'Do I vacinate my children?' is a common question that parents ask before going on a family holiday, especially to less developed countries. If you're heading to a tropical country with your children you've probably considered the issue of taking anti-malarials as well. On short term holidays with young children, its unlikely that they're going to be exposed to too many nasty illnesses but its always worth consulting your family GP to get the best advice. But if you're travelling long term through multiple countries and regions, with varying levels of development and sanitation, possibly trekking through mosquito filled jungles and eating and drinking what the locals do, your family GP might not have the experience to answer your questions accurately.
See a Travel Doctor
If you are planning on taking an extended family vacation through multiple countries, it's worth spending the money on visiting a specialist travel doctor for at least a consultation to get the most accurate advice.
Most large cities have a Travel Clinic that specialises with providing advice for travellers. Comparing the advice our GP had given us for our big trip against the travel doctors advice, I have no hesitation in recommending visiting a travel doctor to anyone travelling long term. Visiting a travel doctor is obviously more expensive than your regular GP so if money is an issue, it may be worth investigating if travel clinics in your first overseas destination are cheaper and reputable.
Vaccinations take time
Leave yourself at least a month for vaccinations, preferably two months. If anyone in your family requires hepatitis shots, you may need to start the vaccination process 6 months out form your trip, although don't worry if you don't think of it in time - you can always get the last needle on the road.
What we were vaccinated against
Given that most of our time was going to be spent in less developed tropical countries, our travel doctor advised us to be vaccinated against typhoid, rabies, polio and hepatitis. Colin and I also had MMR, tetnus boosters, diptheria, whooping cough, a flu shot and cholera/e coli. The kids didn't need a lot of these as they had had them in their routine vaccinations, and others we were advised against giving to the kids because of lack of research on the effects of these vaccines in children.
Obviously every ones trip is different and medicines are constantly changing so don't go by our list of vaccinations. Seek your own advice. We've recently been informed that many people are now being advised to get the Japanese Encephalitis shot for South East Asia. When we got ours this wasn't recommended so things are constantly changing.
We had around 8 needles each over a month. OUCH! The kids were troopers though. I think it helped getting the needles at a travel doctors as all the nurse do all day is give injections. With such experience the needles didn't even hurt... well apart from the typhoid! Leave that one till last!
It's going to cost how much???
Getting vaccinated wasn't cheap. We actually spent more in vaccinations than on our flights to Asia. All up we spent around $2000AUD for a family of four. That's a big dint in your holiday budget!
If you have health insurance or extras its worth checking if they cover any of it. Also check your level of cover - its worth upgrading just for a few months just to get a higher percentage of your vaccinations covered. Our extra's cover and the Australian Medicare system covered roughly half the cost of our vaccinations.
One thing to consider is many popular tourist countries, like Thailand, have international travel clinics that offer vaccinations at a fraction of the cost you'll pay back home. It may be worth getting at least some of your needles whilst on the road to save money.
Why did we vaccinate against rabies?
The three rabies needles were the most expensive, almost $1000AUD in total. We almost didn't get this vaccination simply because of the cost but ended up deciding to for the following reasons:
- Most animals think they are above young children in the pecking order, so a child's chances of getting bitten by a rabid animal though slim is greater than an adults. If we were just on a two week holiday, the chances of the children getting bitten are so infinitely small we wouldn't have bothered. But travelling for several years through Bali, Cambodia and Southern America... well the chances are a lot higher. Having spent some time in rural Cambodia and Bali where dogs outnumber people and roam free in packs at night, we're really glad we did.
- There's no evidence of side effects in children
- Do you have any idea what happens if you get bitten while unvaccinated? We were shocked to find out you actually require 5-7 needles. At the time that we were vaccinated this also included getting a needle into the wound site. Can you imagine holding down a 3 year old and explaining that the doctor now has to stick a needle into the big bleeding doggy bite on her arm? Seriously, its hard enough to convince a sobbing toddler to put a bandaid on their knee, let alone sell the idea of a needle into a wound. Thankfully that doesn't seem to be the case any more.
- The right vaccine can be hard to find overseas if you do get bitten. Several years ago we had a non-vaccinated friend get bitten in a small country town in South America and he had to spend three days on buses and a short flight on a tiny plane to get to the nearest hospital that had the right vaccines. Three days on local buses with children in tow while you are worried that they might have caught rabies ... no thanks. I think that would be enough to see us give up travel, cash in any remaining frequent flyer points and airport parking coupons we can find to get someone deliver a car to us so we don't have to catch a bus for at least 12 months and hightail it home.
Malaria tables on an extended trip
Malaria tablets are one thing that seems to divide travellers down the middle. Some people refuse to leave home without them, others won't touch them due to the common side effect of feeling like utter crap for your entire trip and risk malaria or simply avoid countries where it is prevalent.
After some debate we decided not to take daily anti-malaria tablets. This was for a number of reasons:
- Firstly, we're not planning on going into any remote areas where malaria is real a problem. Most of the time we'll be in cities and tourist beach areas. Getting into more remote places is harder with little kids. If we do go into areas where malaria is a big problem then we'll just start taking the tablets to just cover ourselves for that period. But most of the time we sensibly avoid areas that have a high malaria alert.
- Secondly, if we wanted to completely cover ourselves against malaria on a 12+month trip around Asia in countries that all have some level of risk, we would have to be taking anti-malaria tablets for pretty much the entire time. We just didn't have enough information on what the side effects would be on the kids of taking the tablets for that long.
- Thirdly, malaria tablets are really, really expensive!
Our travel doctor advised us that she felt it would be better to just carry anti-malaria tablets with us at all times and try not to get bitten. Which we do anyway since Noah is allergic to mosquitoes. So we have three days supply of tablets for each of us and have researched which countries in Asia its possible to buy more in if needed. A lot of countries in Asia don't routinely sell anti-malaria tablets, but it is possible to buy them if you are a foreigner and show you have tickets to an area that is affected. If we go into a risky area we have the tablets with us and can decide to start taking them. And if anyone starts showing symptoms we're to start taking the tablets immediately and head to the nearest hospital.
And a quick tip to others - if you are planning on purchasing malaria tablets for your holiday, make sure you don't leave it until the last minute. Most chemists need to order them in specifically and it can take a couple of days. We learnt that the hard way, but luckily Colin had to go back to Australia on business and he purchased ours then.