Know Before you Go: Travel Immunizations

Finally! You've gotten the chance (and income) to take that far-flung adventure. You've booked the flights; set the itinerary; bought the perfect backpack. But have you allowed adequate time to vaccinate yourself against local diseases? Don't spend your well-deserved vacation on a hard hospital bed. Read on for a brief overview of travel vaccines, from how they work to the most commonly recommended.

The Goal

Travel vaccines are administered to people who plan to visit less developed or dramatically different countries than their own. A vaccine is a variable or smaller dose of the same disease it combats. It stimulates the immunisation system to recognize the disease. If the actual disease is encountered thereafter, the body should (hopefully) be able to handle the infection better. The result of properly administered travel vaccines are travel immunizations; once you've been vaccinated for a certain disease, you're more likely to be immune to it.

The Administration

Although there are no specific travel clinic facilities in Malta, the National Immunisation Service Centre in Floriana is veritably the local travel health clinic. Visitors to the clinic must book an appointment to meet with a “travel doctor” or other immunising official. The clinician will assess the travellers needs and recommend a course of vaccines. The traveller then purchases their vaccines at a pharmacy. Finally, they return to the clinic to have the vaccines administered. The centre is open Monday-Friday, 8AM-1PM, and Saturdays from 8AM to noon. Their website is here.

The Essentials: Generally Recommended Vaccines

The actual vaccines you'll need before travelling depends on many factors: where you're travelling to; for how long; what you plan to do there; and your general health. While it's tempting to get every vaccine available, they can be expensive. On the flip side, just because a vaccine doesn't appear on a country's specific list doesn't mean you won't be susceptible to the disease. Below is a list of commonly recommended travel vaccines.

Hepatitis B: Although hepatitis B occurs in nearly every part of the world, it is found mostly in Asia, Africa, South America, and the Caribbean. It is highly recommended for people who plan to exchange bodily fluid or use needles in any way. For example, tattoos, piercing, acupuncture, and sexual intercourse can all transmit the disease. Symptoms include sudden fever, tiredness, loss of appetite, nausea, vomiting, stomach pain, dark urine, joint pain, and jaundice. Anyone travelling to developing countries ought be wary, as many hospitals there do not screen their blood banks.

Japanese encephalitis vaccine: As it's name suggests, this disease is relegated to Asian countries. More importantly, it normally occurs in rural areas. Travellers to Vietnam are recommended to take it; those to Shanghai are not.

Meningitis vaccine: Meningitis is particularly bad in Asian countries during monsoon months. It's a highly contagious disease most often spread when people live in close, cramped quarters, like hostels. It causes inflammation of the brain and spinal cord. Symptoms include headache, stiff neck, fever, and sensitivity to light. Of the two types, viral and bacterial meningitis, viral is rarely life-threatening. Bacterial can be, although it is rare. The easiest way to tell if meningitis is bacterial is by testing the rash with a drinking glass. If redness does not disappear when the rash is pressed by glass, there's cause for concern. Some countries, like Saudi Arabia, require proof of the vaccine upon arrival.

MMR Vaccine: MMR is an acronym for measles, mumps, and rubella. It's a generally recommended vaccine for young children that can be “boosted” before adults travel. When not treated, these three viral diseases can result in pneumonia; brain seizures; and meningitis. Rubella is devastating for pregnant mothers, whose babies are highly likely to be born with birth defects if the mother contracts this disease while the baby is still in the womb.

Pneumococcal vaccine: This vaccine, called by both names, immunizes travellers against the bacteria, Streptococcus pneumoniae. As well as serving as a Pneumonia vaccine, it also guards against meningitis and sepsis. Since many strands of the bacteria are actually drug resistant, it's recommended for only the most likely people to contract it: adults over the age of 65; adults age 19-24 who smoke or have asthma; and individuals with weakened immune systems. While this vaccine blocks against meningitis, which is a complication of the flu, it is not a substitute for influenza vaccine.

Polio vaccine: While polio vaccination largely eradicated polio across the world by 2015. However, it has always existed in Afghanistan and Pakistan. And, six more countries revealed cases since then: Equatorial Guinea, Lao People's Democratic Republic, Madagascar, Myanmar, Nigeria, and Ukraine. Anyone visiting those countries should receive a polio booster. More details about polio can be found on this CDC blog here.

Typhoid Vaccine: As one of the most contagious diseases, this vaccine is highly recommended to anyone travelling to developing countries. Typhoid is transmitted by contaminated food, water or ice, shellfish from contaminated waters, raw fruit, vegetables, and milk. In Malta, the typhoid vaccine costs something like €27 as as the time of writing this article.

Yellow fever: This viral infection occurs in 44 tropical countries in Africa and South America, especially sub-saharan Africa. Some South American and African countries won't actually accept travellers who can't show proof of the vaccination. Transmitted by mosquitoes, symptoms vary in severity; only 15% of people progress to more intense forms of the disease and only ½ of them perish. However, the number of reported cases has increased in recent years due to immunity to infection, deforestation, urbanisation, population movements and climate change. Symptoms include severe illness, bleeding, and jaundice. While there's disagreement regarding the necessity, many organisations recommend travellers who've already gotten the vaccination get “booster” shots before going abroad.

Rabies Vaccine: Rabies is only recommended for those travelling to rural areas or working with animals. Do note that it's also advised for people going to cities with poor healthcare and feral animals, as even animals in cities are potentially rabid.

The Resources

Two excellent websites for determining your vaccine requirements are the Center for Disease Control Travel and NHS Travel. The CDC website also provides excellent blogs on current changes in vaccine requirements and global outbreaks. The NHS website shows NHS travel vaccinations, recommended specifically for Western travellers abroad. The World Health Organisation also provides an excellent list of diseases and the countries with related requirements.

The Essentials: China

For anyone planning to travel to China vaccinations are essential. A Chinese tourism forecast predicts 143 million inbound trips to China in 2017, an increase of 3.5% over the previous year. This year the CDC and WHO recommend typhoid, Japanese encephalitis, hepatitis A and B, MMR, and pneumococcal vaccine. These vaccines must be administered 4-6 weeks before travel.

The Essentials: South America

While similar to those required for China, there are a few variants in vaccinations for South America. It is recommended that travellers vaccinate against tetanus, diphtheria pertussis, hepatitis A, and typhoid. In some localities it is also recommended to take meningococcal, meningitis, and malaria vaccines. Ultimately, the yellow fever vaccine is required for all visitors to South America, often with proof.