Readers often ask what I suggest about travel vaccines, and I have to chuckle a bit because in the past eight years, apart from a couple of trips to England to visit my husband's family, I've barely left the state of California, let alone traveled abroad.
Before having kids, I considered ‘seeing the world' to be my main life objective. As a teen, I collected travel brochures in a large box under my bed, and my wall was covered in a collage of images from the Eiffel Tower to the Taj Mahal and the Great Barrier Reef to the Northern Lights. These days, travel has been put on the back burner as I focus on more ‘domestic' adventures.
Despite the lack of recent stamps in my passport, I have done my research when it comes to travel vaccines, and here's what you need to consider…
If you've been reading Holistic Squid for a while, you may be surprised to learn that I don't live in the anti-vaccine camp. I do, however, feel that we need more information and consciousness before we just nod our heads to a battery of syringes filled with microbes and chemicals that often are doing more harm than good.
Though I find the instances to be increasingly rare, there are times when a vaccine may be a good idea – and foreign travel may be a good time to consider immunizations from strange and deadly diseases.
3 simple steps to deciding about travel vaccines
In his book, The Vaccine Guide, my colleague Dr. Randall Neustaedter, explains how to decide which travel vaccines make sense for you and your family.
- Figure out what illnesses you're at risk of catching in the specific area(s) you will be traveling. Certain countries require proof of vaccinations for entering, but most countries only recommend certain vaccines and do not actually require them. For official, up-to-date information check the official CDC recommendations here as well as a non-government site like TripPrep.com.
- Consider the likelihood of you catching an illness vs. the potential side effects of its vaccine. There is no point in getting a vaccine that is not needed, especially if there may be side effects. Do the risks of the illness outweigh the risks of the particular vaccine? This may vary depending on who may be getting the shot – children, pregnant women, and others with weakened immune systems should get special consideration.
- Examine the efficacy rate of the vaccine in question. Consider if the vaccine's efficacy is high enough to risk the side effects from it's associated vaccine.
Pretty simple. What can you catch? How likely are you to catch it? What is the efficacy and side effects of the vaccine in question? Weigh it out, add it up, and your decision should come into focus with more ease.
Where in the world?
Not every exotic destination warrants the need for inoculation, but there are certain areas of the world where your risk of exposure to illness is increased including underdeveloped parts of Latin America, Africa, and Asia. Studies show that your risk increases even more if you are exposed to rural areas that are off the usual tourist routes for extended periods of time.
Most illness experienced by travelers comes through exposure to contaminated water or transmission by a mosquito, so you need to consider the following factors: Will there be purified water available where you are staying? Will you be exposed to exotic animals or agricultural areas? How long will you be staying? Are you an adventurous eater? What will the sleeping conditions be?
While 50-75% of travelers to high-risk areas report experiencing some sort of health problem, less than 5% seek medical attention, and less than 1% require hospitalization. The rule of thumb: The more adventurous and off-the-grid you plan to travel, the more precautions you may want to take. (source)
Three common travel vaccines to consider
Let's have a look at Hepatitis A, typhoid, and yellow fever, which are often up for consideration when it comes to travel vaccines. Clearly this short list is not exhaustive, so be sure to use the three simple steps at the beginning of this post when considering what you may want to immunize against before traveling.
Hep A is a viral infection that affects the liver, but it is rarely fatal and does not cause chronic illness. It is most commonly acquired by ingesting contaminated water, ice or raw foods.
The side-effects of the Hep A vaccine are rare but serious, and children under 12 months cannot receive this vaccine. An alternative is to get an immunoglobulin (IG) shot which carries less risk, and has shorter but more successful efficacy than the vaccine. The IG will be effective immediately, lasts up to 4-6 months, and is safe enough to administer to infants.
Whether you decide to vaccinate, get the IG, or skip both of these measures, it is essential that you adhere to the following rules when Hep A is a travel risk: Drink water that is bottled or boiled – including ice in your drinks and the water you use to brush your teeth. Peel fruit yourself, and avoid raw foods or unsanitary street vendors.
Typhoid is an illness contracted through water that has been contaminated by sewage. Symptoms such as high fever, weakness and stomach pains can result, but it can be treated with antibiotics, and death from this disease is rare unless left untreated. Typhoid is most frequently acquired in underdeveloped tropical areas of Latin America, Asia and Africa.
The efficacy of the typhoid vaccine has proven disappointing with studies showing a success rate of 60-70% at best. If you use the same precautions listed above for avoiding Hepatitis A, you may decide to skip this vaccine, especially since it responds so well to antibiotics if illness should occur. (source)
Yellow fever is a very serious viral disease that can be transmitted through humans and/or monkeys via mosquitoes. Yellow fever can be fatal if left untreated.
Although this disease is very rare in travelers, flu-like symptoms accompanied by nosebleeds and rashes followed by jaundice, bleeding and death, are a great argument for vaccination if you are traveling in tropical areas of sub-Saharan Africa or South America and Panama.
Over 100 countries require proof of vaccination for yellow fever before you can enter – including for layovers longer than 12 hours, so be sure to check the latest list of current requirements for yellow fever vaccinations before you travel. A medical exemption is available for those with an allergy to eggs or any immunocompromised condition.
Though the risk of contracting yellow fever is quite small – especially for travelers, up to 90% of non-immunized travelers that are infected with yellow fever will die. Studies of the vaccine indicate efficacy from 75-95%, and while serious side effects have been reported, they are rare. (source)
Rather than freak out over every little mosquito bite, or cover yourself head to toe with DEET, it may be wise and far less hassle to vaccinate if you will be traveling in areas where the vaccine is required. For those who are medically exempt, the homeopathic nosode for yellow fever has historically proven to be an effective alternative. Consult with a qualified homeopath if you are interested in exploring this option.
Traveling with kids – special concerns to budding immune systems
The delicate and inexperienced digestive and immune systems of children are at greater risk of illness during travel, and are more apt to need hospitalization if they become ill. However, they are also more apt to have reactions to travel vaccines as well.
To best protect your child’s immune system, it’s probably ideal to limit international travel under the age of 1 year, and to avoid travel to high-risk areas.
For children over 1 – who have demonstrated good health and a strong immune system – the decision should be made on a case-by-case basis. If you are traveling to areas of the world that may pose a risk of infection, take extra precaution in considering the risks of exposure vs the risks of the vaccines, and only vaccinate if and when your child is strong and thriving.
Whether or not your child has been vaccinated, it is important to consider environmental risks that they may encounter. A common way that children acquire illness is through swimming in contaminated bodies of water, eating raw fruits and veggies, and drinking local water.
For kids and adults alike, even if you're vaccinated, don't throw caution to the wind. No shot is 100% effective and foreign travel will always be a tax on your system, because the microbes you encounter are new and foreign to your immune system.
With a little thought and preparation, the right remedies on hand during your trip, and a dash of luck, you might just have an illness-free adventure.
Got an experience or opinion to share about travel vaccines? Please share below!
Be sure to check out next week's post: How to Stock Your Holistic Travel Remedy Kit – where I'll cover everything from supplements to pack when visiting grandma's house to homeopathic nosodes to protect against exotic travel bugs.
For more information about travel vaccines and vaccine decisions in general, I highly recommend that you read The Vaccine Guide by Randall Neustaedter, OMD, which has been the main source of reference for this post. The Vaccine Guide provides a unique and deep perspective into the often over-whelming and confusing decisions about vaccines.