Following the example of the BBC, I apply this caveat: The article is a general guide and does not replace the advice of a medical practitioner or pharmacist.
Useful sites for information:
US CDC and UK NHS. Travelchimps’ Travel Research Tools dashboard enables you to access both US CDC and UK NHS health, vaccination, and malaria advice for any country.
TravelHealthPro created by the UK NHS for use by health professionals has comprehensive information and advice by country.
N.B. If you are not from the US/UK you should bear in mind that the advice in the above links might make assumptions as to what vaccinations residents of these countries will have already taken.
Insect borne diseases for which there are no vaccines/treatments (e.g. Dengue): you will have to depend on bite prevention measures.
Consider immunisation months before your travel, some vaccines or courses have to be started well in advance of your trip/holiday.
Where do I get my vaccinations?
Depending on the number and type of vaccinations, you may have to make a number of trips to your local clinic/surgery.
I’m a US resident:
CDC’s find a clinic page.
I’m a UK resident:
Your Doctor’s Surgery. They will probably be provided by a practice nurse who will also have access to information on what vaccinations you will require. But ensure the nurse has not missed any that you have identified from the above sources. Discuss it, there may be valid reasons for exclusion, or you may have valid reasons for inclusion.
Private Travel Clinic – The NHS website implies that you may have to use a private travel clinic for some of the vaccines. However, I had no problems obtaining the whole A to Z (well Cholera to Yellow Fever anyway) through my NHS Doctor.
How much does it cost? Will I have to pay?
US residents Your insurance (probably) won’t cover you. You can get an idea of costs from Costhelper.com e.g. for Yellow Fever it says between $150 and $350.
NHS Doctors Surgery: some vaccines are free others are charged (in 2005 I paid £25 for Hep B; £35 for Yellow Fever & £110 for 3 rabies injections).
Private Clinics – averages around £50 per injection. MASTA’s pricelist. (Aug 2017 prices when I checked – I assume link is updated)
Protection against Travelers’ Diarrhea:
This section now has its own page: Travelers Tummy – prevention & treatment. Covers practical/medicinal prevention; and self treatment. Includes info on an over the counter medicine that provides protection against TT.
Around 1,500 travellers return to the UK with malaria every year. In 2015, the figure was 1,400 cases and six deaths in the UK. “Most UK travellers who catch malaria either do not take any malaria tablets or do not take the right tablets for the part of the world they visit.” (from NHS website)
If you don’t do anything else read FitForTravel’s advice on Malaria and its prevention
Is the area I’m visiting affected, and what Antimalarial tablets should I take?
Malaria builds up resistance to antimalarial drugs; so one “brand” may provide protection in one country (or even one part of a country) but not another.
FitForTravel (NHS UK), CDC(US) and MDtravelHealth provide Malaria information by country with advice on suitable tablets. Check more than one site; one may provide more detail for a particular country; and recent news on malaria drug resistance may appear on one site before the other. CDC and NHS country pages can be accessed directly from this sites Travel Dashboard.
You may have to obtain and start taking your antimalarials a few weeks BEFORE you visit an affected area, you have to remember to take them DURING and AFTER your trip. The biggest drawbacks are the side effects; and some may not be medically advisable for you to take. Contact your doctor to discuss which tablets you can tolerate.
Antimalarials do not provide 100% protection so you must also take measures to prevent being bitten (covered below).
Where to buy antimalarials (UK only):
Antimalarials can be expensive, and you may need a private subscription from your Doctor. Don’t forget you will need enough tablets to cover the pre & post holiday parts of the antimalarial course. There can be big differences in prices so shop around.
A few years ago my father found that Superdrug and Tesco pharmacies were the cheapest for Malarone, and his local chemist agreed to price match. Best Internet prices were only slightly cheaper.
There is a risk of purchasing counterfeit or substandard drugs over the internet. The British General Pharmaceutical Council (GPhC) has a register to help the public to identify legitimate pharmacies. The pharmacy’s registration number should appear on their site and you can verify it at the GPhC site. If you are buying online, visit the GPhC via your own link (not one given on the “pharmacy’s” website) and go back to the Pharmacy via the web address listed on the GPhC site to avoid being tricked into using an illegitimate site quoting someone elses registration with a similar web address.
You may have advised, or chosen, not to take antimalarials because the area you are visiting is classified as “minimal risk”. Minimal does not mean zero risk, you should still take precautions to prevent insect/mosquito bites in these areas.
FitForTravel has an excellent page on preventing bites; it does not mention air conditioning so also check out this CDC infographic. These links like others advise the use of insect repellents containing DEET. FitForTravel’s page includes guidance on its application and says it can be used on children aged over 2 months with caution.
According to Wikipedia the hours of protection and effectiveness of DEET is dependent on the concentration used – BUT high concentrations may make DEET’s side effects more serious.
Author Andy W+