Vaccinations – Southeast Asia

Its important to be safe when traveling to remote areas and foreign counties with different environments. Sometimes playing it safe means having a map, phone, first aid kit, or telling someone your destination. Other times playing it safe can mean protecting yourself from diseases and other health concerns. Recently I spoke with my doctor about our upcoming trip, as any traveler should do.

First, I am not a doctor or any type of medical expert. I want to tell you about my experience getting prepared so you know what to expect if you should travel.

6 months before traveling, I got a vaccine in each arm

Timing

Although Jon and I aren’t leaving the county for another 5-6 months, I wanted to see the doctor now. The most important reason to see the doctor early in the planning process is in case they recommend a vaccine that requires multiple shots or boosters (for example the hepatitis A vaccine requires a booster 6-12 months after the first shot). Make sure you give yourself enough time to follow up with treatments if you need them.

My second reason for wanting to see the doctor early was to discuss if she had any recommendations for the earlier in-country portion of our trip. Although I know I’m relativity safe in American, I wanted to ask if she had recommendations for ways to protect myself from getting sick while camping, sleeping outside on the ground, or getting rained on. (Beyond a flu-shot she didn’t really).

The last reason I went to see my doctor early was because I am currently insured through my employer; a luxury which will be changing for a lesser insurance plan while we are traveling.

Educate yourself

I have a primary care physician whom I trust, but it is always important to me to have an educated conversation so I understand what is being said and can ask questions. Before seeing my doctor I did my own research online about what are common vaccines required by travelers and what countries are the most at risk areas.

The Center for Disease Control (CDC) is the best resource out there and most doctors will follow CDC advice. The CDC website → Traveler’s health → Destinations provides vaccine information by country. I found that for our travels the same 2-4 vaccines came up again and again. That helped me prepare for my conversation with my doctor.

Talk with your Doctor

After having some idea of what to expect, I went to my doctor’s office. Her office provided a ‘Travel Consultation’ appointment for $50 (because I’d already had my annual physical for the year insurance didn’t cover this appointment). Plus at the end of the appointment she gave me an International Certificate of Vaccination booklet issued by the World Health Organization which lists the vaccines I’ve had and their dates.

My doctor listened to our tentative itinerary and asked a few questions about what we expected to be doing. Then she started to discuss vaccines she recommended one at a time (pretty much verbatim what I had read on the CDC website). For the most part, I just listened to see if she could add anything to what I’d read and I even played a bit dumb because I didn’t want to lead the conversation when she was the expert.

Some vaccines may only be needed if you intend to be working (building homes or in a clinic) in another country, so we discussed the likelihood of this (none). Other times we discussed how remotely we would be traveling, for example rural villages with stray animals may require a rabies vaccine while staying to big cities wouldn’t. For a few vaccines that she was less familiar with she directed me to a clinic that specializes in travel medicine (I didn’t even know those existed, yet this one is in walking distance from my home). Other items we discussed are how I could contact my doctor should I have problems while traveling and how to receive prescribed medications while traveling.

Get your vaccines/medications (or set up a time table)

Some vaccines require multiple shots and boosters, other should be taken close to the time of departure. A few prescriptions my doctor prescribed I will carry with me and take only if I get sick while traveling.

Below is a summary of final medical evaluation. Once again, I’m not a doctor and this is a plan that my doctor came up with for my personal needs, my destinations, and the activities I intend to do while traveling. (For me, this is mostly tourism and hiking in southeast Asia, Australia, New Zealand, and Nepal)

Hepatitis A – My doctor (and the CDC) strongly recommended a Hepatitis A vaccine and she gave it to me while I was there. There is a booster shot that needs to be administered in 6-12 months. My understanding is that the booster will make the vaccine life long. Without it, the vaccine wears off. The booster cannot be given earlier than 6 months.

Polio My doctor (and the CDC) strongly recommended the polio vaccine. In America it is very likely this was given to me as a child but my doctor though I needed booster which she gave me at the time. Jon’s doctor felt that his childhood vaccination was enough protection and didn’t give him a booster.

Typhiod This is another one strongly recommended. There are several forms of this vaccine available, but my doctor suggested a oral vaccine that I left the doctor’s office with a prescription for. The vaccine is to be kept refrigerated as you take it in multiple doses. (My pharmacy didn’t have this, but ordered it for me in three days time). The oral vaccine is good for 5 years.

Japanese Encephalitis – My doctor’s office doesn’t stock this vaccine and admitted to not being very familiar with it. I was provided with the name and number of a doctor at a specialty traveler’s clinic to call for a consultation. They also did not think this was necessary.

RabiesThis is another my doctor didn’t stock. She said this would be needed if we were staying in small rural villages where stray animals are common in the streets. She recommended I ask the travel clinic who also did not think this was necessary.

Hepatitis B This virus is commonly passed through blood and urine. Unless working in a clinic or building project overseas my doctor did not think this would be necessary.

Traveler’s Diarrhea– This is one you can’t prepare for (and hopefully won’t need) however should it occur there are some medications you can take. My doctor proactively gave me two prescription to carry with me while traveling should I experience problems. The first is Cipro. Unfortunately, while Cipro works in most areas, some viruses in Thailand have stopped responding to it, so my doctor also gave me a prescription for a Z-pack to be taken in Thailand if I need it.

Malaria– These pills are to be taken on a schedule before, during, and after traveling in regions where malaria is a concern. Although we don’t have a set itinerary yet, I discussed with my doctor the likelihood I’d be in these regains. We decided a 10 week supply of pills for malaria should cover my travels. This includes 6 weeks in Southeast Asia (plus one week of pills that is taken after you leave) and 2 weeks in China/Nepal (plus the one week afterwards). Insurance likely won’t cover these pills and they can be expensive. Jon and I have decided to wait until we have a better schedule planned so that we are not buying extra pills.

Other items she mentioned:

  • Do not eat fruit or vegetable skins. Always peel or cut them off
  • Do not eat rare or medium-rare meats, or undercooked seafoods
  • Do not use ice
  • Always wear bug spray and sun protection

Tips

  • When I took my prescriptions to the pharmacy, I asked for generics and were able to pick up some of the medications for less than $10.

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