Passport Health: Vaccines; Your passport to travel
According to statistics released by the National Travel and Tourism Office (NTTO), almost 67 million U.S. citizens traveled outside the country in 2016 (2017 statistics have not yet been released). Travel is booming more than ever. Today, more and more travelers such as myself want more than ever to expose themselves to cultural experiences, to meet and befriend the local people, and hopefully return home with a different, new perspective about the world.
Although there are many ways one can try to stay healthy while traveling abroad, international travel can pose various risks to your health and the best way to stay healthy is to plan before you go. Preventative health care is vital.
Because of my medical background, I was a clinical pharmacist before I left my job back at home to travel the world full time, I often have people ask me, “How important is it to get vaccinated prior to travel?” Well… the fact is, it might just save your life or the life of someone around you (a pregnant woman and her unborn baby, cancer or HIV patient who is immunocompromised, etc.). Making yourself aware of the different types of vaccinations (both recommended and required) that you may need prior to going on your next big adventure is very important, but can be both confusing and overwhelming at the same time. The internet is chock full of conflicting information on various unreliable websites that claim to be “medical”.
The Centers for Disease Control and Prevention (CDC) provides great online resources for determining which routine vaccines you should be up to date on prior to travel, which travel vaccines and medicines are highly recommended prior to travel due to a high risk of disease in the country you are going to visit and which vaccines and medicines you will need based on where you will be visiting, your age, your health status, previous vaccinations, how long you will be staying, the time of year you will be traveling, what activities you will partake in (camping, hiking, biking, adventure travel, caving, etc.) and if you are traveling from a country other than the United States. Both the CDC and the World Health Organization (WHO) provide online resources describing each vaccine in great detail (type of vaccine, number of doses required, boosters (if needed), contraindications (when a vaccine should not be given because it could cause harm to the person), side effects (common and uncommon reactions to the vaccine), and special precautions.
So what exactly is a vaccine? In a nutshell, a vaccine is given as an injection (shot) or as an oral dose (capsule, tablet or liquid) that we ingest (swallow) that helps protect us from serious illnesses. Vaccinations work by exposing our bodies to small quantities of these illnesses (called antigens) in the form of a virus or bacteria that is either “live/ severely weakened” (an activated vaccine) or “killed” (an inactivated vaccine). Because these vaccines are severely weakened or are killed, they will not make you sick. The body responds to the vaccine by making antibodies that will attack the illness that will make you sick and will help protect you if you are exposed to the illness in the future (this is called acquired immunity; a sort of defense system against the illness).
So what do you need to do? Prior to travel, make sure to schedule an appointment with your family physician at least 4 to 6 weeks before your departure to ensure that the vaccine will have enough time to work and that you receive all your important vaccines and health advice. Note that there are some vaccines like Japanese Encephalitis (JE) that is given as a 2-dose series; with the doses spaced 28 days apart. The second dose is to be given a least one week prior to travel. You can also check with your local health department or find a travel clinic in your area to administer your pre-travel vaccinations if you do not have a family physician or your family physician does not give travel vaccines. Also, note that for a Yellow Fever (YF-Vax) vaccine you will need to go to an authorized vaccine center.
Another common question I receive is, “What is the difference between routine vaccinations, recommended vaccinations, and required vaccinations?” Simply put, routine vaccinations provide protection from diseases that are still common in many parts of the world yet rarely occur in the United States. Recommended vaccinations are recommended to protect travelers from diseases present in other parts of the world and to help prevent the spread of infectious diseases from crossing international borders when travelers travel from one country to another. As stated above, the recommended vaccine you will need depends on a number of factors (where you will be visiting, age, health status, previous vaccinations, how long you will be staying, the time of year you will be traveling, what activities you will partake in during your stay and if you are traveling from a country other than the United States). Currently, the only vaccine required by International Health Regulations (IHR) of the WHO is the YF-Vax vaccination for travel to certain countries in sub-Saharan Africa and tropical South America. The Meningococcal vaccination is required by the government of Saudi Arabia for annual travel during the Hajj Pilgrimage. Travelers to these areas must show proof of vaccination on a valid International Certificate of Vaccination or Prophylaxis or a visa will not be issued.
Special precautions should be taken to ensure that infants and young children are protected against foodborne illnesses and mosquito bites due to the fact that not all vaccines can be administered to all ages.
Frequent travelers often become lax about taking health precautions as they may have traveled several times without having major health issues. Such travelers not only pose a health risk to themselves but pose a health risk to others around them after returning home or onward travel to another country.
Pregnancy should never deter a traveler from receiving vaccines. However, caution should be used when selecting the appropriate vaccine to avoid the inappropriate administration of certain vaccines that could harm the unborn baby. For example, live Hepatitis A, live influenza, JE, Measles, Mumps, and Rubella (MMR), or the Varicella vaccine should never be administered to a pregnant patient.
Travelers with chronic medical conditions associated with impaired immunity (cancer, diabetes (DM), HIV, etc.) may be at risk for developing complications following administration of vaccines that contain live organisms. It may be advised that these travelers do not receive vaccines such as oral polio, YF-Vax, varicella, oral typhoid, BCG, JE, MMR, etc. These patients should always consult with a physician or licensed vaccination healthcare provider prior to receiving a live vaccine.
Another question I get is, “Will the influenza vaccine I receive in the U.S. protect me during my international travels?” The answer is yes. The influenza vaccine used in one hemisphere usually protects against the main viruses that have been circulating in other parts of the world, including in the opposite hemisphere. The WHO recommends that both groups at risk of serious complications of influenza (cardiovascular and/or respiratory conditions, immunosuppressive conditions and DM) and travelers who have not received the influenza vaccine for the current season and are traveling to parts of the world where there is current influenza activity receive an annual influenza vaccination. Note that the risk to travelers of developing influenza depends on the time of year and destination of travel.
Vaccination is a highly effective way of preventing certain illnesses during your travels. Vaccines, in general, are very safe and serious adverse reactions are uncommon. Routine vaccines protect most of the world’s children from a number of infectious diseases that once caused millions of deaths each year. It should be known that vaccines are not 100% effective in protecting you against illness. Vaccines are not a substitute for practicing good travel hygiene practices which I will outline later. The single most important thing you can do prior to travel is to make an appointment with your family physician, local health department or travel clinic to ensure that you are up to date on your routine vaccines and receive the appropriate travel vaccines and counsel prior to your next travel adventure. Let’s face it, health is wealth and knowledge is power. Take the knowledge you have about travel vaccines and apply it to your health. Protect yourself and enjoy this great big beautiful world! Vaccines are your passport to travel.
*Legal Disclaimer: The contents of this website, such as text, graphics, images, and other material contained on the website (“Content”) are for informational purposes only and do not constitute medical advice. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.