The Essential Guide to Travel Vaccinations for Asia

Typhoid instead of trekking? Hell no! Here's what you need to know when it comes to recommended vaccinations for travel in Asia.

Hoping for a relaxing holiday in Asia? Get some real peace of mind and sort out your vaccinations before you go Photo © GettyImages/Amir Ghasemi

Many travelers hate the idea of getting vaccinations, largely because of the pain of initially receiving them and also in the bank account as several shots may be needed before traveling to various countries or a region. However it's important that travelers get their vaccinations as the diseases which they are protecting themselves against infect thousands of people each year and also kill thousands of people. Every traveler should discuss their options and needs with their doctor prior to travel.

Vaccinations

At a minimum, the following vaccinations are recommended for travel in Asia:

  • Routine vaccinations such as measles, mumps, rubella, polio, tetanus, diphtheria, whooping cough
  • Hepatitis A
  • Typhoid

Other vaccinations which may need to be considered depending on traveler needs and travel activities:

  • Japanese Encephalitis - Travelers who are spending extended periods of travel or doing activities in rural locations, particularly around rice fields and farms
  • Meningitis (Meningococcal) - The risk for the majority of travelers is low however those who are spending extended periods of travel in densely populated areas or in locations where the disease is present e.g health workers or volunteers should consider getting the vaccination.

NOTE: If you are entering any Asian country from Africa or South America where yellow fever is present, you will need to supply proof of vaccination on arrival.

Rabies

It's recommended to get a rabies vaccination if you are planning outdoor activities as a part of your trip (such as camping, hiking, biking, adventure travel, and caving) or traveling extensively in rural locations (where access to medical treatment is non-existent to minimal) that puts you at risk of animal bite.

The majority of rabies deaths occur in Asia and Africa where locals struggle to afford personal vaccinations and vaccinations for their dogs. However, rabies has been eliminated from many countries in South America due to efficient vaccination programs.

Most people don't expect to be bitten by a dog, monkey or bat while traveling but if you're bitten, you will need seek medical treatment immediately (if, in major city or town) or evacuate to a large city with proper medical care and access to the post-exposure prophylaxis. However, it may be difficult to find and in some Asian countries, there can be localized shortages of the rabies vaccine.

Many rural and developing nation hospitals may not use the safer rabies vaccines instead using older types with risk to the traveler such as severe allergic reaction.

Malaria

Malaria is present in several countries in Asia and if not treated, it can lead to further health complications or worse, death. Travelers should consider taking an anti-malarial before traveling however it's important to chat with your doctor as some anti-malarials work better than others.

Travel Health Tips

In terms of general travel safety in Asia, a few other tips to avoid illness are:

1. Water Safety

There's not many places in Asia where you can drink water straight from the tap. Drink and brush your teeth with purified, treated water only. Keep your mouth closed while taking a shower or if you are in the midst of a water festival. Avoid ice and icy drinks unless you know the ice has come from a safe source.

2. Be a Compulsive Hand Washer

A bottle of hand sanitizer should be carried with you and be used after visiting the restroom, before each meal, after handling paper bills and coins, before putting-in or taking-out contact lenses etc. Hepatitis A and typhoid are passed in human faeces, so be a compulsive hand cleaner. 

3. Avoid Mozzie Bites

Use DEET and permethrin, long sleeves and pants and bed nets to prevent insect bites. Need more tips? Check out this article on minimising mosquito bites.

4. Watch What You Eat

Part of the travel experience is trying all the amazing and diverse dishes from the many countries in Asia. However, sometimes things don't go to plan and you may end up with a dose of traveler's diarrhea or worse, hepatitis A or typhoid. You need to know what to look for when planning to eat out, otherwise you could end up stuck to the toilet or laid up in hospital.

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11 Comments

  • Michael Kirsch, M.D. said

    Sound advice from the 2 experts above. I want to reinforce that the decision on which vaccines to accept belongs with the traveler. There is no rigid vaccine 'recipe' for travlers headed abroad. There are many gray areas and travelers may have different tolerances of risk. Those who are particularly safety conscious may opt for more protection than a more 'adventurous' traveler. The travel doctor's obligation is to make sure that the traveler has all of the necessary information to make an informed choice.

  • Jennifer said

    I am traveling to Liberia for work in September. I have to get numerous vaccinations, including yellow fever, meningitis, hepatitis, etc. My question is--should I space these out to minimize secondary (side) effects? Isn't it better for the immune system to do some of this in stages rather than all at once?

  • James said

    My son got sick once, had diarrhea even with bottled water. I remember the doctor told us that it is probably from bathing, so the tip there about getting your mouth closed while showering is pretty sound practice. Well, my child was pretty young then I could not keep his mouth closed so bathed him with purified water. Friends also advised the rabies vaccine prior to travel in developing nations. Dogs with rabies are seriously dangerous, knew people who actually died due to dog bites with rabies.

  • Alicia said

    Hello,<br>I'm currently in Istanbul. Yesterday afternoon i went to get a pre-exposure rabies vaccine, as I'm travelling to South America soon. The doctor said the treatment was 4 shots, and gave the the first two on the spot - one in each arm. The doctor's english was limited, so it was a litttle confusing. I am thinking she actually gave me the post-exposure shots - does this matter?<br>Now I have a high fever, chills, aches and super sensitive skin... Will I have the same reaction when I receive my 2nd and 3rd shots?

  • Safety Hub said

    Hi Alicia,<br><br>We need to say straight up front that the Safety Team at World Nomads aren't doctors - you'll need to either reconsult your physician in Istanbul if you are unsure, or consult a different doctor to clarify.<br><br>But from what we understand, the pre-exposure vaccination for rabies is not a blanket coverage against the disease - you still need to get post-exposure treatment if the situation arises.<br><br>According to the CDC Yellow Book, the pre-exposure vaccine "...simplifies management (of exposure to rabies) by eliminating the need for rabies immune globulin and decreasing the number of doses of vaccine needed"<br><br>http://www.cdc.gov/rabies/specific_groups/travelers/pre-exposure_vaccinations.html<br><br>Also, from our research, the symptoms you have listed seem to match those associated with the kind you get from having the pre-exposure vaccine (fever, chills, headaches and tiredness).<br><br>But again, we are not doctors. Check with a qualified physician (and one who can speak a little better english), if you are worried.<br><br>Thanks,<br><br>The World Nomads Safety Team

  • Ellen said

    Hi Alicia,

    I also want to stress that I'm not a physician or medical expert at all. But I got rabies pre exposure shots before a remote trekking trip to Burma last year and can tell you my experience. There are three rabies pre exposure shots - one on day one, a second 21 days later and a third 28 days after the first shot. My husband and I both felt extremely tired and a little fluish after each one, so your symptoms sound consistent with our experience. Also, Safety Hub is correct in that the pre exposure vaccines don't eliminate the need for the post vaccine in the event that you get bit, licked or scratched by a rabid animal. It does, however, buy you more time in order to get to a place that has the post exposure vaccine.

  • Deb said

    I'm not a doctor but re: the rabies vaccine, I say get it. I had to get my post-exposure prophylaxis while on fhe road after a tiny nick on my finger from a puppy in Arequipa, Perú - a doctor I saw for terrible food poisoning said I didn't need it but when I got to New Zealand, I went to a travel clinic (partially for residual food poisoning issues) and to get vaccinated.

    The World Health Organization provides good information on rabies vaccine pre- and post-exposure. From my post-exposure experience and research, there are different schedules for the vaccination series (I opted for 2 injections on day 0, 1 on day 7, and 1 on day 21; there's also a 5 injection series) and it can depend on the level of contact as defined by the World Health Organization recommendations.

  • Teresa said

    My question is, if i had traveller before and received these shots, like 2006 , i received hepatitis A shot in march and then Sept. In march 2006, i also received typhoid shot. I received dipht tetanus shot apr 1998. Im traveling to same location soon, do i need to get all these shots again?

  • Amari said

    I'm traveling to South Korea soon what shots should I get.

  • Ashlei Payne said

    This is so informational thank you so much for sharing everyone's opinions. I wish I saw this before my husband and I made our own video on travel vaccinations. I am on a hunt to double check a fact for a friend and saw this page.

    I thought i'd attach our video just to give another persons opinion! Love y'alls website, thank you!


    http://bit.ly/WhichTravelVaccinationsToConsider

  • Nick H said

    As I'm planning a trip, and looking at vaccines, I thought it might be worthwhile to point out that WHO rabies pre-exposure prophylaxis (PrEP) recommendations have recently changed. The protocol most people take is a three-dose regimen, days 0, 7, then 21-28. The new regimen is reduced to two doses - day 0, then day 7.

    https://www.who.int/neglected_diseases/news/Rabies_WHO_has_published_new_recommendations_for_immunization/en/

    Something to discuss with your health care provider, or calm nerves if you only can obtain an abbreviated series before travel.

    The WHO also emphasizes the critical importance of immediate initial first-aid. (Flush with water for 15 minutes, use iodine or another viricidal if you have it.) There's a lot of talk online about the vaccinations, less so about first aid you can self-administer.

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