A few years ago, I was surprised when my mother-in-law informed me that I should get vaccinated for typhoid and yellow fever ahead of a family trip to the Caribbean. At the time, I didn’t know that the Centers for Disease Control and Prevention (CDC) often recommends that you protect yourself against certain illnesses when traveling abroad. (Sometimes countries even require proof of specific vaccinations.)
It was easy to get the shots I needed: I asked my doctor for her input; she said, “Yep, go get them”; and after a quick trip to my local pharmacy, I was ready for my trip. But I started thinking about all the places I had traveled to without being properly immunized, and, oh, how I spiraled. How did I not know? How did I not get sick! Or, wait—was not getting the hepatitis A shot actually why I got such bad abdominal pain in Egypt….
Anyway, I learned my lesson, and now I’m here to tell you that if you live in the United States and have summer vacation plans—whether to Mexico, across the pond to Europe, or in Asia or Africa—there’s a good chance you’d benefit from at least one protective measure against illness. Below, we’ll dive into what you should know about the most common vaccines recommended for travelers.
How to make an immunization plan before you travel
First, check out the CDC’s destinations page, where you can look up countries and find the exact treatments they recommend you get. (It sincerely couldn’t be simpler.) Do this way ahead of time—some vaccines take a couple weeks to fully kick in, and others require multiple doses spaced out in specific increments. If you put it off (it happens!), check out the CDC’s guide for last-minute travelers—you can get vaccinated for some diseases on an hastened schedule, or at least learn the best preventive habits to lessen the risk of contracting anything.
No matter where you’re going, you might want to talk to a travel medicine specialist who can whip up a preventative plan for you. Ask a primary care doctor for advice or check out the International Society of Travel Medicine, where you can find a global directory of clinics specializing in safe travel.
If you can’t find your immunization records and don’t know which ones you’ve gotten, go ahead and get additional doses anyway. There’s no harm in getting an extra dose of most immunizations, Maura Sammon, MD, an associate professor of clinical emergency medicine at the Lewis Katz School of Medicine at Temple University, tells SELF. As a rule of thumb: “If you’re not sure, get it,” she says.
What diseases to be aware of and protect yourself against before your trip
Okay, on to the illnesses and preventive measures to have on your radar! Here’s what to know about how to keep yourself safe during your exciting international travels.
Recommended if you’re traveling to: Africa, Asia, Central and South America, Eastern Europe, the Middle East, the western Pacific, and the Caribbean
When to get vaccinated: At least a month before your trip
Hepatitis A and hepatitis B are two very different diseases, both of which can hurt the liver, but there’s a combined hep A/hep B vaccine that you can get if you haven’t been immunized against either one (or just don’t know what you’ve been vaxxed for in the past). You can get this on an expedited schedule too, if you’re up against the clock: Typically this shot is given over the course of six months, but in a pinch, three doses can be administered in 21 days. There are also shots specifically for hep A and hep B, respectively, if you know you’ve been vaccinated for one, but not the other.
In terms of what these diseases are, let’s start with hepatitis A. It’s a very contagious liver infection that’s transmitted through contaminated food and water or contact with an infected person. The symptoms, such as fatigue, nausea, and jaundice, can last up to two months (and, for some unlucky people, up to six months). Pretty much every country in the world recommends travelers get this shot (which, by the way, requires two doses given six months apart, but even one dose provides strong protection). “It is the most recommended vaccine for travel,” Dr. Sammon says.
Hepatitis B is a much more serious liver infection that can be deadly. It’s spread through bodily fluids (like blood, semen, or vaginal fluids), most commonly through sexual contact with someone who’s infected (there are an estimated 350 million hepatitis B carriers globally). It can also be transmitted through sharing personal care items (like a razor or toothbrush) or getting a tattoo or piercing from unsterilized equipment.
Hep B is not as common as hep A, but it’s much more serious. Though many people will get better in a few weeks, some will get chronic hepatitis B, which can lead to issues like liver failure or cancer. It’s particularly important for people who expect to have any sexual contact or medical procedures abroad to get vaccinated for hep B first, Dr. Sammon adds, so talk to your doctor to gauge your risk—but no matter what, “I would recommend that you get it if it’s on the CDC list for your destination,” she says. The good news: Hepatitis B is entirely preventable by vaccines.
Recommended if you’re traveling to: Eastern and southern Asia (especially Pakistan, India, and Bangladesh), Africa, the Caribbean, Central and South America, and the Middle East
When to get vaccinated: At least two weeks before your trip
Typhoid fever is a bacterial infection that causes a sky-high fever along with weakness, headaches, and gastrointestinal issues like diarrhea and constipation. If you’re treated early, you can recover swiftly, but there’s one issue: The infection is often not recognized quickly because it resembles other common illnesses, says Dr. Sammon, adding that it can be fatal.
Typhoid fever spreads through contaminated food and water, and, according to Dr. Sammon, it’s very easy to get. You don’t need to have direct contact with someone who has typhoid—just with the bacteria (which is ubiquitous in certain environments and can be spread through drinking or eating something that’s carrying it). The risks of contracting typhoid are greater if you plan to eat in rural areas or in someone’s home, where there may not be strict handwashing guidelines, says Dr. Sammon.
Typhoid immunization comes in a pill form (a weakened version of the bacteria that provides protection for five years) or a shot (protection lasts for two to three years).
Recommended if you’re traveling to: Western and northern Europe and northern and eastern Asia
When to get vaccinated: At least six months before your trip
If you’re headed to western or central Europe (think: Scandinavia) between April and November, when ticks are the most active, there’s a chance you’ll need this shot—especially if you have plans to hike, camp, or do outdoor activities in forested areas outside of major cities. If you’re gonna stick to urban areas, you can probably skip it: “If you’re going to the city and you’re not going to be out taking hikes in forested areas, it would not be recommended,” says Dr. Sammon.
The majority of people who contract this infection, which affects the central nervous system, don’t feel sick, but it can lead to fever, aches, and GI issues. In certain people, it can cause brain and spinal cord swelling and death. Unfortunately, unlike Lyme disease—in which it can take up to two days of a tick latching onto a human for the disease to be transmitted—tick-borne encephalitis can spread immediately after a tick bites, making the shot all the more crucial.
Recommended if you’re traveling to: Africa and South America
When to get vaccinated: At least 10 days before travel
Yellow fever is a viral infection that’s transmitted by mosquitoes predominantly in Africa and Central and South America. Dr. Sammons says yellow fever used to be much more common than it is today, but it’s still definitely worth getting the shot (one jab will give you lifelong protection) if you’re headed to one of the places where it’s prevalent.
Most people who contract yellow fever won’t get sick or, if they do, will have mild symptoms, such as fever or body aches. A small percentage of people (about 12%) will develop serious issues, including liver failure and kidney failure, says Dr. Sammon. We don’t have an antiviral drug for yellow fever, and symptoms are mainly treated with supportive care, so your best bet is to avoid getting it in the first place.
Recommended if you’re traveling to: Many countries in Africa, the Americas, and Asia
When to start taking the medications: It varies for each drug, but some medication courses start as soon as a day before travel
If you’re going to Mexico, Colombia, or any of the countries flagged here (which are predominantly tropical places), you’ll want to be protected against malaria. This disease isn’t something to mess around with. ”Malaria is probably the most concerning [illness] that people who look at travel medicine worry about,” says Dr. Sammon. People who get it typically get very sick, and in certain cases, it can be life-threatening. It takes just one quick mosquito bite to contract the disease. Fever, headache, and chills are the telltale symptoms. Some types of malaria can be severe (causing convulsions, impaired consciousness, and extreme fatigue) and rapidly fatal, particularly among people who don’t live in an endemic country (a.k.a. travelers), she adds.
The malaria immunization comes in pill form, and you’ll have to take it before your trip, during your trip, and after your trip. There are a few different types of malaria protection drugs that all have varying dosing schedules (check out the risks and benefits of your options here). “Go on the CDC website, see if where you’re going requires malaria prophylaxis, and contact a travel medicine specialist,” says Dr. Sammon.
Another big way to protect yourself from illness while traveling
Yes, this is a story about vaccines, but Dr. Sammon insists we include a blurb about mosquito protection. Why? Because mosquito-borne diseases like Zika, dengue, and West Nile virus are a major threat to your health, even in nearby locations like Puerto Rico. Mosquito-borne illnesses are a massive public health threat, yet they’re extremely preventable, Dr. Sammon says.
While yellow fever and malaria have safe, effective immunizations, many other mosquito-borne diseases don’t. Your best bet for staying safe from mosquitos: DEET and picaridin. Dr. Sammon says people are often afraid of DEET because it smells chemical-y, but decades of research have shown that it’s incredibly safe and very effective. Picaridin is a newer alternative that, while not as extensively studied as DEET, is just as effective. These products essentially hide you so the insect can’t smell you. Dr. Sammon recommends dousing yourself in these products when traveling to buggy places.
Another option is permethrin, an insecticide that repels mosquitoes. You can buy permethrin-treated clothing or soak your clothes in the liquid, wash them, and wear them knowing you’re well-protected for six washes, says Dr. Sammon.
All told: There are plenty more diseases out there that you may want to be vaccinated or otherwise protect yourself against, depending on where you’re going, which is why it’s worth setting up an appointment with a travel medicine doctor if you’re not sure where to start. At the very least, check out what the CDC says and talk to a pharmacist. Just don’t be like me, naively traveling without realizing the next meal, drink, or mosquito could very quickly derail my entire trip—and my health even after I get home.
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