving the Ty21a (Vivotif Berna, Swiss Serum and Vaccine Institute)vaccine then boosters should be done every 5 years.

      But I also use more traditional sources of information as well for much of my research. When I created the vaccination table, which I pulled from the CDC, I ran it by Doctor Nick Walters at Mission Hospital in Bangkok. Dr. Nick (as he is known) is an American physician who is a tropical and preventive medicine specialist.

      So, thank you so much for your feedback and for pointing-out that there is a potential conflict in the Typhoid Fever booster recommendations. No doubt one should check with their health care professional on when to get their next booster.

  9. Elvis Scnither says:

    Vaccination is very important before traveling, but i suggest to buy a travel insurance for your safety travel, its your for own good.

    Visitor Insurance</a

  10. Gue5t says:

    Stay healthy on your next trip abroad. Different countries have different health risks. It is
    possible to get travel vaccines at a samedaydoctor clinic. http://www.samedaydoctor.co.uk

Leave a Reply

Your email address will not be published. Required fields are marked *