Travel Health: Which Vaccinations Should You Get Before You Travel?

Vaccinations are an essential part of preventative healthcare. Not only do they lessen the risk of serious illness, but they also protect us from the complications of vaccine-preventable diseases. For more information on vaccinations in Hong Kong, click here.

Before you travel, it’s advised that you get vaccinated against specific pathogens found abroad to protect you and your family’s health. We recommend you to ask your doctor about the following:

MenACWY Vaccine

Overview

A meningococcal infection causes two major illnesses; meningitis (brain inflammation) and septicaemia (blood poisoning). The condition is observed worldwide, but the area with the highest risk is Sub-Saharan Africa¹.

Prevention & Vaccination

Meningococcal ACWY vaccine provides protection against invasive meningococcal disease caused by N. meningitidis serogroups A, C, W-135 and Y (meningococcal infection). In addition to routine vaccination for children and adolescents¹, meningococcal ACWY vaccine is also recommended for adults with higher risk of infections such as overseas students living in residence halls and travellers to high-risk areas.

Yellow Fever Vaccine

Overview

Yellow fever is a disease passed on by mosquitos that causes symptoms like fever, chills, jaundice, muscle pain, nausea, and more. Learn more about yellow fever. 

Prevention & Vaccination

The yellow fever vaccination is recommended for people travelling to some tropical areas of Africa and Latin America. Yellow fever is a live-attenuated vaccine which is recommended to adults who are living in or traveling to high-risk areas. Yellow fever vaccine may be required for entry into certain countries. A single dose provides lifelong protection for most people. Vaccine is only available at Travel Health Centres of the HK Department of Health.

When travelling, it is also advised to try to avoid mosquito bites as the first line of defence against mosquito-borne infections². The CHP (Centre for Health Protection) recommends implementing the following general measures against mosquito bites³:

• Using mosquito nets if sleeping areas are not screened.
• Use DEET-containing insect repellent on exposed parts of the body and clothing.
• Wear loose, long-sleeved tops and trousers that cover up exposed skin, reducing the amount of skin that can be bitten.

Japanese Encephalitis Vaccine

Overview

Japanese encephalitis (JE) is a mosquito-borne disease that infects the brain by the Japanese encephalitis virus⁴. The areas most affected are rural and agricultural areas of Asia and the Western Pacific Region. As of yet, there is no specific treatment for the disease.

Prevention & Vaccination

Preventative measures similar to that for yellow fever should be followed, such as using DEET insect repellent, avoiding exposing skin and using mosquito nets. You should also ask your doctor about the Japanese encephalitis vaccine.

The vaccine is recommended for persons travelling to a JE-endemic country for prolong period (e.g. 1 month or more) or frequent travellers to JE-endemic areas. Also it is recommended for those who are travelling to high-risk areas for shorter-term but with increased risk of JE based on planned travel duration, season, location, activities, and accommodations.

In Hong Kong, there are two types of Japanese encephalitis vaccines provided by health clinics⁵:

1. Inactivated vaccine - This vaccine is approved for use in people travelling for at least two months. Two doses are given on days 0 and 28 of the primary vaccination regimen, one week before travelling.
2. Live attenuated vaccine - This vaccine is recommended for children aged 9 months and up. One dosage is given at least 14 days before travel in adults, and in children, one dose is provided at least 28 days before travel.

The highly immunogenic live attenuated vaccine Imojev is available at OT&P

Shingles Vaccine

Overview

Shingles is a viral infection caused by the zoster virus (that also causes varicella). When varicella sores heal, the virus remains dormant in nerves, where it can later become shingles. We recommend receiving the Zostavax vaccine before travel, as the infection can spread from person to person via the respiratory route⁶.

Prevention & Vaccination

There are two shingles vaccinations that may help prevent the disease: Shingrix and Zostavax. Hong Kong has both vaccines available.

• Shingrix 

Shingrix is a Food and Drug Administration (FDA) approved vaccine that can help prevent shingles. It is made for adults 50 years and older. This vaccine has been proven to be 90% effective in preventing shingles. Two doses are given with the second shot given 2 to 6 months after the first shot.

• Zostavax 

Zostavax is also FDA approved. The vaccine is used for adults aged 60 or older and reduces risk of developing shingles by 51%. It is given as a single dose shot. Zostavax is also the vaccine that is regularly accessible worldwide in comparison to Shingrix⁷.

Rabies Vaccine

Overview

Rabies is an acute infection of the central nervous system usually caused by a bite, scratch, or licked over broken skin by an infected animal.

Prevention & Vaccination

The rabies vaccination is used to prevent the infection. When travelling, be sure to avoid contact with stray animals and receive the rabies vaccine. High-risk countries include most of central Asia and Africa.

CDC recommends pre-exposure vaccination against rabies for those traveling to country where rabies is widespread. A three-dose course (at day 0, 7 and 21-28) of injection will be given. Depending on the risk assessment, booster dose may also be advised for those who have previously completed the primary series. Learn more about rabies.

Typhoid Fever Vaccine

Overview

Typhoid fever is a bacterial infection passed on through contaminated food and drinking water. There are currently two vaccinations that protect against Typhoid fever.

Prevention & Vaccination

Preventative measures include only drinking bottled water, eating thoroughly cooked food, and regular hand washing⁹. The vaccination is recommended for individuals travelling to high-risk areas, including countries in South Asia, Africa, and Latin America.

There are 2 types of typhoid fever vaccines which is the oral vaccine (to be completed at least 1 week before travel) and injectable vaccine (to be completed at least 2 weeks before travel).

The injectable vaccine requires a booster every 2 years whereas the oral vaccine requires booster every 5 years. Both types of vaccines are available at OT&P.

If you are unsure of which vaccines you need for your trip, discuss your travel plans with your family doctor for accurate recommendations.

MMR Vaccine

Overview

The MMR vaccine gives protection against measles, mumps and rubella. 

Prevention & Vaccination

MMR vaccine, which is live-attenuated, is very effective at protecting people against measles, mumps, and rubella and preventing complications associated with these diseases. Adults should get at least one dose of MMR vaccine. Certain adults with increased risk for measles or mumps transmission should make sure they have had 2 doses completed.

Tick-borne encephalitis

Overview

Tick-borne encephalitis (TBE) is a cause of viral infections of the central nervous system in Europe and Asia. TBE is caused by a single-stranded RNA virus that belongs to the genus Flavivirus. TBE virus is transmitted to humans through the bite of an infected tick or ingestion of unpasteurised dairy products from infected animals.

Prevention & Vaccination

For unvaccinated travellers to endemic areas of TBE, the estimated risk during tick transmission season is approximately 1 case per 10,000 person-months. 

The World Health Organization recommends TBE vaccines for at-risk travellers, and booster doses are required to maintain immunity and should be given every 3 years if there is continuing risk.

In Hong Kong, TBE vaccine is only available upon special arrangement with the Drug Office of the Department of Health on a case by case basis.

Diphtheria/ Tetanus / Acellular Pertussis

Prevention & Vaccination

Anyone who is not vaccinated against tetanus can get it. Tetanus occurs throughout the world and people of all ages can get infected. Getting vaccinated is the best way to protect against tetanus. Tetanus vaccines are combination vaccines which can also protect against diphtheria and pertussis. All adults should get a tetanus booster shot every 10 years.

Learn more about the tetanus, diphtheria and pertussis vaccine. 

Polio Vaccine

Prevention & Vaccination

Adults who are at increased risk of exposure to poliovirus (for example, those living in or travelling to a high-risk place) are recommended to receive a booster dose of inactivated poliovirus vaccine (IPV) or an IPV-containing vaccine every 10 years. They can receive this vaccine as part of Tdap-IPV to have protection against other diseases as well.

Travel Vaccine Clinic at OT&P

Vaccinations play an immense role in optimal health and offer protection for travellers against diseases found abroad, so it’s important to understand what vaccine you should get and when.

If you are unsure, OT&P’s professionals can help you build a tailored vaccination plan that will cater to your health needs and travel plans. Our general practice clinic offers an extensive range of vaccinations in stock for adults, an anti-malarial drug dispense on-site and a vaccine calculator.

References

1. Sarah A. Mbaeyi and Lucy A. McNamara. (2019). ‘Meningococcal Disease.’ Centers for Disease Control and Prevention. June 24. Available at: <https://wwwnc.cdc.gov/travel/yellowbook/2020/travel-related-infectious-diseases/meningococcal-disease> [Accessed 07 May 2021].
2. Fit for Travel. (2020). ‘Mosquito Bite Avoidance.’ NHS. Available at: <https://www.fitfortravel.nhs.uk/advice/malaria/mosquito-bite-avoidance> [Accessed 11 May 20201].
3. Centre for Health Protection. (2019). ‘Yellow Fever.’ Department of Health. 10 December 2019. Available at: <https://www.chp.gov.hk/en/healthtopics/content/24/25044.html> [Accessed 16 July 2021].
4. Travel Health Service. (2020). ‘Japanese Encephalitis.’ Department of Health. 28 December 2020. Available at: <https://www.travelhealth.gov.hk/english/travel_related_diseases/jap_encephalitis.html> [Accessed 16 July 2021].
5. Travel Health Service. (2020). ‘Japanese Encephalitis Vaccine.’ Department of Health. 28 December 2020. Available at: <https://www.travelhealth.gov.hk/english/vaccine_prophylaxis/jap_encephalitis.html> [Accessed 16 July 2021].
6. Centers for Disease Control and Prevention. (2019). ‘Varicella (Chickenpox)’. CDC. June 24 2019. Available at: <https://wwwnc.cdc.gov/travel/yellowbook/2020/travel-related-infectious-diseases/varicella-chickenpox> [Accessed 19 July 2021].
7. Centers for Disease Control and Prevention. (2020). ‘What everyone should know about Zostavax.’ CDC. 05 October 2020. Available at: <https://www.cdc.gov/vaccines/vpd/shingles/public/zostavax/index.html> [Accessed 07 May 2021].
8. Fit for Travel. (2020). ‘Typhoid.’ NHS. Available at: <https://www.fitfortravel.nhs.uk/advice/disease-prevention-advice/typhoid> [Accessed 11 May 2021].
9. Centers for Disease Control and Prevention. (2020). ‘Typhoid Fever and Paratyphoid Fever.’ CDC. 19 May 2020. Available at: <https://www.cdc.gov/typhoid-fever/prevention.html> [Accessed 07 May 2021].