Depending on where you are going, you might not need any vaccinations at all. On the other hand, you might need two arms worth. For many forms of international travel, getting stuck by a bunch of needles is a rite of passage.
Here you will find: what travel immunizations and vaccinations you need to get for your destination, where you can get them, how much they cost, and different options for getting them cheaply.
What Travel Immunizations do you Need?
First of all, let’s just clear something up. Are we talking vaccinations or immunizations here? Well. Immunization is the process of becoming immune to something and it can happen from a vaccination (a weakened or non-live form of the disease) or an inoculation (live organism which will produce a mild form of the disease). Inoculations are uncommon and everything we will be discussing in this post is a vaccination.
Before we talk about travel vaccinations, there are a number of vaccinations that you should have already. Or maybe you don’t, in which case it would be a good idea to get them. In some cases, you may need a booster shot.
Routine vaccinations that are recommended for adults
- Tetanus, Diphtheria and Pertussis (whooping cough) – combination vaccine that requires a booster every ten years
- Measles, Mumps, Rubella (MMR) – 2 dose vaccine (one month apart) that gives you immunity for life
- Varicella (chickenpox) – 2 dose vaccine (for best efficacy) that gives lifetime immunity. If you have had chickenpox you also have lifelong immunity and don’t need a vaccine.
- Hepatitis A and Hepatitis B – Each involve a series of 3 shots. Hep A calls for a booster every 20 years, Hep B every 10. If you do not have the Hep A or Hep B vaccine, you can get the TWINRIX vaccine, which will cover both of them in the same series (instead of 6 shots, you only have to get 3).
- Polio – One dose as a child and one booster as an adult gives lifetime immunity. Many adults have not received their adult booster and it will be strongly recommended that you do so before traveling.
- Meningitis (meningococcal disease) – meningococcal disease is a bacterial infection that can lead to bacterial meningitis (the most dangerous and in many cases, lethal, form of meningitis). It is found worldwide, but cases are rare. It is transmitted via respiratory secretions (via coughing and sneezing) and saliva. The vaccine is one dose and it is good for five years. For travelers, this vaccination is recommended for people traveling to the meningitis belt in Africa. Also, religious pilgrims to the Hajj in Saudi Arabia are required to have had a meningitis vaccine within the past three years. High risk areas map for meningitis from the WHO.
There are other vaccinations that may be considered routine, depending on where you live. Influenza is a common yearly vaccine to prevent against seasonal flu. The PCV or Pneumococcal vaccine is typically given to children, elderly and those with compromised immune systems; it provides immunity against pneumonia. Increasingly, meningitis is recommended as a routine vaccination as well (we will mention it again as a travel vaccination).
Travel vaccinations and the regions where they are recommended or required
- Yellow Fever – yellow fever is a mosquito borne disease found in tropical areas of Latin America and Africa. It is a one dose vaccination and it is good for 10 years. For some countries, a yellow fever vaccination is required to enter. Read our article on yellow fever to see where it is required.
- Typhoid – typhoid is a bacterial infection caused by eating contaminated food or drink. It is found in most developing world countries. If you are traveling to Eastern Europe, Asia, Africa or Latin America, a typhoid vaccination will be highly recommended. There are two vaccination options: an injection and an oral vaccine. The oral vaccine provides immunity for four years and the injection provides immunity for two years.
- Rabies – rabies is an infection of the central nervous system caused by the bite, scratch or in rare circumstances, the lick of an infected animal. Without treatment, rabies is considered 100% fatal. That said, many travelers do not get this vaccine. It is one of the more expensive vaccinations — and it involves a series of 3 jabs – and even with the vaccination, you need to get additional injections if you become infected. In other words, the vaccination does not confer immunity. What it does do is buy you some additional time to get post-exposure treatment and it typically lessens the amount of treatment you need. It is highly recommended for those who will be frequently exposed to animals, especially in rural areas that may be far from a clinic. Bottom line: whether you have the vaccine or not, post exposure vaccination is required and it is highly effective, provided you get it in time (treatment within 48 hours is thought to be near 100% effective). Read our article on rabies information for travelers and be sure to talk about the vaccine with a doctor. Rabies distribution map from the WHO.
- Japanese Encephalitis – japanese encephalitis is a mosquito borne disease found in rural areas of Asia and Southeast Asia. It is most prevalent during the months of May – October. It is rare in travelers, but vaccination is recommended if you are traveling to affected areas during the mentioned months and spending most of your time in rural areas, because 20-30% of clinical cases result in death and some level of physical or mental disability occurs in up to 50% of cases. A new vaccine, IXIARO, is available and it is more effective and more easily tolerated (less side effects). It is given in two doses, 28 days apart. A booster is suggested after two years. Japanese encephalitis distribution map from the WHO.
Got all that? Good.
Can travel vaccinations make you sick?
Most travel vaccinations do not have significant side effects. When you go to the travel health doctor to have them administered, it will be explained to you that if any severe reactions occur, you will need to return to the clinic immediately. That said, severe reactions are rare. Yellow fever has a reputation of being a painful injection and you may have a sore arm for a day or two. In some cases, a low-grade fever can be contracted along with some muscle aches.
How much do travel vaccinations cost and where can I get them?
Travel vaccinations can be very expensive, depending on where you get them. The average traveler can spend several hundred dollars if they need all the recommended immunizations.
If you are a first time traveler or if you are visiting a developing world country for the first time, you should have a consultation at a travel health clinic. This site is no substitute for talking to an actual doctor.
At a travel health clinic, a doctor will discuss your destination and the health risks you will face. They will also recommend the appropriate vaccines, explain their effectiveness and talk about possible side effects.
Before getting any vaccinations, check to see which ones you have and whether your current health insurance covers any of the ones that you need. If you don’t have a record of your immunizations, call your primary care doctor. Many health insurance policies will cover tetanus, diphtheria and pertussis, and polio booster shots, which you may need. In rare cases (but it is worth asking), health insurance will cover travel-specific vaccinations like yellow fever.
Private health clinics will cost the most money and they are not covered by most health insurance policies. Inquire by phone to get exact prices for the office visit and the vaccinations themselves. To find a travel health clinic, check out the directory at the American Society of Tropical Medicine and Hygiene or the directory at the International Society of Travel Health Medicine. For US residents, we recommend Passport Health.
State and county health clinics are significantly cheaper than private clinics. There are many government run clinics that offer travel immunizations for significantly less than private health clinics. If you are a US resident you can use this directory from the CDC to access your state’s department of health website. More useful even is the CDC’s directory of Yellow Fever Vaccination Clinics, which provides addresses and phone numbers to the clinics directly. Clinics that offer yellow fever vaccinations should offer other travel immunizations as well, but you should double check by calling ahead. This way, you can also find about pricing.
Some travelers save hundreds of dollars by getting their immunizations outside the country. Depending on your destination, you may be able to have a thorough travel health consultation and get the recommended vaccines for as much as a fifth of the cost! Just have a look at this post from Johnny Vagabond. Make sure you research your destination before hand to find out whether this is possible or not. Also consider that some countries do not let you in if you don’t have a yellow fever vaccination. See this article for a list of those countries.
Note: this section on cost of travel immunizations was written with US residents in mind. If you live outside the US there is a chance you can get many travel immunizations for free or at a greatly reduced cost. Consult your health insurance policy or national health policy, as it may be, or a local clinic.
Other Considerations
Most vaccines can be administered simultaneously
Most vaccines that use inactive or dead forms of a disease, can be administered simultaneously. In other words, you can get as many jabs as you want in one sitting. Fun! Live vaccines, however, are typically administered several weeks apart to ensure immunity (examples: oral polio vaccine and oral typhoid vaccine).
Vaccines are not 100% effective
Vaccines vary in their efficacy, but the bottom line is this: no vaccine provides 100% immunity. If you have received the vaccination for typhoid, for example, you should still be mindful of what you eat and drink, making sure that it is as hygienic as possible.
Vaccines typically take 10-14 days to become effective
This varies depending on the vaccine. This is important information if you are planning on getting your shots abroad, although it would be incredibly unlucky if you picked up one of these diseases in the first two weeks of your trip.
For certain vaccines, precautions must be taken for children, pregnant women and those with a compromised immune system
This is something that should be discussed with a doctor at a travel health clinic.
Make sure to get a certificate of vaccination
A certificate of vaccination is a World Health Organization approved document that provides a log of your immunizations. For travelers to countries where yellow fever is a required vaccination for entry, this is what you will present to customs officials. You will be given this document at any travel health clinic.
Many of the diseases faced by travelers do not have a vaccine
While there are a number of immunizations you can get before traveling, the most common illnesses do not have vaccinations. Traveler’s diarrhea afflicts travelers more than anything else and while it’s possible to treat it, the only way to prevent it is through behavioral changes (eating and drinking hygienic food).
Additional Resources
Michael, from the humorous and thoughtful blog Go, See, Write, documents his experience getting travel immunizations for a round the world trip.
Jason and Aracely, from the helpful and very engaging multimedia travel blog 2Backpackers, offer a similar post, sharing their experience with travel immunizations for a trip through Latin America.
Theodora, from the wonderfully written and always entertaining blog Travels with a Nine Year Old, makes a compelling case for getting your child vaccinated.
We also mentioned Wes, who is the great storyteller and photographer behind the blog Johnny Vagabond, and his post on saving money on travel shots.
What’s been your experience with travel immunizations? Have you spent lots of money on them? Have you gotten any of the diseases for which you received vaccination? Let us know in the comments.
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