Many a traveller goes to a clinic and says they’re going to somewhere like Brazil or Thailand (or equally mainstream), the nurse types ‘Thailand’ into a computer (experience suggests not all health professionals have first-hand experience or knowledge of travel health or pragmatism) and next thing they know they have a bill for $100s, a painful arm, 10s of expensive pills and coverage for some very bizarre diseases of which the risk of are small compared to others.
Nevertheless, it is important to warn against the foolhardy approach and ‘I’ll take the risk’ attitude you might find travellers on the road with (normally regarding Malaria). You’ll also note things have tried to be kept as simple and concise as possible tackling a big subject.
So what jabs do I need?
You typically need for developing world travel regardless of what country you are visiting the following shots: (followed by Canadian prices in C$ per dose)
Typhoid (3 years – also available as a pill) $50 x i dose
Meningitis (ACYW135 – Menactra) $130 x 1 dose
Hepatitis A (two doses, 10 years – or immunoglobulin that will last for 3-6 months)) $50 x 2 doses
Diphtheria, Polio, Tetanus (all every 10 years – free in Canada)
Yellow fever (10 years – or probably life) if you are heading to parts of South America or Africa $130
Within the UK and other EU countries with a national/socialized health service, for the immunizations listed above, you will typically be charged only for Yellow Fever at a cost of about €80 (£60), with Hep A/Typhoid and Diphtheria/Tetanus/Polio being typically free. In Canada, you will pay for everything but the routine immunizations offered through Public Health (diphtheria, polio, tetanus).
This will of course vary from country to country (in places like Ireland or Switzerland, it is unlikely you will get anything free!). Walk in clinics are good for those in a hurry, but will charge considerably more. In Canada, special travel clinics are the only places to obtain these services.
Within the USA and other countries without a government funded health service the cost of your shots will be quite substantial in some cases and are rarely covered on medical insurance (you might find Tetanus included). The following charges are typical for the United States: Typhoid – $75, Polio Booster – $50, Hep A & B – $200 (per shot 2/3 needed), Yellow Fever – $100, Meno Meningitis -$130 & Rabies – $200 (per shot, 3 needed). In the States you usually have to go to special travel doctors to get the shots, as most doctors and clinic’s don’t carry them.
What you probably don’t actually need:
Rabies, Hepatitis B, Cholera, Meningitis and Japanese B Encephalitis are in many opinions not 100% necessary for most trips considering typical destinations, the cost/number of injections and rarity. They makes a lot more sense to have if those heading to West Africa for a year, volunteering in a disaster zone or dealing with animals.
Rabies. The vaccine is a series of 3 shots at 0, 7 and 21-28 days at $200 per dose. It may not give full protection and everyone needs boosters (two) after a possible exposure. The the vaccine extends the time you have to get the boosters. Without the vaccine, you still need the 5 doses of vaccine over 28 days plus also Human rabies immunoglobulin (HRIG) injected around the wound. Since HRIG is not cheap or easily found if off the beaten track, the vaccine is recommended if really disappearing into the wilderness. Prevention treatment is only successful if started before symptoms appear.
Hep B is perhaps only advisable if you plan to be sexually active (especially male gay sex), as it is an STI (but, for the record, can be contracted in other instances such as passed on during medical or dental treatment with inadequately sterilization). This is included with Hep A (which is important) in a formulation called Twinrix.
Cholera is a risk where there has been flooding or a natural disaster, typically food and water hygiene precautions are normally enough to prevent infection.
Japanese Encephalitis is rare and found in pigs and birds, the jab would be required if you are living and working with animals (pigs) in South East Asia, the Pacific islands or the Far East.
Whereas it would be nice to be vaccinated against ‘everything’, some vaccinations provide protection from infections that have a diminishing risk depending on where you are going and what you are doing. Plus in many cases can be quite costly. However you’d be foolish to discount anything by reading this alone and varied professional advice can make sure you make 100% informed choices, although medical professionals will of course almost always advise total protection in the same way they would always advise alcohol in moderation, not smoking and wearing factor 50 sun block.