Malaria Tablets Needed? Vaccinations?

I’m wondering if someone can help me and explain this clearly as it’s literally driving me insane!! So basically I’ve been in Australia for a year and I’m soon leaving and will be starting traveling Asia at the start of January. Im only in Sydney now for another two weeks and then I’m off to New Zealand, so I’m trying to get all my vaccinations sorted now while I’m in Sydney. The thing is, I went to one doctor in Sydney to ask what I needed and he just Googled it and was crossing random things off. I didn’t trust him at all. I then went to another doctor instead who seemed to know what he was talking about and said I needed the following:

Vivaxim (Injection) - Hepatitis A and Typhoid
Dukoral - Cholera and Ekoli
Zedd - Bali belly
Malarone or Doryxcycline - Both Malaria tablets

Now after having it priced up it all comes to roughly $450. I have Medicare out here in Oz but vaccinations like these aren’t covered. I’m confused though as I’ve been looking online and some places are mentioning needing an updated Tetanus, Meningitis jabs etc. I mean in that list above that the doctor gave me, only Vivaxim is actually an injection, all the rest are taken orally. I’m confused as people that I’ve heard who’ve travelled Asia have had a few injections before going, not just one. I’ll be traveling to Bali, Thailand, Cambodia, Vietnam, Laos, India, Philippines, Sri Lanka, Malaysia, Singapore over 5 months. Now there’s some that I’ve ruled out such as Rabies injection as the only time I plan on coming into contact or touching animals will be the monkey’s in Bali in Ubud and the Rabies injection will apparently add on another $100 to the total cost. Also the doctor said I won’t need Hepatitis B as I won’t be hanging around with needles, drug dealers etc.

Malaria tablets are also confusing me. The doctor told me I need to choose one of those tablets, but the side effects sound like they will ruin the entire holiday!!! Does anyone have any advice on Malaria tablets? I’m extremely confused right now so any help would be appreciated.

The best advice for these things should really come from a medical practitioner. Anecdotal advice is just that - personal experiences from other travelers; don't risk your life on it!

Personally I'd make sure my tetanus jab was up to date and I would look at a hepatitis jab too. As for malaria tablets, they have improved in recent years. I used to be very skeptical about taking them because of the psychotic effects I've heard about but in Africa a couple of years ago, along with covering up and using Bushman's, we used Doxycycline tablets and they were cheap and (for me) side-effect free.

But I'm no doctor - the best advice will come from a medic.

Enjoy Asia - it sounds like an awesome trip!

As above...medical advice not only varies according to your exact itinerary, which you haven't given, but also according to your personal health status.

Having said that, here in the UK Hep A & typhoid are recommended for all travel abroad outside Europe. Hep A, in particular, can and does occur everywhere and is very easily transmitted. I'd most definitely recommend having that vaccination.

Whether you need malaria tablets or not depends on where you are visiting....not just the country but the area of the country too. It's worth remembering that malaria is a killer...and it only takes one bite. On VT we had a long-standing and highly experienced (in travel) member who died of cerebral malaria. If I were visiting a malarial area I personally would not take the risk of visiting without malarial prophylaxis.

I haven't seen anti-cholera/e-coli or 'Bali belly' medication recommended by the UK NHS (National Health Service)

If you're interested, you can see what is recommended for each country by the UK NHS, plus a country malaria map when appropriate, here:

http://www.fitfortravel.nhs.uk/destinations.aspx

At least you know the advice given on that site is from an official and professional medical source rather than just random strangers on the internet! :-)

[ Edit: Edited on 30-Oct-2017, at 00:40 by leics2 ]

Generally big towns are OK. Many small towns OK. Spray around in the evening to kill any mosquitoes. Insect repellent or lightly spray your clothes and exposed flesh when going out in the evening.

Jungles and inland rivers and such you will probably need some inoculations. If you take malaria tablets, make sure you take the full course.

Stay away from animals, notably dogs.

Tummy trouble: Try the traveller's remedy. A small spoon full of salt washed down by a sugary drink.

In terms of alternative medicine for tummy troubles I have heard travellers swear by Kefir Water. They will carry some grains in a container ferment it overnight and drink it through the day, and they tell me they haven't got sick since drinking it ¯\_(ツ)_/¯ . I suppose it is an alternative to sugary drinks if you have blood sugar problems.

I have also gotten contradictory advice about vaccines that have left me far more confused than when I started. Medical professionals I found aren't that educated about medicine for travellers. I once considered visiting a so called travellers clinic but then I met someone who had gone and she told me they had her pay for hundreds of dollars of vaccines she didn't actually need for that particular trip. Either they scammed her or their knowledge is about as good as the local GP

When it comes to long term travel a tetnus shot is a good precaution. Malaria tends to more of a problem in rural or jungle areas, in saying that Laos in particular does have a problem with Malaria. Best thing is to get good repellent after all there other diseases that mosquitoes spread besides Malaria, not to mention repellent will keep away other critters like ticks which can also make you sick. When buying repellent make sure they contain either DEET, Picaridin or PMD otherwise know as oil of lemon eucalyptus (not to be confused with lemon eucalyptus oil).
This article is a good breakdown of what to look for in an effective repellent:

http://www.medicaldaily.com/four-best-bug-repellents-deet-ir3535-picaridin-oil-lemon-eucalyptus-most-effective-says-ewg-247785

Remember the higher the percentage of active ingredients the more hours it will last per use. Since you brought up Rabies it should be noted bats carry it too. I don't know if you plan on visiting caves but scared bats can act erratically and accidentally scratch people.

You really need to find a physician who knows about travel to the areas you have planned. Also check the government web sites on their travel alerts because doctors aren't always completely up to date on those.

Hepatitis A and Hepatitis B are completely different. Having had Hep A, I'd strongly recommend the innoculation. They didn't have one when I got it but Hep A is highly contagious and easily spread. If you can avoid it, it is worth the cost. All you have to do is eat in one restaurant where a worker didn't wash his hands or didn't wash them properly . . .

Malaria . . . That's a tough one. If you are in excellent health, it is unlikely to kill you. I caught malaria one year too and the only reason I even knew I had it was there was an epidemic in the camp where I was teaching so they tested everyone and my test came back positive. You are given the same tablets to treat the disease as you get to prevent it so they gave me a course of malaria meds. (Don't remember which one.) I didn't have any side effects although other faculty did but nothing major.

The general feeling there was the more of the medication you take, the greater the possibility of side effects so several of us decided to just wait and see if we got malaria. In 15 years of teaching at the camp, I only got it once and that was a very bad year for everyone. It is also the only time I got it.

If you health is less than excellent, I'd take the malaria meds and also try to cover up and prevent any mosquito bites if possible. As mentioned above, they carry a lot more diseases than malaria and all of them are nasty. Mosquito repellent is our friend . . .

Most important . . . check with a knowledgeable physician. There is no substitute.

In Thailand when I knew I was going to an area where Malaria is present I purchased Doxycycline from local Thai pharmacies. You should begin taking this preventative before entering a Malaria area. Also continue after leaving the area. Doxy is cheap in Thailand. See your doctor first if this is okay for you!

I have a managed care program where my shots are covered. I get a few that other travelers probably ignore like Yellow Fever and Japanese Encephalitis Vaccine. (I have been on flights more than once where my flight was diverted to other countries I had not expected.)

Dengue Fever (Break-bone Fever) present in Southeast Asia. As far as I know there is no cure only try to keep mosquitoes away. Read up on this problem.

But YOU should do what your doctor recommends!

I was suggested a malaria vaccine when travelling to the caaribbean (even if it's not required)...but when I asked few docs and read a bit here and there myself, it seems like it is only 50% effective and also quite heavy on the liver.