What should you get vaccinated against before travelling?
A large number of Estonians plan a shorter or longer holiday trip during the cool, sun-starved autumn months. What should you know about travel vaccinations?
Meliva general practitioner and Chief Medical Officer Dr Andreas Abel stresses that everyone should first know whether they’re up to date with the national immunisation schedule. “For example, it’s worth checking your vaccination status for mumps, measles, and rubella — the two-dose MMR vaccine. Some people have only received one dose of the MMR vaccine and would definitely need a second. A booster dose is also recommended for those born between 1980 and 1992, who were vaccinated against these diseases during that period,” says Dr Abel. While most Estonians have received the combined diphtheria-tetanus vaccine, many aren’t aware that a booster against these diseases is recommended every ten years.
It’s also worth checking your vaccination status against poliomyelitis (polio).
Seasonal flu viruses and SARS-CoV-2 haven’t gone anywhere either, and vaccination against them is recommended too. Flu vaccination is recommended for everyone, regardless of travel plans. This year, the flu vaccine is also free for children up to age 7, people aged 60 and older, pregnant women, and risk groups. The rest of the population can get the flu vaccine for a fee.
“Before travelling, it’s definitely worth checking the entry requirements for both transit and destination countries, as well as any restrictions in place locally. Advice on necessary vaccinations can be obtained from a travel medicine clinic, or, if an in-person appointment isn’t possible right away, through Digikliinik as well,” says Abel.
Where should you get vaccinated before travelling?
It’s often assumed that vaccination is only necessary when travelling to exotic countries. Dr Abel notes that, in reality, it’s also sensible to be vaccinated against hepatitis A and B when travelling within Europe, particularly Eastern Europe. Hepatitis A is one of the most common travel-related viral illnesses, found worldwide. It can be contracted through contaminated food and water, or through direct contact with an infected person. Hepatitis B is transmitted through blood, most commonly through sexual contact. Hepatitis B is also a significant health concern in many tourist destinations across Southeast Asia and Africa. According to the doctor, both hepatitis A and B can initially progress without obvious symptoms. Treatment is often only sought once acute liver inflammation has developed, along with symptoms such as yellowing and itching of the skin and mucous membranes. With hepatitis B, children face a high risk of developing chronic liver inflammation, with the most severe complications being liver cancer or cirrhosis.
For more exotic destinations, vaccination recommendations broadly mirror those for Europe. When visiting South America, Africa, and many Asian countries, vaccination against yellow fever is necessary, along with preventive medication against malaria. “If you’re planning to live or work abroad for an extended period, additional vaccinations may be needed depending on the country — for example, against typhoid fever,” Dr Abel notes.
For children, the first step should be checking that all vaccinations required under the national immunisation schedule have been completed. “Since vaccinations are given at specific ages and in a defined sequence, I’d recommend, when planning a trip, thinking through which diseases your child has already been vaccinated against and which they haven’t. It’s then worth discussing with a doctor which additional vaccines might be needed for the specific destination country. For example, vaccination against hepatitis A might be necessary, or scheduled vaccinations might need to be brought forward,” Dr Abel explains.
He adds that it’s also worth thinking through the potential risks of travelling with young children to a region where access to, or the quality of, medical care isn’t at the same level as in Estonia. Young children are often affected by stomach viruses while travelling. Compared with adults, children are generally significantly more prone to complications from stomach viruses — dehydration and its symptoms set in more easily in them. With diarrhoea symptoms, then, frequent and adequate fluid intake is especially important. A child’s condition should be monitored continuously, as it can change quickly.
With stomach virus symptoms, physical exertion, high temperatures, and sweating should be avoided, as these speed up fluid loss even further. If the situation seems concerning, it’s always worth taking a young child to see a doctor.
It’s worth thinking about vaccination well in advance
It’s important to remember that vaccines take time to become effective. That’s why, to prevent infectious disease, it’s recommended to see a family doctor or visit a travel medicine clinic at least four weeks before travelling. This allows enough time, if needed, to begin any vaccinations required for the specific destination country. Advice and information on reducing infection risk is also available, for example, from a travel medicine clinic.
The most common vaccine side effects are muscle pain at the injection site, mild fever, and fatigue. According to the doctor, these side effects usually pass within 1-2 days. They generally don’t require specific treatment, though paracetamol can be used for pain if needed. Travel vaccinations can usually all be given on the same day — different vaccines can generally be administered together, simply given as separate injections in different arms.
