Travelling Medicine Vaccinations
Keeping your vaccinations updated is important to maintain good health, protecting yourself and your family against infectious disease. This is particularly important for frequent travelers. Everyone may have different risks of various vaccine-preventable diseases base on your traveling location, own medical condition, work, and age.
Below are the common vaccinations that are good to have for most:
- Flu Vaccination
- Hepatitis A Vaccination
- Hepatitis B Vaccination
- Combined Hepatitis A and Hepatitis B Vaccination
- Varicella Vaccination
- Tdap Vaccination
- MMR Vaccination
- Yellow Fever Vaccination
- HPV (9-valent) Vaccination
Flu Vaccination reduces the risk of influenza. Influenza is an infectious viral condition that leads to high-grade fever, muscle aches, runny nose, cough, and sore throat. It can be spread through inhaled droplets in the air when one is in close contact with an infected person.
Influenza can be further complicated with pneumonia, ear and sinus infection, meningitis, and heart muscle inflammation. Those with low immune systems, the elderly, the young and the pregnant women are more susceptible to complications.
Flu vaccination is recommended for
- Adults 65 years old or above
- People with low immune system
- People with chronic medical conditions such as asthma, heart disease, diabetes, liver disease and kidney disease
- Pregnant ladies
- Frequent traveler
- Anyone who is looking for protection against influenza
Flu vaccination comes in a single dose, and you are advised for a yearly re-vaccination with the updated version of Flu vaccination.
Hepatitis A Vaccination
Hepatitis A disease is a viral disease that can cause liver infection. It is transmitted when an unvaccinated person consumes food or water that is contaminated or the feces of an infected person. Hepatitis A infection is associated with contaminated food and water, poor sanitation and personal hygiene. Symptoms include fever, lethargy, jaundice, abdominal pain, pale stool, tea-colored urine and poor appetite. In mild cases, it can take weeks for one to recover, in severe cases it can cause liver failure or even fatality.
Hepatitis A is recommended for
- Travelers entering endemic countries where hepatitis A is ubiquitous
- People with blood disorders such as Haemophilia, Von Willebrand disease
- People with chronic liver diseases
- People who are waiting or have received a liver transplant
- Men who have sexual encounters with other men
- Recreational drug users
Hepatitis A vaccination comes in 2 doses spaced over 5-12 months.
Hepatitis B vaccination
Hepatitis B is a viral liver infection that is transmitted through blood, body fluid, blood transfusion, sexual contact, mother to child during pregnancy or delivery. One can have a mild disease that may last for weeks, or serious liver failure. Some with hepatitis B become lifelong carriers. Associated symptoms of hepatitis B infection include fever, vomiting, nausea, low appetite, tea-colored urine, pale stool, and jaundice. In a hepatitis B carrier person, one can develop liver scarring, failure or even liver cancer.
Hepatitis B vaccination is part of the Singapore National Immunisation Schedule, however over time, one may lose the antibodies. Blood tests can be used to screen for hepatitis B antibodies to ascertain whether the vaccination is required.
Hepatitis B vaccination is recommended for
- Everyone seeking protection against Hepatitis B infection
- Household contacts of people with hepatitis B infection
- Those whose partners are hepatitis B carrier
- Those with risky sexual behaviors and multiple sexual partners
- Those who are undergoing hemodialysis
- Recreational drug users
Hepatitis B comes in 3 doses, given at 0,1,6 month intervals.
Those who are keen for both hepatitis A and B vaccinations can opt for a convenient 2-in-1 option- Twinrix Vaccination. Twinrix Vaccination comes in 3 doses, given at 0,1,6 month intervals.
Varicella-zoster virus is responsible for both chickenpox and shingles. It is a highly contagious disease that spreads through droplets, air and direct person to person contact.
One can present with fever, tiredness, cough and cold symptoms, multiple itchy and painful blistering rashes over the body, face, and limbs. The disease tends to be mild in children, but more severe with the extreme ages. Potential complications include pneumonia, brain infection. In the later years, a reactivation of the viral disease can cause shingles which occurs in the elderly and those with lower immune system. If the illnesses occur during pregnancy it can cause congenital malformation.
Varicella vaccination is recommended for
- Any adult looking for protection against varicella infection
- Those who are looking after people with weaker immune system
- Those in educational institutions, health care providers, staffs and residents of nursing home
- Military person
- Lady who are non-pregnant, but of child-bearing age
- Frequent travelers
You can opt for an antibody blood test to look for immunity against varicella before the vaccination.
Varicella vaccination comes in 2 doses over 4 weeks.
Tdap Vaccination is a 3-in-1 vaccination that protects against tetanus, diphtheria, and pertussis (whooping cough). Tdap is usually given as part of the National Childhood Immunisation Programme. However, over time, the antibody levels can be reduced, making the older age group more susceptible to the 3 infections.
Tdap Vaccination is recommended for
- Adults whose last Tdap was 10 years ago
- Adults who has close contact with infant age less than 12 months, and the last dose of Tdap was more than 10 years
- Ladies who are planning a pregnancy, or during the third trimester of their every pregnancy, or immediately after delivery.
Tdap vaccination comes in a single dose every 10 years. A single dose during the third trimester of every pregnancy, or immediately after giving birth regardless of previous history of relevant vaccination.
MMR vaccine protects against measles, mumps and rubella infectious viral diseases. These diseases are transmitted via air droplets of coughing and sneezing.
MMR vaccination is recommended for
- All adults who did not complete the vaccinations during their childhood
- Adults who are at high risks of infections due such as health care providers, educational institutions, international travelers to areas with suboptimal vaccination coverage
- Women who are not vaccinated before and planning pregnancy (Ladies are only advisable for conceiving 3 months later after MMR vaccination)
In those who are uncertain of their previous MMR vaccination history, antibodies test against MMR is available. This can be used to assess whether the vaccination is required.
MMR comes in 2 doses given at least 1 month apart.
Yellow Fever Vaccination
Yellow Fever vaccination protects against a mosquito-borne infection known as yellow fever. This condition is common in Africa, Central and South America, and is spread from person to person via Aedes Aegypti mosquitoes. One can develop fever, headache, muscle pain, nausea vomiting, tiredness, and jaundice. In 15% of people with yellow fever, it can be complicated with bleeding, organ failures and even be fatal.
Yellow fever vaccination should be recommended for people age 9 months and above, entering or living in yellow fever endemic regions.
Yellow fever comes in a single dose. You are advisable to take the vaccine at least 10 days before entering the area. In some countries, you may need to show a documentation proof of yellow fever vaccine before allowing to enter the place.
HPV (9-valent) Vaccinations
HPV (9-valent) vaccination is beneficial against HPV viral strain subtypes of 6,11,16,18,31,33,45,52,58. This reduces the risk of HPV infection that are associated with cervical, vulva and vagina cancer, and effective against genital warts.
HPV (9-valent) vaccination is recommended for all unvaccinated females and males between ages 9-26 years, although anyone unvaccinated above 26 may still benefit from the vaccine.
HPV vaccination comes in 3 doses, at 0,2,6 month intervals.
What I should do Before my trip
Research and Homework
Read-up, check www.CDC.gov and understand your travelling destination’s climate, possible health hazards, or medical alerts that you may face during your stay.
Preventive travel vaccines are important especially planning a trip. The last thing that anyone would wish for is to catch a preventable infectious illness during your trip overseas. In certain countries, you may even need certain vaccinations prior to entry. Planning ahead your journey and getting ready the necessary vaccination may take weeks before your trip. You are advised to speak to your doctor at least 6 weeks to 8 weeks prior to your trip. Preventive medicine is tailored to individual base on your own medical health risk, the entering country, and your personal concerns.
Having a travelling kit with basic medication and first aid is a necessity for most trips. Your travelling kit should be equipped with simple medicines to troubleshoot for minor injury and illness. This will be useful when you are in a foreign country with language, culture and even medical facilities barriers. Speak to your doctor for further details on travelling medicinal kit.
What should I take note in the Plane
Risks of Blood Clotting Events
Long-distance travelers are at risk of developing blood clots over their legs and lungs. The conditions are medically termed Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE). Due to prolonged immobility in flights and dehydration, blood clots can form in your deep veins in your lower limbs causing pain, swelling, and difficulty in walking. In serious cases, the clots can migrate through the blood vessels to the lungs causing breathlessness, chest pain or even fatality. Frequent ambulation and calf exercises are important. High-risk patients may need blood-thinning medication in advance to reduce the chances of clotting. Speak to your doctor before your trip.
Air Pressure Differences
High altitude air pressure changes can lead to ear pain, discomfort and hearing loss. Antihistamines and decongestions in the forms of oral and nasal spray can be used 30 minutes prior to boarding your flight. Another trick on board is frequent swallowing or Valsalva Maneuver by blowing air through a pinched nose and a closed mouth to equalize the pressures of the ears.
What should I be aware of during my trip
Careful what you Eat and Drink
All food is advisable to be cooked. Only consume pasteurized milk products. The skin of the fruits should be peeled. It would be advisable to drink from a water bottle with a straw rather than drinking from a glass. Avoid ice cubes or ice water, unless you are certain they are from boiled water. Water should be boiled before drinking. You may opt for water purification tablets to avoid water-borne infectious diseases.
You should be more cautious during dawn or dusk as mosquitoes are active. Consider insect repellents, insecticide, wearing covering clothing to avoid getting arthropod-disease.
Good hand hygiene with soap and water or alcohol-based sanitizer can reduce the risk of infectious disease. Importantly, wash your hands before eating.
High altitude sickness
Accustoming to change of altitude can be tricky. If your trip involves ascending to higher altitude destinations, speak to your doctor on altitude sickness preventive medicine such as acetazolamide. This is to prevent acute mountain sickness with symptoms such as lethargy, dizziness, headache, nausea, vomiting, reduced appetite, and insomnia.
In females, some may experience the inconvenience of having your menstrual period coinciding with their trip. Speak to your doctor on medication that can delay your menses.
What If I am Pregnant
The safest period for a pregnant lady to travel is during the 18-24 weeks of pregnancy ie the second trimester, according to the American College of Obstetricians and Gynaecologists. It is advisable to speak to your gynecologists prior to your travel to ensure your health is at tip-top condition for your journey.
Allergy Testing- worthwhile to proceed? Remember, allergy testing does not diagnose allergies. It should be interpreted prudently together with one’s medical condition and symptoms, and to aid diagnosing allergy.