Some of the most common questions travellers have is what vaccines to prioritize and where to find affordable vaccines. Selective travel vaccinations are specific to your destination, trip duration and itinerary, and type of travel. The costs associated with travel vaccines and travel health consultations vary among providers and you’ll find that prices can skyrocket very quickly.
In North America, travel vaccines are not subsidized by the government so if you don’t have a private insurance policy that covers them, your wallet will undoubtedly take a hit. The good news though is that you can prioritize travel vaccines with the help of your doctor or travel health practitioner.
First off, make sure you are up-to-date with your routine immunizations. Most private and government insurance health plans cover all routine immunizations at little or no cost to you. Routine immunizations protect you from diseases like Influenza, Tetanus-Diphtheria-Pertussis, and Measles-Mumps-Rubella.
To help you decide what travel-related vaccines you need, ask yourself the following questions:
1. What is the risk of acquiring a vaccine-preventable disease at my destination?
Here’s where a little bit of research will go a long way to determine if you need to get vaccinated for a travel-related illness. Find out if there are current outbreaks or ongoing epidemics in the local population or if there are reports of travellers returning with vaccine-preventable illnesses.
2. What is the length of my trip?
Risk of acquiring a travel-related illness increases over time. If you’re going on a 6-week volunteer trip to Central America, the chances of getting sick are greater than if you’re only going for a 1-week resort stay in the Dominican Republic. Also, consider the season during which you’ll be travelling. For example, in the temperate areas of Southeast Asia, the risk of Japanese Encephalitis is higher during and right after the rainy season while Meningococcal Meningitis outbreaks in the African Meningitis Belt usually occur during the dry season.
3. What type of travel will I be doing?
The type of travel influences your exposure to illness. For example, backpacking through Southeast Asia or visiting family and relatives for 2 months in Ghana increases your risk of getting Hepatitis A or Typhoid Fever as opposed to staying in a 5-star hotel in Shanghai.
4. How much time do I have before my departure?
Many travel vaccines come in a series. This means you’ll have to get more than one shot to build up adequate immunity. We recommend starting your vaccination schedule at least 4-6 weeks before your trip so you can get all the shots you need on time and to give your immune system enough time to build-up antibodies.
Even if you’re leaving at the last-minute, try and get an appointment with your healthcare practitioner before your departure, even if it’s the day before. While antibodies usually take 7-14 days to develop, partial immunity is better than none. Talk to your healthcare provider about accelerated vaccine schedules and if this is the right approach for you. In case you didn’t know, all vaccines (at least the first doses of the series) can be given simultaneously, although you will be sore after the experience!
5. Are there any contraindications to the vaccines?
Some travellers are not good candidates for certain vaccines (particularly live vaccines) if they have a compromised immune system or are allergic to a vaccine component like neomycin or gelatin. Some vaccines may also interfere with certain medications. Talk to your healthcare provider about alternatives and appropriate prevention measures for you.
6. Can I protect myself without getting vaccinated?
While it’s difficult to determine your exact risk of acquiring an illness, your behavior plays a large role in determining if you’re more or less prone to acquire an illness.
If you are very conscious of washing your hands frequently and thoroughly, sneezing or coughing in your sleeve or a tissue and disposing of it properly, eating well-cooked foods and fruits and vegetables you can peel on your own, drinking purified water at all times, and diligently using insect repellents or sleeping under a bed net if needed, you reduce your chances of getting ill.
While the risk may be low, remember that one insect bite or contaminated ice cube can ruin your vacation and may even have long term health consequences. No vaccine is 100% effective, but getting vaccinated strengthens your immune system and gives you an additional line of defense against preventable diseases.
The need for travel vaccinations depends on your destination, trip duration and itinerary, type of travel, and your health status. Vaccination is not only about protecting yourself, it’s about protecting others around you who are more susceptible to getting sick, who can’t get vaccinated, or who don’t have access to vaccinations in the countries you visit.
Try to plan ahead and have your specific itinerary finalized in time for your appointment with your healthcare practitioner – that way, they can help you prioritize the vaccines you need for your trip.
If Hepatitis A or Hepatitis B were not part of your routine immunization schedule and you’re planning to travel, they are good value for your money since they provide long-term protection (probably lifetime), a plus if you’re planning to do more travel in the future.
If you’re in a rush and just get the first dose, it affords good initial protection (but don’t forget to finish the series when you return from your trip to get maximum protection).
Typhoid Fever
Vaccination against Typhoid Fever is recommended for long-term travellers, adventure travellers, and those visiting friends or relatives in areas of poor sanitation. Regions at higher risk include Southeast Asia, sub-Saharan Africa, and parts of South America. This vaccine comes in an oral (live) version or inactivated injectable form.
Japanese Encephalitis
Japanese Encephalitis is recommended for travellers going on a long term trip to rural areas of Southeast Asia, especially if visiting or working in agricultural areas. The vaccine available in North America is a series of two shots.
Rabies
The pre-exposure rabies vaccine series is recommended for travellers going on a long-term trip in areas where rabies is endemic (including children, who are vulnerable to animal bites). Having pre-exposure shots buys you more time to seek medical care and get the additional post-exposure shots.
If you don’t get the pre-exposure shots and are bitten, you’ll have to get Rabies Immune Globulin (RIG) injected in the wound site plus 4-5 doses of rabies vaccine depending on your health status (according to Canadian and US protocols). Note that RIG is very short supply worldwide, putting you at greater risk. If you do get the rabies pre-exposure shots, you do not need RIG.
Meningococcal Meningitis
The quadrivalent Meningococcal Meningitis vaccination is recommended if you are going to a country in the African Meningitis Belt (the semi-arid area of sub-Saharan Africa that extends from the Atlantic Ocean to the Red Sea) or a country with a current outbreak for a long term trip or on a working assignment in the healthcare or education fields. It protects you against the 4 bacterial serotypes A, C, Y, and W135. Some countries require proof of Meningococcal Meningitis upon entry from certain travellers.
Some countries require certain or all travellers to provide proof of vaccination upon arrival. Yellow Fever is a requirement for entry in many countries because the mosquito vector is present, meaning the country is at risk for Yellow Fever outbreaks. Some countries may also require proof of Meningococcal Meningitis and/or Polio vaccination due to the risk of transmission.
Yellow Fever may be required regardless of your trip itinerary or if risk is present at your destination. Each country’s Yellow Fever requirements are different – depending on your destination, proof of vaccination may be required from all travellers, from travellers arriving from a country at risk, or from travellers who transited through a country at risk.
If your destination country requires it, you need to be prepared to show proof of vaccination upon arrival. You won’t be able to get around it unless you have a contraindication or a precaution against the vaccine like a compromised immune system, an allergy to a vaccine component, being over 60 years old, or are pregnant or breastfeeding. In such cases, you will need to present a waiver signed by your healthcare practitioner to show border authorities explaining why you cannot get vaccinated. Be aware though, some border security agents do not always honour waivers.
To get a valid Yellow Fever vaccine certificate, you need to be vaccinated 10 days before entering the country. Yellow Fever vaccine certificates are valid for life.
Only certain travel clinics are licensed to administer Yellow Fever so you will have to pay for the consultation fee in addition to the vaccine. The vaccine is currently in limited supply in many areas, so you may need to plan ahead to find a clinic with the vaccine in stock.
If you’re on a budget, check if your doctor administers the vaccines. This may be your cheapest option. Alternatively, your local public health department may also administer travel vaccines at a reduced rate.
Travel clinics are also available to provide any travel-related vaccines and consultations. The costs associated with visiting a travel clinic can vary – shop around to find a clinic that fits your budget. Some clinics provide discounted rates for their consultation and don’t mark-up the cost of vaccines. To save time and money, find out if they charge for subsequent visits in case you need to finish a series of vaccines. You should also check if they have all the vaccines you need at the time of your visit so you don’t have to return (especially if you’re in a rush before your departure), and if they can prescribe other travel-related medications like malaria pills, high altitude sickness pills, or antibiotics for travellers; diarrhea.
A note on cheaper vaccines abroad
There is a case to be made for finding cheaper vaccines abroad, especially if you’re a long-term traveller and have an unexpected change of itinerary or the vaccine is not available back home like the Tick-borne Encephalitis vaccine. It’s not always a good idea to get vaccinated abroad if you can do it before you departure. While vaccines may be cheaper, consider the following:
If you’re looking for the subsequent dose of the vaccine series that you got back home, make sure it’s from the same manufacturer. There are different variants of travel vaccines all over the world and mixing them up may not afford you full protection.
Last reviewed and updated: December 11, 2020.
Image by CDC
When you have reached the point where you no longer expect a response, you will at last be able to give in such a way that the other is able to receive and be grateful. - Dag Hammarskjöld
