In 2024, Dianne Elliot took a three-week, seven-country trip that included stops in the United Kingdom, Egypt, India, Cambodia, Jordan, Indonesia and Oman. Some of those countries require specific vaccinations for entry. Others have no requirements, but because of disease outbreaks and endemic diseases, the Centers for Disease Control and Prevention recommends specific vaccinations.
Elliot, a former nurse who is diligent about her health, began preparations by making an appointment with her primary care physician who referred her to Passport Health, a travel medicine and immunization service.
“I got every shot recommended because I was being overly cautious,” she says. “Having been a nurse, I knew what could go wrong, so I erred on the side of caution.” Because many diseases won’t present until you’re back from traveling, the best reason for vaccination is to reduce or eliminate risk of serious diseases that are present at your destination.
[Read: What to Do If Your Child Is Diagnosed With a Rare Disease.]
Why Getting Vaccinated Before Traveling Is Important
When traveling to certain countries, you’ll want to be protected against diseases that aren’t present in the United States for the following reasons:
— Lack of adequate medical care. In some countries, if you get sick, you may not have access to good medical care.
— Health insurance. Your health insurance may not be accepted in other countries, so you should get as much protection as possible before traveling.
— Contracting disease. If you do get infected with certain diseases while traveling, you won’t be allowed to return to the U.S. unless you have fully recovered.
— Compromised immune system. If you have certain conditions that weaken your immune system, you’re more vulnerable to contracting diseases when you travel.
— No immunity. You may be exposed to diseases for which you have no immunity, and vaccinations lower your risk if you’re exposed.
“When considering vaccines, a travel medicine specialist can help an individual understand the risk of disease in a geographic area and the consequences of that disease to the individual traveler,” says Dr. Scott Weisenberg, medical director of the travel medicine program at NYU Langone Health in New York.
Through shared decision making, he adds, they can decide on which vaccinations are appropriate for each traveler.
Here’s a guide on vaccines you’ll need to protect yourself from getting sick while traveling abroad.
[Ranking the Most Painful Medical Conditions]
Important Vaccines for Traveling
There are several routine vaccines you should be up to date on before traveling:
— Measles, mumps and rubella (MMR)
— Polio
— Tetanus, diphtheria and pertussis (Tdap)
— COVID-19
— Respiratory syncytial virus (RSV)
— Human papillomavirus (HPV)
— Tuberculosis (TB)
“After that, if you’re traveling to more exotic locations, the vaccines you get should depend on which are mandated by the countries you’re visiting, your overall health, your age, how long you’ll be traveling, whether you’re traveling to cities or rural areas, what you’ll be doing in those countries and how long you’ll be away,” says Dr. Priya Sampathkumar, an infectious disease specialist at Mayo Clinic.
These include:
— Hepatitis A
— Yellow fever
— Typhoid
— Chikungunya
— Dengue
— Malaria
[Read: COVID, Flu and RSV: Why Older Adults Need to Get Vaccinated]
Hepatitis A
Hepatitis A is a viral liver infection found in areas with poor sanitation and food hygiene. It’s spread through contaminated food and water or close contact with a person who is infected.
Countries with high rates of hepatitis A include parts of Africa, Asia, Central and South America and eastern Europe.
Hepatitis A symptoms
Not everyone has symptoms, but when they do appear, they can include:
— Unusual tiredness or weakness
— Sudden nausea
— Vomiting
— Diarrhea
— Abdominal pain, which often occurs on the right side of your body beneath your ribs which cover your liver
— Clay or gray colored stool
— Loss of appetite
— Low-grade fever
— Joint pain
— Yellowing of skin and whites of eyes
— Itching
Symptoms of hepatitis A usually appear a few weeks after you’ve been infected with the virus. They can be mild and go away in a few weeks or severe and last for several months.
Hepatitis A vaccine
Hepatitis A is a standard vaccine that is typically given in two doses, with the second dose being administered six months after the first. It’s recommended for the following people:
— High-risk adults. Adults who have not been vaccinated and are at increased risk for infection.
— International travelers. If you’ve been vaccinated for hepatitis A, you likely won’t need to be revaccinated for travel, but your travel medical specialist should be consulted.
You should be fully vaccinated at least two weeks prior to travel.
Yellow Fever
Yellow fever is a virus spread by mosquitos that have been infected by biting primates. The virus is not spread directly, but from person to person through the bites of infected mosquitos. It normally takes three to six days from the time of infection to develop the disease.
Yellow fever is found primarily in Africa and South American countries.
Yellow fever symptoms
Some people who are infected with the yellow fever virus experience no symptoms, others have mild symptoms and some have severe symptoms. At its most serious, it can be fatal.
When symptoms do occur, they are usually severe and include the following:
— High fever
— Jaundice
— Hemorrhage
— Shock
— Liver failure
Yellow fever vaccine
There is no cure or treatment for yellow fever, so depending on where you’re headed, it’s important to be vaccinated before you travel. It’s a one-dose vaccine that should be injected at least 10 days prior to departure. It will protect you for a lifetime and is recommended for the following people:
— People 9 months or older. Vaccination is recommended for people traveling to some parts of Africa and South America who are at high risk for yellow fever.
— People traveling from high-risk countries. Some countries such as South Africa require proof of vaccination before entry if you’re traveling from a high-risk country like Kenya.
Typhoid
Typhoid fever is a life-threatening infection caused by salmonella bacteria in food and water. It’s found in South Asian countries, such as India, Pakistan and Bangladesh, and sub-Saharan Africa. Symptoms usually begin to appear one to three weeks after exposure.
Typhoid symptoms
Some people have no symptoms, but many do, and they include the following:
— High fever, which often increases over several days to reach a high of 104 degrees
— Diarrhea
— Rash
— Loss of appetite
— Nausea
— Vomiting
— Headaches
Typhoid vaccine
A typhoid vaccine is needed if you’re traveling outside of the usual tourist stops. The following are the two kinds of vaccines available:
— Inactivated typhoid vaccine. For people 2 years and older, one injection is needed at least two weeks before travel. For people who are at risk, additional doses are recommended every two years.
— Live typhoid vaccine. For people 6 years and older, the oral vaccine is taken every other day for a total of four capsules. The last dose should be taken at least one week before travel. The vaccine is good for two to five years.
The vaccine is only 50% to 80% effective, so you’ll need to be careful when eating, drinking and being in contact with other people.
Chikungunya
Chikungunya fever is a virus spread by mosquitos infected with the chikungunya virus. One third of the world’s population lives in at-risk areas for chikungunya.
The virus is primarily found in tropical areas of Africa, Asia, Europe, some islands in the Caribbean, India and — in rare cases — the U.S.
Symptoms of chikungunya
While chikungunya doesn’t cause severe problems or death most of the time, symptoms usually appear within two to seven days after a bite. When symptoms do appear, they include the following:
— Severe joint and muscle pain
— High fever
— Headaches
— Rashes
— Nausea
— Vomiting
— Conjunctivitis, a condition characterized by inflammation of the membrane that lines the eyelid and eyeball
Chikungunya usually doesn’t cause serious problems or death, and most people recover within a couple of weeks.
Chikungunya vaccine
The relatively new chikungunya vaccine, IXCHIQ, is a one-dose injection of the chikungunya virus. It’s recommended for the following people:
— People 18 or older. For adults traveling to areas with outbreaks.
Dengue
Dengue is a mosquito-borne viral infection. It’s most common in areas of Southeast Asia, Western Pacific Islands, Latin America and Africa, but it has also spread to some parts of Europe and the U.S.
Dengue symptoms
Often dengue has no symptoms, but if you have mild dengue, you may feel like you have the flu. Symptoms begin about four to 10 days after you’ve been bitten and can be confused with symptoms from chikungunya, zika, malaria or typhoid fever.
When you have a severe case of dengue, you may have some of the following symptoms:
— Serious bleeding from gums and nose
— Blood in urine, stool or vomit
— Blood under the skin that looks like bruising
— Rapid and difficult breathing
— Persistent vomiting
— Fatigue
— Irritability or restlessness
— Headache
— Pain behind your eyes
— Swollen glands
— Dry mouth or lips
— Lethargy
— Cold or clammy feet and hands
Dengue vaccine
As of this month, the manufacturer of the dengue vaccine is discontinuing production due to lack of demand.
You can protect yourself by doing the following:
— Use insect repellant.
— Wear long sleeve shirts and long pants.
— Sleep under a mosquito net.
— Make sure windows and doors are screened.
— If you can, stay in air-conditioned rooms.
Malaria
Malaria is a life-threatening illness caused by parasites you can get from the bite of an infected female mosquito. It’s common in Africa, South and Southeast Asia, Central and South America, Dominican Republic, Haiti and other parts of the Caribbean and islands in the Central and South Pacific Ocean.
Malaria symptoms
Symptoms of malaria can be mild or severe and may not appear for a week to a month after you’ve been bitten. Some people go a year without having symptoms. When they appear, symptoms of malaria include the following:
— Fever and sweating
— Chills
— Headaches
— Muscle aches
— Fatigue
— Chest pain
— Difficulty breathing
— Coughing
— Diarrhea
— Nausea
— Vomiting
Malaria vaccine
While the malaria vaccine is not available in the U.S., an antimalarial drug can provide some protection. Your primary care provider or travel medicine specialist will determine which drug you take depending on where you’re going.
Antimalarial drugs are not 100% effective, so you’ll need to be vigilant about protecting yourself against mosquitos.
Travel Recommendations for Other Tropical Diseases
There are other tropical diseases that travelers should be aware of when visiting certain regions. While there currently are no vaccines to protect against these viruses, there are certain measures people can take to protect themselves from them.
Zika
Zika virus is a mosquito-borne virus that can cause birth defects during pregnancy, including microcephaly, brain damage and other development issues.
It is typically found in areas of the Americas, the Caribbean, Africa, Southern Asia and the Western Pacific.
If you’re infected with zika, it can remain in your body for weeks or months and be spread to others through oral, anal or vaginal sex.
Zika symptoms
Most people who are infected with zika don’t know they’ve been infected or have mild symptoms that can appear three to 14 days after infection.
Symptoms include:
— Fever
— Headache
— Joint pain
— Redness in the white of eyes
— Rash
How to protect yourself from zika
There is currently no vaccine for zika virus.
If you’re pregnant, do not travel to areas where you could contract zika. The virus can pass through the placenta to the fetus and prevent the brain of the fetus from developing properly.
Protect yourself from mosquitos and practice safe sex.
Chagas
Chagas is an infectious tropical disease transmitted by a parasite found in the feces of the triatomine bug, also known as “kissing bugs” because they tend to bite on the face. The disease is found in rural areas of South America, Central America and Mexico.
Chagas symptoms
The risk of serious damage from chagas disease complications is low. There are often no symptoms, but it can cause sudden brief illness. In some cases, it can become an acute or chronic, long-lasting condition. When symptoms do occur, they include the following:
— Muscle aches and pain
— Skin rash
— Swelling at the infection site or around the eyes
— Fever
— Tiredness
— Headaches
— Abdominal pain
— Body aches
How to protect yourself from chagas
There is no vaccine for chagas disease, but you can try to prevent bug bites by doing the following:
— When traveling in areas where chagas is present, don’t sleep outdoors or in poorly built houses made from mud and thatch.
— If you do sleep outdoors, sleep under a bed net treated with insecticide.
— Don’t eat raw fruits and vegetables and peel skin. Drink only bottled or boiled water.
Health Resources for Travelers
You can receive appropriate vaccines, preventive medicine and/or timely information from these sources:
— Primary care providers. To find out whether you and your family are up to date with routine vaccines, including flu shots, hepatitis, tetanus and MMR immunizations, check with your primary care provider. They can immunize you as needed and also adapt regular childhood vaccination schedules as recommended, such as for infants between 6 months and 1 year old, to protect them during travel.
— CDC destination pages. To assess risk before departing, would-be travelers can look up their destinations on the CDC’s travelers’ health site to find out what vaccines or other health precautions are recommended.
— Travel clinics. Travel clinics, such as Passport Health, provide a one-stop-shop for vaccinations people will need based on their destinations.
More from U.S. News
Do I Have to Sign Up for Medicare If I Live Overseas?
How Do You Know If a Clinical Trial Is Right for You?
Stomach Bugs: Causes, Symptoms and Treatment
Vaccines You Need Before Traveling originally appeared on usnews.com
