Health

Backpacker Travel Vaccinations Guide For South East Asia

by stephmylifetravel
by stephmylifetravel

Travel vaccinations can be an annoying, confusing, and costly part of going abroad. However some of the illnesses that you can pick up in South East Asia can have long lasting effects and will cost you a lot more to treat than getting vaccinated against before you go. To stay healthy, avoid hospital stays and just keep your peace of mind while you travel I would advise that you always get the required vaccinations before you travel. Speaking as someone who has been hospitalised in South East Asia it’s something you should try to avoid at all costs!

I often get asked whether Tim and I get vaccinated before we travel and the answer is 100% yes. We’re adventure-lovers, risk-takers, and we love to take life as it comes but three things we never leave to chance are health, money and security. We’re always insured, vaccinated and safety aware.

Disclaimer: Obviously I’m not a nurse or doctor, and you should always take your doctors advice over this post. However all of the information below has come from the NHS website and other medical websites that have been recommended by our doctor.

How Long Before a Trip Should I Get My Vaccines?

The general rule is to see your doctor two months before you travel. Some vaccines require two or three visits to the clinic, for example Hepatitis A & B require 30 days between the two shots. It’s best to go early as leaving it until the last minute can leave you unprotected from some illnesses.

If you do leave it too late but you are backpacking long-term then remember you can get vaccinated while you travel. There are plenty of clinics where you can get immunised and pick up malaria tablets.

How Much Will It Cost

I was lucky enough to be living in the UK when we got ours so some of the vaccinations were free on the NHS.  The following vaccines are free on the NHS: Diphtheria, Polio,  Tetanus (combined booster), Typhoid, Hepatitis A – including when combined with Typhoid or Hepatitis B, Cholera.

Details on how much it costs for vaccines in Ireland can be found here. And for other countries you can find out by contacting your doctor or searching online.

For vaccines that aren’t covered for free I would definitely recommend shopping around to find the best price. I was surprised at was how much the prices of vaccinations can vary depending on where you go. Spend some time on Google finding out which clinic near you offers the best prices, or call around local clinics and ask.

Recommended vs Suggested Vaccines

The vaccinations that you need for backpacking around a country and spending 2 weeks in highly populated tourist areas will be different. Travel clinics and websites will usually give you a list of recommended vaccines and a list of ‘suggested’ vaccines for each country and it can be confusing to figure out which to get.

  •  Recommended vaccines mean that there is a higher risk of contracting an illness and are something you should get even if you’re going on holiday. We always get these.

  •  Suggested vaccines mean that there is still a risk of contracting these illnesses, but it’s lower and depends on where you are going in the country and which activities you are planning to do there. We get these when we’re spending a long time in a country and getting off the beaten track or when we’re planning any fresh water related activities like river trips or tubing.

What Kind of Diseases Are You Being Vaccinated For?

Here are a list of the common vaccines and what the risks are for them. If one of these is on your ‘suggested’ list then you read this and it will help you to decide if you need to get the vaccine. This is taken from the NHS Fit For Travel website which we always consult when getting our vaccinations.

  • Cholera:  spread through consumption of contaminated water and food. More common during floods and after natural disasters, in areas with very poor sanitation and lack of clean drinking water. It would be unusual for travellers to contract cholera if they take basic precautions with food and water and maintain a good standard of hygiene.

  • Diphtheria:  spread person to person through respiratory droplets. Risk is higher if mixing with locals in poor, overcrowded living conditions.

  • Hepatitis A:  spread through consuming contaminated food and water or person to person through the fecal-oral route. Risk is higher where personal hygiene and sanitation are poor.

  • Hepatitis B:  spread through infected blood and blood products, contaminated needles and medical instruments and sexual intercourse. Risk is higher for those at occupational risk, long stays or frequent travel, children (exposed through cuts and scratches) and individuals who may need, or request, surgical procedures abroad.

  • Japanese Encephalitis:  spread through the bite of an infected mosquito. This mosquito breeds in rice paddies and mainly bites between dusk and dawn. Risk is higher for long stay travellers to rural areas, particularly if unable to avoid mosquito bites.

  • Rabies: spread through the saliva of an infected animal, usually through a bite, scratch or lick on broken skin. Particularly dogs and related species, but also bats. Risk is higher for those going to remote areas (who may not be able to promptly access appropriate treatment in the event of a bite), long stays, those at higher risk of contact with animals and bats, and children. Even when pre-exposure vaccine has been received, urgent medical advice should be sought after any animal or bat bite.

  • Tetanus:  spread through contamination of cuts, burns and wounds with tetanus spores. Spores are found in soil worldwide. A total of 5 doses of tetanus vaccine are recommended for life in the UK. Boosters are usually recommended in a country or situation where the correct treatment of an injury may not be readily available.

  • Typhoid:  spread mainly through consumption of contaminated food and drink. Risk is higher where access to adequate sanitation and safe water is limited.

Malaria

Malaria risk is present in many Asian countries, although over the years this risk is declining and is almost eradicated in popular areas. The disease is spread by mosquito bites and there is no vaccine against malaria but you can take antimalarial tablets when you travel to guard against contracting the disease. If there is a low risk then you may not need to take antimalarials and instead use repellent, moqsuito nets to avoid being bitten too much.

Check out the malaria maps linked below to see if you will need to take antimalarials and how many you will need. You probably won’t need to take them if you’re going to popular areas and tourist destinations, just if you’re going to rural or border areas in some countries.

Due to the side effects of malaria tables we don’t take them unless absolutely necessary – we’ve only taken them once in our two years of travel. There are a number of different options of tablets you can take and they all come with their own side effects so read about them and decide which you would prefer to take. They also all vary in price and have to be taken on a precise schedule, so make sure you have an in depth chat with your health advisor about antimalarials.

Vaccine and Malaria Advice by Country

Here are the recommended and suggested vaccines for each country we have been to in Asia. The titles are linked to the NHS Fit For Travel page of that country so that you can get more information, including malaria maps.

Thailand

Recommended vaccines: Tetanus

Suggested vaccines: Cholera; Diphtheria; Hepatitis B; Japanese Encephalitis; Rabies; Typhoid.

Antimalarials: Malaria risk in forested and hilly areas mainly towards the international borders, all year round.

Cambodia

Recommended vaccines: Hepatitis A; Tetanus.

Suggested vaccines: Cholera; Hepatitis B; Japanese Encephalitis; Rabies; Typhoid.

Antimalarials: Malaria risk is present throughout the year in all areas except Phnom Penh, other main cities, Angkor Wat, Siem Reap and close to Tonle Sap. Risk is highest in the north east regions of Preah Vihear, Stung Treng, Ratanakiri and Mondolkiri.

Laos

Recommended vaccines: Diphtheria; Hepatitis A; Poliomyelitis; Tetanus.

Suggested vaccines: Cholera; Hepatitis B; Japanese Encephalitis; Rabies; Typhoid.

Antimalarials: Malaria risk is present throughout the year in all areas except the provinces of Bokeo, Houaphanh and in Vientiane. Risk is highest in the provinces of Attapeu, Champasak, Salavan, Savannakhet and Kekong.

Vietnam

Recommended vaccines: Diphtheria; Tetanus.

Suggested vaccines: Cholera; Hepatitis A; Hepatitis B; Japanese Encephalitis; Rabies; Typhoid.

Antimalarials: Low to no risk in popular areas including Ho Chi Min City and Hanoi, the Red River and Mekong deltas, Phu Quoc Island and coastal plains. In other areas risk is low and and antimalarial tablets are not usually advised unless you are at higher risk e.g. longer stay in rural areas, visiting friends or relatives, those with medical conditions, immunosuppression or those without a spleen.

Myanmar

Recommended vaccines: Diphtheria; Hepatitis A; Poliomyelitis; Tetanus.

Suggested vaccines: Cholera; Hepatitis B; Japanese Encephalitis; Rabies; Typhoid.

Antimalarials: Malaria risk is present throughout the year in all areas except the major cities Mandalay and Yangon. Risk is highest in Chin, Kachin, Kayah, Rakhine, Sagaing and Tanintharyi states.

Sri Lanka

Recommended vaccines: Tetanus.

Suggested vaccines: Hepatitis B; Japanese Encephalitis; Rabies; Typhoid.

Antimalarials: Malaria risk is low throughout the year in all areas. There has been a marked reduction in the number of cases reported in recent years. Antimalarials are not usually advised.

India

Recommended vaccines: Diphtheria; Hepatitis A; Tetanus; Typhoid.

Suggested vaccines: Cholera; Hepatitis B; Japanese Encephalitis; Rabies.

Antimalarials: Malaria risk is present throughout the year. Risk is highest in north-eastern states of Meghalaya, Mizoram, district of Amini in Arunachal Pradesh, north and south Chhattisgarh, Orissa and the city of Mangalore. In central Chhattisgarh, Jharkhand, Tripura and Arunachal Pradesh risk is not high enough to warrant antimalarial tablets for most travellers.

Nepal

Recommended vaccines: Diphtheria; Hepatitis A; Tetanus; Typhoid.

Suggested vaccines: Cholera; Hepatitis B; Japanese Encephalitis; Rabies.

Antimalarials: Low risk throughout the country, antimalarial tablets are not usually advised unless you are at higher risk e.g. longer stay in rural areas, visiting friends or relatives, have medical conditions, immunosuppression or are without a spleen. Risk is highest in the district of Kailali. In this area the risk is not high enough to warrant antimalarial tablets.

Indonesia

Recommended vaccines: Diphtheria; Hepatitis A; Tetanus.

Suggested vaccines: Cholera; Hepatitis B; Japanese Encephalitis; Rabies; Typhoid.

Antimalarials: There is low to no risk in Jakarta municipality, the main cities, urban areas and the main tourist resorts, including Bali and Java. In North Sumatra, Jambi, Bengkulu, Borneo/Kalimantan, Central, South East and North Sulawesi and West Nusa Tenggara, risk is not high enough to warrant antimalarial tablets for most travellers. Risk is highest in rural areas and in the five eastern provinces of East Nusa Tengarra, Maluku, North Maluku, Papua and West Papua and antimalarials are advised.

Philippines

Recommended vaccines: Tetanus

Suggested vaccines: Cholera; Diphtheria; Hepatitis A; Hepatitis B; Japanese Encephalitis; Rabies; Typhoid.

Antimalarials: Malaria risk is low throughout the year in areas below 600m. Risk is higher in the provinces of Palawan, Tawi Tawi, Zambales and Zamboanga del Norte. In these areas the risk is not high enough to warrant antimalarial tablets for most travellers unless you are at higher risk e.g. longer stay in rural areas, visiting friends or relatives, have medical conditions, immunosuppression or are without a spleen.

Japan

Recommended vaccines: none.

Suggested vaccines: Hepatitis B; Japanese Encephalitis; Tetanus; Tick-borne Encephalitis.

Antimalarials:  Malaria not normally present unless the illness was contracted abroad.

Taiwan

Recommended vaccines:  none.

Suggested: Hepatitis A; Hepatitis B; Japanese Encephalitis; Rabies; Tetanus.

Antimalarials: Malaria not normally present unless the illness was contracted abroad.

Malaysia

Recommended vaccines: Tetanus.

Suggested vaccines: Cholera; Diphtheria; Hepatitis B; Japanese Encephalitis; Rabies; Typhoid.

Antimalarials: There is low to no risk in Kuala Lumpur, Penang, the eastern island and other urban/suburban areas and coastal areas. Malaria risk is present throughout the year in pockets of deep hinterland areas of Sabah and Sarawak and a central area in Peninsular Malaysia. In these areas the risk is not high enough to warrant antimalarial tablets unless you are at higher risk e.g. longer stay in rural areas, visiting friends or relatives, have medical conditions, immunosuppression or are without a spleen.

Hong Kong

Recommended vaccines: None.

Suggested vaccines: Hepatitis A; Hepatitis B; Tetanus.

Antimalarials: Malaria not normally present unless the illness was contracted abroad.

Singapore

Recommended vaccines: None.

Suggested vaccines: Hepatitis B; Japanese Encephalitis; Tetanus.

Antimalarials: Human P.knowlesi malaria has been reported. Antimalarial tablets are not usually advised. Travellers are advised to avoid mosquito bites and report any fevers promptly.

Hopefully after reading this you feel a lot more informed about getting vaccinated before you travel. My main piece of advice is just to not take any risks with your health, and think in the long term – saving £100 on a vaccine can cost you a lot more in the future.

While you’re here check out my 9 tips that every backpacker needs to know!

Thanks for reading!
Steph
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