Vaccinations

Do you need a vaccination?

The risk of infection varies with the countries you're visiting, the time you'll be spending abroad, your accommodation, and your activities.

If you're visiting New York on a business trip, vaccination won't be necessary. But you'd be foolish to go backpacking in the heart of Africa without the proper vaccines. Some countries in Africa won't let you cross their borders unless you've had a yellow fever vaccination.

See our bug-by-bug guide for starters. You can get updated reports online that tell you what vaccinations are recommended in a particular country.

We found two good websites:

• www.fitfortravel.nhs.uk
• www.traveldoctor.co.nz

Researching country reports is a good starting point. And you can get a complete picture of the vaccines you'll need by talking to the country's embassy, visiting your GP, or consulting a travel medicine clinic.

How effective are vaccinations?

No vaccination is 100 percent effective. The point of a vaccination is to reduce the risk of illness to an acceptable level. The widely used flu vaccination gives about 80 percent cover on the first jab. That percentage can be increased on a second jab to about 90 percent. But few people have more than one jab.

Different vaccines also offer different periods of protection. The Hepatitis B vaccine can offer immunisation for a lifetime. The Japanese B encephalitis vaccine lasts only two to three years. And some common infections aren't covered by vaccination at all. You combat malaria by taking a course of anti-malarial tablets and slathering yourself in insect repellent.

You can reduce the likelihood of infection even further with basic measures such as:

• sleeping beneath a mosquito net
• being scrupulous about personal hygiene
• watching what you eat

The World Health Organisation (WHO) says: "General precautions should be taken by the traveller regardless of whether any vaccinations or medications have been administered."

Where should I go to get my shots?

Both GPs and travel health specialists are able to provide vaccinations.

GPs
It's cheaper to see a GP (about $40 for a check-up, plus cost of the vaccinations) than a travel health specialist ($80 for a check-up, plus cost of the vaccinations). But GPs won't necessarily have all the required vaccines on hand.

If you've already been to the country before, or if you're certain you need only one or two vaccinations, then you might consider getting the jabs through your GP. Dr Tim Mason says: "I sometimes recommend my patients contact a travel health specialist for advice, which they can get for a fee, if they're going somewhere obscure. But I can then give them the vaccinations."

Travel health specialists

The GPs we talked to said that visiting a travel health specialist was useful, particularly if you're heading off the beaten track. Dr Mason: "Places like the Travel Doctor are often more up to date than me. They know, say, of an outbreak of dengue fever in some place I haven't heard of. They can also give very specific advice about malaria risks in a particular region."

Each vaccination course must be tailored - even when two people are heading to the same destination. And if you're travelling to a developing country then the number of vaccines required might double or triple. Travel health specialists can tailor the cocktail of vaccinations to you and your trip. They can also give additional country-specific advice (like laws governing prescription medicines in certain Middle Eastern countries).

Side-effects

The decision to vaccinate is a matter of judgement - weighing the risk of contracting the infection against side-effects and cost. Vaccinations are evolving and improving. Most of the jabs available nowadays are "dead" purified vaccines rather than the "live" vaccines of the past, so the severity of common side-effects is reduced.

The side-effects that you may encounter from a jab include fainting, itchiness or discomfort at the point of injection, or a slight rash. The yellow fever inoculation can also cause mild flu-like symptoms in up to 10 percent of people.

Any jab can cause rare and less common side-effects. Reactions such as swelling of the throat, difficulty breathing, or limpness (in the case of children) require an immediate trip to the hospital.