Sorry to start another thread about this, as I realize there are probably countless ones, but I would prefer a more up-to-date answer and one that is specifically for my sort of questions.
Any past experience or from people who are going away and have just sorted their vaccines out would be extremely helpful.
I just yesterday went to my GP and had a discussion about the vaccines that I will need for all the places I will be visiting, which are:
I was told I will get all the basic ones free on the NHS:
Hep A Booster
Diptheria, Polio and Tetanus
And told I will have to pay for the others that are recommended:
Japanese Encephalitis – 80-100 GBP
Hep B – 75 + 25 GBP
Rabies – 80-90 GBP
For some reason I didn’t predict it being this expensive, as a friend who recently went travelling was saying it didn’t cost them too much (and they go to the same GP) but I don’t think they stayed in SEA for too much longer than a month, whereas we are staying for about 4 months (and that’s where Malaria Tablets get costly).
In my understanding, Japanese E is a must, as the mossies love me and I don’t want to take any risks with that one.
Hep B is also a must, and its useful for everyday life anyway, so I will be getting both of those.
Rabies, I am not sure on. I’ve heard some people say get it, and some people say don’t bother. My GP was talking as though it wasn’t essential, but she said of course there is a risk. I don’t plan on doing any work with animals, and I don’t plan on petting monkeys, dogs, cats or any other sort of animals for that matter, so will be staying clear of these.
But I know the monkeys will try and get to you anyway they can, be it either stealing food, bottles of water, so at some point I’m practically guaranteed to come into contact with some, especially if I go to Lop Buri in Thailand like I want to.
The thing is though, the vaccine only gives you a longer amount of time to get to a hospital, and I don’t plan on going on any 2 day long treks or anything, but I will be going to Laos…where I’m sure their hospitals probably aren’t up to scratch with those sort of situations.
So I don’t know whether to save 80-90GBP which can be used for my Malaria Tablets (as Malarone seems soooo expensive) or not?
Can anyone give me any advice on that please??
And now for Malaria Tablets, I have been advised that ‘Malarone’ is the most effective and the one with the least side effects, but being in SEA for at least 4 months and them costing 2.25GBP per tablet, it works out at at least 280GBP which is so much more than I would ever had imagined!!
It really is crazy!!!
I have looked at a Malaria Map (shows you the areas at risk) though, and whilst we will be visiting places with high risk, we will also be visiting a lot of places with virtually no risk at all.
Is it worth only taking them when in high risk areas?? Or is that too risky??
I have now just found on travelpharm.com (which I was also told about by my GP) another Malarial Tablet called ‘Doxycycline’, I know this has a few more side effects and is 5% less effective than ‘Malarone’, but these sell at 0.14GBP a tablet which works out so much cheaper than any other option.
I have also noted that these have a lot less side effects than ‘Lariam’ which apparently cause a lot of nasty side effects, so these seem a lot better to me.
So what would you do?
What have you done in the past?
There are obviously a lot of people that have been to SEA and travelled around there for as long a time as 4 months, so I’m just wondering what you did?
Any help as soon as possible would be very gratefully received as I have to go and speak to my GP again soon and would like to have come to a conclusion by then.
Thanks for your help in advance.
[ Edit: Edited on 12-Aug-2010, at 02:51 by N1U9F8C7 ]
For the places you are going to I had Hep A, Typhoid, Diptheria, Polio and Tetanus. I considered the other vaccinations but decided against them as the risk of catching those diseases in that region are relatively low. For malaria I took doxycycline and had no side effects - I'd recommend them.
The mozzies love me too and I seem to get eaten alive wherever I go, but I still thought the risk of Japanese encephalitis was too low to warrant having the injection - as far as I remember it's only recommended if you are going to be spending a long amount of time in rural areas.
[ Edit: Edited on 12-Aug-2010, at 03:54 by bex76 ]
Like bex76 says, Jap E is only 'common' in rural areas, where 95% of the tourist never come. For up to date info, see http://www.itg.be/itg/Uploads/MedServ/ejapenc.pdf.
About rabies, only a small part of the tourists takes it. The vaccine gives you only some more time, once you're bitten you have to go to the hospital anyway.
And my personal opinion (and of my doctor at the Ghent University Travel Clinic) about the malaria tablets, once you go travelling a longer time, don't take them, just take your precautions. It's not only very expensive, but the question is also if it's healthy to take those tablets over a longer period of time...
If your first stop is Thailand you can get doxycycline cheap in Thailand. Price is around 4 to 10 baht per capsule depending on country of manufacture. Check with your doctor to see if you can use doxy.
For any drugs try some of the larger chain stores like Boots, Fascino and Watsons or a Lotus Tesco Big C type mall pharmacy. Also check the expiration date and read up on how to take these meds and any side affects. I always have some doxy with me for certain areas. Even in Thailand you will be able to read the data sheets because they will be in several languages.
While in Thailand you can check on the prices for some of the shots you have to pay for. Some of the places you might check out are in this link:
I really don't want to give you any advise as I am not a doctor, but I can tell you what I did recently. I was in the Philippines lately and Dengue Fever is big there at the moment ( rainy season) so I just always sprayed a good anti-mosquito spray on me all the time and I didn't get bitten. This is not a great tactic but it is very cheap. You have to remember that this is something that only you can decide on because of the risks. Is it worth risking saving a bit of money, or do you spend the money on tablets and have peace of mind for your trip? To be honest, as you have spent the time on a forum asking for advise it would seem that it is something that worries you, so therefore I would buy the tablets and go enjoy your holiday without the worry of the bloody mosquitos biting you.
I went the doctors tonight to get info on travel vaccines. Im planning to go SEA Jan - May 2010.
On her computer system it said that Japanese Encephalitis is only present between may & October - but i have looked on The National Travel Health Network and Centre (NaTHNaC) & cant see where she got this information from.
I had the free ones that you mentioned - but also got Hep B for free (not sure if that is because of the area i live in) and she has printed me a private patients prescription for rabies vaccination & i have to get it from pharmacy but she didnt know what the cost would be.#
I think i'm going to pay for the injections now ( its alot of money but i would rather be safe) then closer to the time, pay the hefty cost for the malaria tablets. I think the risk is low, but if your going to stress then its worth getting them done. Is it cheaper to get it done through a pharmacy or tropical medicine advice clinics?
I came out to Cambodia last year for a holiday - ended up staying. I didn't get encephalitis or rabies, although my partner did. I did get hep and all the boosters however. I took malarone (short stay, initially), and wished I hadn't wasted the cash.
I'd disagree with Bwiiian - not getting bitten is the BEST precaution! Dengue is more of a threat than Malaria, and especially Japanese Encephalitis, at the moment, and there is no vaccine for that one. Not sure I'd want to be on any anti-malarial for several months, either. Not what lots of people want to hear - but wear long sleeves and trousers, keep topping up the DEET, use mosquito coils, and sleep in screened rooms/under a mossie net. If trekking somewhere high risk I'd consider taking anti-malarials for a short time, though.
The risks in most areas are low to non-existent, but they are there. A friend visited from NZ, took Doxy all the time, didn't go anywhere off the beaten track, and got malaria - some people are born unlucky. She'll probably get bitten by a shark next week. And get rabies. I'm an insect magnet, take all the precautions, and get bitten every now and then. And very occasionally I'll do something stupid, and get a bunch of bites (hands, typically). I don't notice the locals falling over left right and centre, so why get stressed about it?
All personal choice though - I'm not a doctor, etc etc