A Sharp Issue – Vaccinations

I completed the epic process of travel vaccinations this week.

Ok, I may being slightly dramatic but, with four clinic visits and ten vaccinations, ‘epic’ may not be an unreasonable description.

Before I continue, I will ask that any readers do not send me any anti-vaccination propaganda. I’m not interested and I am very concerned about the spread of misinformation. The evidence does not support the anti-vaccination rhetoric – it’s nonsense, it’s irresponsible and it can kill.

For the countries I am visiting, I needed vaccinations against (and I hope those of you with a delicate stomach are not reading this while eating):

  • Typhoid: spread through faecally contaminated food and water, shellfish, raw food and vegetables (contaminated with human waste) and it’s common in places with poor food hygiene.
  • Hepatitis A: as above but you can also include close contact with an infected person.
  • Tetanus: bacteria is found in soil worldwide and disease occurs when this bacteria enters the body, often via cuts.
  • Diptheria: bacterial disease mainly spread by exhaled water droplets.
  • Polio: spread through contaminated food and water.
  • Rabies: virus is carried through the saliva of infected mammals and usually caught from the bite or scratch of an infected animal, most often a dog.
  • Hepatitis B: spread through contaminated blood and bodily fluids meaning there are several transmission routes for example unprotected sex, blood transfusions and using unsterilised needles.
  • Japanese Encephalitis: virus is passed from animals to humans through the bite of an infected mosquito.
  • Tick Borne Encephalitis: spread by bites from infected ticks.

Much more information on these diseases and their risks is available via the NHS A-Z. Be careful though, it’s very easy to be sucked into reading about all kinds of horrible diseases. (Maybe that’s just me).

With this list in front of me, I did briefly wonder: “Why am I going there, again?” And, these vaccinations were not cheap. The chap on the payment desk did apologise for the cost but I pointed out that, as a Public Health professional it would be a little embarrassing if I died of a vaccine-preventable illness. “Yeah, it would be ironic,” he said.

(So-called friends have agreed and said they wouldn’t come to my funeral. Cheers, everyone).

So, costs… as you may have gathered I’m English and writing in the UK where we are currently fortunate enough to have the NHS and healthcare that is free at the point of delivery. Not all of these vaccinations are available via the NHS – it often depends on your GP surgery.

For various reasons (a lack of appointments being a key one) I used a private provider. If you thought England limited the potential usefulness of the information here, I’m about to become very geographically specific.

There are various travel clinics around the country and I used Nomad Travel in Manchester. They have clinics in other parts of the UK: London, Bristol, Bath, Cardiff and Birmingham. The service was excellent – all questions answered, all concerns discussed and pricing options highlighted clearly. I’m going to miss my weekly catch ups with Danielle the nurse.

  • Typhoid and Hepatitis A (combined) £90
  • Diptheria, Tetanus and Polio (combined) £35
  • Rabies £47 × 3 doses
  • Hepatitis B (booster) £55
  • Japanese Encephalitis £95 x 2 doses
  • Tick Borne Encephalitis £65 x 2 doses

The total cost reached £641… but I’m quite keen on avoiding illness and not dying.

After clean water, vaccination is the key intervention to improve Public Health and save lives, in my opinion. Ironically, Japanese Encephalitis isn’t actually very common in Japan thanks to a successful vaccination programme.

I’m a member of a number of online traveller discussion groups which are a tremendously useful resource of advice and information. However, I have recently noticed anti-vaccination misinformation creeping into information posts.

It’s usually smuggled in via a reputable appearing document that otherwise provides sound advice. For example, someone shared a ‘Top Ten Tips for Long Distance Flights’ guide they stumbled on. After the points about not getting drunk on flight, exercises to prevent Deep Vein Thrombosis, by the fourth or fifth point there was advice about not seeking travel vaccinations.

Vaccination has eradicated smallpox (1979) and almost eradicated polio. The number of countries where polio is deemed a serious public health problem has dropped from 125 in 1988, when the eradication drive was launched, to only four – Afghanistan, India, Nigeria and Pakistan – where the disease remains endemic. Korea declared measles eradicated in 2006 thanks to 99% vaccination coverage.

For as long as vaccination has existed, there have been objections.

This excellent journal article outlines a brief history of anti-vaccination protests, going all the way back to Edward Jenner and his development of the smallpox vaccination. The interesting aspect of vaccination misinformation is that it’s not globally consistent – different countries have different scares. Dr Ben Goldacre (English writer and doctor) outlines some of these here.

The World Health Organisation has produced this very useful vaccine safety guide which addresses the six most common concerns/objections about vaccination. Meanwhile this newspaper article illustrates the numbers of children who have participated in studies on MMR vaccination that found no link to autism… (over 1million).

Meanwhile, I am all set for my travels. I’m not going anywhere that requires Yellow Fever, Cholera or Meningitis ACWY vaccination otherwise I’d have had a full card of the available vaccinations.

  • Featured Photo:My Nomad Travel vaccination information. I’m not receiving any royalties for this post. It was a better shot than my arm with an elastoplast on it – that was a bit boring.
Categories: Preparation, Public Health, Travel, VaccinationTags: , , , , , , , , , ,

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